Montreal Cognitive Assessment Scale Research Articles

The prevalence and clinical correlation factors of cognitive impairment in patients with major depressive disorder hospitalized during the acute phase

ObjectiveThis study aimed to investigate the prevalence of cognitive impairment among patients with major depressive disorder (MDD) hospitalized during the acute phase and to analyze the in-depth association between this cognitive impairment and clinical correlation factors.MethodsIn this cross-sectional study, we recruited 126 patients aged between 18 and 65 years who were diagnosed with MDD. All these patients were inpatients from the Department of Psychiatry at the Second People’s Hospital of Hunan Province. We employed a series of assessment tools, including the Pittsburgh Sleep Quality Index (PSQI), the 16-item Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS-16), the Pre-sleep Arousal Scale (PSAS), the Morningness-Eveningness Questionnaire (MEQ), the Hamilton Anxiety Rating Scale (HAMA), and the 17-item Hamilton Depression Rating Scale (HAMD-17). The patients were divided into a cognitive impairment group and a non-cognitive impairment group based on their scores on the Montreal Cognitive Assessment Scale (MoCA). Through Spearman’s correlation analysis, we explored the correlation between the total MoCA score and the score of each factor. Additionally, we utilized binary logistic regression analysis to investigate the relationship between cognitive impairment and clinically relevant factors in MDD patients hospitalized during the acute phase and plotted ROC curves to evaluate their clinical efficacy.ResultsIn this study, we found that the prevalence of cognitive impairment among MDD patients hospitalized during the acute phase was as high as 63.49%. Through statistical analysis, we observed significant differences between the cognitive impairment group and the non-cognitive impairment group in terms of age, place of residence, education level, and HAMD-17 scores. In the Spearman correlation analysis, we noted the following trends: visuospatial and executive abilities were negatively correlated with the HAMD-17 score (P < 0.05); naming ability was positively correlated with the PSAS score but negatively correlated with the MEQ score (P < 0.05); memory was also negatively correlated with the MEQ score (P < 0.05); attention was negatively correlated with the HAMA score; and abstract cognitive ability was negatively correlated with the MEQ score (P < 0.05). Through binary logistic regression analysis, we further revealed the relationship between cognitive impairment and factors such as living in a rural area (OR = 2.7, 95% CI = 1.083-6.731, P < 0.05), increased age (OR = 1.049, 95% CI = 1.013-1.087, P < 0.01), and the HAMD-17 score (OR = 1.10295, 95% CI = 1.031-11.79, P < 0.01). Additionally, ROC curve analysis demonstrated a significant correlation between the HAMD-17 score and the prediction of cognitive function in MDD patients hospitalized during the acute phase (P < 0.001). Specifically, the AUC for the HAMD-17 score was 0.73, with an optimal cut-off value of 19.5, sensitivity of 70.0%, and specificity of 63.0%. Furthermore, the AUC for age was 0.71, with an optimal cut-off value of 33.5, sensitivity of 59.0%, and specificity of 80.0%.ConclusionsThis study indicates that MDD patients hospitalized during the acute phase have a higher prevalence of cognitive impairment. This phenomenon reflects a significant correlation between clinical factors such as age, sleep-related characteristics, and the severity of depression with cognitive impairment. Therefore, regular assessment of cognitive function in MDD patients and early intervention may be crucial for the treatment and prognosis of the disease.

Effects of preoperative neoadjuvant chemotherapy on postoperative delirium in patients with gynecological tumor surgery: an observational study.

To investigate whether neoadjuvant chemotherapy (NACT) increases the incidence of postoperative delirium (POD) in patients with gynecological tumors undergoing radical hysterectomy. This study included 60 patients in the neoadjuvant chemotherapy exposure group and 60 in the non-exposure group. Preoperative cognitive function, the incidence of POD and other physiological parameters were assessed on preoperative day 1 (POD-1), postoperative day 1 (POD1), postoperative day 2 (POD2), and postoperative day 3 (POD3). Additionally, preoperative olfactory function was evaluated using an olfactory detection kit on POD-1. The primary outcome was the incidence of POD within three days after surgery. The incidence of POD was 28.33% in the exposed group and 8.33% in the non-exposed group (P = 0.005). Compared to the non-exposed group, the exposed group had a higher rate of cognitive dysfunction (33.33% vs 13.33%; P = 0.010), and a higher rate of olfactory dysfunction (OD) (25.00% vs 10.00%; P = 0.031). A restricted cubic spline analysis revealed a non-linear relationship between olfactory test scores and Montreal Cognitive Assessment Scale (MoCA) scores (P for overall < 0.001, P for nonlinear = 0.001). Logistic regression identified NACT, mild and moderate cognitive dysfunction, OD, and depression as independent risk factors for POD, with all factors showing significant associations (P < 0.05). The area under the curve (AUC) of OD for predicting POD was 0.783 (95%CI 0.656-0.909). This single-blind observational study suggests that NACT increases the incidence of POD in patients with gynecological tumors undergoing radical hysterectomy. Moreover, the results indicate that preoperative OD may reflect preoperative cognitive dysfunction, and have predictive value for the incidence of POD.

Evaluation of tolerability and safety of transcranial electrical stimulation with gel particle electrodes in healthy subjects

BackgroundWith the advancement of transcranial electrical stimulation (tES) technology, an increasing number of stimulation devices and treatment protocols have emerged. However, safety and tolerability remain critical concerns before new strategies can be implemented. Particularly, the use of gel particle electrodes brings new challenges to the safety and tolerability of tES, which hinders its widespread adoption and further research.ObjectiveOur study utilized a specially designed and validated transcranial electrical stimulation stimulator along with preconfigured gel particle electrodes placed at F3 and F4 in the prefrontal lobes. We aimed to assess the tolerance and safety of these electrodes in healthy subjects by administering different durations and types of tES.MethodsEach participant underwent ten sessions of either transcranial direct current stimulation (tDCS) or transcranial alternating current stimulation (tACS), with session durations varying. In the experiment, we collected various measurement data from participants, including self-report questionnaire data and behavioral keystroke data. Tolerability was evaluated through adverse events (AEs), the relationship of adverse events with tES (AEs-rela), the Self-Rating Anxiety Scale (SAS), and the Visual Analog Mood Scale-Revised (VAMS-R). Safety was assessed using the Visual Analog Scale (VAS), the Skin Sensation Rating (SSR), Montreal Cognitive Assessment (MoCA), and Stroop task. These data were analyzed to determine the impact of different parameters on the tolerability and safety of tES.ResultsThere were no significant changes in the results of the MoCA and SAS scales before and after the experiment. However, significant differences were observed in VAS, SSR, AEs, and AEs-rela between tDCS and tACS. Additionally, fatigue increased, and energy levels decreased on VAMS-R with longer durations. No significant differences were found in other neuropsychological tests.ConclusionOur study revealed significant differences in tolerability and safety between tDCS and tACS, underscoring the importance of considering the stimulation type when evaluating these factors. Although tolerance and safety did not vary significantly across different stimulation durations in this study, future research may benefit from exploring shorter durations to further assess tolerability and safety efficiently.

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.

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. 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. 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. 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.

Prevalence and Influence Factors of Cognitive Frailty in the Older Adult Patients Undergoing Maintenance Haemodialysis: A Multi-Centre Cross-Sectional Study.

To examine the prevalence of factors of cognitive frailty in patients undergoing maintenance haemodialysis (MHD). A cross-sectional study. From September 2023 to January 2024, 1023 patients undergoing MHD were recruited from 11 hospitals in Chengdu, China, using convenience sampling. The participants' sociodemographic and lifestyle factors, health information and laboratory indicators were assessed using a general information questionnaire. Cognitive frailty was assessed using the Fried Frailty Phenotype and Montreal Cognitive Assessment Scales. Multivariate logistic regression was used to examine the associations between cognitive frailty and sociodemographic and clinical characteristics. Independent variables for the multivariate logistic regression model encompassing age, sex, educational level, marital status, visual impairment, hearing impairment, falls within a year, depression, weight, height, Malnutrition-inflammation score and serum albumin, sodium, phosphorus, total cholesterol and creatinine levels. Among 1023 participants with a mean age of 69.52 years, 300 (29.3%) had cognitive frailty, with a predominance of older patients. Regression analysis showed that advanced age, low literacy and low serum creatinine, sodium and total cholesterol levels were positively correlated with cognitive frailty. Furthermore, 17.1% of the participants experienced depression, a risk factor for cognitive frailty, and malnutrition was an independent risk factor for cognitive frailty. Older adult patients undergoing (MHD) are at an increased risk of developing cognitive frailty. The aetiology of cognitive frailty in this cohort was multifactorial. Targeted interventions should be designed and implemented based on these factors, prioritising nutritional guidance and mood management to prevent or reverse cognitive frailty. The study adhered to the STROBE checklist. Older adult patients undergoing MHD are at increased risk of developing cognitive frailty. Cognitive frailty screening must be incorporated into the routine assessment of older patients undergoing MHD. No patient or public contribution.

Effect of cognitive training on selected gait parameters in patients with stroke

Background. Not only may early cognitive rehabilitation help stroke patients with their cognitive impairment, but it can also help patients restore their capabilities to do everyday activities. There isn’t much data on how cognitive training affects spatiotemporal gait variables in stroke survivors. Objective. To examine the impact of cognitive training on selected gait parameters in stroke patients. Subjects and Methods. Forty male and female patients with mild ischemic chronic stroke, ranging in age from 45 to 60 years, were recruited and distributed into two equal groups at random (G1 and G2). The Montreal Cognitive Assessment Scale (MOCA) and the Rehacom system were utilized to evaluate the patient’s cognitive function. The Biodex gait trainer device was utilized to measure several gait variables for all patients. Rehacom cognitive training and a selected physiotherapy program were administered to the study group (G1). The similar selected physiotherapy program utilized for the G1 was applied to the control group (G2). For eight weeks, the treatment was administrated three sessions each week, day after day. All variables were evaluated before- and after-intervention. Results. The step length and walking speed, as well as the MOCA scale score of G1, were significantly higher after treatment than those of G2 (p = 0.001). The correlation between step length and median reaction time (MRT) was moderate negative significant correlation (r = – 0.698, p = 0.001). Conclusion. Cognitive training has a beneficial impact on improving the selected spatiotemporal gait parameters in stroke patients.

Increased dementia risk in patients with Parkinson's disease attributed to metabolic syndrome.

Metabolic syndrome (MetS) manifests resembling pathophysiological mechanisms with Parkinson's disease (PD). Current research on the overall population has emphasized MetS as a freestanding risk factor for cognition. This research aims to explore the impact of MetS on cognition in Parkinson's patients. We involved subjects identified as having early-stage PD patients. The MetS was diagnosed dependent on parameters overviewed in the National Cholesterol Education Program's Adult Treatment Panel III. The clinical severity and stages in patients with PD were dependent on the disease rating scales. The cognition was evaluated by the Turkısh version of the Montreal Cognitive Assessment Scale (MoCA-TR). The cases were categorized according to cognitive failure: mild cognitive impairment in PD (PD-MCI), and PD dementia (PDD). Metabolic syndrome was present in 39.6% of the participants. 22.0% of patients were in the normal cognition, 29.1% in the PD-MCI group, and 48.9% in the PD-D group. The cognitive scores in patients with MetS is considerably lower than MetS negative group. A statistically notable inverse association was detected between fasting blood glucose levels and the visual-spatial/executive functions, naming, language, and orientation scores. The multivariate logistic regression analysis showed individuals with MetS were found to have an 11.308 times higher risk of PD-D (odds ratio [OR]: 11,3, 95% confidence interval [CI]: 1.61-79.2 ). We discerned the occurrence of MetS in PD raises the possibility of advancing dementia. This suggests that considering MetS in this patient group could contribute to the effective management of dementia.

"Ups and Downs, Joys and Sorrows" - Assessment and Clinical Relevance of Patient Priorities in an Interdisciplinary Parkinson's Disease Clinic.

Barriers to communication and inaccurate provider assumptions about patient priorities limit the delivery of comprehensive, high-quality, patient-centered care (PCC) to people with Parkinson's (PWP). This study aimed to analyze priorities of PWP using a qualitative, unstructured single-question survey and to test associations with validated quality of life (QOL) measures. During appointments at a subspecialty, interdisciplinary clinic, PWP (n=139) provided written responses to the prompt: "What is important for your care team to know about you?" Patient Health Questionnaire, Montreal Cognitive Assessment, and Hoehn and Yahr scales were obtained through retrospective chart review. Key qualitative themes were identified through grounded theory analysis, and associations with quantitative health measures were tested with correlation analyses. Common themes included participant health (eg, PD-related goals and comorbidities), non-illness identities (eg, family or community role), and the psychosocial impact of PD (eg, losing independence and uncertainty). Positive sentiments (n=73), such as motivation and optimism, were more common than negative sentiments (n=45), such as loss and fear. There was moderate concordance between worsened mental health and uncertainty (rho=0.206, p=0.02) and inverse concordance between worsened mobility and gratitude (rho=-0.174, p=0.04). The range of priorities that PWP want to share with their care team is more diverse than that of common provider assumptions, is correlated with clinical outcomes such as mental health and mobility, and may not be captured by existing QOL assessment tools. An open-ended, qualitative prompt should be incorporated into routine specialist care for PWP as a valuable QOL indicator.

Assessment of prevalence, risk factors, and neuropsychiatric symptoms of mild neurocognitive disorder among elderly in Suez Canal Area

Abstract Background Mild neurocognitive disorder is mild reduction in cognitive abilities than a previous level, requiring compensatory strategies that help maintain independence, and is associated with behavioral and psychiatric symptoms. This cross-sectional comparative study aimed to evaluate prevalence of mild neurocognitive disorder, its risk factors, and associated neuropsychiatric symptoms. It included a sample of 156 elderly people ≥ 60 years old in Suez Canal Area from geriatric homes and primary health care centers. Study tools included a semi-structured clinical interview to assess sociodemographic, clinical, and lifestyle risk factors, DSM-5 criteria for diagnosis of neurocognitive disorders, the Montreal Cognitive Assessment Scale, and the Neuropsychiatric Inventory Questionnaire. Results Prevalence of mild neurocognitive disorder was 37.2% in total sample with mean total score of 22.7 ± 6.1 by Montreal Cognitive Assessment Scale. The most common subtype was amnestic multiple domain subtype (72.4%). Its predicting factors included advanced age, lower education, physical work, non-adherence to treatment, less physical activity, bone and joint disorders, and family history of cognitive impairment. The neuropsychiatric symptoms with highest scores were sleep/nighttime behavior, depression, irritability, and eating/appetite, respectively. Among the two study groups, geriatric home residents had highly significant lower cognitive scores (p &lt; 0.001) and higher Neuropsychiatric Inventory Questionnaire scores. Conclusion Mild neurocognitive disorder is common among elderly people and is associated with neuropsychiatric symptoms that need screening and management. Modifiable risk factors should be identified to provide interventions.

Possibilities of using innovative non-drug technologies in the rehabilitation of patients with early post-stroke cognitive impairment

BACKGROUND: One of the leading factors complicating social adaptation after ischemic stroke is cognitive and motor impairment. AIM: This study aimed to evaluate the effect of rehabilitation using virtual reality technologies and the influence of the main clinical and functional parameters on virtual reality (VR) therapy in patients with different degrees of cognitive decline in the acute period of ischemic stroke. MATERIALS AND METHODS: This study examined 170 patients diagnosed with ischemic stroke with cognitive decline according to the Montreal Cognitive Assessment. Depending on the volume of therapy, the patients were divided into two groups: group 1 included 120 patients who received additional therapy using VR technologies (62 patients with moderate cognitive impairment, 58 patients with dementia), and group 2 consisted of 50 patients who received only basic therapy and standard methods of early rehabilitation. In group 1, on days 4–5 following basic therapy, rehabilitation using VR was performed. The Barthel Index (BI) scale, Rankin Scale (mRS), and National Institute of Health Stroke Scale (NIHSS) were used to examine cognitive and functional status, and tests were performed to assess cognitive functions, as well as neuroimaging scales ASPECTS, STRIVE, and MTA. The effectiveness of rehabilitation (ΔRE) was measured by the indicator of changes in the parameters of the VR system before and after treatment. RESULTS: A more significant improvement of the patient’s independence and regression of perceptual and executive functions was demonstrated in group 1 than in the control group. In patients with MCI, significant improvement was observed in all cognitive and functional parameters except semantic information processing, attention, and constructive praxis. In patients with dementia, improvement was noted in NIHSS, speech and amnestic disorders. In group 1, ΔRE was found to be associated with the parameters of perception, attention, semantic information processing, IQCODE, and NIHSS and the presence of hypertension and repeated stroke. In patients with MCI, ΔRE was correlated with lesion size, attention level, BI, mRS, and NIHSS and with age, sex, degree of IQCODE and STRIVE, semantic aphasia, and perceptual impairment in patients with dementia. CONCLUSION: The present study revealed a polymorphism of factors influencing the effectiveness of VR therapy in patients with varying degrees of cognitive decline. Modern approaches to VR rehabilitation of patients with post-stroke cognitive impairment require the development of individual methods of rehabilitation using immersion environment focused on the structure, etiology, and severity of cognitive deficit considering the degree of the patient’s functional state.

Restriction of Mobile Phone Usage at Bed Time: Effect on Sleep Quality, Mood and Cognitive Function

Introduction: Mobile phones are integral to modern life, but excessive use, particularly at night, can lead to disrupt well-being. Limiting mobile phone use before bedtime may improve individual well-being. This study aimed to evaluate whether restricting mobile phone use at bedtime enhances sleep quality, mood, and cognitive function. Methodology: Undergraduate students from a selected engineering college were assessed for bedtime mobile phone use. Sixty-eight students were chosen via simple random sampling. A self-reported questionnaire including the Pittsburgh Sleep Quality Index, Positive and Negative Affect Scale, and Montreal Cognitive Assessment Scale evaluated sleep quality, mood, and cognitive function before implementing restrictions. The "Lock My Phone" app was used to enforce these restrictions. Post-intervention assessments were conducted on the 15th and 30th days. Results: Before the intervention, all students reported poor sleep quality, 80.8% had reduced positive affect, 91.1% experienced high negative affect, and only 23.5% had normal cognitive function. Significant improvements were observed in sleep quality, mood, and cognitive function post-restriction (p&lt;0.001). Conclusion: Restricting mobile phone use before bedtime significantly improved sleep quality, mood, and cognitive function among undergraduate students.

Does cognitive function affect functional capacity and perceived fatigue severity after exercise in patients with coronary artery disease?

Successful execution of exercise-based cardiac rehabilitation programs, an important branch of physiotherapy in individuals with coronary artery disease (CAD), depends on adequate cognitive abilities. It has been identified that coronary microvascular dysfunction, marked by reduced coronary flow reserve, is associated with impaired cerebral blood flow, affecting haemodynamic and cognitive performance. This study aimed to investigate how cognitive function influences functional capacity and differences in fatigue perception in CAD patients. Fifty CAD patients, with an average age of 59.40±6.58years, were evaluated for comorbidities (Charlson comorbidity index), number of CAD risk factors (hypertension, diabetes mellitus, dyslipidaemia, smoking, and physical inactivity), cognitive performance (Montreal cognitive assessment scale [MoCA]), functional capacity (incremental shuttle walk test [ISWT]), exercise-induced fatigue (Modified Bourg Scale), and physical activity (PA) levels (international physical activity questionnaire-short form). Analyses focused on the links between MoCA scores and CRF, ISWT outcomes, and differences in fatigue perception. Findings revealed a strong positive link between MoCA scores and ISWT performance (r=0.83, p<0.001), and a strong inverse relationship between CRF and MoCA scores (r=-0.95, p<0.001). In addition, MoCA score was positively correlated with differences in fatigue perception (r=0.88, p<0.001). These results highlight the critical role of cognitive function in determining functional capacity and managing fatigue in CAD patients. They also suggest that cognitive interventions may be a potential adjunctive approach in physiotherapy programmes.

Transcutaneous Electrical Acupoint Stimulation for Elders with Amnestic Mild Cognitive Impairment: A Randomized Controlled Pilot and Feasibility Trial

Background: Amnestic mild cognitive impairment (aMCI) is an important window of opportunity for early intervention and rehabilitation in dementia. The aim of this study was to investigate the feasibility and effect of delivering transcutaneous electrical acupuncture stimulation (TEAS) intervention to elders with aMCI. Methods: A total of 61 aMCI patients were randomly allocated into the intervention group (receiving a 12-week TEAS) and control group (receiving health education). The feasibility outcomes included recruitment rate, retention rate, adherence rate, and an exploration of patients’ views and suggestions on the research. The effective outcomes included cognitive function, sleep quality, and life quality, which were measured by the Montreal cognitive assessment scale (MoCA), auditory verbal learning test—Huashan version (AVLT-H), Pittsburgh sleep quality index (PSQI), and quality of life short-term-12 (QoL SF-12). Results: The recruitment rate, retention rate, and adherence rate were 67.35%, 92.42%, and 85.29%, respectively. Most aspects of the research design and administration of the TEAS intervention were acceptable. The quantitative analysis suggests that compared with the control group, the scores of MoCA, AVLT-H, and SF-12 (mental component summary) were significantly better (p &lt; 0.05); however, the differences were not statistically significant in PSQI and SF-12 (physical component summary) (p &gt; 0.05). Conclusions: The findings demonstrated that the study was feasible. TEAS awas possible for enhancing cognitive function and mental health in people with aMCI.

Data base of Cognitive functions and their relation to balance and agility in athletes from differents sports branches

Successful performance in each sport requires high ability in various features, including motor and perceptual-cognitive skills. This study aimed to compare the balance and agility in athletes from several sports branches to find out how cognitive functions relate to these parameters. Seventy-three individuals aged 18-30 were included in this prospective-descriptive study. In the assessment of cognition, Montreal Cognitive Assessment Scale, d2 Test of Attention, and a Bassin Anticipation Timer Device were used. While Prokin-TecnoBody was used to measure the balance skills, Illinois Agility Test (IAT) was used for agility. IAT times showed positive weak correlations with both the absolute error-score (AES) at 8mph (r=0.260, p=0.040) and mediolateral balance score (ML)(r=0.255, p=0.043). While there was a negative weak correlation between AES at 3mph and anteroposterior score of balance (r=-0.267, p=0.035), we found positive weak correlation between AES at 8mph and ML of balance (r=0.253, p=0.046). It was found that the IAT scores of the sedentary group were significantly lower than athletes (p=0.000). According to AES at 3mph, there were significant differences between tennis players and both sedentary and volleyball players (p=0.008, p=0.002, respectively). When the AES at 8mph compared, the only statistically significant difference was between tennis players and sedentary (p=0.008). In conclusion, this study shows how cognitive functions, particularly coincidence anticipation timing (CAT), correlate with essential physical performance factors like agility and balance across different sport branches, suggesting that improving cognitive skills could enhance overall athletic performance and inform mental training strategies in sports. It is recommended that future sports science research focus on enhancing CAT through targeted training programs.

Cognitive functions and their relation to balance and agility in athletes from different sports branches

Successful performance in each sport requires high ability in various features, including motor and perceptual-cognitive skills. This study aimed to compare the balance and agility in athletes from several sports branches to find out how cognitive functions relate to these parameters. Seventy-three individuals aged 18-30 were included in this prospective-descriptive study. In the assessment of cognition, Montreal Cognitive Assessment Scale, d2 Test of Attention, and a Bassin Anticipation Timer Device were used. While Prokin-TecnoBody was used to measure the balance skills, Illinois Agility Test (IAT) was used for agility. IAT times showed positive weak correlations with both the absolute error-score (AES) at 8mph (r=0.260, p=0.040) and mediolateral balance score (ML)(r=0.255, p=0.043). While there was a negative weak correlation between AES at 3mph and anteroposterior score of balance (r=-0.267, p=0.035), we found positive weak correlation between AES at 8mph and ML of balance (r=0.253, p=0.046). It was found that the IAT scores of the sedentary group were significantly lower than athletes (p=0.000). According to AES at 3mph, there were significant differences between tennis players and both sedentary and volleyball players (p=0.008, p=0.002, respectively). When the AES at 8mph compared, the only statistically significant difference was between tennis players and sedentary (p=0.008). In conclusion, this study shows how cognitive functions, particularly coincidence anticipation timing (CAT), correlate with essential physical performance factors like agility and balance across different sport branches, suggesting that improving cognitive skills could enhance overall athletic performance and inform mental training strategies in sports. It is recommended that future sports science research focus on enhancing CAT through targeted training programs.

Effectiveness of Medhasagar Rasa® in Combating Aging-Associated Mild Neurocognitive Disorder: An Open-Label, Exploratory, Interventional Clinical Trial.

With the rising prevalence of neurocognitive disorders (NCDs) among the aging population, particularly in conditions like mild cognitive impairment (MCI), which often precedes dementia, there remains a significant gap in effective pharmacological interventions. This has generated interest in exploring alternative therapies to manage symptoms and enhance cognitive function in the aging population. The primary objective of this study was to evaluate the effect of Medhasagar Rasa® on cognitive functions, daily functioning, and quality of life in participants with aging-associated mild neurocognitive disorder using the Montreal Cognitive Assessment (MoCA) Scale, Ayurvedic Manasabhava Scale, and Brief Cognitive Rating Scale (BCRS). This open-label, interventional study at Karnatak Lingayat Education (KLE) Ayurveda Hospital, Belagavi, Karnataka, involved 32 screened participants, with 30 completing the study. Participants aged 50-70 years with MoCA scores of 18-25 received Medhasagar Rasa (2 tablets at bedtime, provided by M/s. Shree Dhootapapeshwar Limited, Mumbai, India) for 60 days. Assessments occurred at baseline and every 15 days until day 60. Thirty participants were recruited for the study after screening, all of whom completed the study. The median total MoCA score at baseline (visit one) was 20, which significantly improved to 25 by visit five (day 60±3) (p<0.001), indicating enhanced cognitive performance. The BCRS scores also showed significant improvement, with the median score decreasing from 12 to 7.5 (p<0.001) over 60 days. Anxiety symptoms were significantly reduced, with Hamilton Anxiety Rating Scale (HAM-A) scores dropping from 14 to 7 (p<0.001), while the Pittsburgh Sleep Quality Index (PSQI) scores indicated improved sleep quality, reducing from 9.5 to 7 (p<0.001). The Ayurvedic Manasabhava Scale also demonstrated a significant reduction in intensity (14 to 6; p<0.001) and frequency (13.5 to 6; p<0.001). Clinical Global Impression (CGI) scores showed stable illness severity, sustained global improvement, and consistent therapeutic efficacy. No adverse events were reported, and vital parameters remained normal throughout the study. Compliance with the medication was over 80%, and no significant changes were observed in laboratory values. Medhasagar Rasa effectively enhanced cognitive functions and alleviated anxiety and sleep disturbances in aging-related mild neurocognitive disorder, offering a promising therapeutic option.

Highly selective sodium-glucose co-transporter type 2 inhibitor empagliflozin as means of brain protection in conditions of chronic brain dyscirculation

Chronic brain dyscirculation is one of the frequent type 2 diabetes mellitus (DM) complications and leads to patients' disability. Sodium-glucose co-transporter type 2 inhibitors (SGLT-2i) have been proven to have advantages for cardiovascular system, but their effect on the central nervous system (CNS) has not been studied enough. To study empagliflozin effect on CNS damage functional and laboratory parameters in patients with type 2 DM and, under experimental conditions, to investigate the mechanisms of the drug neurotropic effect. The clinical part of the study included patients with type 2 DM on metformin monotherapy (n=39). Patients with a target glycated hemoglobin level formed the "MET" group (n=19), in patients with a non-target glycated hemoglobin level empagliflozin was co-administered for the following 6 months (the "MET+EMPA" group, n=20). Healthy volunteers comprised the control group (n=16). The cognitive status and neuron-specific enolase (NSE) and neurofilament light chains (NLC) concentration were studied. DM was modeled in rats, thereafter the rats were treated with empagliflozin for 8 weeks. Microglia activation was assessed using anti-Iba-1 antibodies and morphological changes in neurons when stained by the Nissl method. Both in the "MET+EMPA" and the "MET" groups cognitive deficits were observed, according to the Montreal Cognitive Assessment (MOCA) (24.0 (23.0; 27.0) and 25.0 (21.0; 27.0) points) and the Mini-Mental State Examination (MMSE) (23.75 (23.0; 27.0) and 25.0 (21.0; 27.0) points). Empagliflozin therapy led to the cognitive status normalization after 6 months (26.5 (24.0; 27.0) points according to the MOCA scale and 27.5 (24.0; 28.0) points according to the MMSE). Initially, all patients had a significant increase of NSE (3.60 (2.66; 3.76) ng/ml in the "MET" group, 3.22 (2.94; 3.54) ng/ml in the "MET+EMPA» group, 2.72 (2.13; 2.72) ng/ml in the «Control» group) and NLC (4.50 (3.31; 5.56) ng/ml in the «MET» group, 5, 25 (3.75; 6.25) ng/ml in the «MET+EMPA» group comparing with 3.50 (2.25; 3.50) ng/ml in the «Control» group). Empagliflozin therapy led to a significant decrease in NLC already after 3 months (3.80 (3.25; 3.87) ng/ml), without significant influence on the NSE level. In the experiment, DM was characterized by an increased number of activated microgliocytes and destructured neurons and a decreased number of neurons with a normal structure. Empagliflozin therapy was accompanied by a decrease in the number of immunopositive microgliocytes in the CA1 zone of the hippocampus and an increase in the number of structured neurons. Type 2 diabetes mellitus is characterized by functional and biochemical changes in the central nervous system even under satisfactory glycemic control. Therapy with empagliflozin has a neuroprotective effect, manifested in an improvement in cognitive status and a decrease in NLC level. Empagliflozin reduces neuronal damage and abnormal microglial activation.

Prevalence of and factors associated with cognitive frailty in elderly patients with chronic obstructive pulmonary disease: A cross-sectional study.

The status of cognitive frailty in elderly patients with chronic obstructive pulmonary disease (COPD) and its influencing factors in China remains unclear. This study aimed to investigate the prevalence of and factors associated with cognitive frailty in elderly patients with COPD. This cross-sectional study enrolled elderly patients with stable COPD between May and November 2022 from the Respiratory Department of the First Affiliated Hospital of Zhengzhou University and the Fifth Affiliated Hospital of Zhengzhou University. Convenience sampling method was adopted. Frailty Phenotype scale, Montreal Cognitive Assessment scale, Geriatric Depression Scale, and Clinical Dementia Rating scale were used to assess the prevalence of cognitive frailty in elderly patients with COPD. Multivariable logistic regression analysis was used to explore the associated factors. A total of 406 valid questionnaires were collected, and 173 patients (35.6%) had cognitive frailty. Binary logistic regression analysis showed that sex (odds ratio [OR] = 0.009; 95%CI: 0.001-0.770; P = .038), depression (OR = 17.780; 95%CI: 1.092-289.478; P = .043), modified Medical Research Council grade 1-3 (OR = 28.394-4095.683; 95%CI: 1.086-4,592,652.211; P < .05), global initiative for chronic obstructive lung disease grade 2 and 3 (OR = 32.508-282.072; 95%CI: 1.101-12,516.874; P < .05), and frequencies of acute exacerbations of COPD and hospitalizations within 1 year of 2 times (OR = 21.907; 95%CI: 4.587-104.622; P < .001) were independently associated with cognitive frailty. The prevalence of cognitive frailty in elderly patients with stable COPD was high. Female, depression, modified Medical Research Council grade, global initiative for chronic obstructive lung disease grade, and frequencies of acute exacerbations of COPD and hospitalizations within 1 year might be the factors independently associated with cognitive frailty, educational level might be a protective associated factor for cognitive frailty.

Depressive symptoms mediate the longitudinal relationships between sleep quality and cognitive functions among older adults with mild cognitive impairment: A cross-lagged modeling analysis

Although it is generally recognized that sleep quality, depressive symptoms, and cognitive functions are related respectively, the main ambiguity comes from difficulties in determining their cause-effect relationships. The present study aimed to explore the longitudinal causation relationships among sleep quality, depressive symptoms, and cognitive functions in older people with mild cognitive impairment (MCI). A total of 134 patients from 24 communities in Ningbo City, Zhejiang Province, China with MCI were interviewed at baseline, while 124 of them were re-interviewed 2 months later, and 122 were re-interviewed 4 months later. The Patient Health Questionnaire-9, the Pittsburgh Sleep Quality Index and the Montreal Cognitive Assessment Scale were assessed in the interview. Cross-lagged models were tested to disentangle the relationships among sleep quality, depressive symptoms, and cognitive functions using structural equation modeling with latent variables on the four-mouth longitudinal data. The correlation coefficients between sleep quality and depressive symptoms were significant showing the stability across time points of assessment, while the correlation coefficient of cognitive function was not significant (r = 0.159, p > 0.05). The results of index of model fit indicated that the cross-lagged model was acceptable (CFI = 0.934, TLI = 0.899, RMSEA = 0.075, χ2/df = 1.684). The results of cross-lagged model analysis supported the complete mediating role of depressive symptoms in the association between sleep quality and cognitive functions, where worse sleep quality may lead to more severe depressive symptoms, which in turn leads to more severe cognitive decline. In Conclusion, sleep quality is significantly correlated with cognitive functions in patients with mild cognitive impairment, which association is fully mediated by depressive symptoms. Approaches addressing sleep quality and depressive symptoms are recommended and hold promise for the management of mild cognitive impairment.

Olanzapine vs. magnesium valproate vs. lamotrigine in anti-N-methyl-D-aspartic acid receptor encephalitis: a retrospective study

BackgroundThis study aimed to compare the impact of olanzapine, magnesium valproate, and lamotrigine as adjunctive treatments for anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. And it is expected to add supporting points related to the rebalance of neurotransmitters in the brain through adjuvant therapy in the clinical management of anti-NMDAR encephalitis.MethodsThis retrospective study included patients diagnosed with anti-NMDAR encephalitis who received standardized immunotherapy at Hunan Brain Hospital between January 2018 and December 2020.ResultsCompared to the olanzapine group, both the magnesium valproate and lamotrigine groups showed lower scores on the positive and negative symptom scale (PANSS) total score after 3 weeks of treatment (all P < 0.05). The Montreal Cognitive Assessment Scale (MoCA) scores in the magnesium valproate and lamotrigine groups were significantly higher than in the olanzapine group after 3 weeks and 3 months of treatment (all P < 0.05). After 3 months of treatment, the proportions of patients with a modified Rankin scale score (mRS) of 0–1 in the magnesium valproate and lamotrigine groups were significantly higher than in the olanzapine group (all P < 0.05). The electroencephalogram (EEG) abnormality ranks at 3 months were significantly lower in the magnesium valproate and lamotrigine groups compared with the olanzapine group (all P < 0.05). Furthermore, the Glx/Cr ratio significantly decreased after 3 months of treatment (all P < 0.05) in the magnesium valproate and lamotrigine groups, while the Glx/Cr ratio in the olanzapine group showed no significant change (P > 0.05).ConclusionCompared with olanzapine, the addition of magnesium valproate or lamotrigine to immunotherapy might be associated with a lower PANSS score, higher MoCA score, and lower mRS score. The improvement of neurological functions and cognitive function may be related to the decreased Glx/Cr ratio.