Characterizing mild cognitive impairment in prodromal Parkinson’s disease: A community‐based study in China

ObjectiveThe International Parkinson and Movement Disorder Society (MDS) has published research criteria for prodromal Parkinson''s disease (pPD), which includes cognitive impairment as a prodromal marker. However, the clinical features of mild cognitive impairment (MCI) in pPD remain unknown. Our study aimed to evaluate the frequency and clinical features of mild cognitive impairment of pPD in the elderly in China.MethodsThe cross‐sectional community‐based study recruited 2688 participants aged ≥50 years. Subjects were diagnosed with pPD according to the MDS criteria. Overall, 39 pPD and 22 healthy controls underwent comprehensive clinical and neuropsychological assessment. MCI was also diagnosed by the MDS criteria. Next, we investigated the relationship between clinical factors and cognition.ResultsAmong the 2,663 dementia‐free and Parkinson disease (PD)‐free participants, 55 met the criteria for pPD (2.1%) and 23 pPD met the criteria for MCI. Memory, attention/working memory, and executive function were the most frequent impaired domains, and amnestic MCI multidomain phenotype was the most frequent MCI subtype (69.57%) in pPD. Additionally, correlation analysis revealed that the global cognitive performance was negatively related to UPDRS‐III score (r = −0.456, p = 0.004).ConclusionMCI, specifically impairment in memory, attention/working memory, and executive domain, is present at the prodromal stage of PD. In addition, cognitive performance is correlated with motor symptoms in pPD. Our results reflect that cognitive profile, combined with motor symptoms, can help clinicians to identify individuals with pPD early, as those would be the optimal candidates for neuroprotective therapy.     

Interactions between cigarette smoking and cognitive status on functional connectivity of the cortico‐striatal circuits in individuals without dementia: A resting‐state functional MRI study

AimsCigarette smoking is a modifiable risk factor for Alzheimer''s disease (AD), and controlling risk factors may curb the progression of AD. However, the underlying neural mechanisms of the effects of smoking on cognition remain largely unclear. Therefore, we aimed to explore the interaction effects of smoking × cognitive status on cortico‐striatal circuits, which play a crucial role in addiction and cognition, in individuals without dementia.MethodsWe enrolled 304 cognitively normal (CN) non‐smokers, 44 CN smokers, 130 mild cognitive impairment (MCI) non‐smokers, and 33 MCI smokers. The mixed‐effect analysis was performed to explore the interaction effects between smoking and cognitive status (CN vs. MCI) based on functional connectivity (FC) of the striatal subregions (caudate, putamen, and nucleus accumbens [NAc]).ResultsThe significant interaction effects of smoking × cognitive status on FC of the striatal subregions were detected in the left inferior parietal lobule (IPL), bilateral cuneus, and bilateral anterior cingulate cortex (ACC). Specifically, increased FC of right caudate to left IPL was found in CN smokers compared with non‐smokers. The MCI smokers showed decreased FC of right caudate to left IPL and of right putamen to bilateral cuneus and increased FC of bilateral NAc to bilateral ACC compared with CN smokers and MCI non‐smokers. Furthermore, a positive correlation between FC of the NAc to ACC with language and memory was detected in MCI smokers.ConclusionsCigarette smoking could affect the function of cortico‐striatal circuits in patients with MCI. Our findings suggest that quitting smoking in the prodromal stage of AD may have the potential to prevent disease progression.     

Quantifying the heterogeneity of cognitive functioning in Alzheimer’s disease to extend the placebo-treatment dichotomy: Latent class analysis of individual-participant data from five pivotal randomized clinical trials of donepezil

BackgroundThe extent and profiles of heterogeneity in cognitive functioning among participants in clinical trials of antidementia medication are unknown. We aimed to quantify and identify profiles of heterogeneity of cognition in Alzheimer’s disease.MethodsIndividual-level participant data were analyzed from five pivotal clinical trials of donepezil for Alzheimer’s disease (N = 2,919). Based on Alzheimer’s Disease Assessment Scale–Cognitive Subscale total scores from baseline up to week 12, a latent class model was used to identify heterogeneous groups. A logistic regression model was used to examine factors associated with group membership. Sensitivity analysis was conducted, restricted to the donepezil, and then the placebo arm.ResultsThe latent class model identified three classes labeled as low scorers (i.e., least cognitive impairment; N = 1,666, 76.04%), improvers (N = 27, 1.23%), and high scorers (N = 498, 22.73%). Logistic modeling showed that donepezil compared to placebo was significantly (p < 0.05) positively associated with membership in the improvers class (OR = 6.88, 95% CI = 2.03, 42.95), and negatively with high scorers (OR = 0.79, 95% CI = 0.64, 0.98). Sensitivity analysis restricted to the placebo, then donepezil arms replicated similar heterogeneity patterns.ConclusionsOur results inform clinicians regarding the extent of heterogeneity in cognitive functioning during treatment and contribute to trial design considerations.     

The effects of a computer-based cognitive and physical training program in a healthy and mildly cognitive impaired aging sample

Objectives: The Long Lasting Memories (LLM) program concerns a newly integrated platform which combines cognitive exercises with physical activity within the context of advanced technologies. The main objective of this study was to present the preliminary results that determine the possible effectiveness of the LLM program in the improvement of cognitive functions and symptoms of depression in healthy elderly and subjects with mild cognitive impairment (MCI). Method: Fifty healthy and MCI subjects participated in the study. All of them received one hour's physical training and 35 minutes’ cognitive training, 3 times a week, during the 12 weeks of the program. Before and after the intervention all participants were assessed using a battery of neuropsychological tests.Results: The results showed a significant improvement after the LLM training in global cognitive function, in verbal memory, in attention, in episodic memory and symptoms of depression. Conclusion: This study indicates that LLM is a promising solution for older adults with and without cognitive impairment, maintaining their wellbeing with few professional and technical requirements.     

Socioeconomic status and depressive symptoms in older people with the mediation role of social support: A population‐based longitudinal study

BackgroundDepressive symptoms has become an increasingly important public health issue, contributing to disability and disease burden around the world. Higher socioeconomic status (SES) has been found to be associated with lower prevalence of depression, but there are few studies about the older Chinese adults with long‐term follow up and rigorous prospective design. Meanwhile, there is little conclusive evidence about the mechanisms through which SES influences the onset of depressive symptoms.ObjectiveTo prospectively examine the association of baseline socioeconomic factors with the risks of developing depressive symptoms during 7‐year follow up in older Chinese population, and to study the mechanism by which SES impacts the prevalence of depressive symptoms.MethodsA total of 5677 individuals over 45 years who participated in an ongoing nationally representative prospective cohort study, China Health and Retirement Longitudinal Study, were free from depressive symptoms at baseline, and completed 7‐year follow‐up were included. Depressive symptoms were assessed using the 10‐item Center for Epidemiological Studies Depression Scale score. Cox proportional hazards regression models were used to examine the association of SES and the incidence of depressive symptoms in 2011 to 2018. Generalized structural equation model was used to analyze the mediation effects of social support on the relation between SES and depressive symptoms.ResultsDuring the 7‐year follow‐up, 2398 (42.2%) cases were identified as depressive symptoms. Compared with the lowest level of household income, participants with the highest level of household income had a 20% reduction in risk (95% CI, 0.70–0.92, P < 0.001). Participants who had junior high school or above education had a 41% lower risk of depressive disorders compared with illiterate participants (95% CI, 0.52–0.69, P < 0.001). The relationship between SES and depressive symptoms was partially mediated by the social support, where higher social support was negatively associated with depressive symptoms. The proportion of mediation effect was even larger for women compared with men.ConclusionSocioeconomic factors were independently associated with the development of depressive symptoms, and the relationship was partially mediated by social support. Social support could be an effective intervention to alleviate the negative effects of lower SES on mental health. Multiple‐level policies should precisely target low‐SES groups, and timely intervention to promote social support for this group should be used to reduce the influence of depression on individuals, family as well as the whole society.     

Social,behavioural, and functional characteristics of community‐dwelling South Korean adults with moderate and severe cognitive impairment

ObjectivesThis study used the 2016 Korean Longitudinal Study on Aging to investigate the social, behavioural, and functional characteristics of community‐dwelling South Korean adults with cognitive impairment.MethodsParticipants were classified as normal, moderate impairment, and severe impairment according to an algorithm that combined the Korean Mini‐Mental State Examination score and the number of difficulties in performing instrumental activities of daily living. Selected characteristics included grip strength, depression, participation in exercise and social activities, and living in a rural, urban, or suburban community.ResultsMost (72.7%) participants were classified as having normal cognition, 20.1% were classified as moderate impairment, and 7.2% were classified as severe impairment. Regardless of sex, the differences in grip strength across the cognitive status classifications were statistically significant, except for the difference between moderate and severe cognitive impairment in males (p = 0.8477). Greater number of depressive symptoms and living in rural areas were associated with significantly higher odds for severe cognitive impairment. Participants with moderate (OR = 0.51) and severe (OR = 0.33) cognitive impairment were less likely to participate in social activities than those with normal cognition.ConclusionsThe study findings revealed that social, behavioural, and functional characteristics are closely related to the cognitive status of community‐dwelling adults in South Korea.     

Effects of cognitive training in Parkinson's disease: A randomized controlled trial

BackgroundIn Parkinson's Disease (PD), cognitive dysfunctions which can reduce patients' quality of life occur frequently. Data on non-pharmacological intervention effects on cognitive functions in patients with PD are rare. The aim of this study was to examine the effects of different cognitive group trainings (structured vs. unstructured) on cognition, depression, and quality of life in non-demented PD patients.MethodsIn this randomized controlled trial, 65 non-demented patients with PD according to UK Brain Bank criteria (Hoehn & Yahr I-III) were allocated to one of two cognitive multi-component treatments (“NEUROvitalis”, a structured training, or the unstructured training “Mentally fit” with randomly assembled cognitive tasks, each including 12 group-sessions à 90 min over 6 weeks) or a waiting list control group (CG). A neuropsychological test battery was performed before and after the training.ResultsCompared to the CG, patients from the “NEUROvitalis” group improved in short-term memory (word list learning “Memo”: p < .01) and working memory (digit span reverse from “DemTect”: p < .05), whereas depression scores where reduced in the “Mentally fit” group (Beck Depression Inventory-II: p < .05). The “NEUROvitalis” group improved significantly more in working memory than the “Mentally fit” group (DemTect: p < .05).DiscussionCognitive and affective functions can be improved by cognitive trainings in PD patients. Specific effects (e.g. on memory and working memory versus depression) seem to be dependent on the type of training. Further research is needed to define long-term effects and the efficacy in PD patients with different extent of cognitive and neuropsychiatric symptoms.     

The effects of 7-week cognitive training in patients with vascular cognitive impairment,no dementia (the Cog-VACCINE study): A randomized controlled trial

IntroductionEvidence for the efficacy of cognitive training in patients with subcortical vascular cognitive impairment no dementia is still lacking.MethodsA randomized, active controlled design using multidomain, adaptive, computerized cognitive training for 30 minutes, 5 days/week for 7 weeks. Assessments included global cognitive function and executive function (primary outcomes) and brain functional connectivity and structural changes (secondary outcomes).ResultsSixty patients were randomized across three medical centers in Beijing. At the end of the intervention, the cognitive training group showed significant improvement in Montreal Cognitive Assessment relative to the active control group (P = .013) and significantly increased functional connectivity between the left dorsolateral prefrontal cortex and medial prefrontal cortex, which was significantly correlated with Montreal Cognitive Assessment change (P = .017).DiscussionComputerized cognitive training significantly improved global cognitive function, which was supported by the improved brain plasticity. Incorporation of biomarkers should be implemented in cognitive training trials.     

The impact of transfer learning on 3D deep learning convolutional neural network segmentation of the hippocampus in mild cognitive impairment and Alzheimer disease subjects

Research on segmentation of the hippocampus in magnetic resonance images through deep learning convolutional neural networks (CNNs) shows promising results, suggesting that these methods can identify small structural abnormalities of the hippocampus, which are among the earliest and most frequent brain changes associated with Alzheimer disease (AD). However, CNNs typically achieve the highest accuracy on datasets acquired from the same domain as the training dataset. Transfer learning allows domain adaptation through further training on a limited dataset. In this study, we applied transfer learning on a network called spatial warping network segmentation (SWANS), developed and trained in a previous study. We used MR images of patients with clinical diagnoses of mild cognitive impairment (MCI) and AD, segmented by two different raters. By using transfer learning techniques, we developed four new models, using different training methods. Testing was performed using 26% of the original dataset, which was excluded from training as a hold‐out test set. In addition, 10% of the overall training dataset was used as a hold‐out validation set. Results showed that all the new models achieved better hippocampal segmentation quality than the baseline SWANS model (p _s < .001), with high similarity to the manual segmentations (mean dice [best model] = 0.878 ± 0.003). The best model was chosen based on visual assessment and volume percentage error (VPE). The increased precision in estimating hippocampal volumes allows the detection of small hippocampal abnormalities already present in the MCI phase (SD = [3.9 ± 0.6]%), which may be crucial for early diagnosis.     

Electroacupuncture ameliorates postoperative cognitive dysfunction and associated neuroinflammation via NLRP3 signal inhibition in aged mice

BackgroundPostoperative cognitive dysfunction (POCD) is associated with worsened prognosis especially in aged population. Clinical and animal studies suggested that electroacupuncture (EA) could improve POCD. However, the underlying mechanisms especially EA’s regulatory role of inflammasomes remain unclear.MethodsThe model of POCD was established by partial hepatectomy surgery in 18‐month mice with or without postoperative EA treatment to the Baihui acupoint (GV20) for 7 days. Cognitive functions were assessed by Morris water maze test, and proinflammatory cytokines IL‐1β and IL‐6 and microglia activity were assayed by qPCR, ELISA, or immunohistochemistry. Tight junction proteins, NLRP3 inflammasome and downstream proteins, and NF‐κB pathway proteins were evaluated by western blotting.ResultsEA markedly preserved cognitive dysfunctions in POCD mice, associated with the inhibition of neuroinflammation as evidenced by reduced microglial activation and decreased IL‐1β and IL‐6 levels in brain tissue. EA also preserved hippocampal neurons and tight junction proteins ZO‐1 and claudin 5. Mechanistically, the activation of NLRP3 inflammasome and NF‐κB was inhibited by EA, while NLRP3 activation abolished EA’s treatment effects on cognitive function.ConclusionEA alleviates POCD‐mediated cognitive dysfunction associated with ameliorated neuroinflammation. Mechanistically, EA’s treatment effects are dependent on NLRP3 inhibition.     

Hippocampal volumes among older Indian adults: Comparison with Alzheimer's disease and mild cognitive impairment

Background:Hippocampal volume data from India have recently been reported in younger adults. Data in older adults are unknown. The present paper describes hippocampal volume from India among older adults and compares the same with patients having Alzheimer''s disease (AD) and mild cognitive impairment (MCI).Results:Age and duration of illness in the MCI group were 70.6 ± 8.6 years and 1.9 ± 0.9 years, respectively. In the AD group, age and duration of illness were 72 ± 8.1 years and 3.1 ± 2.2 years, respectively. In cognitively normal subjects, the age range was 45-88 years (66.9 ± 10.32) years. Mean mini–mental status examination (MMSE) score of healthy subjects was 28.28 ± 1.33. In the MCI group, MMSE was 27.05 ± 1.79. In the AD group, MMSE was 13.32 ± 5.6. In the healthy group, the hippocampal volume was 2.73 ± 0.53 cm³ on the left side and 2.77 ± 0.6 cm³ on the right side. Likewise, in MCI, the volume on the left side was 2.35 ± 0.42 cm³ and the volume on the right side was 2.36 ± 0.38 cm³. Similarly, in the AD group, the volume on the right side was 1.64 ± 0.55 cm³ and on the left side it was 1.59 ± 0.55 cm³. Post hoc analysis using Tukey''s honestly significant difference (HSD) showed, using analysis of variance (ANOVA) that there was a statistically significant difference between healthy and AD (P ≤ 0.01), and between healthy and MCI (P ≤ 0.01) subjects. There was a correlation between MMSE score and hippocampal volume in the AD group.Conclusion:The volume of the hippocampus in older Indian adults was 2.77 ± 0. 6 cm³ on the right side and 2.73 ± 0.52 cm³ on the left side. There was a significant hippocampal volume loss in MCI/AD compared to cognitively normal subjects.     

How to improve the physical health of people with severe mental illness? A multicentric randomized controlled trial on the efficacy of a lifestyle group intervention

Background People with severe mental illnesses (SMI) have a mortality rate two times higher compared to the general population, with a decade of years of life lost. In this randomized controlled trial (RCT), we assessed in a sample of people with bipolar disorder, major depressive disorder, and schizophrenia spectrum disorder, the efficacy of an innovative psychosocial group intervention compared to a brief psychoeducational group intervention on patients’ body mass index (BMI), body weight, waist circumference, Framingham and HOMA-IR indexes. Methods This is a multicentric RCT with blinded outcome assessments carried out in six Italian university centers. After recruitment patients were randomized to receive a 6-month psychosocial intervention to improve patients’ physical health or a brief psychoeducational intervention. All recruited patients were assessed with standardized assessment instruments at baseline and after 6 months. Anthropometric parameters and blood samples have also been collected. Results Four-hundred and two patients with a diagnosis of bipolar disorder (43.3%), schizophrenia or other psychotic disorder (29.9%), or major depression (26.9%) were randomly allocated to the experimental (N = 206) or the control group (N = 195). After 6 months, patients from the experimental group reported a significant reduction in BMI (odds ratio [OR]: 1.93, 95% confidence intervals [CI]: 1.31–2.84; p < 0.001), body weight (OR = 4.78, 95% CI: 0.80–28.27, p < 0.05), and waist circumference (OR = 5.43, 95% CI: 1.45–20.30, p < 0.05). Participants with impaired cognitive and psychosocial functioning had a worse response to the intervention. Conclusions The experimental group intervention was effective in improving the physical health in SMI patients. Further studies are needed to evaluate the feasibility of this intervention in real-world settings.     

Childhood trauma and cardiometabolic risk in severe mental disorders: The mediating role of cognitive control

BackgroundCardiometabolic risk is increased in severe mental disorders (SMDs), and there appears to be a relationship between childhood trauma and cardiometabolic risk, possibly related to adverse health behavior. The current study examined the association between childhood trauma and serum lipids and adiposity in SMDs and the potential mediating role of cognitive and personality characteristics.MethodsParticipants with schizophrenia and bipolar spectrum disorders (N = 819) were included, cardiometabolic risk factors (serum lipids, body mass index, and waist circumference) were measured, and history of childhood trauma was assessed by the Childhood Trauma Questionnaire. Cognitive and personality characteristics were available in subsamples, with assessments of cognitive control, impulsiveness, self-esteem, and affective lability. Linear regressions and mediation analyses with Hayes’ PROCESS were performed, adjusting for age, sex, antipsychotic agent propensity of metabolic side-effect, and diagnostic group.ResultsExperience of three or more subtypes of childhood trauma was positively associated with waist circumference in patients with SMDs (p = 0.014). There were no other significant associations between trauma variables and lipid or adiposity measures in the total sample. Cognitive control was a significant mediator between experience of one or two subtypes of childhood trauma and waist circumference.ConclusionsThe results indicate childhood trauma as a predisposing factor for increased waist circumference in individuals with SMDs. Poorer cognitive control, suggestive of adverse health behavior, might be a mediating factor of the association, and the findings indicate the potential importance of increased focus on these factors in prevention and treatment regimens targeting cardiometabolic health.     

New‐onset and persistent neurological and psychiatric sequelae of COVID‐19 compared to influenza: A retrospective cohort study in a large New York City healthcare network

ObjectivesNeurological and neuropsychiatric manifestations of post‐acute SARS‐CoV‐2 infection (neuro‐PASC) are common among COVID‐19 survivors, but it is unknown how neuro‐PASC differs from influenza‐related neuro‐sequelae. This study investigated the clinical characteristics of COVID‐19 patients with and without new‐onset neuro‐PASC, and of flu patients with similar symptoms.MethodsWe retrospectively screened 18,811 COVID‐19 patients and 5772 flu patients between January 2020 and June 2021 for the presence of new‐onset neuro‐sequelae that persisted at least 2 weeks past the date of COVID‐19 or flu diagnosis.ResultsWe observed 388 COVID‐19 patients with neuro‐PASC versus 149 flu patients with neuro‐sequelae. Common neuro‐PASC symptoms were anxiety (30%), depression (27%), dizziness (22%), altered mental status (17%), chronic headaches (17%), and nausea (11%). The average time to neuro‐PASC onset was 138 days, with hospitalized patients reporting earlier onset than non‐hospitalized patients. Neuro‐PASC was associated with female sex and older age (p < 0.05), but not race, ethnicity, most comorbidities, or COVID‐19 disease severity (p > 0.05). Compared to flu patients, COVID‐19 patients were older, exhibited higher incidence of altered mental status, developed symptoms more quickly, and were prescribed psychiatric drugs more often (p < 0.05).ConclusionsThis study provides additional insights into neuro‐PASC risk factors and differentiates between post‐COVID‐19 and post‐flu neuro‐sequelae.     

A Multimodal Intervention to Improve Cognition in Community-dwelling Older Adults

ObjectiveTo examine the effects of a multimodal intervention composed of cognitive training, physical exercise, and group counseling on cognitive function in community-dwelling older adults.DesignA four-armed, quasi-experimental intervention study.Setting and ParticipantsCommunity-dwelling adults aged 60 years and older (n = 153).InterventionParticipants were allocated into multimodal intervention, cognitive training plus Taichi exercise, cognitive training, or control group. The multimodal intervention included 18 sessions of cognitive training, 18 sessions of Taichi, and 6 sessions of group reminiscence over six weeks.MeasurementsCognitive function, depressive symptoms, and psychological well-being were assessed at the baseline, postintervention, and three-month follow-up. The primary outcome was the change in overall cognition measured by the Montreal Cognitive Assessment (MoCA) and a composite cognitive score derived from a battery of neuropsychological tests.ResultsFor MoCA, there was no significant difference between any of the three intervention groups and controls. For composite cognition, all three intervention groups showed improvements at the three-month follow-up, with a large effect size in the cognitive training plus Taichi group (change difference 0.37, 95% CI 0.18–0.56, Hedge's g = 0.92), and medium effect sizes in the multimodal intervention group (change difference 0.23, 95% CI 0.0 –0.42, g = 0.58) and cognitive training group (change difference 0.22, 95% CI 0.03–0.42, g = 0.55).ConclusionsMultimodal intervention, cognitive training plus Taichi, and cognitive training could foster cognitive function in community-dwelling older adults. The combination of cognitive training and Taichi showed greater efficacy than the other two interventions.     

Plasma ceramides are altered in mild cognitive impairment and predict cognitive decline and hippocampal volume loss

BackgroundA blood-based biomarker of Alzheimer's disease (AD) would be superior to cerebrospinal fluid (CSF) and neuroimaging measures in terms of cost, invasiveness, and feasibility for repeated measures. We previously reported that blood ceramides varied in relation to timing of memory impairment in a population-based study. The present objective was to examine whether plasma ceramides varied by AD severity in a well-characterized clinic sample and were associated with cognitive decline and hippocampal volume loss over 1 year.MethodsParticipants included 25 normal controls (NC), 17 amnestic Mild Cognitive Impairment (MCI), and 21 early probable AD. A thorough neuropsychological battery and neuroimaging with hippocampal volume determination were conducted at baseline and 1 year later. Plasma ceramides were assayed at baseline using high performance liquid chromatography coupled electrospray ionization tandem mass spectrometry.ResultsAlthough all saturated ceramides were lower in MCI compared with AD at baseline, ceramides C22:0 and C24:0 were significantly lower in the MCI group compared with both NC and AD groups (P < .01). Ceramide levels did not differ (P > .05) in AD versus NC. There were no cross-sectional associations between ceramides C22:0 and C24:0 and either cognitive performance or hippocampal volume among any group. However, among the MCI group, higher baseline ceramide C22:0 and C24:0 levels were predictive of cognitive decline and hippocampal volume loss 1 year later.ConclusionResults suggest that very long-chain plasma ceramides C22:0 and C24:0 are altered in MCI and predict memory loss and right hippocampal volume loss among subjects with MCI. These plasma ceramides may be early indicators of AD progression.     

Memory training for adults with probable mild cognitive impairment: a pilot study

Abstract

Background & Objectives: This pilot study aimed to evaluate the efficacy of memory training and health training intervention over a 24-month period in people with probable mild cognitive impairment (MCI).

Research Design & Methods: Based on the accepted criteria, and the neuropsychiatric measures used in the trial, MCI was defined as a subjective change in cognition, impairment in episodic memory, preservation of independence of functional abilities, and no dementia. Without a neurological assessment, laboratory tests, and psychometric evaluation combined, some of our participants may have had dementia that we were unable to detect through neuropsychological testing. Of the 263 total participants, 39 met criteria for a diagnosis of MCI. There were 19 adults in the memory and 20 in health training conditions. Both groups received twenty hours of classroom content that included eight hours of booster sessions at three months post intervention. Hierarchical linear models (HLM) and standardized regression-based (SBR) analyses were used to test the efficacy of the intervention on immediate recall, delayed recall, subjective memory complaints, and memory self-efficacy. Age, education, depression, racial group, ethnic group, MMSE score, and baseline performance were included as covariates.

Results: Over 24 months, the MCI group in the memory training condition showed better objective and subjective memory outcomes compared with the MCI group in the health training condition.

Conclusions: Senior WISE Memory training delivered to individuals with MCI was able to forestall the participants’ declining cognitive ability and sustain the benefit over two years in both subjective and objective memory function.     

Preoperative environment enrichment preserved neuroligin 1 expression possibly via epigenetic regulation to reduce postoperative cognitive dysfunction in mice

AimsPostoperative cognitive dysfunction (POCD) is a common and significant syndrome. Our previous studies have shown that surgery reduces dendritic arborization and spine density and that environment enrichment (EE) reduces POCD. Neuroligin 1 is a postsynaptic protein involved in the formation of postsynaptic protein complex. This study was designed to determine the role of neuroligin 1 in the protection of EE against POCD and the mechanisms for EE to affect neuroligin 1 expression.MethodsEight‐week‐old C57BL/6J male mice with or without EE for 3, 7, or 14 days had right carotid artery exposure under isoflurane anesthesia. An anti‐neuroligin 1 antibody at 1.5 µg/mouse was injected intracerebroventricularly at one and two weeks before the surgery. Mice were subjected to the Barnes maze and fear conditioning tests from one week after the surgery. Cerebral cortex and hippocampus were harvested after surgery.ResultsMice with surgery had poorer performance in the Barnes maze and fear conditioning tests than control mice. EE for 2 weeks, but not EE for 3 or 7 days, improved the performance of surgery mice in these tests. Surgery reduced neuroligin 1 in the hippocampus. Preoperative EE for 2 weeks attenuated this reduction. The anti‐neuroligin 1 antibody worsened the performance of mice with surgery plus EE in the Barnes maze and fear conditioning tests. Surgery increased histone deacetylase activity and decreased the acetylated histone in the hippocampus. EE attenuated these surgery effects.ConclusionOur results suggest that preoperative EE for 2 weeks reduces POCD. This effect may be mediated by preserving neuroligin 1 expression via attenuating surgery‐induced epigenetic dysregulation in the brain.     

Trace of depression: Network structure of depressive symptoms in different clinical conditions

BackgroundPsychopathological network model has received attention recently in the traditional debate about the continuity of depression. However, there is little evidence for comparing the network structure of depressive symptoms in several depressive states at different clinical stages. Through this study of a broad sample of patients with nonclinical to clinical depression, we examined differences in the network structure of depressive symptoms.MethodsFour groups of participants, including cohorts of clinical depression (current depression, n = 294; remitted depression, n = 118) and nonclinical depression (subthreshold depression, N = 184; healthy control, n = 257), responded to Beck Depression Inventory-II (BDI-II). After adjusting for age and sex, the residual scores of the 21 BDI-II items were input into a regularized partial correlation network for each group. Then, the estimated edge strengths/densities and node characteristics were compared.ResultsCurrent depression has a discontinuous structure with a stronger and denser network of symptoms compared with nonclinical groups. Interestingly, remitted depression had improved to the level in healthy controls; however, it retained the same network structure as current depression, which indicates a trace of depression.ConclusionsWe found the traces of depression that remained even after the symptoms disappeared. This study might provide a novel framework for elucidating the development and formation of depression.     

Depressive symptoms and cognitive impairment: A 10-year follow-up study from the Survey of Health,Ageing and Retirement in Europe

BackgroundDepressive symptoms and cognitive impairment often coexisted in the elderly. This study investigates the effect of late-life depressive symptoms on risk of mild cognitive impairment (MCI).MethodsA total of 14,231 dementia- and MCI free participants aged 60+ from the Survey of Health, Ageing, and Retirement in Europe were followed-up for 10 years to detect incident MCI. MCI was defined as 1.5 standard deviation (SD) below the mean of the standardized global cognition score. Depressive symptoms were assessed by a 12-item Europe-depression scale (EURO-D). Severity of depressive symptoms was grouped as: no/minimal (score 0–3), moderate (score 4–5), and severe (score 6–12). Significant depressive symptoms (SDSs) were defined as EURO-D score ≥ 4.ResultsDuring an average of 8.2 (SD = 2.4)-year follow-up, 1,352 (9.50%) incident MCI cases were identified. SDSs were related to higher MCI risk (hazard ratio [HR] = 1.26, 95% confidence intervals [CI]: 1.10–1.44) in total population, individuals aged 70+ (HR = 1.35, 95% CI: 1.14–1.61) and women (HR = 1.28, 95% CI: 1.08–1.51) in Cox proportional hazard model adjusting for confounders. In addition, there was a dose–response association between the severity of depressive symptoms and MCI incidence in total population, people aged ≥70 years and women (p-trend <0.001).ConclusionsSignificant depressive symptoms were associated with higher incidence of MCI in a dose–response fashion, especially among people aged 70+ years and women. Treating depressive symptoms targeting older population and women may be effective in preventing MCI.