轻度认知功能障碍患者的饮食治疗

轻度认知功能障碍(mild cognitive impairment,MCI)是介于正常老化和阿尔茨海默病之间的一种过渡阶段,现无有效治疗药物,但早期进行生活方式干预、包括饮食治疗或能降低MCI向痴呆症的转化率.本文介绍MCI患者的饮食治疗相关研究现状,以期能为改善MCI的风险因素提供一定的参考.     

轻度认知功能障碍患者认知功能与氢质子磁共振波谱的相关性

目的 探讨轻度认知功能障碍(MCI)患者认知功能与氢质子磁共振波谱(1H-MRS)的相关性.方法 选取2020年1月至12月在沈阳市精神卫生中心住院及门诊就诊的20例MCI患者作为MCI组,选取同期在医院住院和门诊就诊的15例阿尔茨海默病(AD)患者作为AD组,选取同期认知功能正常的20例老年志愿者作为对照组.对三组研...     

轻度认知功能障碍的康复治疗进展

随着人口的老龄化,轻度认知功能障碍受到越来越广泛的关注,目前认为MCI是介于正常老化和痴呆之间的一种认知缺损状态,处于这种状态的个体存在超出其年龄所允许的记忆障碍,而记忆以外的大脑高级神经功能被保留,且日常生活不受影响的状态,达不到痴呆的诊断标准。如何对疾病进行干预,延缓甚至逆转病情的发展引起了人们的研究。本文就MCI的康复治疗进展作一综述。1认知训练     

太原市社区老年人轻度认知功能障碍的病例对照研究

<正>轻度认知功能障碍(MCI)是介于正常老化和阿尔茨海默病(AD)之间的一种认知损伤状态,系指老年人出现轻度记忆或某项认知功能障碍,但尚不足以诊断AD的临床现象。目前MCI虽不是明确的疾病实体,但被广泛地认为是一组临床实体或临床症状群。由于MCI干扰老年人正常生活、影响生活质量,并且较健康老年人群相比,MCI患者更易发展为AD     

心房颤动患者轻度认知功能障碍的研究进展

心房颤动可以通过炎症、低灌注、血栓栓塞等多重机制引起颅内病变并影响认知功能,增加轻度认知功能障碍(MCI)及痴呆的风险.MCI是认知功能下降过程中的早期阶段,是临床干预的关键时期,积极的多学科综合管理可延缓认知功能下降进程甚至一定程度改善认知功能,从而预防痴呆.心房颤动患者MCI的患病率居高不下,保护认知功能已逐渐成为...     

轻度认知功能损害患者视觉空间损害的研究

目的 了解轻度认知功能损害(MCI)患者视觉空间损害及其与认知损害之间的关系,揭示视觉功能损害是否可作为痴呆早期诊断的生物学指标.方法 采用横断面比较研究,对20例有轻度认知功能损害的老年人(MCI组)和20例认知功能正常的老年人(NC组)进行Benton视觉保持测验(BVRT)比较.结果 MCI组的BVRT正确得分明显低于对照组(P＜0.05),而总错误得分及各错误得分(特别是遗漏、持续、位置错误)均明显高于对照组(P＜0.05).结论 经BVRT测试后发现,MCI患者存在明显的视觉空间认知功能损害,这种认知功能损伤可能是阿尔茨海默病(AD)早期诊断的生物学指标之一.     

上海市浦东新区轻度认知功能障碍老人的睡眠质量分析

目的 了解上海市浦东新区患有轻度认知功能障碍(mild cognitive impairment,MCI)老年人的睡眠质量,分析其与认知功能的关系.方法 采用PPS(Probability proportional to size)抽样法,对101例老年MCI患者(MCI组)和109例认知健康老年人(对照组)使用匹兹堡...     

胰岛素抵抗和认知功能障碍

从上世纪60年代最早关注糖尿病患者认知功能至今,糖尿病与认知功能障碍之间的关系已得到大量流行病学资料和基础研究证实,从而为广大临床医生所重视。糖尿病所致的认知功能障碍临床表现多样,重者如各种类型的痴呆（阿尔茨海默病、血管性痴呆、混合性痴呆）,轻者如轻度认知功能障碍（MCI）等。     

血清睾酮对老年男性轻度认知功能损害患者认知功能的影响

目的探讨老年男性轻度认知功能损害(MCI)患者血清睾酮水平与认知功能的关系。方法35例轻度认知功能损害男性患者,年龄:78．7±6．1岁。用韦氏成人记忆量表(WMS)和简易智力状态检查量表(MMSE)进行认知功能检查;用化学发光法测定血清睾酮浓度;应用多元线性回归分析各项认知功能与血清睾酮浓度的关系。结果轻度认知功能损害患者血清睾酮浓度与MQ、MMSE评分呈正相关(P＜0．01),主要与视觉再生能力、触摸能力、理解记忆能力和延迟回忆力、语言能力有关(P＜0．01,P＜0．05)。结论血清睾酮水平可选择性影响MCI患者的认知功能,主要影响视空间和言语等能力。     

载脂蛋白Eε4等位基因与轻度认知损害患者认知功能的缺损有关

目的 探讨轻度认知损害（MCI）患者认知功能改变以及认知功能改变和载脂蛋白E（ApoE）ε4等位基因的关系。方法 应用神经心理学方法评估患者的认知功能状况，应用分子生物学的方法进行APOE的基因型检测。结果 ①除记忆力显著下降外。MCI组定向力、语言能力、执行等能力也呈下降趋势。②MCI组ε4等位基因出现的频率远高于正常老年组（P〈0.01）。③ApoEε4的携带者的认知功能的总评分显著低于非ApoEε4携带者（P〈0．001）。除记忆力表现出显著下降外，ApoEε4携带组的语言能力、执行也呈下降趋势（P〈0．05）。结论 轻度认知功能损害患者的认知功能出现改变，且ApoEε4等位基因出现的频率显著高于正常老年组。ApoEε4等位基因与老年人认知功能的下降相关。     

Neuropsychology of cognitive ageing, minimal cognitive impairment, Alzheimer's disease, and vascular cognitive impairment

In this review, the neuropsychological symptoms of different diseases in the elderly are described. After a brief explanation of relevant principles in the neuropsychological assessment of older individuals, a summary of the complex relation between ageing and cognition is presented. It may be concluded that cognitive decline is not an inevitable outcome of ageing, and may well be the result of unrecognised pathology. The term mild cognitive impairment is reserved for patients whose impairment is objectively demonstrable but is not pronounced in more than one domain of cognition and does not seriously affect activities of daily living. The initial phase of Alzheimer's disease is marked by a progressive deterioration of episodic memory. When the process advances, the impairment spreads to other functions, such as semantic memory, language and visuo-spatial ability. Vascular dementia is the second most common type of dementia; however, it is increasingly being recognised that vascular dementia is actually a heterogeneous syndrome and that several vascular pathologies can lead to cognitive deterioration. In contrast to the striking deficits produced by cortical infarcts, lesions of the subcortical white matter are mainly associated with a non-specific slowing of behaviour. Cerebrovascular disease also plays an important role in forms of cognitive decline other than dementia, and as such, it appears to be no less prevalent in old age than Alzheimer's disease. Neuropsychology is an important asset to the study and treatment of cognitive decline, but must be embedded in a multi-disciplinary context.     

认知护理干预对脑梗死轻度认知障碍患者认知功能的影响

目的对认知护理干预对脑梗死轻度认知障碍患者认知功能的影响进行初步研究。方法选取2017年1月～2018年10月我院收治的脑梗死轻度认知障碍患者90例,随机分两组,观察组45例和对照组45例。对照组采取常规治疗和护理,观察组在对照组的基础上给予认知护理干预。通过比较干预后两组患者的MMSE与ADL评分,比较两组的认知功能及精神状态的区别。结果观察组与对照组比较,干预前两组MMSE评分比较,差异无统计学意义(P 0.05),干预后观察组MMSE评分明显高于对照组,差异有统计学意义(P 0.05);观察组与对照组比较,干预前两组ADL评分比较,差异无统计学意义(P 0.05),干预后观察组ADL评分明显低于对照组,差异有统计学意义(P 0.05)。结论认知护理干预对脑梗死轻度认知障碍患者认知功能及精神状态有明显的改善,对于缓解脑梗死患者的认知障碍具有重要的临床参考价值,值得在医院推广应用。     

Early markers of cognitive enhancement: developing an implicit measure of cognitive performance

There is intense interest in the development of effective cognitive enhancing drugs which would have therapeutic application across a number of neurological and psychological disorders including dementia, schizophrenia and depression. However, development in this area has been limited by the absence of sensitive biomarkers which can be used to detect and refine therapeutic-like action in phase 1 clinical studies. The aim of the present study was therefore to develop a measure of cognition relevant to the action of candidate cognitive enhancers which might be sensitive to pharmacological manipulation in healthy volunteers. Healthy volunteers (n?=?34) were randomised to receive a single dose of modafinil (100 mg) or placebo. Five hours post dose, attentional flexibility in learning was assessed using a novel implicit learning task. Volunteers also completed an auditory digit span task and visual analogue scales (VAS). Modafinil increased alertness as measured by the VAS. In the implicit learning task, modafinil enhanced learning rates in terms of both accuracy and reaction time, suggesting an increase in implicit rule learning. These results suggest that the novel learning task should be explored as a biomarker of early cognitive improvement which could be more sensitive than conventional measures.     

Non-pharmacological cognitive enhancement

The term "cognitive enhancement" usually characterizes interventions in humans that aim to improve mental functioning beyond what is necessary to sustain or restore good health. While the current bioethical debate mainly concentrates on pharmaceuticals, according to the given characterization, cognitive enhancement also by non-pharmacological means has to be regarded as enhancement proper. Here we summarize empirical data on approaches using nutrition, physical exercise, sleep, meditation, mnemonic strategies, computer training, and brain stimulation for enhancing cognitive capabilities. Several of these non-pharmacological enhancement strategies seem to be more efficacious compared to currently available pharmaceuticals usually coined as cognitive enhancers. While many ethical arguments of the cognitive enhancement debate apply to both pharmacological and non-pharmacological enhancers, some of them appear in new light when considered on the background of non-pharmacological enhancement. This article is part of a Special Issue entitled 'Cognitive Enhancers'.     

围术期认知护理对老年认知功能的影响

目的观察进行围术期认知护理对老年患者术后认知功能的影响。方法择期髋关节置换手术患者30例,年龄65～89岁,患者术前认知护理干预从术前3d开始,术后认知护理干预从术后1d开始,于术前1d、术后1d、3d记录MMSE评分。结果术后第1d有3例发生POCD(10%);与术前比较,术后第1天MMSE评分降低(P<0.05)。结论髋关节置换手术老年患者术后认知功能有改变;围术期认知护理对老年患者术后认知功能的影响不能确定。     

The cognitive underpinnings of addiction

A new conditional reasoning measure was developed to evaluate the role of implicit biases in perpetuating addictive behavior. Data (N = 669) were collected in 2005 from two samples in a suburban area: individuals with a known history of chemical dependency and individuals from the general population. Results indicated a strong correlation between overall test scores and group membership (r(pb) = .48), which increased when the groups' demographic characteristics were equalized (r(pb) = .65). Overall, findings suggest that addiction-prone individuals rely on a distinct set of cognitive biases that rationalize self-destructive behavior. The study's limitations are noted and implications and directions for future research are discussed.     

药物对认知功能损害的研究

诸多药物能损害认知功能,其作用有专一性,作用强弱与药物剂量、用药时间等因素有关.一个半世纪以来,有关药物与认知损害的关系一直足研究的热点.正确了解药物对认知功能的影响及其作用方式,对药物深入全而地认识,有利于更好地发挥药物的治疗作用.本文探讨药物与认知损害的关系,加深对影响认知功能约物的认识,对临床合理用药具有指导意义.     

Dopaminergic enhancement of cognitive function

The ascending dopamine system of the mammalian brain has been associated with motor, mnemonic and goal-directed or reward-related behaviour. The most progress in understanding the cortical mechanisms of dopaminergic modulation of function has been made with regards to short-term mnemonic (or working memory) function. Research in experimental animals strongly suggests that stimulation of dopamine D1 receptors in the prefrontal cortex can ameliorate spatial working memory related cognitive deficits, and may even enhance cognitive function in healthy animals. Research in humans has not been able to clearly replicate these findings, partly due to the lack of available agents that can safely be used. Low doses of dopamine D2 receptor agonists such as bromocriptine and pergolide may be able to enhance working memory and executive functions, but these effects may be dependent on the nature of the tasks used and the baseline performance levels of the subjects. Thus, the effects of dopaminergic cognitive enhancers may not be simple, or uniform across subjects. Systematic studies in humans carefully controlling task parameters are needed in order to specify the potential cognitive processes open to enhancement with dopaminergics. However, since the DA receptor subtypes in different brain regions appear to differentially influence similar functions, carefully defining the cognitive processes to be tested against potential therapeutics is an equally important goal. Studies in patients groups using selective dopaminergics are rather restricted, but show promise for designing large-scale clinical trials into the cognitive enhancing properties of potential therapeutic agents that act through the dopamine system.     

Attention-modulating effects of cognitive enhancers

Attention can be readily measured in experimental animal models. Animal models of attention have been used to better understand the neural systems involved in attention, how attention is impaired, and how therapeutic treatments can ameliorate attentional deficits. This review focuses on the ways in which animal models are used to better understand the neuronal mechanism of attention and how to develop new therapeutic treatments for attentional impairment. Several behavioral test methods have been developed for experimental animal studies of attention, including a 5-choice serial reaction time task (5-CSRTT), a signal detection task (SDT), and a novel object recognition (NOR) test. These tasks can be used together with genetic, lesion, pharmacological and behavioral models of attentional impairment to test the efficacy of novel therapeutic treatments. The most prominent genetic model is the spontaneously hypertensive rat (SHR). Well-characterized lesion models include frontal cortical or hippocampal lesions. Pharmacological models include challenge with the NMDA glutamate antagonist dizocilpine (MK-801), the nicotinic cholinergic antagonist mecamylamine and the muscarinic cholinergic antagonist scopolamine. Behavioral models include distracting stimuli and attenuated target stimuli. Important validation of these behavioral tests and models of attentional impairments for developing effective treatments for attentional dysfunction is the fact that stimulant treatments effective for attention deficit hyperactivity disorder (ADHD), such as methylphenidate (Ritalin®), are effective in the experimental animal models. Newer lines of treatment including nicotinic agonists, α4β2 nicotinic receptor desensitizers, and histamine H₃ antagonists, have also been found to be effective in improving attention in these animal models. Good carryover has also been seen for the attentional improvement caused by nicotine in experimental animal models and in human populations. Animal models of attention can be effectively used for the development of new treatments of attentional impairment in ADHD and other syndromes in which have attentional impairments occur, such as Alzheimer's disease and schizophrenia.