Normal Cognitive Function Research Articles

Correlation between fat-to-muscle mass ratio and cognitive impairment in elderly patients with type 2 diabetes mellitus: a cross-sectional study

BackgroundFat to muscle mass ratio (FMR), a novel index integrating fat and muscle composition, has garnered attention in age-related conditions such as type 2 diabetes mellitus (T2DM) and neurodegenerative diseases. Despite this research on the relationship between FMR and cognitive impairment (CI) in T2DM remains scarce. This study aimed to investigate the sex-specific association between FMR and CI in elderly T2DM patients.MethodsA total of 768 elderly (> 60 years) T2DM in-patients (356 men and 412 women) were recruited from the Department of Endocrinology at Tianjin Nankai University affiliated hospital. Bioelectrical Impedance Analysis (BIA) was used to assess body composition, and Montreal Cognitive Assessment (MoCA) was used to evaluate cognitive performance. T2DM patients were categorized into normal cognitive function (NC) and cognitive impairment (CI) groups based on MoCA scores and stratified by sex. Binary logistic regression was employed to examine the association between FMR and CI.ResultsAmong the participants, 42.7% of men and 56.3% of women experienced cognitive deterioration. Women with CI exhibited lower body mass index (BMI) and skeletal muscle mass index (SMI), while men with cognitive disorders showed lower SMI, FMR, and higher fat mass index (FMI). FMR was consistently unrelated to cognition in females, irrespective of adjustment made. However, in males, FMR was significantly associated with an increasing risk of cognitive dysfunction after adjusting for demographic and clinical variables (OR: 1.175, 95% CI: 1.045–1.320, p = 0.007). Furthermore, for each 0.1 increase in FMR, the incidence of CI rose by 31.1% after additional adjustment for BMI. In males, the prevalence of CI increased sequentially across FMR quartiles (p < 0.05).ConclusionElderly T2DM men with high FMR had unfavorable cognitive function. FMR is independently associated with an increased risk of CI in male T2DM patients regardless of BMI.

The Benson Complex Figure Test: Normative Data for the Healthy Iranian Population

Purpose: Visual-related abilities such as visual memory and visuo-constructional skills are among the cognitive abilities with fundamental importance for normal cognitive function, and their impairment is manifested in many neurological and psychiatric disorders. The present study aimed to generate normative data for the Benson Complex Figure Test (BCFT), a well-known simplified version of the Rey-Osterrieth Complex Figure Test, in Iran and to assess the effect of demographic variables of age, gender, and education on its various measures. Materials and Methods: The present study was conducted in 2017-2018 as part of the Iranian Brain Imaging Database (IBID) project. The study sample consisted of 300 normal individuals in the age range of 20 to 70 years, with an equal number of participants and an equal proportion of genders in each age decade (#60). Independent and dependent variables, respectively, were age (classified by five decades including 20-30-year-olds, 31-40-year-olds, 41-50-year-olds, 51-60-year-olds, and 61-70-year-olds) and performance in the BCFT (defined in terms of 3 scores on a copy, recall, and recognition of the geometric figure and 2 scores on time of copy and recall). Results: The correlation matrix among the variables showed that age and education have a significant correlation with most of the BCFT scores, while gender only has a significant correlation with recognition score. Multivariate analysis of variance showed the effect of age, gender, and their interaction on scores, while education did not make a significant difference in the BCFT scores. Also, the t-test showed a significant difference between men and women in recall and recognition, so women and men showed better performance in recall and recognition, respectively. Conclusion: In summary, our results suggest that demographic variables of age, gender, and education affect visual memory and visuospatial abilities, and it is essential to generate normative data for research or clinical settings.

Color discrimination in fixed saturation level of patients with acute traumatic injury.

Traumatic brain injury (TBI) is an important public health concern and that may lead to severe neural sequels, such as color vision deficits. We evaluated the color vision of 10 TBI patients with normal cognitive function using a color discrimination test in a fixed saturation level. We also analyzed computerized tomography scans to identify the local of the brain damages. Four TBI patients that had lesions in brain areas of the ventral visual streams, five TBI patients had lesions inferred in brain areas of the dorsal visual stream, and one TBI patient had lesion in the occipital area. All the patients had cognitive and color vision screened and they had characterized the chromatic discrimination at high and low saturation. All participants had no significant cognitive impairment in the moment of the color vision test. Additionally, they had perfect performance for discrimination of chromatic stimulus at high saturation and similar to controls (n = 37 age-matched participants). Three of four TBI patients with lesions in the ventral brain and one patient with lesion in the occipital area had impairment of the chromatic discrimination at low saturation. All TBI patients with lesions in the dorsal brain had performance similar or slightly worse than the controls. Chromatic discrimination at low saturation was associated to visual damage in the ventral region of the brain and is a potential tool for functional evaluation of brain damage in TBI patients.

High Frequency of Cognitive and Behavioral Impairment in Amyotrophic Lateral Sclerosis Patients with SOD1 Pathogenic Variants.

While the cognitive-behavioral characteristics of amyotrophic lateral sclerosis (ALS) patients carrying C9orf72 pathological repeat expansion have been extensively studied, our understanding of those carrying SOD1 variants is mostly based on case reports. The aim of this paper is to extensively explore the cognitive-behavioral characteristics of a cohort of ALS patients carrying pathogenetic variants of SOD1 gene, comparing them to patients without pathogenetic variants of 46 ALS-related genes (wild-type [WT]-ALS) and healthy controls. All ALS patients seen at the Turin ALS expert center in the 2009-2021 period who underwent both cognitive/behavioral and extensive genetic testing were eligible to be included in the study. Only patients with SOD1 pathogenetic variants (n = 28) (SOD1-ALS) and WT-ALS (n = 829) were enrolled in the study. A series of 129 controls was also included. Among the 28 SOD1-ALS patients, 16 (57.1%) had normal cognitive function, 5 (17.9%) isolated cognitive impairment (ALSci) (17.9%), 6 (21.4%) isolated behavioral impairment (ALSbi), 1 (3.6%) cognitive and behavioral impairment (ALScbi), and no one ALS-FTD. SOD1-ALS performed worse than controls in all explored domains, in particular Social Cognition and Language domains. SOD1-ALS patients had similar scores in all tests compared to WT-ALS, except the Story-based Empathy Task (SET), where they performed worse. Cognitive-behavioral impairment is much more common in SOD1 patients than previously assumed. SOD1-ALS are characterized by a more frequent impairment of Social Cognition and, less markedly, of Language domains. These findings have relevant implication both in the clinical and in the research setting, also considering recently approved treatment for SOD1-ALS. ANN NEUROL 2024;96:150-158.

Sleep and cognition in Bipolar Disorder in full or partial remission

IntroductionCognitive impairment in Bipolar Disorder (BD) is frequent and is associated with reduced function in several areas. Close to half of the patients with BD have persistent cognitive dysfunction. The causes of cognitive impairments and factors associated with normal cognitive function are not clearly described.Some preliminary evidence links sleep disturbances and cognition impairment in BD. A limited number of studies have investigated the link between sleep and cognitive function in BD using objective measures.ObjectivesWe aim to investigate associations between sleep and objective and subjective cognitive function in patients with BD in full or partial remission.MethodsThis is a cross-sectional study. The participants will be 90 adults meeting criteria for DSM 5 BD type 1 or type 2 in full or partial remission. Participants are recruited from psychoeducational groups for BD and from a specialist outpatient clinic.Diagnoses are set with SCID-5 and are confirmed in a consensus meeting with at least two psychiatrists and/or specialists in psychology. Symptoms of depression and mania are measured with Montgomery Asberg depression rating scale (MADRS) and Young Mania Rating Scale (YMRS). Sleep is measured subjectively with Insomnia Severity Index (ISI) and objectively with actigraphs which participants wear on their non-dominant hand for ten days. Subjective cognition is measured with Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA). Participants undergo neurocognitive testing with a self-administered validated web-based neuropsychological test platform. The testing is carried out in the participant’s home on their smart phones. The tests include measures of learning, storing, recalling, and recognizing visual and verbal information, working memory and reaction time. Normal cognitive function is defined as scores within or above mean on all cognitive subtests. The test-platform has been validated.We will use descriptive statistics to examine distribution of demographic characteristics. We will test for correlations between sleep factors and subjective and objective measures of cognitive function.EthicsThe Regional Committees for Medical and Health research ethics approved the study.ResultsResults will be presented at the conference. So far, 74 out of 90 participants have been included.ConclusionsWe anticipate that normal sleep may be associated with good cognitive functioning. The findings of this study could offer supplementary insights into BD heterogeneity and potential treatment targets.Abbreviations: SCID-5, Structured Clinical Interview for DSM-5Disclosure of InterestNone Declared

Characteristics of physical activity, life-space mobility, and mental function in Japanese nonagenarians with normal cognitive function

Characteristics of physical activity, life-space mobility, and mental function in Japanese nonagenarians with normal cognitive function

Alzheimer's disease cerebrospinal fluid biomarkers and kidney function in normal and cognitively impaired older adults.

Recent Alzheimer's disease (AD) clinical trials have used cerebrospinal fluid (CSF) biomarker levels for screening and enrollment. Preliminary evidence suggests that AD risk is related to impaired renal function. The impact of kidney function on commonly used AD biomarkers remains unknown. Participants in studies conducted at the Goizueta Alzheimer's Disease Research Center (N=973) had measurements of serum creatinine and CSF AD biomarkers. General linear models and individual data were used to assess the relationships between biomarkers and eGFR. Lower estimated glomerular filtration rate (eGFR) was associated with lower amyloid beta (Aβ)42/tau ratio (p<0.0001) and Aβ42 (p=0.002) and higher tau (p<0.0001) and p-tau (p=0.0002). The impact of eGFR on AD biomarker levels was more robust in individuals with cognitive impairment (all p-values were<0.005). The association between eGFR and CSF AD biomarkers has a significant impact that varies by cognitive status. Future studies exploring this impact on the pathogenesis of AD and related biomarkers are needed. There is a significant association between Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarkers and both estimated glomerular filtration rate (eGFR) and mild cognitive impairment (MCI).Kidney function influences CSF biomarker levels in individuals with normal cognitive function and those with MCI.The impact of kidney function on AD biomarker levels is more pronounced in individuals with cognitive impairment.The variation in CSF tau levels is independent of cardiovascular factors and is likely directly related to kidney function.Tau may have a possible role in both kidney and cognitive function.

Characteristics of physical activity, life-space mobility, and mental function in Japanese nonagenarians with normal cognitive function

Characteristics of physical activity, life-space mobility, and mental function in Japanese nonagenarians with normal cognitive function

Prevalence of Cognitive Impairment among Iraqi Patients with Ankylosing Spondylitis

Abstract Background: Ankylosing spondylitis (AS) is the prototype of spondyloarthropathies and one of the common rheumatic diseases (RDs). Various degrees of cognitive impairment have been reported with most autoimmune RDs. Objectives: To estimate the prevalence of cognitive impairment in AS patients and its relationship to disease activity and functional limitations and the effect of various sociodemographic and clinical characteristics on cognitive function in AS patients. Materials and Methods: This case–control study comprised 100 patients with AS and 100 healthy subjects who were matched for age, gender, and educational level. Private interviews were conducted with participants to complete the questionnaire and evaluate cognitive function using the 6-item Cognitive Impairment Test (6-CIT) and the Montreal Cognitive Assessment (MoCA). Results: According to MoCA, 48% of AS patients and 16% of healthy controls were cognitively impaired (P = 0.001). By 6-CIT, 6% of the AS group had cognitive impairment, whereas all 100 controls had normal cognitive function (P = 0.029). There was a significant direct correlation between 6-CIT score with marital status (P = 0.020), BMI (P = 0.021), and Bath Ankylosing Spondylitis Disease Activity Index (P = 0.008) and inverse correlation with employment (P = 0.015), education (P = 0.008), and family income (P = 0.12). There was significant direct correlation between MoCA with employment (P = 0.009), education (P = 0.005), family income (P = 0.022), and use of non-steroidal anti-inflammatory drugs (NSAIDs) (P = 0.008) and inverse correlation with marital status (P = 0.002). Conclusions: Patients with AS have a higher degree of cognitive impairment than healthy individuals. It is associated with disease activity, lower socioeconomic status, being widowed, and obesity. Use of NSAIDs is associated with lower cognitive impairment.

Evaluation of the Oxford cognitive screen Indonesian version (OCS-Ina) for assessing cognitive function disorders: validation and reliability study

Background and objectives. The Oxford Cognitive Screen (OCS) is a valuable tool for assessing cognitive function, particularly in the context of aphasia and neglect. This study aims to assess the validity and reliability of the Indonesian version of OCS (OCS-INA), which has been adapted and translated following WHO guidelines. Materials and methods. The adaptation and translation process of OCS, in accordance with WHO guidelines, preceded the validity and reliability testing of OCS-INA. The study included participants aged 18 years and above with normal cognitive function, as assessed by the Moca-INA. Data collection took place in social institutions and healthcare facilities that met the specified inclusion criteria. Results. Among the 104 participants meeting the inclusion criteria, a majority were male (51.92%), with ages ranging from 20 to 87 years, and the highest age group being above 60 years (60%). Most participants had a high school education level (35.58%) and were not employed (62.5%). Validity testing, using the Spearman correlation coefficient formula, revealed that the majority of domains had calculated correlation coefficients (r values) exceeding the table values (0.1927). In terms of reliability, the kappa p statistic indicated very good agreement for six examination tasks: semantic (0.874), orientation (0.842), verbal memory (0.822), episodic memory (0.870), and visual field test (1.000). Good agreement scores were obtained for the picture naming test (0.774), sentence reading (0.726), and calculation (0.774). Conclusions. In conclusion, OCS-INA demonstrates both validity and reliability as a screening tool for cognitive impairment. It serves as a valuable complement to existing instruments used for similar purposes.

Brodmann Areas, V1 Atlas and Cognitive Impairment: Assessing Cortical Thickness for Cognitive Impairment Diagnostics.

Background and Objectives: Magnetic resonance imaging is vital for diagnosing cognitive decline. Brodmann areas (BA), distinct regions of the cerebral cortex categorized by cytoarchitectural variances, provide insights into cognitive function. This study aims to compare cortical thickness measurements across brain areas identified by BA mapping. We assessed these measurements among patients with and without cognitive impairment, and across groups categorized by cognitive performance levels using the Montreal Cognitive Assessment (MoCA) test. Materials and Methods: In this cross-sectional study, we included 64 patients who were divided in two ways: in two groups with (CI) or without (NCI) impaired cognitive function and in three groups with normal (NC), moderate (MPG) and low (LPG) cognitive performance according to MoCA scores. Scans with a 3T MRI scanner were carried out, and cortical thickness data was acquired using Freesurfer 7.2.0 software. Results: By analyzing differences between the NCI and CI groups cortical thickness of BA3a in left hemisphere (U = 241.000, p = 0.016), BA4a in right hemisphere (U = 269.000, p = 0.048) and BA28 in left hemisphere (U = 584.000, p = 0.005) showed significant differences. In the LPG, MPG and NC cortical thickness in BA3a in left hemisphere (H (2) = 6.268, p = 0.044), in V2 in right hemisphere (H (2) = 6.339, p = 0.042), in BA28 in left hemisphere (H (2) = 23.195, p < 0.001) and in BA28 in right hemisphere (H (2) = 10.015, p = 0.007) showed significant differences. Conclusions: Our study found that cortical thickness in specific Brodmann Areas-BA3a and BA28 in the left hemisphere, and BA4a in the right-differ significantly between NCI and CI groups. Significant differences were also observed in BA3a (left), V2 (right), and BA28 (both hemispheres) across LPG, MPG, NC groups. Despite a small sample size, these findings suggest cortical thickness measurements can serve as effective biomarkers for cognitive impairment diagnosis, warranting further validation with a larger cohort.

Motor or non-motor speech interference? A multimodal fMRI and direct cortical stimulation mapping study

We retrospectively analyzed data from 15 patients, with a normal pre-operative cognitive performance, undergoing awake surgery for left fronto-temporal low-grade glioma. We combined a pre-surgical measure (fMRI maps of motor- and language-related centers) with intra-surgical measures (MNI-registered cortical sites data obtained during intra-operative direct electrical stimulation, DES, while they performed the two most common language tasks: number counting and picture naming).Selective DES effects along the precentral gyrus/inferior frontal gyrus (and/or the connected speech articulation network) were obtained. DES of the precentral gyrus evoked the motor speech arrest, i.e., anarthria (with apparent mentalis muscle movements). We calculated the number of shared voxels between the lip-tongue and overt counting related- and silent naming-related fMRI maps and the Volumes of Interest (VOIs) obtained by merging together the MNI sites at which a given speech disturbance was observed, normalized on their mean the values (i.e., Z score). Both tongue- and lips-related movements fMRI maps maximally overlapped (Z = 1.05 and Z = 0.94 for lips and tongue vs. 0.16 and −1.003 for counting and naming) with the motor speech arrest seed. DES of the inferior frontal gyrus, pars opercularis and the rolandic operculum induced speech arrest proper (without apparent mentalis muscle movements). This area maximally overlapped with overt counting-related fMRI map (Z = −0.11 and Z = 0.09 for lips and tongue vs. 0.9 and 0.0006 for counting and naming). Interestingly, our fMRI maps indicated reduced Broca's area activity during silent speech compared to overt speech. Lastly, DES of the inferior frontal gyrus, pars opercularis and triangularis evoked variations of the output, i.e., dysarthria, a motor speech disorder occurring when patients cannot control the muscles used to produce articulated sounds (phonemes). Silent object naming-related fMRI map maximally overlapped (Z = −0.93 and Z = −1.04 for lips and tongue vs. −1.07 and 0.99 for counting and naming) with this seed.Speech disturbances evoked by DES may be thought of as selective interferences with specific recruitment of left inferior frontal gyrus and precentral cortex which are differentiable in terms of the specific interference induced.

Link of Serum Esterase Enzymes with Cognitive Impairment in Diabetic Patients

Cognitive impairment is one of the main complications of diabetes and patients with cognitive impairment are considered to be in an intermediate stage of decreased cognition with higher risk of developing dementia and Alzheimer's disease. This study aimed at evaluating serum activity of two esterase enzymes including cholinesterase and paraoxonase 1 (PON 1) in diabetic patients and association with cognitive performance and metabolic parameters. In this crosssectional study, 128 diabetic patients were enrolled. Cognitive performance was evaluated using the Wechsler Adult Intelligence Scale-Revised (WAIS-R). Body mass index, fasting blood glucose, fasting blood insulin, insulin resistance, serum cholinesterase and paraoxonase 1 activity were measured. Prevalence of cognitive impairment was found to be 77% in the study population. Serum cholinesterase activity was found to be higher in diabetic patients with cognitive impairment than the patients with normal cognitive performance (p &lt; 0.04). Further, a negative correlation was found between cognitive performance and cholinesterase activity, albeit statistically non-significant. Alteration in the activity of cholinesterase enzyme was shown to be associated with cognitive impairment in diabetic patients and future studies are required to find the pathophysiological mechanisms of diabetic cognitive dysfunction.

Abstract 01: Childhood Socioeconomic Position is Associated With Accelerated Brain Aging in U.S Hispanic/Latino Population. Findings From the Hispanic Community Health Study/Study of Latinos

Introduction: Low childhood socioeconomic position (SEP) may have a long-lasting influence on functional and structural brain development. However, little is known about whether early-life SEP is associated with a steeper age-related reduction in measures of brain structure, previously linked to Alzheimer’s Disease and Related Dementias (ADRD) vulnerability. Hypothesis: Low childhood SEP measured by parental education modifies the association between age and magnetic resonance imaging (MRI)-derived brain volumes, with worse age-related brain volumes among adults with low early-life SEP. Methods: We used data from adults (age range 50-85) in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL-INCA-MRI), a population-based cohort study conducted in four major U.S cities. Measures of brain structure (e.g., total brain volume-TBV, total gray matter volume-TGMV, total cortical gray volume-TCGV, hippocampus volume-HV, and white matter hyperintensity volume-WMHV were quantified using MRI in 2400 adults with normal and impaired cognitive function. We used participants' self-reports of the highest education attained by either their father or mother as a proxy for childhood SEP (&lt; high school and ≥ high school). We conducted survey linear regression models of age on brain volumes adjusting for participant’s sex, Hispanic/Latino background, field center, nativity, and age at immigration. We then included interaction terms between age and childhood SEP. Results: In multivariable regression models, older age was associated with smaller brain volumes (β, and 95% confidence interval-CI for TBV for each year increment in age: -3.22, 95% CI: -3.73, -2.71), while older age was associated with larger log-transformed WMHV (β: 0.90, 95% CI: 0.08, 0.10). Childhood SEP modifies the association between age and brain volumes, with significant smaller age-related brain volumes among adults whose parents have less than high school (β for TBV:-3.65, 95% CI: -4.25, -3.04; and TGMV: -1.29, 95% CI: -1.62, -0.95) as compared with those with high school or more (β for TBV: -2.32, 95% CI: -3.17, -1.45; p-value for interaction: 0.024; and TGMV: -0.54, 95% CI: -0.98, -0.10; p-value for interaction: 0.017). These smaller age-related volumes persisted after accounting for participant’s education and income. In contrast, higher childhood SEP was associated with a slightly larger age-related WMHV (β for interaction term: 0.03, 95% CI: 0.01, 0.05, p-value: 0.016). Conclusions: This study highlights the unique contributions of childhood SEP to accelerated brain aging. The age by childhood SEP interaction suggests that childhood socioeconomic disadvantage has a long-lasting influence in accelerated disparities in brain aging as indexed by bran MRI.

Analysis of related factors for neuropsychiatric comorbidities in children with epilepsy

ObjectiveTo analyze the risk factors affecting psychiatric behavior and study the psychobehavioral conditions of children with epilepsy.MethodWe randomly selected and enrolled 294 children with epilepsy who visited and were hospitalized in the pediatric clinic of Hebei General Hospital between January 2017 and January 2022, as the study participants. We comprehensively assessed their cognitive functions using the Gesell development schedule or Wechsler Intelligence Scales. The participants were divided into the study group (n = 123) with cognitive impairment and the control group (n = 171) with normal cognitive functions, for analysis.ResultsThere were statistically significant differences between the two groups in disease course, frequency of epilepsy, status epilepticus, and the number of antiseizure medications (ASMs) used (P < 0.05), while there were no statistically significant differences in age, gender, age of onset, form of onset, interictal epileptiform discharge, history of febrile convulsion, and the time from onset to initial visit (P > 0.05). Based on multivariate logistic regression analysis, the course of disease, frequency of onset, status epilepticus and number of ASMs used were identified as high-risk factors for cognitive impairment in children with epilepsy. Similarly, early onset, long course of disease, known etiology, and combination of multiple drugs have a negative impact on behavioral problems, school education, and social adaptability.ConclusionThe course of disease, the frequency of onset, status epilepticus, and the number of ASMs used are high-risk factors for cognitive impairment in children with epilepsy, which can be prevented and controlled early. When selecting ASMs, their advantages and disadvantages should be weighed. Moreover, the availability of alternative treatment options must be considered. With the help of genomic technology, the causes of epilepsy should be identified as early as possible, and precision medicine and gene therapy for children with epilepsy should be actively developed.

Neuropsychology of Spinocerebellar Ataxia Type 2, a Case Study in Stage I Disease

Currently, the evaluation of cognitive disorders in Spinocerebellar Ataxia Type 2 is of great interest, given that the identification of its neuropsychological characteristics allows for a deeper understanding of the disease. However, its approach from the field of study of neuropsychology, based on the integration of the cognitive, affective and behavioral state, is insufficient. The objective of study is characterized from a neuropsychological point of view, a series of cases with Spinocerebellar Ataxia Type 2 in stage I. A multiple case study was carried out with four patients with diagnosis of Spinocerebellar Ataxia Type 2 in stage I genetically confirmed and intentionally chosen. Psychological and neurocognitive tests were applied to evaluate the cognitive, affective and behavioral spheres. Patients with SCA2 stage I presented cognitive impairment in the neuropsychological examination, only one of the subjects showed normal global cognitive functioning, although in the evaluation by specific domains he evidenced various cognitive deficits. Anxiety and depression at pathological levels were not identified in the patients. They showed satisfaction and self-actualization with their lifestyles. The neuropsychological characterization of the cases studied with SCA2 in stage I contributed to a greater understanding of the disease. The identified deficits speak in favor of carrying out a neuropsychological evaluation from the initial stages, to project more effective neuropsychological rehabilitation strategies, which is of interest to the scientific community in the field of Neurosciences.

The associations between peripheral inflammatory and lipid parameters, white matter hyperintensity, and cognitive function in patients with non-disabling ischemic cerebrovascular events

BackgroundThe global prevalence of VCI has increased steadily in recent years, but diagnostic biomarkers for VCI in patients with non-disabling ischemic cerebrovascular incidents (NICE) remain indefinite. The primary objective of this research was to investigate the relationship between peripheral serological markers, white matter damage, and cognitive function in individuals with NICE.MethodsWe collected clinical data, demographic information, and medical history from 257 patients with NICE. Using the MoCA upon admission, patients were categorized into either normal cognitive function (NCF) or VCI groups. Furthermore, they were classified as having mild white matter hyperintensity (mWMH) or severe WMH based on Fazekas scores. We then compared the levels of serological markers between the cognitive function groups and the WMH groups.ResultsAmong 257 patients with NICE, 165 were male and 92 were female. Lymphocyte count (OR = 0.448, P < 0.001) and LDL-C/HDL-C (OR = 0.725, P = 0.028) were protective factors for cognitive function in patients with NICE. The sWMH group had a higher age and inflammation markers but a lower MoCA score, and lymphocyte count than the mWMH group. In the mWMH group, lymphocyte count (AUC = 0.765, P < 0.001) and LDL-C/HDL-C (AUC = 0.740, P < 0.001) had an acceptable diagnostic value for the diagnosis of VCI. In the sWMH group, no significant differences were found in serological markers between the NCF and VCI groups.ConclusionLymphocyte count, LDL-C/HDL-C were independent protective factors for cognitive function in patients with NICE; they can be used as potential biological markers to distinguish VCI in patients with NICE and are applicable to subgroups of patients with mWMH.

Cognition and emotional distress in middle-aged and older adults with spina bifida myelomeningocele.

To investigate cognitive functioning and emotional distress in adults aged 55 to 68 years old with spina bifida myelomeningocele (SBM), both with and without hydrocephalus. A secondary aim was to explore the associations between psychosocial factors in relation to emotional distress. Cross-sectional study of eleven females and eight males with SBM, five with and twelve without hydrocephalus. Cognitive functioning was investigated with neuropsychological tests and self-report measures. Furthermore, participants completed questionnaires regarding resilience, access to social support, coping, and emotional distress. Descriptive statistics were applied, and Spearman Rho correlation coefficients were used to explore the relationships between psychosocial factors and emotional distress. Eleven exhibited normal cognitive functioning. An observed difference was seen between participants with and without hydrocephalus, where six and five persons reported clinical levels of depression and anxiety, respectively. Positive perceptions of self and future were associated with lower levels of depression and anxiety. This study adds important information about cognitive functioning and emotional distress in an understudied population. The results indicated normal cognitive functioning in adults aged 55 to 68 years with SBM without hydrocephalus. Prevalence of emotional distress was comparable with previous studies of younger adults with SBM. There is a need for longitudinal studies investigating cognition and psychological health to fully capture important aspects of the life course of SBM with and without hydrocephalus.

The effect of the whole-process care model of the medical union on the improvement of kinesiophobia and bone mineral density in patients with osteoporosis.

To observe the effect of the whole-process care model of the medical union on the improvement of kinesiophobia and bone mineral density in patients with osteoporosis. In this descriptive study, a convenient sampling method was used to select 148 patients with osteoporosis who visited the hospital from January 2020 to December 2021. Patients aged ≥ 18years and diagnosed with osteoporosis through quantitative computed tomography (QCT) were included in the study. They were able to cooperate during follow-up and had normal cognitive function. Patients with combined spinal curvature, thoracic deformity, and pulmonary dysfunction, accompanied by severe cardiovascular or limb dysfunction, and those who withdrew midway or participated in other clinical studies were excluded. According to whether to use the whole-process care model of the medical union, they were divided into intervention group and control group, with 74 cases each. The control group used conventional care, and the intervention group used the whole-process care model of the medical association. The occurrence of kinesiophobia between the two groups were compared. The dual-energy X-ray absorption detector is used to measure differences in bone density changes. There was no significant difference between the two groups in the TSK scale score and the incidence of kinesiophobia before intervention (P > 0.05). The TSK scale scores of patients in the intervention group were higher than those in the control group at 3months and 6months after operation (P < 0.05). The incidence of kinesiophobia in the intervention group for 3months and 6months was significantly lower than that in the control group (P < 0.05). There was no significant difference in bone mineral density between the two groups before and 3months after intervention (P > 0.05). The bone mineral density of lumbar spine, femoral neck and total hip in the intervention group was significantly higher than that in the control group after 6months of intervention (P < 0.05). The whole-process care model of the medical association is used for osteoporosis patients, which might reduce the risk of kinesiophobia and improve the bone density of the lumbar spine and total hip in patients. But further promotion and improvement of relevant support systems are needed to achieve comprehensive promotion and maximize clinical benefits in this field.

The Role of Socioeconomic and Cognitive Status in Determining Traffic Behaviour of Elderly Pedestrians in Iran: A Cross-Sectional Study

Elderly pedestrians are among the most vulnerable groups in terms of traffic-related injuries. This study aimed to investigate traffic behaviour and its determinants among elderly pedestrians in Iran. This cross-sectional study examined the traffic behaviour of 600 elderly pedestrians in Zanjan, Northwestern Iran. The participants were selected using the multistage random sampling method. Pedestrians’ traffic behaviour, socioeconomic status (SES), and cognitive function were assessed using the Pedestrian Behaviour Questionnaire (PBQ), SES questionnaire, and Abbreviated Mental Test score (AMTS), respectively. Multiple linear regression was used to investigate the association of total score of pedestrian traffic behaviour with socioeconomic and cognitive status while adjusting for potential confounding roles of demographic variables. More than 90 percent of elderly pedestrians showed unsafe traffic behaviour. This included traffic violations and failure to adhere to traffic rules. Almost half the elders were aggressive and distracted when walking and crossing the street. A higher total score of PBQ was associated with a higher cognitive status, higher SES, higher levels of education, and walking more than 1 hour a day. The majority of the elders showed unsafe traffic behaviour and elderly pedestrians with high SES and normal cognitive function were more likely to exhibit safe behaviour than those with low SES and cognitive dysfunction. Interventions are needed to improve the traffic behaviour of elderly pedestrians especially those with low SES levels.