Demographic and Clinical Profile of Patients with Mild Cognitive Impairment Seen at St. Luke’s Medical Center-Global City Memory Service

Author(s):  
Christianne V. Mojica ◽  
Justine Megan F. Yu ◽  
Encarnita R. Ampil ◽  
Jon Stewart H. Dy ◽  
Erickson F. Torio ◽  
...  

<b><i>Introduction:</i></b> Mild cognitive impairment (MCI) is a dynamic state, which has evolved into a highly defined condition due to its association with dementia syndromes. There are no published data on the demographic and clinical characteristics of MCI in the Philippines. These data will help in defining the population at risk for the condition and in modifying the factors for its prevention. <b><i>Methods:</i></b> From 2010 to 2019, 434 subjects were diagnosed with MCI based on the criteria published by the International Working Group on MCI last 2004. The demographic profile, vascular risk factors, and levels of Vitamin B12, Vitamin D, and homocysteine were reviewed. Results of neuropsychological tests, such as Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-Cog), Mini-Mental State Exam (MMSE), and Montreal Cognitive Assessment (MoCA), were collected. The Fazekas score of the cranial magnetic resonance imaging of patients was also considered. <b><i>Results:</i></b> The median age was 72 years [34–97] with 58.3% females. The median years of education were 14 [4–28]. Median ADAS-Cog, MMSE, and MoCA scores were 11.3 [0–27.67], 27 [13–30], and 21 [7–30], respectively. Hypertension and dyslipidemia were present in 66.8% and 64.1%, respectively. Normal homocysteine, Vitamin B12, and Vitamin D levels were found in 64.2%, 59.8%, and 48.8%, respectively. The median Fazekas score was 1 (59.4%). <b><i>Conclusion:</i></b> This is the first study to document the demographic and clinical profile of Filipinos with MCI in a clinical setting. This review serves as a foundation for increased understanding of MCI with the ultimate goal of controlling the factors which may impact its prevention.

2018 ◽  
Vol 15 (6) ◽  
pp. 561-569 ◽  
Author(s):  
Carol D. SanMartín ◽  
Mauricio Henriquez ◽  
Carlos Chacon ◽  
Daniela P. Ponce ◽  
Felipe Salech ◽  
...  

Background: Mild cognitive impairment (MCI) has an increased rate of progression to dementia. Alterations of some metabolic factors, such as deficiency of vitamin D, are a risk factor for cognitive deterioration. Vitamin D is involved in the clearance of β-amyloid (Aβ) from the brain. We have reported that lymphocytes from Alzheimer's disease (AD) patients have an increased susceptibility to oxidative death by H2O2 exposure, but currently it is unknown if this characteristic is modifiable in vivo. Objective: To determine if correction of low vitamin D levels protects lymphocytes from oxidative death and increases Aβ1-40 plasma levels in MCI and very early AD (VEAD) patients. Method: Sixteen MCI, 11 VEAD and 25 healthy control (HC) voluntaries were evaluated with the Clinical Dementia Rating (CDR), Montreal Cognitive assessment (MoCA), and Memory Index score (MIS). Lymphocyte death was measured by flow cytometry after 20h exposure to H2O2. In patients with low levels of vitamin D -11 MCI, 9 VEAD and 20 HC- lymphocyte H2O2-death, plasma Aβ1-40 levels and cognitive status were evaluated pre- and post-vitamin D supplementation for 6 months. Results: Lymphocytes from MCI and VEAD patients showed increased susceptibility to oxidative death at study entry. In MCI, but not VEAD patients, lymphocyte susceptibility to death and Aβ1-40 levels plasma levels improved after 6 months of vitamin D supplementation. In addition, cognitive status on follow-up (18 months) improved in MCI patients after vitamin D supplementation. Conclusion: Vitamin D supplementation may be beneficial in MCI. The lack of effect in VEAD may be due to a more advanced stage or different characteristics of the neurodegenerative process.


2018 ◽  
Vol 15 (12) ◽  
pp. 1151-1160 ◽  
Author(s):  
Zihan Jiang ◽  
Huilin Yang ◽  
Xiaoying Tang

Objective: In this study, we investigated the influence that the pathology of Alzheimer’s disease (AD) exerts upon the corpus callosum (CC) using a total of 325 mild cognitive impairment (MCI) subjects, 155 AD subjects, and 185 healthy control (HC) subjects. Method: Regionally-specific morphological CC abnormalities, as induced by AD, were quantified using a large deformation diffeomorphic metric curve mapping based statistical shape analysis pipeline. We also quantified the association between the CC shape phenotype and two cognitive measures; the Mini Mental State Examination (MMSE) and the Alzheimer’s Disease Assessment Scale-Cognitive Behavior Section (ADAS-cog). To identify AD-relevant areas, CC was sub-divided into three subregions; the genu, body, and splenium (gCC, bCC, and sCC). Results: We observed significant shape compressions in AD relative to that in HC, mainly concentrated on the superior part of CC, across all three sub-regions. The HC-vs-MCI shape abnormalities were also concentrated on the superior part, but mainly occurred on bCC and sCC. The significant MCI-vs-AD shape differences, however, were only detected in part of sCC. In the shape-cognition association, significant negative correlations to ADAS-cog were detected for shape deformations at regions belonging to gCC and sCC and significant positive correlations to MMSE at regions mainly belonging to sCC. Conclusion: Our results suggest that the callosal shape deformation patterns, especially those of sCC, linked tightly to the cognitive decline in AD, and are potentially a powerful biomarker for monitoring the progression of AD.


Author(s):  
Min-Ki Jeong ◽  
Kyung-Won Park ◽  
Je-Kwang Ryu ◽  
Gwon-Min Kim ◽  
Hyun-Hun Jung ◽  
...  

Age-related dementia refers to a state in which someone experiences multiple cognitive function impairment due to degenerative brain disease, and which causes difficulties in their daily life or social life. Dementia is the most common and serious obstacle in later life. Early intervention in the case of patients who are in the mild cognitive impairment (MCI) stage among the high-risk group can maintain and improve their cognitive function. The purpose of the current trial is aimed at investigating the association between a multi-component (exercise with cognitive) intervention program and habitual physical activity parameters on cognitive functions in MCI patients. Neuropsychological cognitive and depression assessments were performed by neuropsychologists according to normalized methods, including the Korean mini-mental State examination (K-MMSE) and modified Alzheimer’s disease assessment scale-cognitive subscale (ADAS-Cog) and cognitive assessment tool (attention, processing speed), and the Korean version of the geriatric depression scale (SGDS-K), both at baseline and at a 12 weeks follow-up. The 12-week multi-component intervention improved cognitive function and habitual physical activity parameters in patients with MCI relative to controls. A multi-component intervention program for patients with MCI is considered to be an effective method of dementia prevention by improving global (ADAS-Cog) and frontal (trail-making test, digit symbol substitution test) cognition and habitual physical activity parameters such as moderate to vigorous physical activity and step count. In addition, it is important to encourage habitual physical activities to ensure that exercise intervention strategies are carried out at the duration and intensity required for improving physical and cognitive wellbeing and obtaining health benefits.


Author(s):  
Zahra Ayati ◽  
Guoyan Yang ◽  
Mohammad Hossein Ayati ◽  
Seyed Ahmad Emami ◽  
Dennis Chang

Abstract Background Saffron (stigma of Crocus sativus L.) from Iridaceae family is a well-known traditional herbal medicine that has been used for hundreds of years to treat several diseases such as depressive mood, cancer and cardiovascular disorders. Recently, anti-dementia property of saffron has been indicated. However, the effects of saffron for the management of dementia remain controversial. The aim of the present study is to explore the effectiveness and safety of saffron in treating mild cognitive impairment and dementia. Methods An electronic database search of some major English and Chinese databases was conducted until 31st May 2019 to identify relevant randomised clinical trials (RCT). The primary outcome was cognitive function and the secondary outcomes included daily living function, global clinical assessment, quality of life (QoL), psychiatric assessment and safety. Rev-Man 5.3 software was applied to perform the meta-analyses. Results A total of four RCTs were included in this review. The analysis revealed that saffron significantly improves cognitive function measured by the Alzheimer’s Disease Assessment Scale-cognitive subscale (ADAS-cog) and Clinical Dementia Rating Scale-Sums of Boxes (CDR-SB), compared to placebo groups. In addition, there was no significant difference between saffron and conventional medicine, as measured by cognitive scales such as ADAS-cog and CDR-SB. Saffron improved daily living function, but the changes were not statistically significant. No serious adverse events were reported in the included studies. Conclusions Saffron may have the potential to improve cognitive function and activities of daily living in patients with Alzheimer’s disease and mild cognitive impairment (MCI). However, due to limited high-quality studies there is insufficient evidence to make any recommendations for clinical use. Further clinical trials on larger sample sizes are warranted to shed more light on its efficacy and safety.


2021 ◽  
Vol 28 (5) ◽  
pp. 879
Author(s):  
Nalan Kozaci ◽  
Cafer Caliskan ◽  
Mustafa Avci ◽  
Gulsum Caliskan ◽  
Ilhan Uysal

2020 ◽  
Author(s):  
Sang Won Seo ◽  
Seung Joo Kim ◽  
Sook-Young Woo ◽  
Young Ju Kim ◽  
Yeshin Kim ◽  
...  

Abstract Background: Few studies have investigated cognitive trajectories or developed a prediction model for amyloid beta-positive (Aβ+) mild cognitive impairment (MCI) patients. We aimed to identify distinct cognitive trajectories in Aβ+ MCI patients based on longitudinal Alzheimer’s Disease Assessment Scale-Cognitive subscale (ADAS-cog) 13 scores. Furthermore, we aimed to develop and visualize a prediction model to predict trajectory groups using the demographic, genetic, and clinical biomarkers of Aβ+ MCI patients.Methods: We performed a retrospective analysis of the data in 238 Aβ+ MCI patients from the Alzheimer’s Disease Neuroimaging Initiative who underwent at least three rounds of annual neuropsychological testing to identify cognitive trajectories. A group-based trajectory model (GBTM) was used to classify distinct groups based on ADAS-cog 13 scores. The prediction model was estimated using multinomial logistic regression and visualized using a bar-based method for risk prediction. Results: Three distinct classes, namely slow decliners (18.5%), intermediate decliners (42.9%), and fast decliners (38.7%), were suggested. Intermediate decliners were associated with higher age (≥70 years) (odds ratio [OR] 2.72, 95% confidence interval [CI] 1.78-6.28), higher AV45 standardized uptake value ratios (SUVRs)*10 (OR 1.69, 95% CI 1.22-2.34), and lower fluorodeoxyglucose (FDG) SUVR*10 (OR 0.65, 95% CI 0.46-0.93) than slow decliners. Fast decliners were associated with higher age (≥70 years) (OR 3.76, 95% CI 1.40-10.10), greater likelihood of being an apolipoprotein E 4 carrier (OR 4.2, 95% CI 1.53-11.58), higher AV45 positron emission tomography SUVR*10 (OR 2.14, 95% CI 1.50-3.05), and lower FDG SUVR*10 (OR 0.31, 95% CI 0.20-0.48) than slow decliners. The predicted probability of being classified to a trajectory group according to the risk scores of predictors was visualized.Conclusions: Our GBTM analysis yielded novel insights into the heterogeneous cognitive trajectories among Aβ+ MCI patients, which further facilitates the effective stratification of Aβ+ MCI patients in Aβ-targeted clinical trials.


2018 ◽  
Vol 8 (3) ◽  
pp. e00936 ◽  
Author(s):  
Shinji Ouma ◽  
Midori Suenaga ◽  
Funda F. Bölükbaşı Hatip ◽  
Izzettin Hatip-Al-Khatib ◽  
Yoshio Tsuboi ◽  
...  

2021 ◽  
Vol 84 (6) ◽  
pp. 472-480
Author(s):  
Yulin Luo ◽  
Li Tan ◽  
Joseph Therriault ◽  
Hua Zhang ◽  
Ying Gao ◽  
...  

<b><i>Background:</i></b> Apolipoprotein E (<i>APOE</i>) ε4 is highly associated with mild cognitive impairment (MCI). However, the specific influence of <i>APOE</i> ε4 status on tau pathology and cognitive decline in early MCI (EMCI) and late MCI (LMCI) is poorly understood. Our goal was to evaluate the association of <i>APOE</i> ε4 with cerebrospinal fluid (CSF) tau levels and cognition in EMCI and LMCI patients in the Alzheimer’s Disease Neuroimaging Initiative database, and whether this association was mediated by amyloid-β (Aβ). <b><i>Methods:</i></b> Participants were 269 cognitively normal (CN), 262 EMCI, and 344 LMCI patients. They underwent CSF Aβ42 and tau detection, <i>APOE</i> ε4 genotyping, Mini-Mental State Examination, (MMSE), and Alzheimer’s disease assessment scale (ADAS)-cog assessments. Linear regressions were used to examine the relation of <i>APOE</i> ε4 and CSF tau levels and cognitive scores in persons with and without Aβ deposition (Aβ+ and Aβ−). <b><i>Results:</i></b> The prevalence of <i>APOE</i> ε4 is higher in EMCI and LMCI than in CN (<i>p</i> &#x3c; 0.001 for both), and in LMCI than in EMCI (<i>p</i> = 0.001). <i>APOE</i> ε4 allele was significantly higher in Aβ+ subjects than in Aβ− subjects (<i>p</i> &#x3c; 0.001). Subjects who had a lower CSF Aβ42 level and were <i>APOE</i> ε4-positive experienced higher levels of CSF tau and cognitive scores in EMCI and/or LMCI. <b><i>Conclusions:</i></b> An <i>APOE</i> ε4 allele is associated with increased CSF tau and worse cognition in both EMCI and LMCI, and this association may be mediated by Aβ. We conclude that <i>APOE</i> ε4 may be an important mediator of tau pathology and cognition in the early stages of AD.


2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Jungho Cha ◽  
Jung-Min Hwang ◽  
Hang Joon Jo ◽  
Sang Won Seo ◽  
Duk L. Na ◽  
...  

Resting-state functional magnetic resonance imaging (RS FMRI) has been widely used to analyze functional alterations in amnestic mild cognitive impairment (aMCI) and Alzheimer’s disease (AD) patients. Although many clinical studies of aMCI and AD patients using RS FMRI have been undertaken, conducting a meta-analysis has not been easy because of seed selection bias by the investigators. The purpose of our study was to investigate the functional differences in aMCI and AD patients compared with healthy subjects in a meta-analysis. Thus, a multimethod approach using regional homogeneity, amplitude of low-frequency fluctuation (ALFF), fractional ALFF (fALFF), and global brain connectivity was used to investigate differences between three groups based on previously published data. According to the choice of RS FMRI approach used, the patterns of functional alteration were slightly different. Nevertheless, patients with aMCI and AD displayed consistently decreased functional characteristics with all approaches. All approaches showed that the functional characteristics in the left parahippocampal gyrus were decreased in AD patients compared with healthy subjects. Although some regions were slightly different according to the different RS FMRI approaches, patients with aMCI and AD showed a consistent pattern of decreased functional characteristics with all approaches.


Sign in / Sign up

Export Citation Format

Share Document