Background: Dementia is one of the major causes of dependency after stroke. The prevalence of poststroke dementia (PSD)defined as any dementia occurring after stroke is likely to increase in the future.Objectives: This study have two purposes: 1) Clinical study of MCI and dementia after the first stroke of patients with age of 60 years and older; 2) Overview on clinical characteristics of memory disorders. Subjects and method: 30 patients with were diagnosed with the first ischemic stroke in Huu nghi hospital together with the same number in the control group were involved in this study. The subjects in the two groups were all satisfied with included/excluded criteria diagnosis. Clinical diagnosis of new - onset dementia or other mental disorders was determined using neuropsychological tests. Results: Many functions of the brain were impaired including: logical memory, visiospatial skills, executive function were statistically reduced in the research group compared to the control. However, language function was also impacted but not as much as others. The frequency of the poststrocke dementia in this study was 12.3% while the poststrocke mild cognitive impairment rate was 47%. Conclusions: Global cognitive functioning together with memory state was significantly declined in the ischemic stroke compared to the control group.
Stroke/ pathology ; complications ; Dementia/ pathology ; complications

Adrenal Cortex Hormones ; therapeutic use ; Dementia ; etiology ; physiopathology ; Giant Cell Arteritis ; complications ; drug therapy ; physiopathology ; Humans

Delirium can be defined as an ‘acute brain dysfunction.’ Compared to dementia, which is a disease that deteriorates the brain function chronically, delirium shows very similar symptoms but is mostly ameliorated when the causative factors are normalized. Due to the heterogeneity in etiologies and symptoms, people including health care workers often mistake delirium for dementia or other psychiatric disorders. Delirium has attracted global interest increasingly and a vast amount of research on its management has been conducted. Experts in the field have constantly suggested that systematic intervention should be implemented through a team-based multicomponent approach aimed to reduce the incidence and duration of delirium. Surgery involves many health care workers with different expertise who are not familiar with delirium. For a team-based approach on the management of delirium, it is vital that all medical personnel concerned have a common understanding of delirium and keep in constant communication. Postoperative delirium is a common complication and exerts an enormous burden on patients, their families, hospitals, and public resources. To alleviate this burden, this article aimed to review general features and the latest evidence-based knowledge of delirium with a focus on postoperative delirium.
Brain ; Delirium ; Delivery of Health Care ; Dementia ; Humans ; Incidence ; Population Characteristics ; Postoperative Complications ; Prognosis ; Risk Factors

OBJECTIVE: To observe the effects of moxibustion at Yongquan（KI 1） on the cognitive function and lower limb motor function in patients with post-stroke cognitive impairment of kidney essence deficiency. METHODS: Eighty-four patients with post-stroke cognitive impairment of kidney essence deficiency were randomly divided into an observation group（42 cases，1 case dropped off）and a control group（42 cases，1 case dropped off）.The control group was treated with medication，electroacupuncture，rehabilitation training and repetitive transcranial magnetic stimulation（rTMS）；on the basis of the treatment as the control group，moxibustion at bilateral Yongquan（KI 1）was adopted in the observation group.Both groups were treated once a day，5 days a week with 2-day interval，4 weeks were required. The Montreal cognitive assessment (MoCA) score, mini-mental state examination (MMSE) score, Fugl-Meyer assessment-lower extremity (FMA-LE) score, Berg balance scale (BBS) score, functional independence measure (FIM) score, modified fall efficacy scale (MFES) score and scale for the differentiation of syndromes of vascular dementia (SDSVD) score before and after treatment were observed in the two groups. RESULTS: After treatment，the MoCA, MMSE, FMA-LE, BBS, FIM and MFES scores were higher than those before treatment in both groups (P<0.05), and the scores in the observation group were higher than those in the control group (P<0.05). After treatment，the SDSVD scores were lower than those before treatment in both groups (P< 0.05), and the SDSVD score in the observation group was lower than that in the control group (P< 0.05). CONCLUSION Moxibustion at Yongquan（KI 1） can improve the cognitive function and motor and balance function of lower limbs in patients with post-stroke cognitive impairment of kidney essence deficiency，reduce the risk of fall and improve the quality of life.
Humans ; Cognition ; Cognitive Dysfunction/therapy* ; Dementia, Vascular ; Kidney ; Lower Extremity ; Moxibustion ; Quality of Life ; Stroke/complications*

PURPOSE: The aim of this study was to clarify the actual condition of elders with dementia who were registered in the Seoul Dementia Management Project. METHODS: Data were collected from 5,312 elderly patients with dementia. Demographic included characteristics, comorbidity, and healthy lifestyle habits; data from the Seoul Dementia Management Project. RESULTS: First, demographic characteristics were as follows; mean age at the time of definite diagnosis was 78.0 yr. There were slightly more women (69.3%), and 4.55 yr was the average length of education with 41.4% being illiterate or uneducated patients. Second, there were several comorbidities including hypertension (61.7%), diabetes mellitus (31.8%), hypercholesterolemia (10.2%), heart disease (11.1%), obesity (4.2%), and stroke (21.4%). Third, alcoholic history was found in 11.8% of the patients, and smoking in 9.8%. Regular exercise was done by only 29.1% of the patients with dementia. Finally, significant differences between men and women were found for the following; age, education, medical security, hypertension, diabetes mellitus, stroke, alcoholic consumption, smoking, and regular exercise. CONCLUSION: Authors expect that the present data will be used for establishment of dementia associated projects and policies.
Aged ; Aged, 80 and over ; Alcohol Drinking ; Comorbidity ; Dementia/*complications/psychology ; Demography ; Diabetes Mellitus, Type 2/complications ; Exercise ; Female ; *Health Behavior ; Heart Diseases/complications ; Humans ; Hypercholesterolemia/complications ; Hypertension/complications ; Male ; Middle Aged ; Obesity/complications ; Smoking ; Stroke/complications

Most cases of intussusception in adults present with chronic and nonspecific symptoms, and can sometimes be challenging to diagnose. We herein report on a patient with the rare symptom of colonic intussusceptions presenting with rectal prolapse and review the existing literature of similar case reports to discuss how to reach an accurate diagnosis. A 75-year-old woman with dementia presented with per rectal bleeding, rectal prolapse and lower abdominal pain. An operation was scheduled and a large sigmoid intussusception with a polyp as a leading point was found intraoperatively. She subsequently recovered well and was discharged. As large sigmoid intussusceptions may present as rectal prolapse, intussusception should be considered as a differential diagnosis for immobile patients, especially when the leading point is a lesion.
Abdominal Pain ; Aged ; Colectomy ; Colon, Sigmoid ; pathology ; surgery ; Dementia ; complications ; Diagnosis, Differential ; Female ; Hemorrhage ; complications ; Humans ; Intussusception ; complications ; diagnosis ; surgery ; Necrosis ; Prolapse ; Rectal Prolapse ; diagnosis ; Rectum ; pathology ; surgery

Adult ; Female ; Frontal Lobe ; physiopathology ; Frontotemporal Dementia ; diagnosis ; etiology ; physiopathology ; Humans ; Magnetic Resonance Imaging ; Treatment Outcome ; Tuberculoma, Intracranial ; complications

PURPOSE: To compare functional recovery and clinical outcome for internal fixation and hemiarthroplasty groups over eighty years old for basal intertrochanteric fracture. MATERIALS AND METHODS: Forty-two cases among 62 treated from Aug. 1997 to May 2001 (22 internal fixation-group A and 20 hemiarthroplasty-group B) were retrospectively evaluated to assess walking level, activity of daily living, mental status, dementia, chronic illness and complications after at least a one year follow up. RESULTS: Partial weight bearing was started at a postoperative 14.5 and 9.5 days and full weight bearing at 10 and 3 weeks in group A and B, respectively. Walking level changed from 3.5 to 2.2 in group A, from 3.0 to 2.5 in group B, and the daily living activity scale from 4.8 to 7.9, and from 4.6 to 6.2. Mental status reduced from 22.8 to 18.2, and from 22.8 to 19.7 in each group. Newly developed dementia occurred in 6 and 5, and the index of chronic illness increased from 2.09 to 2.27, and from 2.05 to 2.25 in each group. Other postoperative complications showed no significant difference between the groups. CONCLUSION: The authors suggest bipolar hemiarthroplasty shows better functional recovery in terms of walking level, activity of daily living, and mental status, but same recovery for dementia, postoperative delirium and chronic illness compared to the internal fixation group. Therefore, the authors suggest that bipolar hemiarthroplasty in an effective surgical method in the over eighties.
Activities of Daily Living ; Chronic Disease ; Delirium ; Dementia ; Femur ; Follow-Up Studies ; Hemiarthroplasty* ; Postoperative Complications ; Retrospective Studies ; Walking ; Weight-Bearing

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*

PURPOSE: This study was done to compare demographic characteristics, comorbidity, and health habits of elders with mild cognitive impairment (MCI) and elders with cognitively normal function (CNF). METHODS: Secondary data analysis was conducted using data from the Database of the Seoul Dementia Management Project for 5,773 adults age 60 and above. RESULTS: The MCI group showed an older age distribution, but there was no significant education difference between the two groups. Elders with MCI had more diabetes and stroke than elders with CNF. In subgroups, the same findings were observed in women, but not in men. While more men with MCI had hypertension compared to men with CNF, there was no significant difference in hypertension between the two groups for women. Elders with MCI, men in particular, had a lower prevalence of obesity than men with CNF. MCI individuals did less exercise compared to individuals with CNF. While there were no significant differences in alcohol consumption and smoking between MCI and CNF groups, the over 80's subgroup with MCI reported more alcohol consumption. CONCLUSION: Findings from this study could be helpful in designing community-based dementia prevention programs and health policies to reduce the prevalence of dementia or related cognitive impairments.
Aged ; Aged, 80 and over ; Alcohol Drinking ; Body Mass Index ; Comorbidity ; Databases, Factual ; Dementia/complications ; Demography ; Female ; *Health Behavior ; Heart Diseases/complications ; Humans ; Hypertension/complications ; Male ; Middle Aged ; Mild Cognitive Impairment/complications/*physiopathology ; Obesity/epidemiology ; Sex Factors ; Smoking ; Stroke/complications