Mini-Mental State Research Articles

Chronic pain in older adults with disabilities is associated with cognitive impairment-a prospective cohort study.

Chronic pain may be an important factor influencing cognitive impairment; however, there is limited research on that link in older adults with disabilities. We aimed to determine the association between chronic pain and cognitive impairment in older adults with disabilities. This 24-month prospective cohort study involved 143 Japanese older adults (≥65 years of age) with long-term care insurance. Chronic pain was defined as pain persisting for ≥3 months, and cognitive impairment was defined as a Mini-Mental State Examination score ≤ 23. We employed logistic regression analysis with chronic pain as the independent variable and cognitive impairment as the dependent variable after propensity score matching (PSM). Sixty-six participants were selected using PSM, and logistic regression analysis showed that chronic pain was significantly associated with cognitive impairment (odds ratio: 4.103, 95% confidence interval: 1.455-11.567, P = 0.008). To prevent cognitive impairment in older adults with disabilities, the management of chronic pain should be considered, as they are related.

Enlarged choroid plexus related to atrophy of hippocampal subfield volumes and glymphatic dysfunction in benzodiazepine use disorder.

The aim of this study was to explore the relationship of choroid plexus (CP) volume with hippocampal subregion volume and glymphatic system in patients with benzodiazepine use disorders (BUD). Eighty-four participants were recruited including 23 patients with BUD, 29 patients with chronic insomnia (CI) and 32 healthy controls (HC). The morphological alterations in CP, hippocampal subfield volumes and diffusion tensor image analysis along the perivascular space (DTI-ALPS) index were compared between the three groups and the relationships between CP volume and hippocampal subfield volumes and the glymphatic system were further investigated. Compared with the HC individuals, the CP volumes augmented and hippocampal subfield volumes reduced in patients with BUD (P < .05) but not in patients with CI (P > .05). In patients with BUD, there were extensive relationships between augmented CP volume and decreased hippocampal subfield volumes (P < .05, r = -0.421--0.513). CP volume was negatively related with the DTI-ALPS index (r = -0.582, P = .004) within the BUD group. In patients with BUD, the volume of bilateral cornu ammonis (CA)1 body, molecular layer (ML) body, hippocampal tail, left CA1 head volumes, right dentate gyrus body volumes, and right CA4 body volumes were positively related with the Montreal Cognitive Assessment scores (P < .05, r = 0.422-0.683). Right CA1 and ML body volumes positively related with the Mini-Mental State Examination scores (P < .05, r = 0.503-0.575). The enlarged CP related to atrophy of hippocampal subfield volumes and the glymphatic system dysfunction were shown in BUD patients.

Exploring the Effect of Single-Session Transcranial Direct Current Stimulation on Attention, Verbal Fluency, and Working Memory in Patients With Alzheimer's Disease-Related Dementia

Objectives Alzheimer's disease (AD) is a leading cause of morbidity and mortality among the elderly. Transcranial direct current stimulation (tDCS) applies low-intensity currents to the brain, resulting in short-term neurocognitive effects and long-term neuroplasticity enhancement. Limited research reported on the impact of tDCS on cognitive functions in dementia due to AD. This study aims to compare changes in verbal fluency and working memory following a single tDCS application to the left dorsolateral prefrontal cortex (DLPFC) in AD patients. Methods Patients with mild dementia due to AD underwent cognitive assessment using the Standardized Mini-Mental Test, Clock Drawing Test, Rey Auditory Verbal Learning Test, Functional Activities Questionnaire, Informant Questionnaire on Cognitive Decline in the Elderly, and Montreal Cognitive Assessment Scale. A single-session tDCS was administered by applying anodal tDCS to the left DLPFC for a duration of 30 minutes. Verbal fluency and working memory were evaluated before and after tDCS using the WAIS-R Digit Span Test forward and backward subscales, Trail Making Test (TMT) A and B, and Verbal Fluency Test. Results Regarding cognitive test scores before and after tDCS application, there were statistically significant reductions in the durations of TMT-A and TMT-B. However, there were no significant differences observed for TMT B-A, VFT, DST-forward, and DST-backward performances. Conclusions The findings indicate that a single anodal tDCS targeting the left DLPFC enhances attention and processing speed in AD patients but has no effect on working memory or verbal fluency.

Analysis of Speech Features in Alzheimer’s Disease with Machine Learning: A Case-Control Study

Background: Changes in the speech and language of patients with Alzheimer’s disease (AD) have been reported. Using machine learning to characterize these irregularities may contribute to the early, non-invasive diagnosis of AD. Methods: We conducted cognitive function assessments, including the Mini-Mental State Examination, with 83 patients with AD and 75 healthy elderly participants, and recorded pre- and post-assessment conversations to evaluate participants’ speech. We analyzed the characteristics of the spectrum, intensity, fundamental frequency, and minute temporal variation (∆) of the intensity and fundamental frequency of the speech and compared them between patients with AD and healthy participants. Additionally, we evaluated the performance of the speech features that differed between the two groups as single explanatory variables. Results: We found significant differences in almost all elements of the speech spectrum between the two groups. Regarding the intensity, we found significant differences in all the factors except for the standard deviation between the two groups. In the performance evaluation, the areas under the curve revealed by logistic regression analysis were higher for the center of gravity (0.908 ± 0.036), mean skewness (0.904 ± 0.023), kurtosis (0.932 ± 0.023), and standard deviation (0.977 ± 0.012) of the spectra. Conclusions: This study used machine learning to reveal speech features of patients diagnosed with AD in comparison with healthy elderly people. Significant differences were found between the two groups in all components of the spectrum, paving the way for early non-invasive diagnosis of AD in the future.

Deferiprone in Alzheimer Disease

Interventions that substantially slow neurodegeneration are needed to address the growing burden of Alzheimer disease (AD) to societies worldwide. Elevated brain iron observed in AD has been associated with accelerated cognitive decline and may be a tractable drug target. To investigate whether the brain-permeable iron chelator deferiprone slows cognitive decline in people with AD. This phase 2, double-masked, placebo-controlled randomized clinical trial of 12-month duration was conducted at 9 sites in Australia between August 2, 2018, and April 1, 2023. Patients older than 54 years with amyloid-confirmed mild cognitive impairment or early AD (a Mini-Mental State Examination score of 20 or higher) were screened. Randomization was 2:1 and masked to participants and all study staff. Deferiprone 15 mg/kg twice a day or placebo administered orally for 12 months. The primary outcome was a composite cognitive measure assessed at baseline, 6 months, and 12 months using a neuropsychological test battery (NTB) of memory, executive function, and attention tasks. Secondary outcomes included change in brain iron burden measured by quantitative susceptibility mapping (QSM) magnetic resonance imaging (target engagement), brain volume changes (secondary efficacy measure), and adverse events (safety analysis). Of 167 patients screened for eligibility, 81 were included, with 53 randomly assigned to the deferiprone group (mean [SD] age, 73.0 [8.0] years; 29 male [54.7%]) and 28 to the placebo group (mean [SD] age, 71.6 [7.2] years; 17 male [60.7%]); 54 participants completed the study (7 [25.0%] withdrew from the placebo group and 20 [37.7%] from the deferiprone group). In an intention-to-treat analysis, participants in the deferiprone group showed accelerated cognitive decline on the NTB primary outcome (β for interaction = -0.50; 95% CI, -0.80 to -0.20) compared with placebo (change in NTB composite z score for deferiprone, -0.80 [95% CI, -0.98 to -0.62]; for placebo, -0.30 [95% CI, -0.54 to -0.06]). Secondary analysis revealed that this result was driven by worsening performance on executive function tests. The QSM confirmed that deferiprone decreased iron in the hippocampus compared with placebo (change in hippocampal QSM for deferiprone, -0.36 ppb [95% CI, -0.76 to 0.04 ppb]; for placebo, 0.32 ppb [95% CI, -0.12 to 0.75 ppb]; β for interaction = -0.68 [95% CI, -1.27 to -0.09]). Longitudinal hippocampal volume loss was not affected by deferiprone, but exploratory analysis of other brain regions revealed increased volume loss with deferiprone in frontal areas. The frequency of the adverse effect of neutropenia (4 participants [7.5%] in the deferiprone group) was higher than in similar studies (1.6%-4.4%). These trial findings show that deferiprone 15 mg/kg twice a day decreased hippocampal QSM and accelerated cognitive decline in patients with amyloid-confirmed early AD, suggesting that lowering iron with deferiprone is detrimental to patients with AD. ClinicalTrials.gov Identifier: NCT03234686.

Associations of Cognitive Function with Serum Magnesium and Phosphate in Hemodialysis Patients: A Cross-Sectional Analysis of the Osaka Dialysis Complication Study (ODCS)

Cognitive impairment and dementia are common in patients with chronic kidney disease, including those undergoing hemodialysis. Since magnesium and phosphate play important roles in brain function and aging, alterations in these and other factors related to bone mineral disorder (MBD) may contribute to low cognitive performance in patients on hemodialysis. This cross-sectional study examined the associations between cognitive function and MBD-related factors among 1207 patients on maintenance hemodialysis. Cognitive function was assessed by the Modified Mini-Mental State examination (3MS). The exposure variables of interest were serum magnesium, phosphate, calcium, calcium–phosphate product, intact parathyroid hormone, fetuin-A, T50 calciprotein crystallization test, use of phosphate binders, use of cinacalcet, and use of vitamin D receptor activators. Multivariable-adjusted linear regression models were used to examine the associations between 3MS and each of the exposure variables independent of 13 potential non-mineral confounders. We found that lower 3MS was associated with lower serum magnesium, lower phosphate, lower calcium–phosphate product, and nonuse of phosphate binders. These results suggest that magnesium and phosphate play potentially protective roles against cognitive impairment in this population.

Sensitive written hedgehog PICture Naming and Immediate Recall (PICNIR) as a valid and brief test of semantic and short-term episodic memory for very mild cognitive impairment.

Semantic and short-term episodic memory are impaired in some brain disorders including Alzheimer's disease. Development and validation of an almost self-administered, but cognitively demanding four-minute test identifying very mild cognitive impairment (vMCI). The innovative hedgehog PICture Naming and Immediate Recall (PICNIR) consisted of two parts. The first task was to write down the names of 20 black-and-white pictures to evaluate long-term semantic memory and language. The second task involves immediate recall and writing the names of as many previously named pictures as possible in one minute. The PICNIR is assessed using the number of naming errors (NE) and correctly recalled picture names (PICR). The PICNIR and a neuropsychological battery were administered to 190 elderly individuals living independently in the community. They were divided into those with vMCI (n = 43 with Montreal Cognitive Assessment (MoCA) 24 ± 3 points) and sociodemographically matched cognitively normal (CN) individuals (n = 147 with MoCA 26 ± 3). Both subgroups had predicted mean Mini-Mental State Examination scores of 28-29 points. Compared to CN, vMCI participants made more NE (0.3 ± 0.6 versus 0.6 ± 0.9; p = 0.02) and recalled fewer PICR (8.9 ± 2.2 versus 6.8 ± 2.2; p < 0.000001). Discriminative validity was satisfactory using the area under the ROC curve (AUC): 0.76 for PICR, 0.74 for MoCA, 0.67 for MoCA-five-word recall, and 0.59 for NE. The AUCs of PICR and MoCA were comparable and larger than those of MoCA five-point recall or NE. Logical Memory scores, RAVLT scores, Digit symbol, and animal fluency correlated with PICR. The picture-based PICNIR is an ultra-brief, sensitive cognitive test valid for assessing very mild cognitive impairment. Its effectiveness should be validated for other languages and cultures.

Boston Naming Test as a Screening Tool for Early Postoperative Cognitive Dysfunction in Elderly Patients After Major Noncardiac Surgery.

The Boston naming test (BNT), as a simple, fast, and easily administered neuropsychological test, was demonstrated to be useful in detecting language function. In this study, BNT was investigated whether it could be a screening tool for early postoperative cognitive dysfunction (POCD). This prospective observational cohort study included 132 major noncardiac surgery patients and 81 nonsurgical controls. All participants underwent a mini-mental state examination (MMSE) and BNT 1 day before and 7 days after surgery. Early POCD was assessed by reliable change index and control group results. Seven days after surgery, among 132 patients, POCD was detected in 30 (22.7%) patients (95% CI, 15.5%-30.0%) based on MMSE, and 45 (34.1%) patients (95% CI, 26.3%-41.9%) were found with postoperative language function decline based on BNT and MMSE. Agreement between the BNT spontaneous naming and MMSE total scoring was moderate (Kappa .523), and the sensitivity of BNT spontaneous naming for detecting early POCD was .767. Further analysis showed that areas under receiver operating characteristics curves (AUC) did not show statistically significant differences when BNT spontaneous naming (AUC .862) was compared with MMSE language functional subtests (AUC .889), or non-language functional subtests (AUC .933). This study indicates the feasibility of implementing the BNT spontaneous naming test to screen early POCD in elderly patients after major noncardiac surgery.

The impact of early cranioplasty on neurological function, stress response, and cognitive function in traumatic brain injury.

To analyze the efficacy of early cranioplasty in patients with traumatic brain injury and its impact on neurological function, stress response, and cognitive function. A total of 90 patients with traumatic brain injury admitted to the hospital from January 2021 to March 2024 were included in the study. The patients were divided into an observation group (45 cases) and a control group (45 cases) based on the timing of their cranioplasty. The control group underwent cranioplasty 3 to 6 months post-trauma, while the observation group received cranioplasty within 3 months post-trauma. Neurological function was assessed using the National Institutes of Health Stroke Scale. Cognitive function was evaluated using the Functional Independence Measure, Mini-Mental State Examination, and Neurobehavioral Cognitive Status Examination. Blood samples were collected to measure and compare serum levels of interleukin-6, cortisol, and tumor necrosis factor-alpha between the 2 groups. The observation group demonstrated a higher rate of excellent recovery compared to the control group (95.56% vs 80.00%), with significantly lower National Institutes of Health Stroke Scale scores ([11.18 ± 2.35] vs [14.74 ± 3.61], P < .05). Posttreatment scores for Functional Independence Measure, Mini-Mental State Examination, and Neurobehavioral Cognitive Status Examination were significantly higher in the observation group compared to the control group ([59.26 ± 6.12] vs [47.86 ± 5.27], [25.02 ± 4.61] vs [22.74 ± 5.13], [103.52 ± 10.63] vs [88.76 ± 7.39], P < .05). Serum levels of interleukin-6, cortisol, and tumor necrosis factor-alpha were significantly lower in the observation group ([22.76 ± 4.15] ng/mL vs [25.38 ± 5.27] ng/mL, [66.29 ± 4.91] nmol/L vs [78.24 ± 6.08] nmol/L, [3.36 ± 1.02] ng/mL vs [4.91 ± 0.98] ng/mL, P < .05). The total incidence of postoperative complications was significantly lower in the observation group (8.70% vs 26.09%, P < .05). Early cranioplasty is beneficial for the postoperative recovery of patients with traumatic brain injury. It improves neurological function, enhances cognitive function, and reduces stress response, while also significantly lowering the incidence of postoperative complications.

Education attainment and nutritional status in the prevention of cognitive impairment in the hospitalized Chinese elderly.

Effect of education attainment and nutritional status on the development of cognitive impairment in Chinese elderly has not been reported. To investigate the role of education and nutrition in preventing cognitive impairment in the hospitalized Chinese elderly. Cognitive function was examined using the scoring system of Mini-Mental State Examination (MMSE) domains performed under instruction of Physicians of Geriatrics. Generalized linear mixed-effect regression was used for analyzing the association of demographic factors (age and gender), socioeconomic factors (education attainment and monthly income), as well as health-related factors (nutritional status, comorbidity, anxiety, and depression) and MMSE scores. Total 246 hospitalized Chinese elders were enrolled into this study. Of them, 96 participants were 60-70 years old, 65 participants were 71-80 years old, and 85 of them were 81 years or older. Of the examined factors, we found that age, education attainment, and nutritional status were significantly associated with the outcome of MMSE scores, while monthly income and health condition (comorbidity, anxiety, and depression) were not significantly associated with MMSE score. Furthermore, education attainment was significantly associated with majority of the MMSE domains, including orientation, registration, attention and calculation, recall, and most of language sub-domains. Education attainment and nutritional status were significantly associated with MMSE scores in the hospitalized Chinese elderly. Higher education and better nutritional status are protective factors for the development of cognitive impairment in the hospitalized elderly Chinese population.

TAVIGER : Intérêt d’une expertise coordonnée gériatrique et cardiologique dans le bilan d’éligibilité des patients âgés à un remplacement valvulaire aortique par voie percutanée

BackgroundTranscatheter aortic valve implantation (TAVI) is the gold standard treatment for aortic stenosis in the elderly. Pre-identification of patients likely to benefit from this procedure remains crucial. A standardised geriatric assessment is used to identify the major geriatric syndromes likely to influence postoperative outcomes. ObjectiveTo identify factors associated with lack of TAVI management and to compare one-year survival in TAVI vs. non-TAVI patients. MethodsRetrospective study, between 2016 and 2020, at the Arras hospital. Patients aged 70 years and older with symptomatic severe aortic stenosis who had undergone geriatric assessment were included. ResultsOne hundred and ninety-two (192) patients, mean age 82.3 years. The 1-year mortality rate was 18% in the TAVI group and 44% in the non-TAVI group (p < 0.001).Parameters associated with no TAVI were Euroscore (ESL) 1 (19.6 ± 10.9 vs. 23.2 ± 13.5, p = 0.020), malnutrition (14% vs. 35%, p = 0.004), walking speed < 0.8 m/s (39% vs. 75%, p = 0.001), Activities of Daily Life (ADL) score (5.4 ± 1 vs. 4.2 ± 1. 6, p < 0. 001) and Instrumental Activities of Daily Life (IADL) score (2.6 ± 1.2 vs. 1.8 ± 1.4, p = 0.002), Mini Geriatric Depression Scale (mini GDS) ≥ 1 (16% vs. 38%, p = 0.045), Mini Mental State Examination (MMSE) score (25.1 ± 3.5 vs. 21.6 ± 4.3 < 0.001). ConclusionsGeriatric syndromes are important determinants of TAVI candidacy. Cardiological surgical risk scores are not effective in discriminating between patients. Coordinated assessment may optimise selection. Therefore, geriatric assessment should be systematically performed as part of the pre-TAVI evaluation.

Relationship between MRI brain-age heterogeneity, cognition, genetics and Alzheimer’s disease neuropathology

Brain ageing is highly heterogeneous, as it is driven by a variety of normal and neuropathological processes. These processes may differentially affect structural and functional brain ageing across individuals, with more pronounced ageing (older brain age) during midlife being indicative of later development of dementia. Here, we examined whether brain-ageing heterogeneity in unimpaired older adults related to neurodegeneration, different cognitive trajectories, genetic and amyloid-beta (Aβ) profiles, and to predicted progression to Alzheimer's disease (AD). Functional and structural brain age measures were obtained for resting-state functional MRI and structural MRI, respectively, in 3460 cognitively normal individuals across an age range spanning 42-85 years. Participants were categorised into four groups based on the difference between their chronological and predicted age in each modality: advanced age in both (n=291), resilient in both (n=260) or advanced in one/resilient in the other (n=163/153). With the resilient group as the reference, brain-age groups were compared across neuroimaging features of neuropathology (white matter hyperintensity volume, neuronal loss measured with Neurite Orientation Dispersion and Density Imaging, AD-specific atrophy patterns measured with the Spatial Patterns of Abnormality for Recognition of Early Alzheimer's Disease index, amyloid burden using amyloid positron emission tomography (PET), progression to mild cognitive impairment and baseline and longitudinal cognitive measures (trail making task, mini mental state examination, digit symbol substitution task). Individuals with advanced structural and functional brain-ages had more features indicative of neurodegeneration and they had poor cognition. Individuals with a resilient brain-age in both modalities had a genetic variant that has been shown to be associated with age of onset of AD. Mixed brain-age was associated with selective cognitive deficits. The advanced group displayed evidence of increased atrophy across all neuroimaging features that was not found in either of the mixed groups. This is in line with biomarkers of preclinical AD and cerebrovascular disease. These findings suggest that the variation in structural and functional brain ageing across individuals reflects the degree of underlying neuropathological processes and may indicate the propensity to develop dementia in later life. The National Institute on Aging, the National Institutes of Health, the Swiss National Science Foundation, the Kaiser Foundation Research Institute and the National Heart, Lung, and Blood Institute.

Association of longitudinal changes in 24-h blood pressure level and variability with cognitive decline.

A high office blood pressure (BP) is associated with cognitive decline. However, evidence of 24-h ambulatory BP monitoring is limited, and no studies have investigated whether longitudinal changes in 24-h BP are associated with cognitive decline. We aimed to test whether higher longitudinal changes in 24-h ambulatory BP measurements are associated with cognitive decline. We included 437 dementia-free participants from the Maracaibo Aging Study with prospective data on 24-h ambulatory BP monitoring and cognitive function, which was assessed using the selective reminding test (SRT) and the Mini-Mental State Examination (MMSE). Using multivariate linear mixed regression models, we analyzed the association between longitudinal changes in measures of 24-h ambulatory BP levels and variability with cognitive decline. Over a median follow-up of 4 years (interquartile range, 2-5 years), longitudinal changes in 24-h BP level were not associated with cognitive function ( P ≥ 0.09). Higher longitudinal changes in 24-h and daytime BP variability were related to a decline in SRT-delayed recall score; the adjusted scores lowered from -0.10 points [95% confidence interval (CI), -0.16 to -0.04) to -0.07 points (95% CI, -0.13 to -0.02). We observed that a higher nighttime BP variability during follow-up was associated with a decline in the MMSE score (adjusted score lowered from -0.08 to -0.06 points). Higher 24-h BP variability, but not BP level, was associated with cognitive decline. Prior to or in the early stages of cognitive decline, 24-h ambulatory BP monitoring might guide strategies to reduce the risk of major dementia-related disorders including Alzheimer's disease.

Association between sleep quality and cognitive impairment in older adults hypertensive patients in China: a case–control study

BackgroundPrevious studies have found that poor sleep quality promotes the occurrence of cognitive impairment (CI), but this relationship has been rarely reported in older adults hypertensive patients. The purpose of this study was to investigate the relationship between sleep quality and CI in older adults hypertensive patients and the mediating effect of sleep quality between physical activity (PA) and CI.MethodsA total of 2072 older adults hypertensive patients were included in this case–control study. Five hundred and eighteen older adults hypertensive patients with CI were matched 1:3 by age and sex to 1,554 older adults hypertensive patients with normal cognitive function. The International Physical Activity Questionnaire-Long Form, Pittsburgh Sleep Quality Index, and Mini-Mental State Examination were used to evaluate PA intensity, sleep quality, and cognitive function in older adults hypertensive patients. Multivariate logistic regression and the mediation package in R Language were used to analyze the relationship between sleep quality and CI and the mediating effect of sleep quality between PA intensity and CI in older adults hypertensive patients.ResultsAfter adjusting for all confounding factors, sleep quality was positively correlated with CI in older adults hypertensive patients (OR = 2.565, 95%CI: 1.958–3.360, p &amp;lt; 0.001), and this relationship also existed in the older adults hypertensive patients with education levels of primary school and below and junior high school and above (OR = 2.468, 95%CI: 1.754–3.473, p &amp;lt; 0.001; OR = 2.385, 95%CI: 1.367–4.161, p = 0.002). In addition, sleep quality mediated part of the mediating effect between PA intensity and CI in older adults hypertensive patients (Za*Zb: - 17.19339; 95%CI: −0.37312, −0.04194).ConclusionPoor sleep quality was associated with the occurrence of CI in older adults hypertensive patients, and this relationship also existed in older adults hypertensive patients with education levels of primary school and below and junior high school and above.

Myocardial fibrosis is associated with brain microstructural alterations in patients with heart failure: A diffusion MRI study

PurposeThis study aimed to examine the changes in brain diffusion in patients with heart failure (HF) by measuring the apparent diffusion coefficient (ADC) and to investigate the relationship between these changes and cardiac injury features. MethodsThe study included 49 patients with HF and 39 healthy controls. Cognitive performance was assessed using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). All participants underwent a brain DWI scan, followed by cardiac MR in patients with HF. The ADC values in different regions of the brain were estimated using region-of-interest analysis. Cardiac MR was used to evaluate left ventricular function and the volume of late gadolinium enhancement (LGE). Group differences in ADC values were analysed using generalised linear mixed modelling. Correlation analysis was used to explore the associations between brain diffusion alterations, cognitive performance, and cardiac injury features. ResultsPatients with HF showed significantly increased ADC values in several brain regions, including the frontal, parietal, temporal, occipital lobes, cingulate cortex, hippocampus, cerebellum, and deep nuclei. ADC values in the right hippocampus, right amygdala, and bilateral insula were negatively correlated with MoCA scores. ADC values in the left inferior occipital gyrus (r = 0.570, P<0.001) and lobule VI of the cerebellar hemisphere (r = 0.560, P = 0.001) were correlated with LGE volume. ConclusionThese findings suggest that specific brain regions in patients with HF experience microstructural changes associated with cognitive impairment. Moreover, chronic brain microstructural alterations may be related to myocardial fibrosis in patients with HF.

The influence of healthy eating index on cognitive function in older adults: chain mediation by psychological balance and depressive symptoms

BackgroundThis study aims to investigate the relationships between the Chinese Healthy Eating Index (CHEI), psychological balance, depressive symptoms, and cognitive function in the rural older population. Additionally, it examines the impact of CHEI on cognitive function and the potential chain mediating roles of psychological balance and depressive symptoms.MethodsThe study utilized data from 2,552 rural older adults aged 65 and above, drawn from the Chinese Longitudinal Healthy Longevity Study (CLHLS). The CHEI was self-reported, with scores ranging from 0 to 50, representing adherence to healthy eating habits. Psychological balance was assessed using status and personality-emotion characteristics recorded in the database, with scores ranging from 6 to 30. Cognitive function was measured using the Mini-Mental State Examination (MMSE), with scores ranging from 0 to 30; higher scores indicated better cognitive function. Depressive symptoms were evaluated using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10), with scores ranging from 0 to 30, where higher scores reflected more severe depressive symptoms.ResultsThe median CHEI score was 40.0 (IQR: 34.0–45.0), reflecting moderate adherence to healthy dietary practices. The median Psychological Balance score was 19.0 (IQR: 17.0–21.0), and the median Depressive Symptoms score was 13.0 (IQR: 10.0–15.0), indicating mild depressive symptoms among participants. Additionally, the median Cognitive Function score was 28.0 (IQR: 27.0–29.0), suggesting relatively stable cognitive abilities within the sample. Correlational analysis revealed the following: (1) Depressive symptoms were negatively correlated with both cognitive function (rs = -0.100, p < 0.001) and CHEI (rs = -0.206, p < 0.001), as well as with psychological balance (rs = -0.142, p < 0.001). (2) CHEI was positively correlated with both cognitive function (rs = 0.144, p < 0.001) and psychological balance (rs = 0.131, p < 0.001). (3) Cognitive function was also positively correlated with psychological balance (rs = 0.096, p < 0.001). Mediation analysis demonstrated that both psychological balance and depressive symptoms partially mediated the relationship between CHEI and cognitive function, forming a chain-mediating effect.ConclusionThe Chinese Healthy Eating Index was found to have a direct positive impact on cognitive function in rural older adults. Furthermore, it exerted an indirect effect through the independent and chain-mediating roles of psychological balance and depressive symptoms. These findings suggest that dietary adherence can influence cognitive health not only directly but also by improving psychological well-being and reducing depressive symptoms.

Diagnostic Accuracy of Combined Measurement of Serum Homocysteine, C-Reactive Protein, and Serum Ferritin in Mild Cognitive Impairments and Alzheimer's Disease.

Evaluation of the diagnostic accuracy of combined detection of serum homocysteine (Hcy), C-reactive protein (CRP), and serum ferritin (SF) levels in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). Descriptive study. Place and Duration of the Study: Clinical Laboratory Section, Affiliated Hospital of Hebei University, Baoding, Heibei, China, from May 2022 to June 2023. Data of 120 patients with memory decline were retrospectively collected. They were divided into an MCI group and an AD group. A further 50 healthy participants were used as a normal control (NC) group. Differences in the Hcy, CRP, and SF levels between the three groups were evaluated. The specificity, accuracy, and sensitivity of these three indices in the combined or single diagnosis of AD and MCI were compared. Their associations with the severity of AD and MCI were also compared. The AD group had the highest levels of Hcy, CRP, and SF (18.79 ± 4.50, 6.35 ± 2.04, and 355.69 ± 120.36), followed by MCI (16.75 ± 3.06, 4.58 ± 2.31, and 203.48 ± 12.76), and NC group (14.32 ± 2.06, 2.06 ± 0.76, and 98.46 ± 5.06), with statistically significant differences (all p <0.001). The diagnostic efficacy of AD for CRP was 98.50%, sensitivity was 96.00%, and specificity was 94.00%, which was higher than Hcy and SF. Tested together, the area under the ROC curve was 99.90%, specificity was 98.00%, and sensitivity was 98.00%. The diagnostic efficacy of SF for MCI had sensitivity of 100.00%, and specificity of 100.00%, which was higher than that of Hcy and CRP. When the three were combined for detection, the area under the curve of SF was 100.00%, sensitivity of 100.00%, and specificity of 100.00%. The levels of Hcy, CRP, and SF were positively correlated with the severity of AD (p <0.01), while negatively correlated with the mini-mental state examination (MMSE) score (p <0.01). The combined detection of Hcy, CRP, and SF improved the diagnostic accuracy of comorbid AD and MCI. Homocysteine, C-reactive protein, Cognitive impairment, Serum ferritin, Alzheimer's disease.

Diagnostic Accuracy of Combined Measurement of Serum Homocysteine, C-Reactive Protein, and Serum Ferritin in Mild Cognitive Impairments and Alzheimer's Disease.

Evaluation of the diagnostic accuracy of combined detection of serum homocysteine (Hcy), C-reactive protein (CRP), and serum ferritin (SF) levels in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). Descriptive study. Place and Duration of the Study: Clinical Laboratory Section, Affiliated Hospital of Hebei University, Baoding, Heibei, China, from May 2022 to June 2023. Data of 120 patients with memory decline were retrospectively collected. They were divided into an MCI group and an AD group. A further 50 healthy participants were used as a normal control (NC) group. Differences in the Hcy, CRP, and SF levels between the three groups were evaluated. The specificity, accuracy, and sensitivity of these three indices in the combined or single diagnosis of AD and MCI were compared. Their associations with the severity of AD and MCI were also compared. The AD group had the highest levels of Hcy, CRP, and SF (18.79 ± 4.50, 6.35 ± 2.04, and 355.69 ± 120.36), followed by MCI (16.75 ± 3.06, 4.58 ± 2.31, and 203.48 ± 12.76), and NC group (14.32 ± 2.06, 2.06 ± 0.76, and 98.46 ± 5.06), with statistically significant differences (all p <0.001). The diagnostic efficacy of AD for CRP was 98.50%, sensitivity was 96.00%, and specificity was 94.00%, which was higher than Hcy and SF. Tested together, the area under the ROC curve was 99.90%, specificity was 98.00%, and sensitivity was 98.00%. The diagnostic efficacy of SF for MCI had sensitivity of 100.00%, and specificity of 100.00%, which was higher than that of Hcy and CRP. When the three were combined for detection, the area under the curve of SF was 100.00%, sensitivity of 100.00%, and specificity of 100.00%. The levels of Hcy, CRP, and SF were positively correlated with the severity of AD (p <0.01), while negatively correlated with the mini-mental state examination (MMSE) score (p <0.01). The combined detection of Hcy, CRP, and SF improved the diagnostic accuracy of comorbid AD and MCI. Homocysteine, C-reactive protein, Cognitive impairment, Serum ferritin, Alzheimer's disease.

Effects of speech tracking method using hearing aids for hearing disorder in older people.

Speech tracking is defined as a complex act or task of listening in which the learner tracks the speech heard and repeats it as accurately as possible while paying attention to incoming contextual information. This ability involves auditory input, speech output, repetition, and divided attention. In this small-scale study, we aimed to use a speech-tracking method to train older adults with hearing loss and examine its effects on hearing loss from multiple perspectives, including hearing handicap, frailty, and neuropsychological testing. Auditory rehabilitation was provided to older patients who purchased hearing aids at the clinic and wanted to engage in rehabilitation. The Hearing Handicap Inventory for the Elderly, Nursing Home Hearing Handicap Index, speech-tracking rate, Token Test, Communication Activities of Daily Living, Kihon Checklist, Mini-Mental State Examination, Digit Symbol Substitution Test, symbol search, and word recall were used for assessments before and after rehabilitation using the speech-tracking method. Changes in scores of each assessment item and sub-item were examined using Wilcoxon's signed-rank test, and changes per question were examined using the sign test. The speech tracking rate (p<0.001), Token Test score (p<0.001), and Mini-Mental State Examination score (p=0.035) improved significantly after the training. Notably, the speech-tracking rate improved for 31 of the 33 participants, with a maximum increase of 19.6 phrases per minute. The combination of a hearing aid and the speech-tracking method improved auditory comprehension.

Depressive syndrome, cognitive impairment, and associated factors among community-dwelling aged persons in Cameroon.

Background: Depressive syndrome (DS) and cognitive impairment (CI) are associated with unsuccessful aging. However, little is known about Cameroon. This study aimed to assess the factors associated with DS and CI among older adults in Cameroon. Methods: A representative sample of 599 individuals aged ≥ 60 years was selected for this cross-sectional study. Sociodemographic and health data were also collected. DS and CI were assessed using the Center for Epidemiologic Studies-Depression Scale (CES-D) and Mini-Mental State Examination (MMSE), respectively. The Rosow Mobility Scale, Activities of Daily Living (ADL), and Instrumental Activities of Daily Living (IADL) scales were used to evaluate functional abilities. Chi-2, ANOVA, and multiple regression analyses were performed to assess the factors associated with DS and CI. The threshold of statistical significance was 5%. Results: The average age was 68.9±7.2 years, sex ratio M/F=0.93, and weight 68.5±14.7 kg. DS affected 14.5% of the population and the CI was 21.4%. In the multivariate analysis, DS was positively associated with male gender (Odds Ratio (OR)=1.7 [95% Confidence Interval (CI):1.1-2.7], p=0.031) and inactivity (OR=1.7 [95% CI:1.0-3.0], p=0.043). CI was positively associated with lack of education (OR=6.5 [95% CI:3.5-12.2], p<0.001), inactivity (OR=5.3 [95% CI:1.6-17.9], p=0.008), single (OR=3.7 [95% CI:1.2-11.3], p=0.023), and widowhood (OR=3.3 [95% CI:1.6-6.5], p=0.001), and negatively associated with no IADL (OR=0.3 [95% CI:0.2-0.6], p=0.001) and ADL disability (OR=0.5 [95% CI:0.2-0.9], p=0.032) limitations. Conclusions: The associated factors suggest that it might be of interest to fight inactivity and encourage early and long-term education to prevent DS and/or CI among older adults.