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[PMID]:28464917
[Au] Autor:You YN; Cho MR; Park JH; Park GC; Song MY; Choi JB; Na CS; Han JY; Shin JC; Kim JH
[Ad] Endereço:Clinical Research Center, DongShin University Gwangju Oriental Hospital, Gwangju City, Republic of Korea.
[Ti] Título:Assessing the quality of reports about randomized controlled trials of scalp acupuncture treatment for vascular dementia.
[So] Source:Trials;18(1):205, 2017 May 02.
[Is] ISSN:1745-6215
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: This study aimed to evaluate the quality of reports about randomized controlled trials (RCTs) of scalp acupuncture (SA) for the treatment of vascular dementia (VD). METHOD: A systematic search of reports published through to December 2015 was performed in eight databases. The quality of RCTs that used SA as an intervention for VD was evaluated based on the 2010 Consolidated Standards for Reporting of Trials (CONSORT) and 2010 Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) guidelines. Thirteen items from the CONSORT guideline were scored to give an overall quality score (OQS, range 0-13), and a combined key methodological index score (MIS) (range 0-5) of five key methodological items was measured. The OQS of 17 items from the STRICTA guideline (range 0-17) was also measured. RESULTS: In total, 26 reports were evaluated. The median OQS based on the CONSORT guideline was 8 (minimum 5, maximum 11), and "trial design," "sample size," "ancillary analyses," and "harms" had a positive rate of less than 10%. The median MIS was 2 (minimum 0, maximum 5), with "allocation concealment and implementation," "blinding," and "intent-to-treat analysis" having a positive rate of less than 15%. The median OQS based on the STRICTA guideline was 12 (minimum 8, maximum 14), with "extent to which treatment was varied (1c)," "number of needle insertions per subject per session (2a)," and "setting and context of treatment (4b)" having a positive rate of less than 10%. CONCLUSIONS: The overall quality of reports on RCTs of SA treatment for VD was moderate to low. The quality of methodological items was markedly lower than that of other items. The CONSORT and STRICTA guidelines should be used more frequently to standardize the quality of RCT reports of SA treatment for VD.
[Mh] Termos MeSH primário: Pontos de Acupuntura
Terapia por Acupuntura/métodos
Demência Vascular/terapia
Controle de Qualidade
Indicadores de Qualidade em Assistência à Saúde/normas
Ensaios Clínicos Controlados Aleatórios como Assunto/normas
Projetos de Pesquisa/normas
Couro Cabeludo
[Mh] Termos MeSH secundário: Demência Vascular/diagnóstico
Demência Vascular/psicologia
Seres Humanos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1186/s13063-017-1945-0


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[PMID]:29390252
[Au] Autor:Li SS; Zheng J; Mei B; Wang HY; Zheng M; Zheng K
[Ad] Endereço:Department of Geriatrics.
[Ti] Título:Correlation study of Framingham risk score and vascular dementia: An observational study.
[So] Source:Medicine (Baltimore);96(50):e8387, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Vascular dementia (VaD) is one of the most common forms of dementia, and second only to Alzheimer's disease. The purpose of this study was to evaluate the potential diagnostic value of Framingham risk score (FRS) in VaD by investigating the relationship among cardiovascular risks, FRS, and VaD.Data were collected from patients (n = 130) at Tongji Hospital in Wuhan, China. They were divided into 2 groups, including the control group (n = 70) and the VaD group (n = 60). Statistical methods including t-test, logistic regression model, multiple linear regression model, and receiver-operating characteristic (ROC) curve were adopted for the assessment.A significant difference (all P < .05) was observed in systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure, total cholesterol (TC), homosysteine (HCY), glycosylated hemoglobin A1c (HbA1c), FRS, and cerebral white matter lesions (WMLs) between the 2 groups, even after adjusting for age (both P < .05). Age [odds ratio (OR) = 1.20; P = .002], FRS (OR = 1.55; P = .006), and WMLs (OR = 10.17; P = .011) were independent prognostic factors for VaD. The area under the ROC curve (AUC) of FRS for VaD diagnosis prediction was 0.830 (95% confidence interval, 95% CI: 0.730∼ 0.929). There was a significant difference in the AUC between WMLs and WMLs combined with FRS (0.788 (95% CI: 0.667 ∼ 0.880) versus 0.863 (95% CI: 0.754 ∼ 0.936, P = .049). Age, HbA1c, and FRS were negatively correlated with the mini-mental state examination (MMSE) scores (all P < .05) in the VaD group. Moreover, multiple stepwise linear regression analysis showed that the age and FRS were independent predictors of MMSE scores.FRS has a moderate predictive value for the VaD diagnosis, and also increases the risk of cognitive decline.
[Mh] Termos MeSH primário: Demência Vascular/diagnóstico
Medição de Risco/métodos
[Mh] Termos MeSH secundário: Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Pressão Sanguínea/fisiologia
Estudos de Casos e Controles
Colesterol/sangue
Disfunção Cognitiva/fisiopatologia
Feminino
Hemoglobina A Glicada/análise
Homocisteína/sangue
Seres Humanos
Modelos Lineares
Imagem por Ressonância Magnética
Masculino
Testes de Estado Mental e Demência
Meia-Idade
Prognóstico
Substância Branca/diagnóstico por imagem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Glycated Hemoglobin A); 0 (hemoglobin A1c protein, human); 0LVT1QZ0BA (Homocysteine); 97C5T2UQ7J (Cholesterol)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008387


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[PMID]:29023080
[Au] Autor:Valkanova V; Ebmeier KP; Allan CL
[Ti] Título:Depression is linked to dementia in older adults.
[So] Source:Practitioner;261(1800):11-5, 2017 01.
[Is] ISSN:0032-6518
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Depression and dementia are both common conditions in older people, and they frequently occur together. Late life depression affects about 3.0-4.5% of adults aged 65 and older. Depression occurs in up to 20% of patients with Alzheimer's disease and up to 45% of patients with vascular dementia. Rather than a risk factor, depression with onset in later life is more likely to be either prodromal to dementia or a condition that unmasks pre-existing cognitive impairment by compromising cognitive reserve. Depression can be a psychological response to receiving a diagnosis of dementia. The distinction between depression and early dementia may be particularly difficult. Detailed histories obtained from patients and their relatives as well as longitudinal follow-up are important. Cognitive testing can be very helpful. It is preferable to use a neuropsychological test that is sensitive to subtle cognitive changes and assesses all cognitive domains, such as the Montreal Cognitive Assessment. Older people with depression are at raised risk of dementia and this risk is increased if they have had symptoms for a long time, if their symptoms are severe, where there are multiple (vascular) comorbidities, and where there are structural brain changes including hippocampal atrophy and white matter abnormalities.
[Mh] Termos MeSH primário: Transtornos Cognitivos
Depressão
[Mh] Termos MeSH secundário: Demência
Demência Vascular
Transtorno Depressivo
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171013
[St] Status:MEDLINE


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[PMID]:28963120
[Au] Autor:Duncombe J; Kitamura A; Hase Y; Ihara M; Kalaria RN; Horsburgh K
[Ad] Endereço:Centre for Neuroregeneration, University of Edinburgh, Edinburgh, U.K.
[Ti] Título:Chronic cerebral hypoperfusion: a key mechanism leading to vascular cognitive impairment and dementia. Closing the translational gap between rodent models and human vascular cognitive impairment and dementia.
[So] Source:Clin Sci (Lond);131(19):2451-2468, 2017 Oct 01.
[Is] ISSN:1470-8736
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Increasing evidence suggests that vascular risk factors contribute to neurodegeneration, cognitive impairment and dementia. While there is considerable overlap between features of vascular cognitive impairment and dementia (VCID) and Alzheimer's disease (AD), it appears that cerebral hypoperfusion is the common underlying pathophysiological mechanism which is a major contributor to cognitive decline and degenerative processes leading to dementia. Sustained cerebral hypoperfusion is suggested to be the cause of white matter attenuation, a key feature common to both AD and dementia associated with cerebral small vessel disease (SVD). White matter changes increase the risk for stroke, dementia and disability. A major gap has been the lack of mechanistic insights into the evolution and progress of VCID. However, this gap is closing with the recent refinement of rodent models which replicate chronic cerebral hypoperfusion. In this review, we discuss the relevance and advantages of these models in elucidating the pathogenesis of VCID and explore the interplay between hypoperfusion and the deposition of amyloid ß (Aß) protein, as it relates to AD. We use examples of our recent investigations to illustrate the utility of the model in preclinical testing of candidate drugs and lifestyle factors. We propose that the use of such models is necessary for tackling the urgently needed translational gap from preclinical models to clinical treatments.
[Mh] Termos MeSH primário: Comportamento Animal
Circulação Cerebrovascular
Transtornos Cerebrovasculares/complicações
Transtornos Cognitivos/etiologia
Cognição
Demência Vascular/etiologia
Pesquisa Médica Translacional/métodos
[Mh] Termos MeSH secundário: Peptídeos beta-Amiloides
Animais
Comportamento Animal/efeitos dos fármacos
Encéfalo/metabolismo
Encéfalo/patologia
Encéfalo/fisiopatologia
Transtornos Cerebrovasculares/tratamento farmacológico
Transtornos Cerebrovasculares/fisiopatologia
Transtornos Cerebrovasculares/psicologia
Doença Crônica
Cognição/efeitos dos fármacos
Transtornos Cognitivos/tratamento farmacológico
Transtornos Cognitivos/fisiopatologia
Transtornos Cognitivos/psicologia
Demência Vascular/tratamento farmacológico
Demência Vascular/fisiopatologia
Demência Vascular/psicologia
Modelos Animais de Doenças
Progressão da Doença
Seres Humanos
Leucoencefalopatias/etiologia
Leucoencefalopatias/fisiopatologia
Leucoencefalopatias/psicologia
Placa Amiloide
Fatores de Risco
Especificidade da Espécie
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Amyloid beta-Peptides)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171001
[St] Status:MEDLINE
[do] DOI:10.1042/CS20160727


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[PMID]:28832877
[Au] Autor:Kessing LV; Gerds TA; Knudsen NN; Jørgensen LF; Kristiansen SM; Voutchkova D; Ernstsen V; Schullehner J; Hansen B; Andersen PK; Ersbøll AK
[Ad] Endereço:Psychiatric Center Copenhagen, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
[Ti] Título:Association of Lithium in Drinking Water With the Incidence of Dementia.
[So] Source:JAMA Psychiatry;74(10):1005-1010, 2017 Oct 01.
[Is] ISSN:2168-6238
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Results from animal and human studies suggest that lithium in therapeutic doses may improve learning and memory and modify the risk of developing dementia. Additional preliminary studies suggest that subtherapeutic levels, including microlevels of lithium, may influence human cognition. Objective: To investigate whether the incidence of dementia in the general population covaries with long-term exposure to microlevels of lithium in drinking water. Design, Setting, and Participants: This Danish nationwide, population-based, nested case-control study examined longitudinal, individual geographic data on municipality of residence and data from drinking water measurements combined with time-specific data from all patients aged 50 to 90 years with a hospital contact with a diagnosis of dementia from January 1, 1970, through December 31, 2013, and 10 age- and sex-matched control individuals from the Danish population. The mean lithium exposure in drinking water since 1986 was estimated for all study individuals. Data analysis was performed from January 1, 1995, through December 31, 2013. Main Outcomes and Measures: A diagnosis of dementia in a hospital inpatient or outpatient contact. Diagnoses of Alzheimer disease and vascular dementia were secondary outcome measures. In primary analyses, distribution of lithium exposure was compared between patients with dementia and controls. Results: A total of 73 731 patients with dementia and 733 653 controls (median age, 80.3 years; interquartile range, 74.9-84.6 years; 44 760 female [60.7%] and 28 971 male [39.3%]) were included in the study. Lithium exposure was statistically significantly different between patients with a diagnosis of dementia (median, 11.5 µg/L; interquartile range, 6.5-14.9 µg/L) and controls (median, 12.2 µg/L; interquartile range, 7.3-16.0 µg/L; P < .001). A nonlinear association was observed. Compared with individuals exposed to 2.0 to 5.0 µg/L, the incidence rate ratio (IRR) of dementia was decreased in those exposed to more than 15.0 µg/L (IRR, 0.83; 95% CI, 0.81-0.85; P < .001) and 10.1 to 15.0 µg/L (IRR, 0.98; 95% CI, 0.96-1.01; P = .17) and increased with 5.1 to 10.0 µg/L (IRR, 1.22; 95% CI, 1.19-1.25; P < .001). Similar patterns were found with Alzheimer disease and vascular dementia as outcomes. Conclusions and Relevance: Long-term increased lithium exposure in drinking water may be associated with a lower incidence of dementia in a nonlinear way; however, confounding from other factors associated with municipality of residence cannot be excluded.
[Mh] Termos MeSH primário: Doença de Alzheimer
Demência Vascular
Demência
Água Potável/análise
Exposição Ambiental
Lítio/análise
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Doença de Alzheimer/diagnóstico
Doença de Alzheimer/epidemiologia
Estudos de Casos e Controles
Demência/diagnóstico
Demência/epidemiologia
Demência Vascular/diagnóstico
Demência Vascular/epidemiologia
Dinamarca/epidemiologia
Exposição Ambiental/análise
Exposição Ambiental/estatística & dados numéricos
Feminino
Seres Humanos
Incidência
Masculino
Estatística como Assunto
Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Drinking Water); 9FN79X2M3F (Lithium)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170824
[St] Status:MEDLINE
[do] DOI:10.1001/jamapsychiatry.2017.2362


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[PMID]:28784822
[Au] Autor:Oishi E; Ohara T; Sakata S; Fukuhara M; Hata J; Yoshida D; Shibata M; Ohtsubo T; Kitazono T; Kiyohara Y; Ninomiya T
[Ad] Endereço:From Department of Epidemiology and Public Health (E.O., T. Ohara, S.S., J.H., D.Y., M.S., T.N.), Department of Medicine and Clinical Science (E.O., S.S., J.H., T. Ohtsubo, T.K.), Department of Neuropsychiatry (T. Ohara), and Department of Center for Cohort Studies (J.H., D.Y., T.K., T.N.), Graduate
[Ti] Título:Day-to-Day Blood Pressure Variability and Risk of Dementia in a General Japanese Elderly Population: The Hisayama Study.
[So] Source:Circulation;136(6):516-525, 2017 Aug 08.
[Is] ISSN:1524-4539
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Several observational studies have reported that higher visit-to-visit blood pressure variability is a risk factor for cognitive impairment and dementia. However, no studies have investigated the association of day-to-day blood pressure variability assessed by home blood pressure measurement with the development of dementia. METHODS: A total of 1674 community-dwelling Japanese elderly without dementia, ≥60 years of age, were followed up for 5 years (2007-2012). Home blood pressure was measured 3 times every morning for a median of 28 days. Day-to-day systolic (SBP) and diastolic blood pressure variabilities, calculated as coefficients of variation (CoV) of home SBP and diastolic blood pressure, were categorized into quartiles. The hazard ratios and their 95% confidence intervals of the CoV levels of home blood pressure on the development of all-cause dementia, vascular dementia (VaD), and Alzheimer disease (AD) were computed with a Cox proportional hazards model. RESULTS: During the follow-up, 194 subjects developed all-cause dementia; of these, 47 had VaD and 134 had AD. The age- and sex-adjusted incidences of all-cause dementia, VaD, and AD increased significantly with increasing CoV levels of home SBP (all for trend <0.05). These associations remained unchanged after adjustment for potential confounding factors, including home SBP. Compared with subjects in the first quartile of CoV levels of home SBP, the risks of the development of all-cause dementia, VaD, and AD were significantly higher in those in the fourth quartile (hazard ratio=2.27, 95% confidence interval=1.45-3.55, <0.001 for all-cause dementia; hazard ratio=2.79, 95% confidence interval=1.04-7.51, =0.03 for VaD; hazard ratio=2.22, 95% confidence interval=1.31-3.75, <0.001 for AD). Similar associations were observed for CoV levels of home diastolic blood pressure. Meanwhile, home SBP levels were significantly associated with the risk of VaD but not with the risks of all-cause dementia and AD. There was no interaction between home SBP levels and CoV levels of home SBP on the risk of each subtype of dementia. CONCLUSIONS: Our findings suggest that increased day-to-day blood pressure variability is, independently of average home blood pressure, a significant risk factor for the development of all-cause dementia, VaD, and AD in the general elderly Japanese population.
[Mh] Termos MeSH primário: Pressão Sanguínea/fisiologia
Demência/epidemiologia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Doença de Alzheimer/diagnóstico
Doença de Alzheimer/epidemiologia
Demência/diagnóstico
Demência Vascular/diagnóstico
Demência Vascular/epidemiologia
Feminino
Seguimentos
Seres Humanos
Japão/epidemiologia
Masculino
Meia-Idade
Modelos de Riscos Proporcionais
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170830
[Lr] Data última revisão:
170830
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170809
[St] Status:MEDLINE
[do] DOI:10.1161/CIRCULATIONAHA.116.025667


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[PMID]:28667178
[Au] Autor:Donadio V; Incensi A; Rizzo G; Capellari S; Pantieri R; Stanzani Maserati M; Devigili G; Eleopra R; Defazio G; Montini F; Baruzzi A; Liguori R
[Ad] Endereço:From the IRCCS Institute of Neurological Sciences (V.D., A.I., G.R., S.C., R.P., M.S.M., F.M., A.B., R.L.); Department of Biomedical and Neuromotor Sciences (G.R., S.C., R.L.), University of Bologna; Neurological Unit (G. Devigili, R.E.), Department of Neurosciences, "Santa Maria della Misericordia"
[Ti] Título:A new potential biomarker for dementia with Lewy bodies: Skin nerve α-synuclein deposits.
[So] Source:Neurology;89(4):318-326, 2017 Jul 25.
[Is] ISSN:1526-632X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To investigate whether (1) phosphorylated α-synuclein (p-syn) deposits in skin nerves could be useful in differentiating dementia with Lewy bodies (DLB) from different forms of dementia and (2) small fiber neuropathy (SFN) is associated with DLB. METHODS: We studied 18 well-characterized patients with DLB (11 with autonomic dysfunction), 23 patients with nonsynucleinopathy dementia (NSD; 13 with young-onset Alzheimer disease dementia, 6 frontotemporal dementia, and 4 vascular dementia), and 25 healthy controls. All participants underwent skin biopsies from proximal (i.e., cervical) and distal (i.e., thigh and distal leg) sites to study small nerve fibers and deposits of p-syn, considered the pathologic form of α-synuclein. RESULTS: No p-syn was detected in any skin sample in patients with NSD and controls but was found in all patients with DLB. SFN was found in patients with DLB and the autonomic denervation of skin was more severe in patients with autonomic dysfunctions. CONCLUSIONS: (1) In autonomic skin nerves, p-syn is a sensitive biomarker for DLB diagnosis, helping to differentiate DLB from other forms of dementia, although this needs to be confirmed in a larger, more representative sample; and (2) skin autonomic neuropathy is part of the DLB pathology and may contribute to autonomic symptoms. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that p-syn in skin nerve fibers on skin biopsy accurately distinguishes DLB from other forms of dementia.
[Mh] Termos MeSH primário: Doença por Corpos de Lewy/diagnóstico
Doença por Corpos de Lewy/metabolismo
Pele/inervação
Pele/metabolismo
alfa-Sinucleína/metabolismo
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Doença de Alzheimer/diagnóstico
Doença de Alzheimer/metabolismo
Doença de Alzheimer/patologia
Vias Autônomas/metabolismo
Vias Autônomas/patologia
Biomarcadores/metabolismo
Demência Vascular/diagnóstico
Demência Vascular/metabolismo
Demência Vascular/patologia
Diagnóstico Diferencial
Feminino
Demência Frontotemporal/diagnóstico
Demência Frontotemporal/metabolismo
Demência Frontotemporal/patologia
Seres Humanos
Perna (Membro)/inervação
Perna (Membro)/patologia
Doença por Corpos de Lewy/patologia
Masculino
Microscopia Confocal
Meia-Idade
Fosforilação
Pele/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (SNCA protein, human); 0 (alpha-Synuclein)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170728
[Lr] Data última revisão:
170728
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170702
[St] Status:MEDLINE
[do] DOI:10.1212/WNL.0000000000004146


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[PMID]:28667059
[Au] Autor:Appleton JP; Scutt P; Sprigg N; Bath PM
[Ad] Endereço:Stroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, Nottingham NG5 1PB, U.K.
[Ti] Título:Hypercholesterolaemia and vascular dementia.
[So] Source:Clin Sci (Lond);131(14):1561-1578, 2017 Jul 15.
[Is] ISSN:1470-8736
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Vascular dementia (VaD) is the second commonest cause of dementia. Stroke is the leading cause of disability in adults in developed countries, the second major cause of dementia and the third commonest cause of death. Traditional vascular risk factors-diabetes, hypercholesterolaemia, hypertension and smoking-are implicated as risk factors for VaD. The associations between cholesterol and small vessel disease (SVD), stroke, cognitive impairment and subsequent dementia are complex and as yet not fully understood. Similarly, the effects of lipids and lipid-lowering therapy on preventing or treating dementia remain unclear; the few trials that have assessed lipid-lowering therapy for preventing (two trials) or treating (four trials) dementia found no evidence to support the use of lipid-lowering therapy for these indications. It is appropriate to treat those patients with vascular risk factors that meet criteria for lipid-lowering therapy for the primary and secondary prevention of cardiovascular and cerebrovascular events, and in line with current guidelines. Managing the individual patient in a holistic manner according to his or her own vascular risk profile is recommended. Although the paucity of randomized controlled evidence makes for challenging clinical decision making, it provides multiple opportunities for on-going and future research, as discussed here.
[Mh] Termos MeSH primário: Demência Vascular/etiologia
Hipercolesterolemia/complicações
[Mh] Termos MeSH secundário: Doença de Alzheimer/etiologia
Hemorragia Cerebral/complicações
Hemorragia Cerebral/epidemiologia
Demência Vascular/epidemiologia
Demência Vascular/prevenção & controle
Seres Humanos
Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico
Hipercolesterolemia/tratamento farmacológico
Hipercolesterolemia/epidemiologia
Hipolipemiantes/uso terapêutico
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors); 0 (Hypolipidemic Agents)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170828
[Lr] Data última revisão:
170828
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170702
[St] Status:MEDLINE
[do] DOI:10.1042/CS20160382


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[PMID]:28667060
[Au] Autor:Love S; Miners JS
[Ad] Endereço:Dementia Research Group, School of Clinical Sciences, University of Bristol, Learning and Research Level 1, Southmead Hospital, Bristol BS10 5NB, U.K. seth.love@bris.ac.uk.
[Ti] Título:Small vessel disease, neurovascular regulation and cognitive impairment: post-mortem studies reveal a complex relationship, still poorly understood.
[So] Source:Clin Sci (Lond);131(14):1579-1589, 2017 Jul 15.
[Is] ISSN:1470-8736
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The contribution of vascular disease to cognitive impairment is under-recognized and the pathogenesis is poorly understood. This information gap has multiple causes, including a lack of post-mortem validation of clinical diagnoses of vascular cognitive impairment (VCI) or vascular dementia (VaD), the exclusion of cases with concomitant neurodegenerative disease when diagnosing VCI/VaD, and a lack of standardization of neuropathological assessment protocols for vascular disease. Other contributors include a focus on end-stage destructive lesions to the exclusion of more subtle types of diffuse brain injury, on structural abnormalities of arteries and arterioles to the exclusion of non-structural abnormalities and capillary damage, and the use of post-mortem sampling strategies that are biased towards the identification of neurodegenerative pathologies. Recent studies have demonstrated the value of detailed neuropathology in characterizing vascular contributions to cognitive impairment (e.g. in diabetes), and highlight the importance of diffuse white matter changes, capillary damage and vasoregulatory abnormalities in VCI/VaD. The use of standardized, evidence-based post-mortem assessment protocols and the inclusion of biochemical as well as morphological methods in neuropathological studies should improve the accuracy of determination of the contribution of vascular disease to cognitive impairment and clarify the relative contribution of different pathogenic processes to the tissue damage.
[Mh] Termos MeSH primário: Disfunção Cognitiva/etiologia
Doenças Vasculares/complicações
[Mh] Termos MeSH secundário: Autopsia
Barreira Hematoencefálica/fisiopatologia
Hemorragia Cerebral/complicações
Hemorragia Cerebral/patologia
Infarto Cerebral/complicações
Infarto Cerebral/patologia
Disfunção Cognitiva/patologia
Disfunção Cognitiva/fisiopatologia
Demência Vascular/etiologia
Demência Vascular/patologia
Demência Vascular/fisiopatologia
Seres Humanos
Doenças Vasculares/patologia
Doenças Vasculares/fisiopatologia
Vasoconstrição/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170828
[Lr] Data última revisão:
170828
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170702
[St] Status:MEDLINE
[do] DOI:10.1042/CS20170148


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[PMID]:28611236
[Au] Autor:Yang R; Fu S; Zhao L; Zhen B; Ye L; Niu X; Li X; Zhang P; Bai J
[Ad] Endereço:Department of Orthopedics, First Affiliated Hospital, Chinese PLA General Hospital, Beijing 100048, China.
[Ti] Título:Quantitation of circulating GDF-11 and ß2-MG in aged patients with age-related impairment in cognitive function.
[So] Source:Clin Sci (Lond);131(15):1895-1904, 2017 Aug 01.
[Is] ISSN:1470-8736
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Growth differentiation factor 11 (GDF-11) has been implicated in reverse effects of ageing on the central nervous system of humans. ß2-microglobulin (ß2-MG) has been reported to negatively regulate cognition. However, there is a lot of controversy about the role of GDF-11 and ß2-MG in ageing and cognitive regulation. To examine the involvement of GDF-11 and ß2-MG in the ageing process and cognitive dysfunction, a total of 51 healthy subjects and 41 elderly patients with different degrees of age-related cognitive impairment participated in the study. We measured plasma GDF-11 and ß2-MG levels using ELISA and immunoturbidimetry, respectively. The results were statistically analyzed to evaluate the associations between levels of GDF-11 and ß2-MG, and ageing and cognitive impairments. Circulating GDF-11 levels did not decline with age or correlate with ageing in healthy Chinese males. We did not detect differences in circulating GDF-11 levels amongst the healthy advanced age and four cognitive impairment groups. ß2-MG levels increased with age, but there was no significant difference between healthy elderly males and advanced age males. Increased levels of ß2-MG were observed in the dementia group compared with the healthy advanced age group. Our results suggest that circulating GDF-11 may not exert a protective effect during the ageing process or on cognitive function, and ß2-MG may play a role in ageing and cognitive impairment. However, it is possible that the relatively small sample size in the present study affected the quality of the statistical analysis, and future studies are needed to further validate our findings.
[Mh] Termos MeSH primário: Envelhecimento/sangue
Proteínas Morfogenéticas Ósseas/sangue
Transtornos Cognitivos/sangue
Fatores de Diferenciação de Crescimento/sangue
Microglobulina-2 beta/sangue
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Doença de Alzheimer/sangue
Biomarcadores/sangue
Proteína C-Reativa/metabolismo
Demência Vascular/sangue
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (Bone Morphogenetic Proteins); 0 (GDF11 protein, human); 0 (Growth Differentiation Factors); 0 (beta 2-Microglobulin); 9007-41-4 (C-Reactive Protein)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170615
[St] Status:MEDLINE
[do] DOI:10.1042/CS20171028



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