Associations of accelerometer-based sleep duration and self-reported sleep difficulties with cognitive function in late mid-life: the Finnish Retirement and Aging Study

ObjectivesPrior evidence suggests that sleep duration and sleep difficulties may be associated with cognitive function in old age, but little is known about the sleep–cognition association in late mid-life. Our aim was to examine the associations of accelerometer-based sleep duration as well as subjective sleep difficulties with different domains of cognitive function among aging workers.MethodsThe study population consisted of 289 participants (mean age 62.4 years, SD 1.02; 83% women) from the Finnish Retirement and Aging Study (FIREA). Sleep difficulties were measured using Jenkins Sleep Problem Scale (difficulties falling asleep, difficulties maintaining sleep, waking up too early in the morning, and nonrestorative sleep). Sleep duration was measured with wrist-worn accelerometer and self-report, and participants were divided into short (<7 h/night), mid-range (7–9 h/night) and long (≥9 h/night) sleepers. Participants underwent extensive cognitive testing covering three domains: (1) memory, (2) executive function, and (3) attention and information processing.ResultsGreater difficulties in waking up too early in the morning were associated with poorer executive function measured with Spatial Working Memory (SWM) test (p = 0.005). Additionally, nonrestorative sleep was associated with poorer executive function measured with Trail Making Test, B–A, (p = 0.036) and borderline significantly with lower SWM (p = 0.056). Compared to mid-range sleepers, long sleepers tended to have poorer cognitive function (all memory function tests and SWM), but the associations were not statistically significant due to small number of long sleepers.ConclusionsSubjective sleep difficulties may be linked to poorer executive function in a relatively healthy population of older workers in their 60 s. Thus, promoting good sleep quality may translate into better cognitive health in late mid-life.     

Efficacy of istradefylline for gait disorders with freezing of gait in Parkinson’s disease: A single-arm,open-label,prospective, multicenter study

Background: Gait disorders are common in Parkinson’s disease patients who respond poorly to dopaminergic treatment. Blockade of adenosine A_2A receptors is expected to improve gait disorders. Istradefylline is a first-in-class selective adenosine A_2A receptor antagonist with benefits for motor complications associated with Parkinson’s disease.

Research design and methods: This multicenter, open-label, single-group, prospective interventional study evaluated changes in total gait-related scores of the Part II/III Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) and Freezing of Gait Questionnaire (FOG-Q) in 31 Parkinson’s disease patients treated with istradefylline. Gait analysis by portable gait rhythmogram was performed.

Results: MDS-UPDRS Part III gait-related total scores significantly decreased at Weeks 4–12 from baseline with significant improvements in gait, freezing of gait, and postural stability. Significant decreases in MDS-UPDRS Part II total scores and individual item scores at Week 12 indicated improved daily living activities. At Week 12, there were significant improvements in FOG-Q, new FOG-Q, and overall movement per 48 h measured by portable gait rhythmogram. Adverse events occurred in 7/31 patients.

Conclusions: Istradefylline improved gait disorders in Parkinson’s disease patients complicated with freezing of gait, improving their quality of life. No unexpected adverse drug reactions were identified.

Trial registration: UMIN-CTR (UMIN000020288).     

The association among demographic factors,health behaviors and sleep quality in youth with Autism Spectrum Disorder

BackgroundA majority of youth with Autism Spectrum Disorder (ASD) have disrupted sleep patterns, but there has been limited research examining factors associated with sleep in this population. Objective: The objective of this study was to compare demographic and lifestyle behaviors with sleep quality in youth with ASD. Methods: A total of 49 children (12.44 years; 78% male) with ASD wore the Actigraph GT9X accelerometer over seven days and nights to assess moderate to vigorous physical activity (MVPA), sedentary behavior (SB), total sleep duration, and sleep efficiency. Parents reported their child’s weekly amount of screen time and demographic information. Participants were classified according to whether they met sleep criteria for duration and efficiency (8–9 h of sleep duration and ≥85% sleep efficiency). T-tests and ANOVA were used to compare demographic and lifestyle factors between the groups. Results: Participants who meet both sleep duration and efficiency criteria had greater minutes of MVPA per day (113.65 min/day) than participants who only met sleep efficiency criteria (40.27 min/day) and participants who did not meet either sleep criteria (67.5 min/day; p < 0.0001). Additionally, participants who met both sleep criteria had fewer minutes of SB compared to those who only met sleep efficiency criteria (384.79 vs 526.05 min/day; p = 0.02). Conclusions: Youth who had indicators of good sleep quality had greater amounts of MVPA and lower amounts of SB. Studies should further examine the relationship between sleep and health behaviors in youth with ASD to determine causal mechanisms, leading to more effective sleep interventions.     

Neurocognitive markers of suicidal ideation in patients with anxiety and mood disorders

Abstract

Objective: This study aims at identifying associations between cognitive function and suicidal ideation in the sample of patients with anxiety and mood disorders (AMD).

Methods: In sum, 186 (age = 39?±?12.3 years; 142 [76.3%] females) patients with AMD were enrolled in the study. Assessment included evaluation of socio-demographic information, medication use, anxiety and depression symptoms. Cognitive tests included measures of psychomotor performance and incidental learning using the Digit Symbol Test. Trail Making Tests respectively measured perceptual speed, task-switching and executive control. Additionally, 21 patients completed tests from the Cambridge Automated Neuropsychological Test Battery measuring set shifting (Interdimensional/extradimensional set-shift), executive planning (Stockings of Cambridge), and decision making (Cambridge Gamble Task [CGT]).

Results: Almost half (45.0%, n?=?86) of the study sample patients had experienced suicidal ideations. In multivariable regression analysis, suicidal ideation was associated with a greater overall proportion of bet and risk taking on the CGT task (β?=?0.726, p?=?.010 and β?=?0.634, p?=?.019), when controlling for socio-demographic characteristics, medication use, anxiety and depression symptoms.

Conclusions: Outpatients with AMD and suicidal ideation could be distinguished by the presence of cognitive deficits in the executive function domain, particularly in impulse-control and risk taking.     

维生素D在孤独症谱系障碍中作用的研究进展

孤独症谱系障碍(ASD)是影响儿童健康的严重公共问题之一,以社交沟通障碍、兴趣或活动范围狭窄以及重复刻板行为为特征。近年来越来越多的研究显示,ASD患儿维生素D(VitD)水平明显低于同龄健康儿童,VitD缺乏可能与ASD的发病机制相关。本文就VitD与ASD的相关研究进行综述。     

妊娠期疾病类型与甲状腺功能异常相关性分析

目的研究妊娠期疾病类型与甲状腺功能异常相关性。方法回顾性分析2015年1月-2017年1月期间在天津港口医院治疗的107例孕妇,根据妊娠期是否患病分为A组、B组与对照组。A组为22例确诊为妊娠期糖尿病的患者;B组为36例确诊为妊娠期高血压疾病的患者;对照组为49例妊娠期血糖与血压正常、无其他疾病的孕妇。所有研究对象妊娠期定期抽取静脉血检测甲状腺功能、血压及血糖水平。采用妊娠期高血压疾病诊断标准、妊娠期糖尿病诊断标准以及妊娠期甲状腺疾病诊断标准联合评价。结果此研究发现糖尿病组与对照组在孕中期游离T4值、A组与对照组在孕晚期、B组与对照组在孕中期和孕晚期的促甲状腺激素(TSH)值对比,差异均有统计学意义(均P<0.05);3组孕妇不同妊娠时期临床甲状腺功能亢进、减退的发病情况各组别数据对比,差异无统计学意义(P>0.05);A组、B组与对照组在孕中期与孕晚期亚临床甲状腺功能减退发病情况数据对比,A组、B组与对照组在不同妊娠时期低T4血症发病情况数据对比,差异均有统计学意义(均P<0.05);孕早期仅甲状腺过氧化物酶抗体(TPOAb)阳性与甲状腺正常数据对比,B组发生率高于对照组、A组发生率低于对照组,差异均有统计学意义(均P<0.05)。结论与正常孕妇相比,妊娠期高血压疾病与妊娠期糖尿病患者在不同妊娠期的游离T4水平更低、TSH水平更高,且随着妊娠期的增长,变化趋势不断增大;妊娠期疾病类型与甲状腺功能异常存在着联系,妊娠期高血压疾病和糖尿病患者甲状腺功能异常发病率明显更高。     

艾滋病儿童神经认知障碍相关因素研究进展

目的 总结艾滋病儿童神经认知障碍影响因素。方法 在PubMed、Web of Science、CNKI、万方和维普数据库，以“艾滋病”、“儿童”、“神经认知障碍”、“脑病”、“影响因素”为主题词或关键词，同时辅以手工检索和文献追溯检索近年相关文献。着重整理影响艾滋病儿童神经认知障碍的因素。对资料进行汇总并撰写综述。结果 检索并阅读相关文献100余篇。艾滋病病毒相关因素（HIV损害中枢神经系统、HIV逃逸及病毒储存库、HIV亚型）、宿主因素（启动抗病毒治疗时机、遗传因素、营养状况及合并其他疾病）、抗病毒治疗药物、社会心理因素等均可影响艾滋病感染儿童神经认知。结论 为了尽可能避免或降低艾滋病儿童神经认知障碍，应当尽早诊断、尽早给予高效的抗逆转录病毒治疗；随访中应重视神经认知发育的观察和筛查，及早识别神经认知障碍，积极寻找多方面的原因并进行有效干预。