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  1 / 6 MEDLINE  
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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


  2 / 6 MEDLINE  
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[PMID]:27778099
[Au] Autor:Fiorenzato E; Weis L; Seppi K; Onofrj M; Cortelli P; Zanigni S; Tonon C; Kaufmann H; Shepherd TM; Poewe W; Krismer F; Wenning G; Antonini A; Biundo R; Movement Disorders Society MSA (MODIMSA) Neuropsychology and Imaging Study Groups
[Ad] Endereço:Parkinson Disease and Movement Disorders Unit, IRCCS San Camillo Hospital Foundation, via Alberoni, 70, 30126, Venice-Lido, Italy. eleonora.fiorenzato@gmail.com.
[Ti] Título:Brain structural profile of multiple system atrophy patients with cognitive impairment.
[So] Source:J Neural Transm (Vienna);124(3):293-302, 2017 Mar.
[Is] ISSN:1435-1463
[Cp] País de publicação:Austria
[La] Idioma:eng
[Ab] Resumo:Current consensus diagnostic criteria for multiple system atrophy (MSA) consider dementia a non-supporting feature, although cognitive impairment and even frank dementia are reported in clinical practice. Mini-Mental State Examination (MMSE) is a commonly used global cognitive scale, and in a previous study, we established an MSA-specific screening cut-off score <27 to identify cognitive impairment. Finally, MSA neuroimaging findings suggest the presence of structural alterations in patients with cognitive deficits, although the extent of the anatomical changes is unclear. The aim of our multicenter study is to better characterize anatomical changes associated with cognitive impairment in MSA and to further investigate cortical and subcortical structural differences versus healthy controls (HC). We examined retrospectively 72 probable MSA patients [50 with normal cognition (MSA-NC) and 22 cognitively impaired (MSA-CI) based on MMSE <27] and compared them to 36 HC using gray- and white-matter voxel-based morphometry and fully automated subcortical segmentation. Compared to HC, MSA patients showed widespread cortical (bilateral frontal, occipito-temporal, and parietal areas), subcortical, and white-matter alterations. However, MSA-CI showed only focal volume reduction in the left dorsolateral prefrontal cortex compared with MSA-NC. These results suggest only a marginal contribution of cortical pathology to cognitive deficits. We believe that cognitive dysfunction is driven by focal fronto-striatal degeneration in line with the concept of "subcortical cognitive impairment".
[Mh] Termos MeSH primário: Encéfalo/diagnóstico por imagem
Disfunção Cognitiva/complicações
Disfunção Cognitiva/diagnóstico por imagem
Atrofia de Múltiplos Sistemas/complicações
Atrofia de Múltiplos Sistemas/diagnóstico por imagem
[Mh] Termos MeSH secundário: Feminino
Substância Cinzenta/diagnóstico por imagem
Seres Humanos
Imagem Tridimensional
Imagem por Ressonância Magnética
Masculino
Testes de Estado Mental e Demência
Meia-Idade
Atrofia de Múltiplos Sistemas/psicologia
Neuroimagem
Tamanho do Órgão
Reconhecimento Automatizado de Padrão
Estudos Retrospectivos
Substância Branca/diagnóstico por imagem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.1007/s00702-016-1636-0


  3 / 6 MEDLINE  
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[PMID]:28740370
[Au] Autor:Bai K; Pan Y; Lu F; Zhao Y; Wang J; Zhang L
[Ad] Endereço:Renal Division, Department of Medicine, Peking University First Hospital, Beijing, People's Republic of China.
[Ti] Título:Kidney function and cognitive decline in an oldest-old Chinese population.
[So] Source:Clin Interv Aging;12:1049-1054, 2017.
[Is] ISSN:1178-1998
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Early-stage chronic kidney disease has been suggested to be correlated with cognitive decline, but the association has rarely been explored in the oldest old. SUBJECTS AND METHODS: This prospective study included 284 Chinese participants aged 80 years or older with serum creatinine levels <150 µmol/L. The median follow-up time was 3.3 years, and 247 (87.0%) participants provided valid data at their last visit. Kidney function was evaluated by measuring the estimated glomerular filtration rate (eGFR) at baseline, and cognitive function was evaluated using the Mini-Mental State Examination (MMSE) at both baseline and annual visits. A reliable decrease in the MMSE score over the follow-up period was observed based on a Reliable Change Index of 1.645 (equivalent to a 90% confidence interval [CI]), which was used to define cognitive decline. Poisson regression models were built to analyze the association between baseline kidney function and cognitive decline. RESULTS: A total of 18 (7.3%) cases of incident cognitive decline were observed during the follow-up period. After adjusting for potential confounders, the relative risk of developing cognitive decline was 4.03 (95% CI 1.09-13.81) among participants with an eGFR of 30-59 mL/min/1.73 m compared to participants with an eGFR of ≥60 mL/min/1.73 m . CONCLUSION: Early-stage chronic kidney disease was correlated with cognitive decline in an oldest-old Chinese population.
[Mh] Termos MeSH primário: Disfunção Cognitiva/epidemiologia
Insuficiência Renal Crônica/epidemiologia
[Mh] Termos MeSH secundário: Idoso de 80 Anos ou mais
Grupo com Ancestrais do Continente Asiático
China/epidemiologia
Cognição
Feminino
Seguimentos
Taxa de Filtração Glomerular
Seres Humanos
Masculino
Testes de Estado Mental e Demência
Estudos Prospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180212
[Lr] Data última revisão:
180212
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.2147/CIA.S134205


  4 / 6 MEDLINE  
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Registro de Ensaios Clínicos
Registro de Ensaios Clínicos
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[PMID]:29365294
[Au] Autor:Honig LS; Vellas B; Woodward M; Boada M; Bullock R; Borrie M; Hager K; Andreasen N; Scarpini E; Liu-Seifert H; Case M; Dean RA; Hake A; Sundell K; Poole Hoffmann V; Carlson C; Khanna R; Mintun M; DeMattos R; Selzler KJ; Siemers E
[Ad] Endereço:From the Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York (L.S.H.); Gérontopôle, Centre Hospitalier Universitaire Toulouse, Unité Mixte de Recherche INSERM Unité 1027 Université Toulouse III-Paul Sabatier
[Ti] Título:Trial of Solanezumab for Mild Dementia Due to Alzheimer's Disease.
[So] Source:N Engl J Med;378(4):321-330, 2018 01 25.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Alzheimer's disease is characterized by amyloid-beta (Aß) plaques and neurofibrillary tangles. The humanized monoclonal antibody solanezumab was designed to increase the clearance from the brain of soluble Aß, peptides that may lead to toxic effects in the synapses and precede the deposition of fibrillary amyloid. METHODS: We conducted a double-blind, placebo-controlled, phase 3 trial involving patients with mild dementia due to Alzheimer's disease, defined as a Mini-Mental State Examination (MMSE) score of 20 to 26 (on a scale from 0 to 30, with higher scores indicating better cognition) and with amyloid deposition shown by means of florbetapir positron-emission tomography or Aß1-42 measurements in cerebrospinal fluid. Patients were randomly assigned to receive solanezumab at a dose of 400 mg or placebo intravenously every 4 weeks for 76 weeks. The primary outcome was the change from baseline to week 80 in the score on the 14-item cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS-cog14; scores range from 0 to 90, with higher scores indicating greater cognitive impairment). RESULTS: A total of 2129 patients were enrolled, of whom 1057 were assigned to receive solanezumab and 1072 to receive placebo. The mean change from baseline in the ADAS-cog14 score was 6.65 in the solanezumab group and 7.44 in the placebo group, with no significant between-group difference at week 80 (difference, -0.80; 95% confidence interval, -1.73 to 0.14; P=0.10). As a result of the failure to reach significance with regard to the primary outcome in the prespecified hierarchical analysis, the secondary outcomes were considered to be descriptive and are reported without significance testing. The change from baseline in the MMSE score was -3.17 in the solanezumab group and -3.66 in the placebo group. Adverse cerebral edema or effusion lesions that were observed on magnetic resonance imaging after randomization occurred in 1 patient in the solanezumab group and in 2 in the placebo group. CONCLUSIONS: Solanezumab at a dose of 400 mg administered every 4 weeks in patients with mild Alzheimer's disease did not significantly affect cognitive decline. (Funded by Eli Lilly; EXPEDITION3 ClinicalTrials.gov number, NCT01900665 .).
[Mh] Termos MeSH primário: Doença de Alzheimer/tratamento farmacológico
Anticorpos Monoclonais Humanizados/uso terapêutico
Imunoterapia
[Mh] Termos MeSH secundário: Atividades Cotidianas
Idoso
Idoso de 80 Anos ou mais
Doença de Alzheimer/diagnóstico
Doença de Alzheimer/psicologia
Peptídeos beta-Amiloides/líquido cefalorraquidiano
Anticorpos Monoclonais Humanizados/efeitos adversos
Biomarcadores/líquido cefalorraquidiano
Método Duplo-Cego
Feminino
Seres Humanos
Infusões Intravenosas
Masculino
Testes de Estado Mental e Demência
Meia-Idade
Fragmentos de Peptídeos/líquido cefalorraquidiano
Placa Amiloide/tratamento farmacológico
Tomografia por Emissão de Pósitrons
Falha de Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE III; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Amyloid beta-Peptides); 0 (Antibodies, Monoclonal, Humanized); 0 (Biomarkers); 0 (Peptide Fragments); 0 (amyloid beta-protein (1-42)); 5D6PWO0333 (solanezumab)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180125
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMoa1705971


  5 / 6 MEDLINE  
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[PMID]:28457989
[Au] Autor:Toyoshima K; Fujii Y; Mitsui N; Kako Y; Asakura S; Martinez-Aran A; Vieta E; Kusumi I
[Ad] Endereço:Department of Psychiatry, Graduate School of Medicine, Hokkaido University, Sapporo, Japan. Electronic address: toyoshima@med.hokudai.ac.jp.
[Ti] Título:Validity and reliability of the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA) in Japanese patients with bipolar disorder.
[So] Source:Psychiatry Res;254:85-89, 2017 Aug.
[Is] ISSN:1872-7123
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:In Japan, there are currently no reliable rating scales for the evaluation of subjective cognitive impairment in patients with bipolar disorder. We studied the relationship between the Japanese version of the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA) and objective cognitive assessments in patients with bipolar disorder. We further assessed the reliability and validity of the COBRA. Forty-one patients, aged 16-64, in a remission period of bipolar disorder were recruited from Hokkaido University Hospital in Sapporo, Japan. The COBRA (Japanese version) and Frankfurt Complaint Questionnaire (FCQ), the gold standard in subjective cognitive assessment, were administered. A battery of neuropsychological tests was employed to measure objective cognitive impairment. Correlations among the COBRA, FCQ, and neuropsychological tests were determined using Spearman's correlation coefficient. The Japanese version of the COBRA had high internal consistency, good retest reliability, and concurrent validity-as indicated by a strong correlation with the FCQ. A significant correlation was also observed between the COBRA and objective cognitive measurements of processing speed. These findings are the first to demonstrate that the Japanese version of the COBRA may be clinically useful as a subjective cognitive impairment rating scale in Japanese patients with bipolar disorder.
[Mh] Termos MeSH primário: Grupo com Ancestrais do Continente Asiático/psicologia
Transtorno Bipolar/diagnóstico
Transtorno Bipolar/psicologia
Disfunção Cognitiva/diagnóstico
Disfunção Cognitiva/psicologia
Testes de Estado Mental e Demência/normas
[Mh] Termos MeSH secundário: Adulto
Transtorno Bipolar/epidemiologia
Disfunção Cognitiva/epidemiologia
Feminino
Seres Humanos
Japão/epidemiologia
Masculino
Meia-Idade
Testes Neuropsicológicos/normas
Reprodutibilidade dos Testes
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180131
[Lr] Data última revisão:
180131
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE


  6 / 6 MEDLINE  
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[PMID]:29284465
[Au] Autor:Jia Y; Zhang X; Yu J; Han J; Yu T; Shi J; Zhao L; Nie K
[Ad] Endereço:First Teaching Hospital of Tianjin University of Traditional ChineseMedicine, Tianjin, 300193, China.
[Ti] Título:Acupuncture for patients with mild to moderate Alzheimer's disease: a randomized controlled trial.
[So] Source:BMC Complement Altern Med;17(1):556, 2017 Dec 29.
[Is] ISSN:1472-6882
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Alzheimer's disease (AD) is the most common cause of dementia. However, none of medical treatment can stop or reverse the underlying neurodegenerative of AD at present. Acupuncture has attracted more and more attention in recent years due to its efficacy and very few side effects. Lately, a systematic review has thought that the evidence on the effectiveness of acupuncture in improving the cognitive function of AD patients was not powerful enough. Therefore, the aim of this study is to explore the efficacy and safety of acupuncture in patients with mild to moderate AD. METHODS: This was a randomized, controlled, parallel-group, exploratory study with 4-week baseline (T0), 12-week treatment phase (T1) and 12-week follow-up period (T2). Patients with mild to moderate AD meeting the included criteria were randomly allocated into either acupuncture or donepezil hydrochloride groups. The acupuncture group(AG) was given acupuncture treatment three times per week and the donepezil hydrochloride group(DG) group was administered donepezil hydrochloride once daily (5 mg/day for the first 4 weeks and 10 mg/day thereafter). Primary efficacy was measured using Alzheimer's disease Assessment Scale-Cognitive (ADAS-cog) and Clinician's Interview-Based Impression of Change-Plus (CIBIC-Plus). The second outcomes were measured with 23-Item Alzheimer's disease Cooperative Study Activities of Daily Living Scales (ADAS-ADL ) and Neuropsychiatric Index (NPI). RESULTS: Of 87 participants enrolled in the study, 79 patients finished their treatment and follow-up processes. The ADAS-cog scores for AG group showed obvious decreases at T2 and ∆(T2-T0)when compared with DG group, and significant between-group differences were detected (all p < 0.05). The mean CIBIC-Plus values for the AG group at T1 and T2 were much lower than that for the DG group, and there were significant differences between the two groups (푃<0.05). There were no significant between-group differences in the scores of ADAS-ADL and NPI during the study period. Treatment discontinuations due to adverse events were 0 (0%) and 4 (9.09%) for the AG and DG groups, respectively. CONCLUSIONS: Acupuncture is safe, well tolerated and effective in improving the cognitive function, global clinical status of AD. TRIAL REGISTRATION: ChiCTR-IOR-17010465 (Retroactively registered on 18 JAN 2017).
[Mh] Termos MeSH primário: Terapia por Acupuntura
Doença de Alzheimer/terapia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Doença de Alzheimer/fisiopatologia
Feminino
Seres Humanos
Indanos
Masculino
Testes de Estado Mental e Demência
Piperidinas
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Indans); 0 (Piperidines); 8SSC91326P (donepezil)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180122
[Lr] Data última revisão:
180122
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171230
[St] Status:MEDLINE
[do] DOI:10.1186/s12906-017-2064-x



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