1.Cognitive impairment and depression among breast cancer patients undergoing chemotherapy in a tertiary hospital
Meleza Mea B. Cambalon-Ongco ; Marissa T. Ong
Philippine Journal of Neurology 2023;26(2):42-53
		                        		
		                        			Background:
		                        			Breast cancer is the leading cause of cancer death among women worldwide. Studies showed
conflicting results regarding presence of cancer, cancer treatment, and its association with
dementia. Likewise, depression is often associated with cognitive problems. 
		                        		
		                        			Objectives:
		                        			This study aims to determine the prevalence and association of cognitive impairment and depression among breast cancer patients
		                        		
		                        			Methods:
		                        			This is a prospective cross-sectional study utilizing Montreal Cognitive Assessment –
Philippines (MOCA-P) and Patient Health Questionnaire (PHQ-9) Filipino version
questionnaires through face-to-face interview. In analyzing the presence of cognitive
impairment and depression, Chi-square was performed; all significant factors from this test
underwent binary logistic regression to ascertain the statistical effect size for the presence of
cognitive impairment and depression. 
		                        		
		                        			Results:
		                        			Results showed that 80.8% (97 out of 120 patients) have cognitive impairment while 27.5% of
the patients have depression. Among the patients with cognitive impairment, 24.2% of them
had depression. Results also showed significant association between the level of education and
MOCA-P score suggesting that the higher the level of education, the better the MOCA-P score.
This study showed no significant association between presence of cognitive impairment and
depression. 
		                        		
		                        			Conclusion
		                        			In analyzing and managing patients with cognitive impairment, the level of educational
attainment should be put into consideration since it is correlated significantly with MOCA-P
results. As such, concomitant depression should be addressed accordingly since it may affect
the patients’ overall health status. 
		                        		
		                        		
		                        		
		                        			Cognitive Dysfunction
		                        			;
		                        		
		                        			 Depression
		                        			;
		                        		
		                        			 Breast Neoplasms
		                        			;
		                        		
		                        			 Mental Status and Dementia Tests
		                        			
		                        		
		                        	
2.Cognitive impairment in two subtypes of a single subcortical infarction.
Tang YANG ; Qiao DENG ; Shuai JIANG ; Yu-Ying YAN ; Ye YUAN ; Si-Miao WU ; Shu-Ting ZHANG ; Jia-Yu SUN ; Bo WU
Chinese Medical Journal 2021;134(24):2992-2998
		                        		
		                        			BACKGROUND:
		                        			Single subcortical infarction (SSI) is caused by two main etiological subtypes, which are branch atheromatous disease (BAD) and cerebral small vessel disease (CSVD)-related SSI. We applied the Beijing version of the Montreal Cognitive Assessment (MoCA-BJ), the Shape Trail Test (STT), and the Stroop Color and Word Test (SCWT) to investigate the differences in cognitive performance between these two subtypes of SSI.
		                        		
		                        			METHODS:
		                        			Patients with acute SSIs were prospectively enrolled. The differences of MoCA-BJ, STT, and SCWT between the BAD group and CSVD-related SSI group were analyzed. A generalized linear model was used to analyze the associations between SSI patients with different etiological mechanisms and cognitive function. We investigated the correlations between MoCA-BJ, STT, and SCWT using Spearman's correlation analysis and established cut-off scores for Shape Trail Test A (STT-A) and STT-B to identify cognitive impairment in patients with SSI.
		                        		
		                        			RESULTS:
		                        			This study enrolled a total of 106 patients, including 49 and 57 patients with BAD and CSVD-related SSI, respectively. The BAD group performances were worse than those of the CSVD-related SSI group for STT-A (83 [60.5-120.0] vs. 68 [49.0-86.5], P = 0.01), STT-B (204 [151.5-294.5] vs. 153 [126.5-212.5], P = 0.015), and the number of correct answers on Stroop-C (46 [41-49] vs. 49 [45-50], P = 0.035). After adjusting for age, years of education, National Institutes of Health Stroke Scale and lesion location, the performance of SSI patients with different etiological mechanisms still differed significantly for STT-A and STT-B.
		                        		
		                        			CONCLUSIONS
		                        			BAD patients were more likely to perform worse than CSVD-related SSI patients in the domains of language, attention, executive function, and memory. The mechanism of cognitive impairment after BAD remains unclear.
		                        		
		                        		
		                        		
		                        			Cerebral Infarction
		                        			;
		                        		
		                        			Cerebral Small Vessel Diseases
		                        			;
		                        		
		                        			Cognitive Dysfunction/etiology*
		                        			;
		                        		
		                        			Executive Function
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Mental Status and Dementia Tests
		                        			
		                        		
		                        	
3.TREM2: A Novel Potential Biomarker of Alzheimer's Disease.
Xiao Min ZHANG ; Jing LIU ; Min CAO ; Ting Ting YANG ; Ya Qi WANG ; Yu Li HOU ; Qiao SONG ; Yu Ting CUI ; Pei Chang WANG
Biomedical and Environmental Sciences 2021;34(9):719-724
		                        		
		                        		
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Aged, 80 and over
		                        			;
		                        		
		                        			Alzheimer Disease/diagnosis*
		                        			;
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Biomarkers/blood*
		                        			;
		                        		
		                        			Cognitive Dysfunction
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Membrane Glycoproteins/blood*
		                        			;
		                        		
		                        			Mental Status and Dementia Tests
		                        			;
		                        		
		                        			Mice
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Models, Animal
		                        			;
		                        		
		                        			Morris Water Maze Test
		                        			;
		                        		
		                        			Parkinson Disease/diagnosis*
		                        			;
		                        		
		                        			ROC Curve
		                        			;
		                        		
		                        			Receptors, Immunologic/blood*
		                        			;
		                        		
		                        			Sensitivity and Specificity
		                        			
		                        		
		                        	
4.Correlation between preoperative sleep disorders and postoperative delayed neurocognitive recovery in elderly patients.
Renhua LI ; Na CHEN ; E WANG ; Zhaohui TANG
Journal of Central South University(Medical Sciences) 2021;46(11):1251-1259
		                        		
		                        			OBJECTIVES:
		                        			Perioperative neurocognitive disorders (PND) is one of the important factors affecting the recovery of the elderly after surgery, and sleep disorders are also one of the common diseases of the elderly. Previous studies have shown that the quality of postoperative sleep may be factor affecting postoperative cognitive function, but there are few studies on the relationship between preoperative sleep disorders and postoperative cognitive dysfunction. This study aims to explore the relationship between preoperative sleep disorders and postoperative delayed neurocognitive recovery in elderly patients, and provide references for improving the prognosis and quality of life of patients.
		                        		
		                        			METHODS:
		                        			This study was porformed as a prospective cohort study. Elderly patients (age≥65 years old) underwent elective non-cardiac surgery at Xiangya Hospital of Central South University from October 2019 to January 2020 were selected and interviewed 1 day before the operation. The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment Scale (MoCA) were used to assess the patient's baseline cognitive status. Patients with preoperative MMSE scores of less than 24 points were excluded. For patients meeting the criteria of inclusion, Pittsburgh Sleep Quality Index (PSQI) scale was used to evaluate the patients, and the patients were divided into a sleep disorder group and a non-sleep disorder group according to the score. General data of patients were collected and intraoperative data were recorded, such as duration of surgery, anesthetic time, surgical site, intraoperative fluid input, intraoperative blood product input, intraoperative blood loss and drug use. On consecutive 5 days after surgery, Numerical Rating Scale (NRS) was used to evaluate the sleep of the previous night and the pain of the day, which were recorded as sleep NRS score and pain NRS score; Confusion Assessment Method for ICU (CAM-ICU) scale and Confusion Assessment Method (CAM) scale were used to assess the occurrence of delirium. On the 7th day after the operation, the MMSE and MoCA scales were used to evaluate cognitive function of patients. We compared the incidence of postoperative complications, the number of deaths, the number of unplanned ICU patients, the number of unplanned secondary operations, etc between the 2 groups. The baseline and prognosis of the 2 groups of patients were analyzed by univariate and multivariate logistics to analyze their correlation.
		                        		
		                        			RESULTS:
		                        			A total of 105 patients were collected in this study, including 32 patients in the sleep disorder group and 73 patients in the non-sleep disorder group. The general information of the 2 groups, such as age, gender, body mass index, and surgery site, were not statistically significant (all 
		                        		
		                        			CONCLUSIONS
		                        			Preoperative sleep disorders can increase the risk of delayed neurocognitive function recovery in elderly patients. Active treatment of preoperative sleep disorders may improve perioperative neurocognitive function in elderly patients.
		                        		
		                        		
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Mental Status and Dementia Tests
		                        			;
		                        		
		                        			Postoperative Complications/epidemiology*
		                        			;
		                        		
		                        			Prospective Studies
		                        			;
		                        		
		                        			Quality of Life
		                        			;
		                        		
		                        			Sleep Quality
		                        			;
		                        		
		                        			Sleep Wake Disorders/etiology*
		                        			
		                        		
		                        	
5.Alcohol Cessation in Late Life is Associated with Lower Risk of Cognitive Impairment among the Older Adults in China.
Xiao Chang ZHANG ; Xiang GAO ; Yue Bin LYU ; Jin Hui ZHOU ; Yuan WEI ; Zhao Xue YIN ; Ji Xiang MA ; Chen MAO ; Xiao Ming SHI
Biomedical and Environmental Sciences 2021;34(7):509-519
		                        		
		                        			Objective:
		                        			Evidence regarding alcohol consumption and cognitive impairment is controversial. Whether cessation of drinking alcohol by non-dependent drinkers alters the risk of cognitive impairment remains unknown. This study prospectively evaluated the potential association between the history of lifetime alcohol cessation and risk of cognitive impairment.
		                        		
		                        			Methods:
		                        			This study included 15,758 participants age 65 years or older, selected from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) that covered 23 provinces in China. Current alcohol use status, duration of alcohol cessation, and alcohol consumption before abstinence were self-reported by participants; cognitive function was evaluated using Mini-mental State Examination (MMSE). Cause-specific hazard models and restricted cubic splines were applied to estimate the effect of alcohol use on cognitive impairment.
		                        		
		                        			Results:
		                        			Among the 15,758 participants, mean (± SD) age was 82.8 years (± 11.9 years), and 7,199 (45.7%) were males. During a mean of 3.9 years of follow-up, 3,404 cases were identified as cognitive impairment. Compared with current drinkers, alcohol cessation of five to nine years [adjusted 
		                        		
		                        			Conclusion
		                        			A longer duration of alcohol cessation was associated with a lower risk of cognitive impairment assessed by MMSE. Alcohol cessation is never late for older adults to prevent cognitive impairment.
		                        		
		                        		
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Aged, 80 and over
		                        			;
		                        		
		                        			Alcohol Abstinence
		                        			;
		                        		
		                        			Alcohol Drinking
		                        			;
		                        		
		                        			China
		                        			;
		                        		
		                        			Cognition
		                        			;
		                        		
		                        			Cognitive Dysfunction/epidemiology*
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Health Behavior
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Longitudinal Studies
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Mental Status and Dementia Tests
		                        			;
		                        		
		                        			Risk
		                        			
		                        		
		                        	
6.Effect of electronic moxibustion on memory function in patients with amnestic mild cognitive impairment.
Qi-Qi LIU ; Shang-Jie CHEN ; Guo-Ming SHEN ; Xin-Yan JIA ; Xiao-di QIAO ; Guo-Long WU
Chinese Acupuncture & Moxibustion 2020;40(4):352-356
		                        		
		                        			OBJECTIVE:
		                        			To observe the effect of electronic moxibustion on memory function in the patients with amnestic mild cognitive impairment (aMCI).
		                        		
		                        			METHODS:
		                        			A total of 59 aMCI patients were randomized into an electronic moxibustion group (30 cases) and a placebo moxibustion group (29 cases). In the electronic moxibustion group, the electronic moxibustion was applied to Baihui (GV 20), Dazhui (GV 14), Mingmen (GV 4) and Taixi (KI 3), 45 ℃ in temperature, 20 min each time. The treatment was given once a day, 5 times a week. The treatment for 4 weeks was as one course and 2 courses were required totally. In the placebo moxibustion group, the moxa-free patch was used, 38 ℃ in temperature. The acupoint selection and the treatment frequency were same as the electronic moxibustion group. Before and after treatment, Rivermead behavior memory test (RBMT) was adopted to evaluate the global memory function of the patients in the two groups and the N-back task test was adopted to evaluate working memory function separately. Additionally, the mini-mental state examination (MMSE) and its immediate memory, Montreal cognitive assessment (MoCA) and its delay recall were adopted to evaluate the global cognitive function and memory function
		                        		
		                        			RESULTS:
		                        			In the electronic moxibustion group, after treatment, RBMT score, N-back accuracy rates, MMSE and MoCA scores and the scores of immediate memory and delay recall were improved significantly as compared with those before treatment (<0.01). In the placebo moxibustion group, the accuracy rates of 1-back and 2-back task and the scores of immediate memory and delay recall were improved obviously as compared with those before treatment (<0.05, <0.01). After treatment, the improvements of RBMT score, the accuracy rates of N-back task and MMSE and MoCA scores in the electronic moxibustion group were higher than those in the placebo moxibustion group (<0.05).
		                        		
		                        			CONCLUSION
		                        			Electronic moxibustion improves memory function in the patients with amnestic mild cognitive impairment.
		                        		
		                        		
		                        		
		                        			Acupuncture Points
		                        			;
		                        		
		                        			Amnesia
		                        			;
		                        		
		                        			therapy
		                        			;
		                        		
		                        			Cognitive Dysfunction
		                        			;
		                        		
		                        			therapy
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Memory
		                        			;
		                        		
		                        			Mental Status and Dementia Tests
		                        			;
		                        		
		                        			Moxibustion
		                        			;
		                        		
		                        			methods
		                        			
		                        		
		                        	
8.A Pilot Test for A One-year Cognitive Training Intervention in Elderly Adults with Mild Cognitive Impairment.
Cristina MENDOZA-HOLGADO ; Fidel LOPEZ-ESPUELA ; Jose Maria MORAN ; Raul RONCERO-MARTIN ; Jesús LAVADO-GARCÍA ; Ignacio ALIAGA ; Luis Manuel PUERTO-PAREJO ; Olga LEAL-HERNANDEZ ; Vicente VERA ; Maria PEDRERA-CANAL
Biomedical and Environmental Sciences 2020;33(10):796-802
9.Prognostic value of Montreal Cognitive Assessment in heart failure patients.
Si Qi LYU ; Hui Qiong TAN ; Shao Shuai LIU ; Xiao Ning LIU ; Xiao GUO ; Dong Fang GAO ; Ran MO ; Jun ZHU ; Li Tian YU
Chinese Journal of Cardiology 2020;48(2):136-141
		                        		
		                        			
		                        			Objective: To explore the occurrence of cognitive impairment in Chinese heart failure (HF) patients and it's impact on prognosis. Methods: In this prospective observational study, a total of 990 HF patients were enrolled from 24 hospitals in China during December 2012 to November 2014. All patients were administrated with the interview-format Montreal Cognitive Assessment (MoCA), according to which they were divided into MoCA<26 (with cognitive impairment) group and MoCA≥26 (without cognitive impairment) group. Baseline data were collected and a 1-year follow up was carried out. Univariate and multivariate logistic or Cox regression were performed for 1-year outcomes. Results: Cognitive impairment was evidenced in 628 patients (63.4%) and they were more likely to be older, female, and with higher proportion of New York Heart Association(NYHA) class Ⅲ-Ⅳ, chronic obstructive pulmonary disease (COPD), ischemic heart disease, while body mass index (BMI), education level, and medical insurance rate were lower (all P<0.05) as compared to patients in MoCA≥26 group. The rate of percutaneous intervention, device implantation, cardiac surgery and evidence-based medications were significantly lower in MoCA<26 group than in MoCA≥26 group (all P<0.05). During the 1-year follow up, patients in the MoCA<26 group had higher all-cause mortality (10.2%(64/628) vs. 2.2%(8/362), P<0.01), cardiovascular mortality (5.9%(37/628) vs. 0.8%(3/362), P<0.01) and major adverse cardiac and cerebrovascular events (MACCE) (9.6%(60/628) vs. 2.5%(8/362), P<0.01) than patients in the MoCA≥26 group. In univariate regression, MoCA<26 was associated with increased all-cause mortality (HR(95%CI):4.739(2.272-9.885), P<0.01), cardiovascular mortality (HR(95%CI):7.258(2.237-23.548), P=0.001) and MACCE (OR(95%CI):4.143(2.031-8.453), P<0.01). After adjustment by multivariate regression, MoCA<26 was indicated as an independent risk factor for all-cause mortality (HR(95%CI): 6.387(2.533-16.104), P<0.01), cardiovascular mortality (HR(95%CI): 10.848(2.586-45.506), P=0.001) and MACCE (OR(95%CI): 4.081(1.299-12.816), P=0.016), while not for re-hospitalization for HF (OR(95%CI):1.010(0.700-1.457), P=0.957). Conclusions: Cognitive impairment is common in HF patients,and it is an independent prognostic factor for 1-year outcomes. Routine cognitive function assessment and active intervention are thus recommended for HF patients.
		                        		
		                        		
		                        		
		                        			China
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Heart Failure
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Mental Status and Dementia Tests
		                        			;
		                        		
		                        			Prognosis
		                        			;
		                        		
		                        			Prospective Studies
		                        			
		                        		
		                        	
10.acupuncture method for mild cognitive impairment: a randomized controlled trial.
Yue-Qi CHEN ; Huan-Gan WU ; Ping YIN ; Jian XU ; En-Ting HUANG ; Shi-Fen XU
Chinese Acupuncture & Moxibustion 2019;39(11):1141-1145
		                        		
		                        			OBJECTIVE:
		                        			To observe the clinical efficacy of acupuncture method for mild cognitive impairment in the elderly.
		                        		
		                        			METHODS:
		                        			A total of 96 patients were randomly divided into an observation group, a control group and a waiting group, 32 cases in each group. The patients in the observation group were treated with acupuncture at Baihui (GV 20), Shenting (GV 24), Yintang (GV 29) and Sishencong (EX-HN 1), etc, while the patients in the control group were treated with nonpenetrating sham acupuncture at the same acupoints as the observation group. The treatment was given once every other day, three times a week for 8 weeks. The patients in the waiting group only received health guidance for 8 weeks. Montreal cognitive assessment scale (MoCA) and mini-mental state examination (MMSE) were used before and after 8-week treatment in all three groups. The observation group and the control group were followed up for 2 months and evaluated with MoCA and MMSE.
		                        		
		                        			RESULTS:
		                        			The MoCA scores in the observation group after treatment and during follow-up were higher than before treatment (<0.01), but there was no significant difference between follow-up and after treatment (>0.05). The MoCA scores in the control group after treatment and during follow-up were higher than before treatment (<0.01, <0.05), and the MoCA score during follow-up was lower than after treatment (<0.01). There was no significant difference before and after treatment in the waiting group (>0.05). The difference before and after treatment in the observation group was higher than the control group and waiting group (<0.01), while that in the control group was higher than the waiting group (<0.01). The difference between follow-up and before treatment in the observation group was higher than the control group (<0.01), and the improving between follow-up and after treatment was superior to the control group (<0.01). The MMSE scores after treatment and during follow-up were higher than before treatment in the observation group (<0.01), but there was no significant difference between the follow-up and after treatment (>0.05). The MMSE scores after treatment and during follow-up were higher than before treatment in the control group (<0.01), and the MMSE score during follow-up was lower than after treatment (<0.01). There was no significant difference before and after treatment in the waiting group (>0.05). The difference before and after treatment the observation group and control group was not significant (>0.05), and those in the two groups were higher than the waiting group (<0.01). The difference between follow-up and before treatment in the observation group was higher than the control group (<0.01), and the difference between follow-up and after treatment was lower than the control group (<0.01).
		                        		
		                        			CONCLUSION
		                        			 acupuncture method could improve cognitive impairment in elderly patients with mild cognitive impairment.
		                        		
		                        		
		                        		
		                        			Acupuncture Points
		                        			;
		                        		
		                        			Acupuncture Therapy
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Cognitive Dysfunction
		                        			;
		                        		
		                        			therapy
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Mental Status and Dementia Tests
		                        			;
		                        		
		                        			Treatment Outcome
		                        			
		                        		
		                        	
            

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