Montreal Cognitive Assessment Scale Research Articles

DO HEALTH-RELATED FACTORS AFFECT SMARTPHONE USE IN ELDERLY INDIVIDUALS

The purpose of this study was to investigate the impact of physical and cognitive characteristics of elderly individuals living in nursing homes on their smartphone usage. The study included 67 volunteer individuals residing in a nursing home in Muğla. Sociodemographic characteristics and smartphone usage details of the individuals were questioned using a form prepared by the researchers. Participants' physical functions were assessed using the 6-Minute Walk Test, the 5 Times Sit-to-Stand Test, and the Berg Balance Scale. The Montreal Cognitive Assessment Scale (MoCA) was used to examine cognitive function. The mean age of the individuals included in the study was 74.18±3.26 years. A statistically significant moderate positive relationship was observed between the smartphone usage duration and MoCA score of the individuals (r=0.530, p0.05). As per the results of our study, an increase in smartphone usage duration has been seen to be associated with the preservation of cognitive abilities in elderly individuals. We believe that smartphones, which can provide access to various health services when used effectively, as well as meeting the socialization needs of individuals living in nursing homes, play an essential role in promoting active aging.

Possibilities of personalized pharmacotherapy and medical rehabilitation of patients with long COVID from the perspective of clinical metabolomics

Introduction. The material presents the results of the study of the effectiveness of the drug Ethylmethylhydroxypyridine malate in patients with long COVID, based on the dynamics of clinical manifestations and metabolomic parameters responsible for the level of oxidative stress. Aim. Evaluation of efficacy and registration of adverse reactions of ethylmethylhydroxypyridine malate administration to decrease oxidative stress level and reduce symptoms of asthenia and cognitive disorders in patients with long COVID. Materials and methods. 24 patients diagnosed with U09.9 “Condition after COVID-19 unspecified” were included in a non-randomized controlled prospective study, Patients were divided into 2 groups of 12 each. The experimental group received Ethylmethylhydroxypyridine malate tablets chewable 100 mg in a dosage of 400 mg/day. Clinical assessment by scales (mMRC dyspnea scale; 6-minute walk test (6MWT); MFI-20 subjective asthenia assessment scale; Montreal Cognitive Assessment Scale (MoCA); Barthel Baseline Functional Activity Rating Scale), and determination of metabolomic parameters were performed on days 1 and 14–18 of the study. Results. Use of the drug ethylmethylhydroxypyridine malate in patients with long COVID, led to a decrease in the level of oxidative stress, and normalization of mitochondrial function, as well as more pronounced improvements of the clinical picture. According to the scale of evaluation of asthenia (MFI-20) in the group of patients who received ethylmethylhydroxypyridine malate improvement of 21% was noted, in the control group improvement of 13% was noted. According to cognitive impairment assessment scale (MoCA), the drug group showed 20% improvement, while the control group showed 12,5% improvement. Conclusion. The drug ethylmethylhydroxypyridine malate tablets chewable 100 mg in a dosage of 400 mg/day demonstrates clinical efficacy characterized by, among other things, a decrease in oxidative stress, as well as clinical safety due to the absence of development of adverse reactions in patients with long COVID.

Use of SGLT2 inhibitors in the treatment of cognitive disorders

Background:Dementia is a progressive and irreversible disease entity that affects memory, verbal fluency, thinking and the performance of daily activities.The most common type of dementia is alzheimer's disease(AD).Currently, there are no specific therapies with established efficacy against cognitive decline or AD.Objective:The aim of this study is to summarize the current knowledge about the effectiveness of SGLT2 inhibitors(SGLT2i) in the treatment of cognitive disorders.Method and material:The article was created based on the PubMed database and the Polish Journal of Endocrinology.Articles were searched in English using the following keywords: SGLT2ihibitors;dementia;Alzheimer type 3 diabetes mellitus.State of knowledge:Patients with type 2 diabetes (TD2) are 1.5-2 times more likely to develop dementia than the general population.Dementia among diabetic patients is characterized by an earlier age of onset, slightly worse overall cognitive status and a higher prevalence of cognitive impairment in male patients.Diabetes and pre-diabetes shorten the time from the onset of mild cognitive impairment (MCI) to the development of full-blown dementia.Conclusions:The use of SGLT2i is associated with reduced mortality from dementia, in contrast to insulin and sulfonylurea derivatives.SGLT2 inihibitors prevent cognitive impairment more potently than dipeptidylpeptidase-4 inhibitors. Taking empagliflozin for one month, is associated with improved cognitive function and increased scores on the Montreal Cognitive Assessment scale.

EFFECT OF COGNITIVE REMEDIATION THERAPY PACKAGE ON COGNITIVE FUNCTIONS AND QUALITY OF LIFE AMONG ELDERLY AT SELECTED OLD AGE HOMES

Background: Old age, also called senescence, in human beings, the nal stage of the normal life span. Cognitive function declines with advancing age particularly in elderly people. Mild Cognitive Impairment (MCI) is an intermediate phase between normal cognitive ageing and overt dementia. ·To assess and compare Objectives: pre & post-test level of cognitive functions and quality of life among elderly before cognitive remediation therapy package, both in experimental and control group.·To evaluate the effectiveness of cognitive remediation therapy package on cognitive functions and quality of life among elderly, both in experimental and control group. To correlate the mean differed score of cognitive functions and quality of life among elderly, both in experimental and control group Methodology: A quasi experimental research design was adopted. After screening a total 20 elderly people, 10 for each experimental and control group were selected were selected by using non probability purposive sampling technique in a selected old age homes. The pre test data was collected through the structured interview schedule, cognitive functions were assessed by Montreal Cognitive Assessment scale and quality of life was assessed by WHO bref scale. Cognitive remediation therapy was given for a period of 6 weeks and post test was conducted. Collected data were analysed by using descriptive and inferential statistics. There Results: was a statistically signicant difference in the post test level of cognitive functions and quality of life after administration of cognitive remediation package. Effectiveness of cognitive remediation therapy package of Cognitive functions score was from 60% to 80%, percentage gain score was 20% and QOL score was from 50% to 66%, percentage gain score was 16%.The comparison mean score was statically signicant in post test cognitive functions and QOL score. (p=0.001). There was a signicant positive fair corelation between cognitive functions and QOL in experimental group, there was a signicant positive poor corelation between cognitive functions and QOL in control group. The overall statisticall Conclusion: y signicant difference in the level cognitive functions and quality of life was revealing the effectiveness of the intervention. Nurse directed cognitive remediation therapy was effective in signicantly enhancing the cognitive functions and quality of life thereby reducing the impact of cognitive impairment among elderly

Parameters of Auditory Evoked Related Potentials P300 in Disorders of Different Cognitive Function Domains (Visuospatial/Executive and Memory) in Elderly Hypertensive Persons.

The neurophysiological correlates of certain types of cognitive impairment in relation to the spatial pattern of auditory cognitive evoked-related potentials (ERPs) in hypertensive persons remain unclear. The aim of this study was to determine the parameters of ERPs (N200, P300) in impaired different domains (visuospatial/executive and memory) of cognitive function in arterial hypertension, including cardiovascular ischemic events. A total of 46 patients (65-84 years) were observed. The clinical diagnosis of vascular dementia, the Montreal Cognitive Assessment Scale (MoCA test) and the spatial pattern of ERPs (N200, P300) were the parameters used to identify three groups: the Control Group without cognitive impairment (n = 13), the group with a leading memory disturbance (Memory Group, n = 20) and the group with a leading visuospatial/executive disturbance (VS/E Group, n = 13). In persons belonging to the Memory Group, N2 latency was prolonged in the central (C3 C4) and right parietal (P4) brain parts; latency of the motor component (P300) may remain similar to that of the ControlGroup. In persons belonging to theVS/E Group, maximal prolonged recognition time (N2), especially in the left central (C3), frontal-midline (Fz), right parietal (P3) and temporal (P4) brain parts, was observed; P300 latency in the central-midline (Cz) and left anterior-temporal (F7) brain parts among all the groups was revealed.

Post-COVID-19 syndrome among healthcare workers in Jordan.

Post-COVID-19 syndrome covers a wide range of new, recurring or ongoing health conditions, which can occur in anyone who has recovered from COVID-19. The condition may affect multiple systems and organs. To evaluate the frequency and nature of persistent COVID-19 symptoms among healthcare providers in Jordan. Post-COVID-19 syndrome refers to symptoms extending beyond 4-12 weeks. We conducted a historical cohort study among 140 healthcare staff employed at the National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan. All of them had been infected with COVID-19 virus during March 2020 to February 2022. Data were collected through face-to-face interviews using a structured questionnaire. Some 59.3% of the study population reported more than 1 persisting COVID-19 symptom, and among them 97.5%, 62.6% and 40.9% reported more than 1 COVID-19 symptom at 1-3, 3-6 and 6-12 months, respectively, after the acute phase of the infection. Post-COVID-19 syndrome was more prevalent among females than males (79.5% vs 20.5%) (P = 0.006). The most frequent reported symptom was fatigue. Females scored higher on the Fatigue Assessment Scale than males [23.26, standard deviation (SD) 8.00 vs 17.53, SD 5.40] (P < 0.001). No significant cognitive impairment was detected using the Mini-Mental State Examination and the Montreal Cognitive Assessment scales. More than half (59.3%) of the healthcare workers in our study reported post-COVID-19 syndrome. Further studies are needed to better understand the frequency and severity of the syndrome among different population groups.

The Mediating Role of Sleep Quality in the Association Between Negative Affect and Cognitive Function Among Patients With Nasopharyngeal Carcinoma After Intensity-Modulated Radiotherapy.

Cognitive function impairment is a severe yet largely unrecognized adverse reaction among patients with nasopharyngeal carcinoma (NPC) following radiotherapy. The aims of this study were to examine the level of cognitive function, explore the influencing factors of the cognitive function of NPC after intensity-modulated radiotherapy (IMRT), and identify the mediating role of sleep quality between negative affect and cognitive function. In total, 200 patients with NPC after IMRT were recruited from a tertiary cancer center in Southern China between September 2020 and March 2021. Participants completed the demographic and disease-related questionnaire, Montreal Cognitive Assessment Scale, Profile of Mood States-Short Form, and Pittsburgh Sleep Quality Index. The mean Montreal Cognitive Assessment Scale scores were 24.42 after adjustment, with 54.5% of patients having cognitive function impairment. Education level, income, seeking rehabilitation knowledge, radiation dose, sleep quality, and negative affect entered the final regression model and explained 82.6% of cognitive function variance. The total and direct effects of negative affect and indirect effects via sleep quality on cognitive function were significant ( P < .05). Clinicians should pay close attention to patients with poor educational levels, low income, and having difficulties seeking rehabilitation knowledge and patients who accept higher radiation doses. Improving their sleep quality and positive affect may contribute to preventing or reducing cognitive function impairment. Clinical nurses should pay more attention to cognitive function among NPC patients after IMRT and take effective measures or interventions to prevent and reduce their cognitive function impairment.

Altered brain networks and connections in chronic heart failure patients complicated with cognitive impairment.

Accumulating evidence shows that cognitive impairment (CI) in chronic heart failure (CHF) patients is related to brain network dysfunction. This study investigated brain network structure and rich-club organization in chronic heart failure patients with cognitive impairment based on graph analysis of diffusion tensor imaging data. The brain structure networks of 30 CHF patients without CI and 30 CHF patients with CI were constructed. Using graph theory analysis and rich-club analysis, changes in global and local characteristics of the subjects' brain network and rich-club organization were quantitatively calculated, and the correlation with cognitive function was analyzed. Compared to the CHF patients in the group without CI group, the CHF patients in the group with CI group had lower global efficiency, local efficiency, clustering coefficient, the small-world attribute, and increased shortest path length. The CHF patients with CI group showed lower nodal degree centrality in the fusiform gyrus on the right (FFG.R) and nodal efficiency in the orbital superior frontal gyrus on the left (ORB sup. L), the orbital inferior frontal gyrus on the left (ORB inf. L), and the posterior cingulate gyrus on the right (PCG.R) compared with CHF patients without CI group. The CHF patients with CI group showed a smaller fiber number of edges in specific regions. In CHF patients with CI, global efficiency, local efficiency and the connected edge of the orbital superior frontal gyrus on the right (ORB sup. R) to the orbital middle frontal gyrus on the right (ORB mid. R) were positively correlated with Visuospatial/Executive function. The connected edge of the orbital superior frontal gyrus on the right to the orbital inferior frontal gyrus on the right (ORB inf. R) is positively correlated to attention/calculation. Compared with the CHF patients without CI group, the connection strength of feeder connection and local connection in CHF patients with CI group was significantly reduced, although the strength of rich-club connection in CHF patients complicated with CI group was decreased compared with the control, there was no statistical difference. In addition, the rich-club connection strength was related to the orientation (direction force) of the Montreal cognitive assessment (MoCA) scale, and the feeder and local connection strength was related to Visuospatial/Executive function of MoCA scale in the CHF patients with CI. Chronic heart failure patients with CI exhibited lower global and local brain network properties, reduced white matter fiber connectivity, as well as a decreased strength in local and feeder connections in key brain regions. The disrupted brain network characteristics and connectivity was associated with cognitive impairment in CHF patients. Our findings suggest that impaired brain network properties and decreased connectivity, a feature of progressive disruption of brain networks, predict the development of cognitive impairment in patients with chronic heart failure.

New‑onset non‑motor symptoms in patients with Parkinson's disease and post‑COVID‑19 syndrome: A prospective cross‑sectional study.

The clinical range of post-coronavirus disease 2019 (COVID-19) symptoms in patients with Parkinson's disease (PD) has not yet been thoroughly characterized, with the exception of a few small case studies. The aim of the present study was to investigate the motor and non-motor progression of patients with PD (PWP) and post-COVID-19 syndrome (PCS) at baseline and at 6 months after infection with COVID-19. A cross-sectional prospective study of 38 PWP+/PCS+ and 20 PWP+/PCS- matched for age, sex and disease duration was conducted. All patients were assessed at baseline and at 6 months using a structured clinicodemographic questionnaire, the Unified Parkinson's Disease Rating Scale Part III (the UPDRS III), the Montreal Cognitive Assessment, the Hoehn and Yahr scale, the Geriatric Depression Scale and the levodopa equivalent daily dose (LEDD). There was a statistically significant difference in the LEDD (P=0.039) and UPDRS III (P=0.001) at baseline and at 6 months after infection with COVID-19 between the PWP with PCS groups. The most common non-motor PCS symptoms were anosmia/hyposmia, sore throat, dysgeusia and skin rashes. There was no statistically significant difference in demographics or specific scores between the two groups, indicating that no prognostic factor for PCS in PWP could be identified. The novelty of the present study is that it suggests the new onset of non-motor PCS symptoms of PWP with a mild to moderate stage.

Plasma Inflammatory Biomarkers Are Associated With Poststroke Cognitive Impairment: The Nor-COAST Study.

Inflammation is proposed to be involved in the pathogenesis of poststroke cognitive impairment. The aim of this study was to investigate associations between concentrations of systemic inflammatory biomarkers after ischemic stroke and poststroke cognitive impairment. The Nor-COAST study (Norwegian Cognitive Impairment After Stroke) is a prospective observational multicenter cohort study, including patients hospitalized with acute stroke between 2015 and 2017. Inflammatory biomarkers, including the TCC (terminal C5b-9 complement complex) and 20 cytokines, were analyzed in plasma, collected at baseline, 3-, and 18 months poststroke, using ELISA and a multiplex assay. Global cognitive outcome was assessed with the Montreal Cognitive Assessment (MoCA) scale. We investigated the associations between plasma inflammatory biomarkers at baseline and MoCA score at 3-, 18-, and 36-month follow-ups; the associations between inflammatory biomarkers at 3 months and MoCA score at 18- and 36-month follow-ups; and the association between these biomarkers at 18 months and MoCA score at 36-month follow-up. We used mixed linear regression adjusted for age and sex. We included 455 survivors of ischemic stroke. Higher concentrations of 7 baseline biomarkers were significantly associated with lower MoCA score at 36 months; TCC, IL (interleukin)-6, and MIP (macrophage inflammatory protein)-1α were associated with MoCA at 3, 18, and 36 months (P<0.01). No biomarker at 3 months was significantly associated with MoCA score at either 18 or 36 months, whereas higher concentrations of 3 biomarkers at 18 months were associated with lower MoCA score at 36 months (P<0.01). TCC at baseline and IL-6 and MIP-1α measured both at baseline and 18 months were particularly strongly associated with MoCA (P<0.01). Higher concentrations of plasma inflammatory biomarkers were associated with lower MoCA scores up to 36 months poststroke. This was most pronounced for inflammatory biomarkers measured in the acute phase following stroke. URL: https://www. gov; Unique identifier: NCT02650531.

Association of Cerebral Hemodynamics and Cognitive Function in Adult Patients with Moyamoya Disease: A Three-Dimensional Pseudo-Continuous Arterial Spin Labeling Study

Cognitive dysfunction is a serious complication of moyamoya disease (MMD) in adults, and reduced cerebral blood flow (CBF) might be the potential cause. We aimed to explore the correlation between cerebral hemodynamics and cognitive function in adults with MMD by using three-dimensional pseudo-continuous arterial spin labeling (3D-pCASL). A total of 24 MMD patients with a history of cerebral infarction, 25 asymptomatic MMD patients, and 25 healthy controls were prospectively enrolled in this study. All participants were performed 3D-pCASL, and cognitive function was evaluated with the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment Scale (MoCA), and the Trail Making Test Part A (TMTA). The correlation between cerebral hemodynamics and cognitive function was explored in the region of interest-based analysis. Compared with healthy controls, both CBF and cognition decreased in adult MMD. In the infarction group, the MMSE and MoCA scores correlated with CBF of the right anterior cerebral artery (P=0.037 and 0.010, respectively) and the left middle cerebral artery (MCA) cortical territories (P=0.002 and 0.001, respectively), and the TMTA time-consuming has a negative correlation with CBF of the right and left MCA cortical territories (P=0.044 and 0.010, respectively); in the asymptomatic group, the MMSE and MoCA scores correlated with CBF of the left MCA cortical territory (P=0.032 and 0.029, respectively). The 3D-pCASL can find the hypoperfusion area of CBF in adults with MMD, and hypoperfusion in specific brain regions may cause cognitive dysfunction even in asymptomatic patients.

The Relevance of Serum Macrophage Migration Inhibitory Factor Level and Executive Function in Patients with White Matter Hyperintensity in Cerebral Small Vessel Disease

(1) Objective: To investigate the relationship between serum macrophage migration inhibitory factor (MIF) level and white matter hyperintensity (WMH) and executive function (EF) in cerebral small vascular disease (CSVD), and assess the impact and predictive value of MIF level and Fazekas scores in CSVD-related cognitive impairment (CI) (CSVD-CI); (2) Methods: A total of 117 patients with WMH admitted to the First Affiliated Hospital of Xinxiang Medical College from January 2022 to August 2022 were enrolled. According to the Montreal cognitive assessment (MoCA) scale, subjects were divided into a normal cognitive group and an impaired group. All subjects required serum MIF level, 3.0 T MRI, and neuropsychological evaluation to investigate the risk factors for CDVD-CI, analyze the correlation between MIF level, WMH, and EF, and to analyze the diagnostic value of MIF and WMH degree in predicting CSVD-CI; (3) Results: 1. Fazekas score and MIF level were the risk factors of CSVD-CI. 2. The Fazekas score was negatively correlated with MoCA score, positively correlated with Stroop C-Time, Stroop C-Mistake, Stroop interference effects (SIE)-Time, SIE-Mistake, and color trails test (CTT) interference effects (CIE) (B-A). 3. The MIF level was positively correlated with Fazekas score, Stroop C-Time, SIE-Time, CTT B-Time, and CIE (B-A), and negatively correlated with MoCA score. 4. Fazekas score and MIF level were significant factors for diagnosing CSVD-CI; (4) Conclusion: The Fazekas score and MIF level may be the risk factors of CSVD-CI, and they are closely correlated to CI, especially the EF, and they have diagnostic value for CSVD-CI.

Effect of Goal-directed Fluid Therapy on Postoperative Cognitive Dysfunction in Elderly Patients Undergoing Combined Lingual and Cervical Radical Surgery

Background: The intraoperative rehydration technique known as the effect of Goal-Directed Fluid Therapy (GDFT), which is guided by the dynamic monitoring of volume responsiveness, has received a lot of attention recently. According to a meta-analysis by Bene, GDFT can maintain intraoperative hemodynamic stability, which lowers the incidence of postoperative complications and reduces stay at the intensive care unit. Objectives: This study aimed to determine how GDFT affected elderly patients who underwent combined lingual and cervical radical surgery after an operation for postoperative cognitive dysfunction (POCD). Methods: This interventional study was conducted between December 2021 and December 2022 in a medical center affiliated with Fujian Medical University on people undergoing radical neck and tongue surgery for tongue cancer. The samples (n=36) were selected using an availability sampling method and randomly divided into conventional fluid therapy (the Non-GDFT, n=18) and GDFT (n=18) groups. The Non-GDFT group was hydrated normally during anesthesia. A continuous infusion of 8 mL/(kg/h) of compounded sodium chloride was administered to the GDFT group to maintain basal hydration volume during the operation. Before and following surgery, Montreal Cognitive Assessment Scale scores were completed, arterial blood lactate values and bilateral cerebral oxygen saturation levels were measured at various times following the stabilization of anesthesia, and the levels of interleukin 6 (IL-6) and S100 protein in venous blood were calculated. Results: The Non-GDFT group had a higher incidence of POCD than the GDFT group, the GDFT group had significantly lower levels of IL-6 and S100 than the Non-GDFT group, the GDFT group had significantly lower levels of serum lactate than the Non-GDFT group. The GDFT group experienced significantly lower rates of intraoperative hypotensive and intraoperative low rSO2 events than the Non-GDFT group, and this difference was statistically significant (P&lt;0.05). Conclusion: Assuring the balance of cerebral oxygen supply and demand, lowering the production of inflammatory mediators, and successfully reducing the incidence of POCD are all possible benefits of GDFT.

Correlation between resilience and cognitive functioning in veterans with traumatic brain injury

Resilience in veterans with brain trauma in remote period has received considerable attention over the past years. Cognitive functioning is described among factors that may influence resilience and included in the modern theoretical models of this positive psychology phenomenon. However, the characteristics of relationship between resilience and cognitive functioning in veterans with traumatic brain injury (TBI) in remote period was not studied empirically. Therefore, the purpose of this study was to gain better understanding of the possible association between resilience and cognitive functioning in Ukrainian war veterans with traumatic brain injury in remote period. This study included 146 veterans who were admitted to two clinical hospitals for war veterans. The Connor-Davidson Resilience Scale and Montreal Cognitive Assessment Scale were used. The present study shows that lower cognitive functioning in total and in several domains is associated with less effective resilience regardless of TBI clinical type (whether it is concussion or mild cerebral contusion). Moreover, such correlation was still present after excluding the effect of age, education and TBI characteristics like number of traumas and time since last TBI. Overall, we found empirical evidence that good cognitive functioning (especially executive functions, memory, attention, abstract thinking, and orientation) is essential for effective resilience in veterans with mild TBI even years after trauma and has more effect on ability to adapt than age, education, and trauma characteristics. Educating veterans to use their cognitive potential and to compensate the restrictions after mild TBI possibly may lead to better overcoming adversities and counteracting the risks of des­adaptation and traumatic events. Therefore, psychological interventions for improving the ability to readapt and recover possibly should consider this relationship and include the component of educating veterans to use their cognitive reserve and compensate limitations to better adapt and thrive. Studies related to such interventions appear to be promising.

Clinical Values of Serum Uric Acid Levels in the Occurrence of Cognitive Impairment in Alcohol-Dependent Patients.

Studies have confirmed that uric acid is involved in the regulation of cognitive function. This study aimed to investigate the expression of serum uric acid in alcohol-dependent patients and evaluate its clinical diagnostic value for cognitive impairment. Blood sample was collected for assessment of serum uric acid levels. Montreal Cognitive Assessment Scale scores were obtained to assess cognitive function. Anxiety and depression scores on the Symptom Check List 90 scale were used to assess mental health status. The alcohol-dependent patients were divided into non-cognitive impairment and cognitive impairment groups according to Montreal Cognitive Assessment Scale score, and the serum uric acid levels of these groups were analyzed. The receiver operating characteristic curve evaluated the diagnostic value of serum uric acid in cognitive impairment patients. Pearson correlation coefficient evaluated the correlation between uric acid and Montreal Cognitive Assessment Scale score, anxiety score, and depression score. Multivariate logistic regression analyzed the association between each index and cognitive impairment in patients. Serum uric acid was higher in patients than in controls (P < .001). Uric acid was significantly increased in cognitive impairment patients than in non-cognitive impairment patients (P < .001). Serum uric acid has certain diagnostic value in patients with cognitive impairment. Anxiety score and depression score were positively correlated with uric acid level, while Montreal Cognitive Assessment Scale score was negatively correlated with uric acid. Additionally, serum uric acid, Montreal Cognitive Assessment Scale score, and anxiety and depression scores were the risk factors for cognitive impairment in patients (P < .05). The abnormal expression of uric acid has a high diagnostic accuracy for distinguishing cognitive impairment from non-cognitive impairment.

Correlation between cognitive impairment and serum phosphorylated tau181 protein in patients with preeclampsia.

To study the cognitive function status, serum phosphorylated tau181 (P-tau181) protein level, and total tau (T-tau) protein level in patients with preeclampsia (PE), pregnant healthy controls (PHCs), and non-pregnant healthy controls (NPHCs), and to research their feasibility as serum biomarkers for evaluating cognitive functional impairment in PE patients. Sixty-eight patients with PE, 48 NPHCs, and 30 PHCs were included. Cognitive functional status was assessed using standardized Symbol Digit Modalities Test (SDMT) and Montreal Cognitive Assessment (MoCA) scales. Enzyme-linked immunosorbent assay (ELISA) was used to detect the level of serum P-tau181 and T-tau protein. The concentration of serum P-tau181 and T-tau protein were compared by one-way analysis of variance in the three groups of subjects. The correlation between P-tau181, T-tau, and SDMT was explore by multiple linear regression analysis. The areas under the receiver operating characteristic (ROC) curves of serum P-tau181 and SDMT were calculated to predict the cognitive level of subjects. PE patients significantly had lower scores on SDMT (47.97 ± 7.54) and MoCA (28.00 ± 2.00) than normotensive PHCs (30.00 ± 1.25, 54.73 ± 8.55, respectively). The significant difference was found in serum P-tau181 protein levels among the three groups [H(K) = 19.101, P < 0.001]. Serum P-tau181 was thicker in PE patients than PHCs or NPHCs (both P < 0.05). According to the ROC curve, T-tau had no statistical significance in predicting the ability of cognizance, while P-tau181 and SDMT had. The DeLong test showed that P-tau181 was better than T-tau in predicting the ability of cognizance (P < 0.05). The patients with PE have occurred the decline of cognitive function during pregnancy. The high level of serum P-tau181 can be used as a clinical laboratory indication for non-invasive assessment of cognitive functional impairment in PE patients.

Nonlinear relationship between glycated hemoglobin and cognitive impairment after acute mild ischemic stroke

BackgroundStroke is the second most common cause of morbidity and mortality. Even mild stroke survivors have an increased risk of cognitive impairment. Studies have been conducted on the relationship between glycated hemoglobin (HbA1c) and cognitive decline, but the findings have been inconsistent. Therefore, this study examined the link between HbA1c levels and cognitive impairment following acute mild ischemic stroke.MethodsData from 311 patients with acute mild ischemic stroke admitted to Suining Central Hospital, Sichuan Province, China, from January 1, 2015, to December 31, 2018, were evaluated. Fasting venous blood was taken to assess HbA1c levels on the day after admission. Cognitive function was assessed using the Chinese version of the Montreal Cognitive Assessment Scale (MoCA) 3–6 months after stroke onset. We used a generalized additive model and smooth curve fitting (penalty spline method) to assess the nonlinear relationship between HbA1c and poststroke cognitive impairment (PSCI).ResultsThis study included 311 patients aged 23 to 96 years old (mean age: 67.37 ± 11.92 years), of whom 198 (63.67%) were men. Among the 311 stroke patients, 120 (38.59%) had PSCI. After adjusting for potential confounders, there was a nonlinear relationship between HbA1c and PSCI, with an inflection point of 8.2. To the left of the inflection point, the effect size, 95% confidence interval, and P value were 0.87, 0.58 to 1.31, and 0.5095, respectively; however, to the right of the inflection point, these numbers were 1.96, 1.08 to 3.58, and 0.0280.ConclusionWe found a nonlinear relationship between HbA1c and PSCI. When HbA1c was greater than 8.2%, HbA1c was positively correlated with PSCI.

Inflammatory biomarkers and lipid metabolism parameters in women with mild cognitive impairment and dementia

ABSTRACT The detection of specific markers of dementia and mild cognitive decline (MCI) could be the key to disease prevention and forehanded treatment. Female gender is one of the major risk factor for dementia. The aim of our study was to compare serum concentration of some factors related to lipid metabolism and the immune system in patients with MCI and dementia. The study was performed on women >65 years old: controls (n = 75), diagnosed with dementia (n = 73) and MCI (n = 142). Patients were evaluated using Mini-Mental State Examination, Clock Drawing Test and Montreal Cognitive Assessment scales in the period 2020–2021. The level of Apo A1 and HDL was significantly decreased in patients with dementia; the level of Apo A1 was also decreased in MCI. EGF, eotaxin-1, GRO-α, and IP-10 were elevated in patients with dementia compared to the controls. IL-8, MIP-1β, sCD40L, and TNF-α levels were decreased in MCI patients and increased in patients with dementia compared to the control. Serum VEGF levels were decreased in MCI and dementia patients in comparison with the control. We hypothesize that no single marker can indicate a neurodegenerative process. Future research should focus on identifying markers to determine possible diagnostic combinations that can reliably predict neurodegeneration.

Association between cognitive impairment and motor dysfunction among patients with multiple sclerosis: a cross-sectional study

BackgroundPrevious studies have shown that there is a relationship between cognitive impairment (CI) and motor dysfunction (MD) in neurological diseases, such as Alzheimer’s and Parkinson’s disease. However, there whether CI and MD are associated in patients with multiple sclerosis (MS) is unknown. Here we studied the association between CI and MD in patients with MS and examined if muscle weakness or incoordination, balance impairment, gait abnormalities, and/or increased fall risk are indicators of CI in patients with MS.MethodsSeventy patients with MS were included in this cross-sectional study. Cognitive impairment was assessed using the Montreal Cognitive Assessment Scale (MoCA), muscle strength using a hand-held dynamometer, and balance, gait, and fall risk assessment using the Tinetti scale. Motor coordination was assessed using the timed rapid alternating movement test for the upper extremity and the timed alternate heel-to-knee test for the lower extremity.ResultsThere was a significant association between CI and motor coordination, balance, gait, and risk of fall (p < 0.005) but not muscle strength. Stepwise multiple linear regression showed that 22.7% of the variance in the MoCA was predicted by the fall risk and incoordination of the upper extremities in the MS population.ConclusionsCI is significantly associated with motor incoordination, balance impairment, gait abnormality, and increased fall risk. Furthermore, the risk of fall and upper extremity incoordination appeared to be best indicators of CI in patients with MS.

Plasma Lipoprotein-Associated Phospholipase A2 Affects Cognitive Impairment in Patients with Cerebral Microbleeds.

The plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) is an inflammatory biomarker of cerebral microbleeds (CMBs) and may be related to the occurrence, development, and prognosis of cognitive impairment. The present study aimed to investigate the impact of plasma Lp-PLA2 level on the cognitive impairment in patients with CMBs. In this study, 213 patients with CMBs confirmed by 3.0 T brain magnetic resonance imaging (MRI) were analyzed. Lp-PLA2 levels were determined by magnetic particle chemiluminescence immunoassay technology, and cognitive function was assessed using the Montreal Cognitive Assessment Scale (MoCA). The cognitive functions of patients with CMBs were divided into three groups according to the MoCA scale, including normal cognition (NC), mild cognitive impairment (MCI), and moderate-severe cognitive impairment (MSCI). Clinical, laboratory and radiological data of the three groups were analysed. The relationship between plasma Lp-PLA2 and MoCA score in patients with CMBs was investigated through rank correlation analysis and multivariate regression analysis, and receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of Lp-PLA2. CMBs were detected in 213 (30.2%) of 705 patients who underwent 3.0 T MRI. Multiple comparisons showed that plasma Lp-PLA2 in patients with CMBs with normal cognitive scores was significantly lower than that in the other two groups with cognitive impairment (p < 0.05). In the single factor correlation analysis, high level of plasma Lp-PLA2 was negatively correlated with the decrease of MoCA score in patients with CMBs (r =-0.389, p < 0.01). Multivariate regression analysis showed that high plasma Lp-PLA2 was an independent risk factor for a low MoCA score in patients with CMBs (odds ratio [OR]=1.014; 95% confidence interval [CI], 1.002-1.026; p=0.025). A high level of plasma Lp-PLA2 is positively correlated with the generation of cognitive impairment in patients with CMBs and negatively correlated with the degree of impairment. Plasma Lp-PLA2 is an important indicator of cognitive impairment in patients with CMBs and may provide a therapeutic target for preventing CMB-induced cognitive impairment.