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Aging Clinical and Experimental Research Jul 2024Cognitive Reserve (CR) reflects acquired knowledge, skills, and abilities throughout life, and it is known for modulating cognitive efficiency in healthy and clinical...
Cognitive Reserve (CR) reflects acquired knowledge, skills, and abilities throughout life, and it is known for modulating cognitive efficiency in healthy and clinical populations. CR, which was initially proposed to explain individual differences in the clinical presentation of dementia, has subsequently been extended to healthy ageing, showing its role in cognitive efficiency also during middle age. Recently, CR has been linked to affective processes in psychiatric conditions such as schizophrenia, major depressive and anxiety symptoms, and psychological distress, suggesting its potential role in emotional expression and regulation. Whether the role of CR in mental health extends to non-pathological adults, and whether this is only relevant in older age is not yet clear. The aim of this work was therefore to explore the relationship between CR and mental health in healthy adults, with a focus on middle adulthood (40-60). In a sample of 96 participants, we found a positive association between CR and mental health outcomes, such that a higher cognitive reserve index corresponded to fewer mental health reported symptoms. Specifically, a higher CR reflecting professional activities was associated with lower stress levels, especially in middle agers. Taken together, these data therefore suggest that engaging occupations may help maintain a robust mental health, especially by reducing stress symptoms during middle age. These results broaden previous findings suggesting that CR relates to affective components of mental health in middle aged and older adults.
Topics: Humans; Cognitive Reserve; Male; Female; Middle Aged; Mental Health; Adult; Stress, Psychological; Aging
PubMed: 38954168
DOI: 10.1007/s40520-024-02776-w -
The Journals of Gerontology. Series A,... Jul 2024Thyroid dysfunction has been associated with cognitive decline and dementia. However, the role of subtle thyroid hormone alterations in cognitive function is still...
BACKGROUND
Thyroid dysfunction has been associated with cognitive decline and dementia. However, the role of subtle thyroid hormone alterations in cognitive function is still debatable.
METHODS
Participants without overt thyroid dysfunction aged 35-74 years at baseline were evaluated in three study waves (2008-10, 2012-14, and 2017-19). We assessed baseline thyroid stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3). Cognitive performance was evaluated every four years in each wave using 10-word immediate and late recall, word recognition, semantic (animals category) and phonemic (letter f) verbal fluency, and the trail-making B-version tests. A global composite z-score was derived from these tests. The associations of TSH, FT4, and FT3 levels with cognitive decline over time were evaluated using linear mixed-effect models adjusted for sociodemographic, clinical, and lifestyle variables.
RESULTS
In 9,524 participants (mean age 51.2±8.9 years old, 51% women, 52% White), there was no association between baseline TSH, FT4, and FT3 levels and cognitive decline during the follow-up. However, increase in FT4 levels over time was associated with faster memory (β=-0.004, 95%CI=-0.007; -0.001, p=0.014), verbal fluency (β=-0.003, 95%CI=-0.007; -0.0005, p=0.021), executive function (β=-0.004, 95%CI=-0.011; -0.003, p<0.001), and global cognition decline (β=-0.003, 95%CI=-0.006; -0.001, p=0.001). Decrease in FT4 levels over time was associated with faster verbal fluency (β=-0.003, 95%CI=-0.007; -0.0004, p=0.025) and executive function (β=-0.004, 95%CI=-0.007; -0.0003, p=0.031) decline.
CONCLUSION
An increase or decrease in FT4 levels over time was associated with faster cognitive decline in middle-aged and older adults without overt thyroid dysfunction during 8 years of follow-up.
PubMed: 38953739
DOI: 10.1093/gerona/glae169 -
Journal of Neuroscience Research Jul 2024Increasing neuroimaging studies have attempted to identify biomarkers of Huntington's disease (HD) progression. Here, we conducted voxel-based meta-analyses of... (Meta-Analysis)
Meta-Analysis Review
Increasing neuroimaging studies have attempted to identify biomarkers of Huntington's disease (HD) progression. Here, we conducted voxel-based meta-analyses of voxel-based morphometry (VBM) studies on HD to investigate the evolution of gray matter volume (GMV) alterations and explore the effects of genetic and clinical features on GMV changes. A systematic review was performed to identify the relevant studies. Meta-analyses of whole-brain VBM studies were performed to assess the regional GMV changes in all HD mutation carriers, in presymptomatic HD (pre-HD), and in symptomatic HD (sym-HD). A quantitative comparison was performed between pre-HD and sym-HD. Meta-regression analyses were used to explore the effects of genetic and clinical features on GMV changes. Twenty-eight studies were included, comparing a total of 1811 HD mutation carriers [including 1150 pre-HD and 560 sym-HD] and 969 healthy controls (HCs). Pre-HD showed decreased GMV in the bilateral caudate nuclei, putamen, insula, anterior cingulate/paracingulate gyri, middle temporal gyri, and left dorsolateral superior frontal gyrus compared with HCs. Compared with pre-HD, GMV decrease in sym-HD extended to the bilateral median cingulate/paracingulate gyri, Rolandic operculum and middle occipital gyri, left amygdala, and superior temporal gyrus. Meta-regression analyses found that age, mean lengths of CAG repeats, and disease burden were negatively associated with GMV atrophy of the bilateral caudate and right insula in all HD mutation carriers. This meta-analysis revealed the pattern of GMV changes from pre-HD to sym-HD, prompting the understanding of HD progression. The pattern of GMV changes may be biomarkers for disease progression in HD.
Topics: Huntington Disease; Humans; Gray Matter; Neuroimaging; Brain; Magnetic Resonance Imaging
PubMed: 38953592
DOI: 10.1002/jnr.25366 -
Trends in memory function and memory impairment among older adults in the USA and Europe, 1996-2018.The Journals of Gerontology. Series A,... Jul 2024Single-country studies document varying time trends in memory function and impairment. Comparative analyses are limited.
BACKGROUND
Single-country studies document varying time trends in memory function and impairment. Comparative analyses are limited.
METHODS
We used self-respondent data on adults aged 50+ years in 13 countries from three surveys (USA: HRS, 1998-2018; England: ELSA, 2002-2018; 11 European countries: SHARE, 2004-2019). Memory is measured with tests of immediate and delayed word recall. Unweighted age- and gender-adjusted mixed effects regression models as well as models with adjustments for additional socio-demographic characteristics and health behaviors were examined. Heterogeneity in trends by gender, age group, and educational attainment were measured.
RESULTS
The age-adjusted 10-year improvement in average test score is 0.04 standard deviations (SDs) (95% confidence interval (CI): 0.03, 0.05) in the USA, 0.17 SDs (95% CI: 0.15, 0.19) in England, and 0.24 SDs (95% CI: 0.23, 0.25) in SHARE countries. Trends are largely similar across gender, age groups, and educational attainment. Regional differences in trends remain after adjustment for potential mechanisms. Difference between the USA and other countries is particularly large under aged 75 years compared to over aged 75 years.
CONCLUSIONS
Pace of improvement in memory function varies strongly across countries. On average, the 11 European countries studied had the fastest improvement, followed by England. The trend in the USA indicates improvement, but at a much slower pace compared to that in England and other European countries. Uncovering the causes for the cross-country heterogeneity in time trends, and in particular the reasons for the comparatively poor performance of the USA, should be both a research and public health priority.
PubMed: 38953519
DOI: 10.1093/gerona/glae154 -
The Gerontologist Jul 2024This study examined day-to-day variation in care-resistant behaviors (CRBs) exhibited by persons living with dementia during mouth health care and the potential...
BACKGROUND AND OBJECTIVES
This study examined day-to-day variation in care-resistant behaviors (CRBs) exhibited by persons living with dementia during mouth health care and the potential influence of time-of-day on CRB trajectories.
RESEARCH DESIGN AND METHODS
A secondary analysis was conducted on a sample of 75 nursing home-dwelling persons living with dementia who exhibited CRBs during mouth care activities. Over 21 days, CRBs were measured using the revised Resistiveness to Care Scale (RTC-r) during morning and afternoon mouth care sessions. Group-based Trajectory Modeling was used to identify trajectory patterns and assess differences between morning and afternoon CRB patterns.
RESULTS
Three trajectory patterns were identified: morning CRB trajectory patterns showed 50.6% of persons living with dementia had consistently low RTC-r scores, 37.5% of persons living with dementia exhibited fluctuating, moderate RTC-r scores, and 11.9% exhibited RTC-r scores that started high and then decreased over time. Similarly, CRB trajectory patterns during afternoon mouth care showed a consistently low RTC-r score for 54.5% and a fluctuating moderate RTC-r score for 38.6% of persons living with dementia. However, the third CRB trajectory group followed a high-increasing trajectory, with RTC-r scores starting high and continuing to increase for 6.9% of persons living with dementia.
DISCUSSION AND IMPLICATIONS
CRBs are dynamic and vary within days and over time; however, the time of the day is often not considered in interventions to manage CRBs. Thus, it is important to consider the timing of providing mouth care for persons living with dementia. Based on the characteristics of the trajectories, we suggest that morning mouth activities may be more efficient.
PubMed: 38953432
DOI: 10.1093/geront/gnae084 -
Zhongguo Yi Xue Ke Xue Yuan Xue Bao.... Jun 2024Alzheimer's disease (AD) is a severe threat to human health and one of the three major causes of human death.Double-stranded RNA-dependent protein kinase (PKR) is an... (Review)
Review
Alzheimer's disease (AD) is a severe threat to human health and one of the three major causes of human death.Double-stranded RNA-dependent protein kinase (PKR) is an interferon-induced protein kinase involved in innate immunity.In the occurrence and development of AD,PKR is upregulated and continuously activated.On the one hand,the activation of PKR triggers an integrated stress response in brain cells.On the other hand,it indirectly upregulates the expression of β-site amyloid precursor protein cleaving enzyme 1 and facilitates the accumulation of amyloid-β protein (Aβ),which could activate PKR activator to further activate PKR,thus forming a sustained accumulation cycle of Aβ.In addition,PKR can promote Tau phosphorylation,thereby reducing microtubule stability in nerve cells.Inflammation in brain tissue,neurotoxicity resulted from Aβ accumulation,and disruption of microtubule stability led to the progression of AD and the declines of memory and cognitive function.Therefore,PKR is a key molecule in the development and progression of AD.Effective PKR detection can aid in the diagnosis and prediction of AD progression and provide opportunities for clinical treatment.The inhibitors targeting PKR are expected to control the activity of PKR,thereby controlling the progression of AD.Therefore,PKR could be a target for the development of therapeutic drugs for AD.
Topics: Alzheimer Disease; Humans; eIF-2 Kinase; Amyloid beta-Peptides; tau Proteins; Phosphorylation; Brain; Amyloid beta-Protein Precursor
PubMed: 38953267
DOI: 10.3881/j.issn.1000-503X.15792 -
The Gerontologist Jul 2024Previous research has tended to prioritize the condition of dementia when investigating positive lived experiences, while there is no evidence that well-being becomes...
BACKGROUND AND OBJECTIVES
Previous research has tended to prioritize the condition of dementia when investigating positive lived experiences, while there is no evidence that well-being becomes fundamentally different when living with dementia. The current exploratory qualitative study examined how people living with dementia describe how they realize their well-being, without treating dementia as a central concern, and specifically addressed people who are successful in maintaining their well-being.
RESEARCH DESIGN AND METHODS
Semi-structured face-to-face interviews (n=16) and two focus groups (n=13) were conducted with community-dwelling older people living with dementia, aged 65-93 years (68% male). Conversations covered contributors to experienced life satisfaction, and life enjoyment, and were analyzed using inductive thematic analysis.
RESULTS
Two main themes described how people realize well-being. (1) To live a fulfilling life, participants engaged in activities in order to feel useful and relaxed, and they engaged with others, by interacting and sharing with others, and relying on others. (2) To have a positive attitude towards life, participants appreciated the good things in their current life, their lived life, and about their own person, and positively coped with difficulties by accepting them as part of life, not dwelling on the negative, and actively addressing difficulties.
DISCUSSION AND IMPLICATIONS
The results appear to reflect universal ways of realizing well-being, justifying the use of universal models of well-being for people living with dementia. We can learn from people living with dementia that living a fulfilling life and having a positive attitude towards life are key to realizing their well-being.
PubMed: 38953169
DOI: 10.1093/geront/gnae077 -
Cureus May 2024Background The elderly population continues to grow worldwide, including in Saudi Arabia. Caring for older people with Alzheimer's and dementia disease is very...
Background The elderly population continues to grow worldwide, including in Saudi Arabia. Caring for older people with Alzheimer's and dementia disease is very challenging and merits specific skills, knowledge, and attitudes among nurses and nursing students. Consequently, nursing students must be prepared with the appropriate knowledge and attitude to care for patients affected by Alzheimer's in their future professions. This study aimed to investigate the knowledge and attitudes of Alzheimer's disease (AD) among bachelor's nursing students in Saudi Arabia. Methods This study used a descriptive cross-sectional design, and data were collected via an online questionnaire comprising two main instruments: the Alzheimer's Disease Knowledge Scale (ADKS) and the Dementia Attitudes Scale (DAS). A total of 477 undergraduate nursing students participated in the study at four universities in four regions of Saudi Arabia. Result The results indicated that Saudi nursing students exhibited insufficient knowledge regarding individuals with AD, reflected by a mean ADKS score of 13.83 out of 30. Yet, they displayed positive attitudes, as indicated by a mean DAS score of 99.29 out of 140. Nursing students in their third year and those who had family members with AD had a higher significant score regarding their knowledge of AD than nursing students who were in their fourth year or those who did not have family members who had AD. Additionally, nursing students aged 20 to 25 years, as well as nursing students in their fourth year, had more positive attitudes toward working with AD patients. Conclusions In conclusion, this study revealed that although many nursing students have a positive attitude toward working with AD patients, they have insufficient knowledge of AD. Therefore, there is an urgent necessity for enhanced educational initiatives, encompassing both greater depth and improved quality, as well as increased clinical training to address this knowledge gap among nursing students in Saudi Arabia.
PubMed: 38953079
DOI: 10.7759/cureus.61444 -
Frontiers in Immunology 2024Antiglycine receptor (anti-GlyR) antibody mediates multiple immune-related diseases. This study aimed to summarize the clinical features to enhance our understanding of... (Review)
Review
BACKGROUND AND OBJECTIVES
Antiglycine receptor (anti-GlyR) antibody mediates multiple immune-related diseases. This study aimed to summarize the clinical features to enhance our understanding of anti-GlyR antibody-related disease.
METHODS
By collecting clinical information from admitted patients positive for glycine receptor (GlyR) antibody, the clinical characteristics of a new patient positive for GlyR antibody were reported in this study. To obtain additional information regarding anti-GlyR antibody-linked illness, clinical data and findings on both newly reported instances in this study and previously published cases were merged and analyzed.
RESULTS
A new case of anti-GlyR antibody-related progressive encephalomyelitis with rigidity and myoclonus (PERM) was identified in this study. A 20-year-old man with only positive cerebrospinal fluid anti-GlyR antibody had a good prognosis with first-line immunotherapy. The literature review indicated that the common clinical manifestations of anti-GlyR antibody-related disease included PERM or stiff-person syndrome (SPS) (n = 179, 50.1%), epileptic seizure (n = 94, 26.3%), and other neurological disorders (n = 84, 24.5%). Other neurological issues included demyelination, inflammation, cerebellar ataxia and movement disorders, encephalitis, acute psychosis, cognitive impairment or dementia, celiac disease, Parkinson's disease, neuropathic pain and allodynia, steroid-responsive deafness, hemiballism/tics, laryngeal dystonia, and generalized weakness included respiratory muscles. The group of PERM/SPS exhibited a better response to immunotherapy than others.
CONCLUSIONS
The findings suggest the presence of multiple clinical phenotypes in anti-GlyR antibody-related disease. Common clinical phenotypes include PERM, SPS, epileptic seizure, and paraneoplastic disease. Patients with RERM/SPS respond well to immunotherapy.
Topics: Humans; Male; Receptors, Glycine; Autoantibodies; Young Adult; Encephalomyelitis; Muscle Rigidity; Myoclonus; Stiff-Person Syndrome; Adult
PubMed: 38953026
DOI: 10.3389/fimmu.2024.1387591 -
Frontiers in Public Health 2024Studies have analyzed the effects of industrial installations on the environment and human health in Taranto, Southern Italy. Literature documented associations between...
INTRODUCTION
Studies have analyzed the effects of industrial installations on the environment and human health in Taranto, Southern Italy. Literature documented associations between different variables and dementia mortality among both women and men. The present study aims to investigate the associations between sex, environment, age, disease duration, pandemic years, anti-dementia drugs, and death rate.
METHODS
Data from the regional medication registry were used. All women and men with an anti-dementia medication between 2015 and 2021 were included and followed-up to 2021. Bayesian mixed effects logistic and Cox regression models with time varying exposures were fitted using integrated nested Laplace approximations and adjusting for patients and therapy characteristics.
RESULTS
A total of 7,961 person-years were observed. Variables associated with lower prevalence of acetylcholinesterase inhibitors (AChEIs) medication were male sex (OR 0.63, 95% CrI 0.42-0.96), age 70-79 years (OR 0.17, 95% CrI 0.06-0.47) and ≥ 80 years (OR 0.08, 95% CrI 0.03-0.23), disease duration of 2-3 years (OR 0.43, 95% CrI 0.32-0.56) and 4-6 years (OR 0.21, 95% CrI 0.13-0.33), and pandemic years 2020 (OR 0.50, 95% CrI 0.37-0.67) and 2021 (OR 0.47, 95% CrI 0.33-0.65). Variables associated with higher mortality were male sex (HR 2.14, 95% CrI 1.75-2.62), residence in the contaminated site of national interest (SIN) (HR 1.25, 95% CrI 1.02-1.53), age ≥ 80 years (HR 6.06, 95% CrI 1.94-18.95), disease duration of 1 year (HR 1.50, 95% CrI 1.12-2.01), 2-3 years (HR 1.90, 95% CrI 1.45-2.48) and 4-6 years (HR 2.21, 95% CrI 1.60-3.07), and pandemic years 2020 (HR 1.38, 95% CrI 1.06-1.80) and 2021 (HR 1.56, 95% CrI 1.21-2.02). Variables associated with lower mortality were therapy with AChEIs alone (HR 0.69, 95% CrI 0.56-0.86) and in combination with memantine (HR 0.54, 95% CrI 0.37-0.81).
DISCUSSION
Male sex, age, disease duration, and pandemic years appeared to be associated with lower AChEIs medications. Male sex, residence in the SIN of Taranto, age, disease duration, and pandemic years seemed to be associated with an increased death rate, while AChEIs medication seemed to be associated with improved survival rate.
Topics: Humans; Male; Female; Italy; Aged; Bayes Theorem; Dementia; Aged, 80 and over; Sex Factors; Cholinesterase Inhibitors; Survival Analysis; Cohort Studies; COVID-19; Middle Aged; Registries
PubMed: 38952726
DOI: 10.3389/fpubh.2024.1380609