高龄老人认知功能的初步研究

目的探讨高龄老龄人群的认知功能状况。方法对75岁以上军队离退休干部进行认知功能评定，分为成功老龄、常态老龄、轻度认知功能损伤三组进行分析。结果三组老人认知功能存在显著差异，主要表现在视空间技能、认知加工速度、延迟回忆、学习能力、注意力和即刻记忆。结论老年人认知功能存在差异性，不同人群认知功能亦有各自特点。     

踝臂指数与血管性认知功能障碍的相关研究

目的探讨踝臂指数与血管性认知功能障碍间的相关性。方法取年龄在60-75岁存在1个及以上心脑血管病危险因素,或影像学提示脑血管病者或有明确脑血管病史患者300例（男性180例,女性120例）,每例按AHA推荐方法测定踝臂指数;分别进行简易精神状态评分（MMSE）、临床痴呆评估量表（CDR）评分及蒙特利尔认知功能评分（MoCA评分）以评估认知功能,并进行相关性分析。结果低踝臂指数（〈0．9）与认知功能障碍严重程度呈正相关。结论踝臂指数可以做为评估认知功能障碍的一个新指标,低踝臂指数可能提示易患认知功能障碍。     

Clinical study on electroacupuncture for obese patients with binge eating disorder: A retrospective study

Binge eating disorder (BED) is a common dietary disorder among obese people. Obesity and eating disorders are related to mental health and physical health. At present, there is no definite and effective method for treatment in clinic. The curative effect of electroacupuncture on obesity is definite. Although there is no conclusive evidence to support its long-term benefits, electroacupuncture has been increasingly used in clinic. This retrospective study determined the prognosis and outcome of electro-acupuncture on obese patients with BED.One hundred forty-three patients with BED and obesity were found from 658 people who participated in the scientific experiment of obesity treatment in Nanjing Hospital of Traditional Chinese Medicine and Nanjing Brain Hospital from March 2015 to June 2018, and 84 patients (aged 18–40 years old) with valid data and uninterrupted treatment were found to be eligible for this retrospective study. According to the intervention methods, the patients were divided into electro-acupuncture combined with cognitive group (n = 32), cognitive therapy group (n = 28), and control group (n = 24). In this study, the 5th edition of Diagnosis and Statistics Manual of Mental Diseases, fasting blood glucose, fasting insulin, total cholesterol (TC), triglyceride, high-density lipoprotein, low-density lipoprotein, body fat rate, muscle mass, visceral index grade, nutrient intake (energy, protein, fat, carbohydrate), body weight, and weight changes before and after treatment were observed.Compared with the cognitive therapy group, negative emotion score, TC, triglyceride, high-density lipoprotein, waist circumference, BW, BMI, body fat percentage of the electroacupuncture combined with cognitive group were lower, while positive emotional scores were higher, and there were significant differences in negative emotional scores, TC, waist circumference and BMI (P < .05). The dietary energy and three major nutrients in the electroacupuncture combined with cognitive group were lower than those in the cognitive group and the blank group (P < .05).The current results suggest that electroacupuncture combined with cognitive therapy is more effective than cognitive therapy alone in treating obese patients with BED. Future prospective studies are necessary to further study the mechanism of electroacupuncture on the obese with BED.     

反复短暂性脑缺血发作对认知功能累积性损害的临床研究

目的:研究反复短暂性脑缺血发作(TIA)对认知功能的累积性损害.方法:采用事件相关电位、改良威斯康辛卡片分类测试、数字连线测试、数字广度测验、言语流畅性测验等评价42例反复TIA患者每次TIA发作后的认知功能状况,并对不同发作次数后的认知功能状况进行比较和分析.结果:不同发作次数后的认知功能状况、P300潜伏期和波幅、轻度认知障碍的检出率存在显著差异.随着发作次数增加,认知功能损害加重,轻度认知障碍的检出率逐渐增高.结论:反复TIA对认知功能可产生累积性损害效应,防治TIA有可能成为降低认知障碍患病率的重要途径.     

The neighborhood effect of cognitive function on self-rated health: A population-based observational study

This study investigates the interaction between the neighborhood effect of cognitive function on self-rated health among middle aged and older adults. Data from the Korean Longitudinal Study on Aging (KLoSA) were analyzed. A total of 9,998 participants were selected for biennial follow-ups from 2006 to 2018 to estimate the probability of change in cognitive function according to individual, regional and dependent variables. A generalized estimating equation (GEE) model and chi-square test were used. The odds ratio (OR) of underestimation, when an individual's cognitive function is lower than his/her regional average of cognitive function, was 1.173 times higher (95 % Confidence Interval [CI]: 1.108–1.241, p-value: <.0001) compared to accurate, when an individual's cognitive function is equal to his/her regional average of cognitive function. The OR of individuals with low cognitive function in regions with low cognitive function levels had the highest probability of poor SRH (self-rated health) (OR: 3.525; 95 % CI: 3.182–3.905, p-value: <.0001) compared to individuals with high cognitive function in regions with high cognitive function levels. Findings speak of the importance of the neighborhood effect of cognitive function on self-rated health among Korean middle aged and older adults. Further research is needed to investigate the potential mediation of pleasurable mechanisms in the rapidly aging population of Korea.     

Mediating role of instrumental activities of daily living ability on cognitive function of older adults living alone: A 4-year longitudinal study from the Kasama study

The aim of this study was to clarify the effect of living alone on the cognitive function of older people and the mediating effect of instrumental activities of daily living (IADL) ability.The data for a final sample of 3276 participants aged 65 years and above who did not require long-term care at the baseline were used from a 4-year prospective cohort study conducted in Kasama City, Japan. Demographic data including age, sex, and depression at baseline were used as covariates. The Kihon checklist evaluated the IADL ability at baseline and cognitive function at follow-up. The characteristics of those living alone and with others were compared using the student t test and χ² test. The effect of living alone on cognitive function was analyzed using logistic regression analysis. Mediation analyses determined the mediating effects of IADL.A total of 325 participants were living alone; they were significantly older than those living with others, more likely to be female, not provide emotional support, and have low physical function, more severe depression, and lower IADL disability. Living alone had a significantly lower risk of cognitive decline at follow-up than living with others. The mediation analysis revealed that IADL disability at follow-up was significantly associated with cognitive decline. Thus, greater IADL ability decreased cognitive decline risk.Older people living alone had a significantly lower risk of cognitive decline, and cognitive function significantly mediated IADL ability. Health support for enhancing IADL abilities may help older people living alone maintain good cognitive function.     

Cognitive functioning in spousal caregivers of dementia patients: findings from the prospective MAASBED study

BACKGROUND: Spousal caregivers are usually of the same age as the dementia patient and therefore at risk of age-related cognitive decline. Suboptimal cognitive functioning in caregivers may have profound implications. METHODS: Fifty-four spousal caregivers of dementia patients from the Memory Clinic of the Academic Hospital Maastricht and the Regional Institute for Community Mental Health Care in the Netherlands were compared with 108 non-caregiving controls. Data were collected on patient and caregiver characteristics and caregiver cognitive functioning. Repeated measures statistical analyses were carried out to investigate the relationship between caregiver cognitive functioning at baseline and patient behavioural problems and caregiver competence during 1 year of follow-up. RESULTS: Caregivers performed significantly worse on several cognitive domains compared with control subjects. Low performance on a verbal memory task was related to a decrease in caregiver subjective competence and an increase in patient hyperactivity. CONCLUSION: The results indicate that screening for cognitive impairment of spousal caregivers may be helpful, because suboptimal cognitive functioning may affect the ability to provide adequate care.     

Cognitive screening using a tape recorder: a pilot study

OBJECTIVES: To determine whether a tape recorder can be used to administer cognitive tests efficiently and yield valid results. DESIGN: Convenience sample. Administration of cognitive test materials by tape recorder and conventional technique. SETTING: Outpatient clinic. PARTICIPANTS: Subjects from memory disorder clinic, hostel accommodation, and community. MEASUREMENTS: Responses to Hopkins Verbal Learning Test-revised, verbal fluency items from the controlled oral word association test, 10-item naming task, a construction task, and speed writing task. RESULTS: Performances on the tape- and clinician-administered battery of tests were highly correlated. Memory impairment was accurately detected using the tape battery. Data from 30 minutes of testing via tape were obtained at the cost to the clinician of 2 to 3 minutes of scoring time. CONCLUSION: Tape-administration of cognitive test material warrants further study as an efficient means of cognitive screening.     

A prospective study of psychiatric disorder and cognitive function in systemic lupus erythematosus.

OBJECTIVES--To investigate change in psychiatric disorder and change in cognitive function in patients with systemic lupus erythematosus (SLE) assessed on two occasions two years apart. METHODS--A prospective cohort study of 49 patients with SLE using standardised psychiatric and clinical research methods. RESULTS--The point prevalence of psychiatric disorder (20% and 24%), and of cognitive impairment (23% and 18%), was similar at first and second interview for the whole group. There was, however, considerable change in individual patient's psychiatric status and cognitive function: only 1/9 patients with impairment on two or more cognitive tests at first interview was still impaired at second interview. Change in cognitive function appeared to mirror change in psychiatric status. CONCLUSIONS--These findings suggest that the previously reported high prevalence of cognitive impairment in SLE may be explained by coexisting psychiatric disorder, rather than reflecting subclinical central nervous system (CNS) involvement.     

A longitudinal study of cardiorespiratory fitness and cognitive function in healthy older adults

OBJECTIVES: To determine whether cardiorespiratory fitness at baseline is associated with maintenance of cognitive function over 6 years or with level of cognitive function on tests performed 6 years later in a longitudinal study of healthy older people. DESIGN: Prospective cohort. SETTING: Community-based study of noninstitutionalized adults aged 55 and older living in Sonoma, California. PARTICIPANTS: Three hundred forty-nine cohort members without evidence of cardiovascular disease, musculoskeletal disability, or cognitive impairment at baseline. MEASUREMENTS: Cardiorespiratory fitness measures were based on a standard treadmill exercise test protocol and included peak oxygen consumption (peak VO2), treadmill exercise duration, and oxygen uptake efficiency slope (OUES). Cognitive function was evaluated at baseline with a modified Mini-Mental State Examination (mMMSE) and after 6 years of follow-up with a detailed cognitive test battery that included the full MMSE, three tests of attention/executive function, two measures of verbal memory, and two tests of verbal fluency. RESULTS: Participants with worse cardiorespiratory fitness at baseline experienced greater decline on the mMMSE over 6 years (mean mMMSE decline (95% confidence interval) by baseline peak VO2 tertile: lowest = -0.5 (-0.8 to -0.3), middle = -0.2 (-0.5-0.0), highest = 0.0 (-0.3-0.2), P =.002 for trend over tertiles). Participants with worse baseline cardiorespiratory fitness also performed worse on all cognitive tests conducted 6 years later. Results were similar for analyses based on peak VO2, treadmill exercise duration, and OUES. After adjustment for demographic and health-related covariates, measures of cardiorespiratory fitness were associated most strongly with measures of global cognitive function and attention/executive function. CONCLUSION: Baseline measures of cardiorespiratory fitness are positively associated with preservation of cognitive function over a 6-year period and with levels of performance on cognitive tests conducted 6 years later in healthy older adults. High cardiorespiratory fitness may protect against cognitive dysfunction in older people.     

Schizophrenia and cognitive dysmetria: a positron-emission tomography study of dysfunctional prefrontal-thalamic-cerebellar circuitry.

Patients suffering from schizophrenia display subtle cognitive abnormalities that may reflect a difficulty in rapidly coordinating the steps that occur in a variety of mental activities. Working interactively with the prefrontal cortex, the cerebellum may play a role in coordinating both motor and cognitive performance. This positron-emission tomography study suggests the presence of a prefrontal-thalamic-cerebellar network that is activated when normal subjects recall complex narrative material, but is dysfunctional in schizophrenic patients when they perform the same task. These results support a role for the cerebellum in cognitive functions and suggest that patients with schizophrenia may suffer from a "cognitive dysmetria" due to dysfunctional prefrontal-thalamic-cerebellar circuitry.     

Reading and solving arithmetic problems improves cognitive functions of normal aged people: a randomized controlled study

The relationship between mental exercise and mental aging is a controversial issue. People generally believe the so-called mental-exercise hypothesis, that is, the age-related decline in cognitive function is less pronounced for people who are mentally active, yet there is insufficient scientific evidence supporting this hypothesis. Previous randomized controlled trial studies showed convincing beneficial effects of cognitive training on directly targeted cognitive functions. In this study, we performed a single-blind, randomized controlled trial on cognitive intervention in 124 community-dwelling seniors (age range, 70 to 86) and estimated the beneficial effects of non-targeted cognitive functions. As for cognitive intervention, the subjects were asked to solve systematized basic problems in reading and arithmetic every day for 6 months. Neuropsychological measures were determined prior to and 6 months after the intervention (post-test) by mini-mental state examination (MMSE), frontal assessment battery at bed side (FAB), and digit-symbol substitution test (DST) of WAIS-R. The FAB and DST scores showed a statistically significant (p<0.001 and p<0.01, respectively) improvement in the post-test compared with the pre-test, such improvement was maintained up to 6 months of follow-up tests in only the experimental group. The transfer effect of cognitive intervention by reading and solving arithmetic problems on non-targeted cognitive functions was demonstrated in this study. This study shows that daily mental training can improve cognitive functions in normal adults. Although general interests in brain training have been increasing in the public, evidence for its beneficial effects, particularly the positive transfer effect on non-targeted cognitive function still remains insufficient. Here, we introduce a new cognitive intervention program for normal aged people, the concept of which is derived from the knowledge of both brain science and clinical studies. We performed a carefully designed single-blind, randomized controlled study, and the results of this study showed convincing evidence that cognitive training provides the beneficial transfer effect.     

No evidence for increased self-reported cognitive failure in Type 1 and Type 2 diabetes: a cross-sectional study.

AIMS: Mild cognitive deficits have been determined in both types of diabetes using neurocognitive tests. Little is known about the degree to which patients complain about their cognitive functioning. This study set out to investigate the magnitude and correlates of self-reported cognitive failure in adult out-patients with Type 1 and Type 2 diabetes. METHODS: Subjective cognitive functioning was measured in 187 diabetic patients using the Cognitive Failures Questionnaire (CFQ). Demographic and clinical characteristics were retrieved from the medical records. The Patient Health Questionnaire 9 items (PHQ-9) was self-administered along with the CFQ to correct for the confounding effect of depression. RESULTS: Analyses were based on 55 patients with Type 1 diabetes and 100 patients with Type 2 diabetes. No difference in mean CFQ score was observed between Type 1 and Type 2 diabetic patients or between Type 1 diabetic patients and healthy control subjects. Female patients with Type 2 diabetes reported significantly fewer cognitive complaints compared with female healthy control subjects. None of the demographic variables and diabetes-related complications was associated with subjective cognitive complaints. A strong positive association was found between depression symptomatology and frequency of self-reported cognitive failure. CONCLUSIONS: Our study could not confirm elevated subjective cognitive complaints in a group of Type 1 and Type 2 diabetes patients, as might be expected given the observed elevated rates of mild cognitive dysfunction in patients with diabetes. Self-reported cognitive failure appears largely determined by depressive symptomatology. Therefore, affective status should be included in any cognitive assessment procedure.     

100例成功老龄认知功能及相关因素的初步研究

目的通过对成功老龄认知功能及相关因素研究,完善理解老年人群的认知功能状况.方法对100例75岁以上符合成功老龄标准的军队离退休干部进行调查,分75～79岁、80～84岁、85岁及以上3个年龄组进行横断面分析.结果100例老人均保持较好的认知功能、躯体活动功能及良好的心态和身心健康,但认知功能随增龄有下降趋势.结论不同年龄段老人在视空间技能和运动速度上虽有显著差异,但认知功能水平保持还是较好的.     

Cigarette smoking and cognitive impairment: A 10-year cohort study in Taiwan

The relationship between cigarette smoking and cognitive impairment is not a simple one. Some studies have demonstrated that cigarette smoking is a risk factor for cognitive impairment in the elderly, whereas other studies have shown cigarette smoking to be protective against dementia. This study aims to explore the relationship between cigarette smoking and cognitive impairment in elderly persons without dementia, during a 10-year period. Data were derived from a population-based cohort study of 1436 elderly Taiwanese. Cognitive function was measured by the SPMSQ both in 1993 and in 2003. A total of 1436 participants free of cognitive impairment at baseline (SPMSQ ≥ 6 in 1993) were included in these analyses. Subsequently, participants were divided into three groups: never, past, and current smokers. The effect of cigarette smoking on cognitive function was assessed using logistic regression. In the logistic regression model adjusted for age, education, hypertension, diabetes, heart disease, and stroke at baseline, persons who had quit smoking (Odds ratio = OR = 0.31; 95% CI = 0.18-0.53; p < 0.001) and those who continued to smoke (OR = 0.37; 95% CI = 0.20-0.70; p < 0.001) were about one-third as likely to develop cognitive impairment as were those who never smoked. However, no dose-response relationship was observed between pack-years and cognitive impairment. Past and current smokers were less likely to develop cognitive impairment during a 10-year follow-up than were those who had never smoked. The present study suggests that smoking may be protective for cognitive function.     

Age-related changes in cognitive domains. A population-based study

BACKGROUND AND AIMS: The aim of the present study is to describe the effects of aging on various cognitive domains (global cognitive function, executive function, motor speed) in a population sample of elderly men, and to describe how their age-related changes are influenced by education, depression, or prevalent cerebrovascular accidents (CEVD). METHODS: A cross-sectional observational study was conducted in a cohort of 334 men, 65 to 95 years old, living in rural communities, participating in the Italian cohort of two population studies--MATISS (Malattie cardiovascolari ATerosclerotiche Istituto Superiore di Sanità) and FINE (Finland, Italy, Netherlands, Elderly). Global cognitive function was measured by the Mini-Mental State Examination (MMSE), executive function by the Stroop test, motor speed by the Purdue Pegboard test, and depression by the CES-D test. Prevalence of cerebrovascular accidents (CEVD), myocardial infarction, and diabetes were evaluated by a questionnaire and a clinical examination. Blood pressure, and total and HDL cholesterol were measured. Current smoking status was self-reported. RESULTS: An age-associated decline in global cognitive functions, executive functions, and motor speed was observed. The decline is more apparent after the age of 85 for the MMSE, and after 75 for executive functions and motor speed. Logistic regression analysis revealed that age was independently associated with altered global cognitive functions, executive functions, and motor speed, even after adjusting for education, depression or prevalent CEVD. CONCLUSIONS: In a cohort of community-living elderly men aged 65 to 95 years, age-associated changes in mental functions are more evident after the age of 85. These changes are independent of education, depression, or prevalent CEVD.     

Periprocedural complications of cardiac implantable electronic device implantation in very elderly patients with cognitive impairment: A prospective study

Very elderly people (over 80 years) with cardiac implantable electronic devices (CIEDs) indications often have a higher prevalence of aging comorbidity, among which cognitive impairment is not uncommon. This study aimed to investigate periprocedural complications of CIED implantation among very elderly patients with and without cognitive impairment. One hundred eighty patients ≥80 years of age indicated for CIED implantation were included in our study. During hospitalization, the cognitive evaluation was performed according to the Diagnostic and Statistical Manual of Mental Disorders (fifth edition). According to the cognitive test results, patients were divided into 2 groups (90 patients with normal cognitive function and 90 patients with cognitive impairment). Meanwhile, their physical parameters and laboratory measurements were completed. The procedural data and periprocedural complications were collected from both groups. The association between cognitive impairment and periprocedural complications was analyzed using univariate and multiple logistic regression analyses. During a one-month follow-up, the most frequent periprocedural complications in very elderly patients were pocket hematoma and thrombosis events. Cognitively impaired patients had a higher incidence of complications than normal cognitive patients. Multivariate regression analysis showed that cognitive impairment was positively correlated with periprocedural complications in very elderly patients. Cognitive impairment is associated with increased periprocedural complications of CIED implantation in very elderly patients.     

Normative data for elderly adults: the Maine-Syracuse study

The primary objective of this study was to provide supplementary normative data on aging and cognition from an ongoing community-based study. This dementia- and stroke-free sample (age range = 70-89; mean = 77.5) consisted of 228 women and 155 men participating in the Maine-Syracuse Longitudinal Study at waves 6 to 7 (2001-2009). The authors employed a battery of 23 widely utilized clinical cognitive tests. In this cross-sectional study, the authors focus on subjects 70 to 79 (n = 248) and 80 to 89 (n = 135) years old, and provide preliminary data for a smaller number of subjects aged 90 to 98 years old (n = 14). More highly educated and younger participants exhibited better performance on cognitive tests. Education was not significantly associated with every cognitive outcome, nor was age cohort membership. The addition of cardiovascular disease (CVD)/health variables to a model including age, education, and gender main effects provided statistically significant increases in R2 (range = .021-.084) of performance on some tests. Results are discussed in relation to this study's value with respect to determining cognitive impairment in individuals free from probable dementia or stroke.     

The neural system that bridges reward and cognition in humans: an fMRI study

We test the hypothesis that motivational and cognitive processes are linked by a specific neural system to reach maximal efficiency. We studied six normal subjects performing a working memory paradigm (n-back tasks) associated with different levels of monetary reward during an fMRI session. The study showed specific brain activation in relation with changes in both the cognitive loading and the reward associated with task performance. First, the working memory tasks activated a network including the dorsolateral prefrontal cortex [Brodmann area (BA) 9/46] and, in addition, in the lateral frontopolar areas (BA 10), but only in the more demanding condition (3-back task). This result suggests that lateral prefrontal areas are organized in a caudo-rostral continuum in relation with the increase in executive requirement. Second, reward induces an increased activation in the areas already activated by working memory processing and in a supplementary region, the medial frontal pole (BA 10), regardless of the level of cognitive processing. It is postulated that the latter region plays a specific role in monitoring the reward value of ongoing cognitive processes. Third, we detected areas where the signal decreases (ventral-BA 11/47 and subgenual prefrontal cortices) in relation with both the increase of cognitive demand and the reward. The deactivation may represent an emotional gating aimed at inhibiting adverse emotional signals to maximize the level of performance. Taken together, these results suggest a balance between increasing activity in cortical cognitive areas and decreasing activity in the limbic and paralimbic structures during ongoing higher cognitive processing.     

老年男性轻度认知功能损害患者轻度帕金森样体征的研究

目的 探讨男性轻度帕金森样体征（MPS）与轻度认知功能损害（MCI）的相关性。方法临床收集老年男性MCI患者85例，以91名认知正常老年人为对照人群，采用统一帕金森病评定量表（UPDRS）运动部分进行MPS评估，应用单因素方差分析和Logistic回归分析揭示MPS与MCI之间的相关性。结果1、单因素方差分析显示MCI组UPDRS运动总评分、强直单项评分、运动迟缓单项评分和轴性损害单项评分均较对照组显著升高（P〈0．05），两组间震颤单项评分差异无统计意义（P〉0．05）。2、多元Logistic回归调整了年龄、教育年限、高血压等危险因素的影响后，UPDRS总评分、运动迟缓单项评分和轴性损害评分仍与MCI密切相关。结论MPS，尤其运动迟缓和轴性损害，常常是MCI的伴随征象。MPS与MCI可能存在类似的发病机制和病理基础。