Huanqing Yu, Shufang Ding, Wei Wei, F. Guo, Zhongnan Li, Quan Yuan, Xin-Miao Zhao
{"title":"Impact of Pre-Stroke Dementia or Mild Cognitive Impairment on Stroke Outcome: A Systematic Review and Meta-Analysis","authors":"Huanqing Yu, Shufang Ding, Wei Wei, F. Guo, Zhongnan Li, Quan Yuan, Xin-Miao Zhao","doi":"10.1159/000522302","DOIUrl":"https://doi.org/10.1159/000522302","url":null,"abstract":"Background and Objective: Pre-stroke dementia (PSD) and pre-stroke mild cognitive impairment (PSMCI) are important risk factors for stroke. The present meta-analysis aimed to investigate the impact of PSD or PSMCI on stroke outcomes. Methods: Electronic databases (PubMed, EMbase, Google Scholar, Cochrane Library, and TRIP) were screened for eligible studies published prior to March 31, 2021. Risk ratios (RR) and mean differences with 95% confidence intervals (CIs) using random or fixed effect models were used to calculate pooled estimates. Study quality was assessed using the Newcastle Ottawa Scale. Results: Fifteen studies were included in our meta-analysis. Pooled data from ten studies involving 3,107 PSD and 20,645 non-PSD subjects showed a higher risk of mortality in PSD patients (RR = 2.03; 95% CI: 1.40–2.91; I2 = 89%). Risk of recurrent stroke risk was observed more in patients with PSD compared to non-PSD patients (RR = 2.02; 95% CI: 1.40–2.91; I2 = 0%). Three studies involving 300 mild cognitive impairment (MCI) and 1,025 normal cognition subjects showed a significant increased risk of mortality in stroke patients with MCI (RR = 2.43; 95% CI: 1.81–3.27; I2 = 20%). However, elevated stroke severity was not observed in PSMCI patients. Conclusions: Our meta-analysis shows an increased risk of mortality in stroke patients with a history of PSD and PSMCI. Proper clinical management and increased attention are therefore required for the prevention and management of stroke in patients with cognitive deficits.","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":"51 1","pages":"101 - 109"},"PeriodicalIF":2.4,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48003608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chuthiphun Panyawattanakit, Wadee Wongpradit, Ruankwan Kanhasing, P. Kulalert
{"title":"Cognitive Impairment and Associated Factors among Older Adults with Diabetes in a Suburban Primary Health Center in Thailand","authors":"Chuthiphun Panyawattanakit, Wadee Wongpradit, Ruankwan Kanhasing, P. Kulalert","doi":"10.1159/000524132","DOIUrl":"https://doi.org/10.1159/000524132","url":null,"abstract":"Introduction: Thailand is a rapidly aging society. The percentage of older adults with diabetes has also been increasing. Since diabetes mellitus is documented as a risk factor for dementia, it is important to address cognitive impairment in older adults with diabetes. Thus, this study aimed to evaluate the prevalence and associated factors of cognitive impairment among older adults with diabetes in a suburban primary health center in Thailand. Methods: A cross-sectional study in 244 diabetic patients aged 60 years or older was conducted in a primary health care unit in Pathum Thani, Thailand. Cognitive function was assessed with the validated Thai version of the Mini-Addenbrooke’s Cognitive Examination Test. Sociodemographic and health characteristic data were obtained. Results: The prevalence of cognitive impairment was 54.5% (133 out of 244). Multivariate logistic regression disclosed that factors significantly associated with cognitive impairment were ages 70–79 years compared to ages 60–69 years (odds ratio [OR] 1.90, 95% confidence interval [CI]: 1.01–3.62, p value 0.048), ages ≥80 years compared to ages 60–69 years (OR 3.65, 95% CI: 1.19–11.24, p value 0.024), education ≤ primary school (OR 7.28, 95% CI: 3.56–14.89, p value <0.001), and medication managed by caregiver compared to self-management of medication (OR 13.40, 95% CI: 1.55–116.10, p value 0.019). Conclusion: We revealed that approximately half of older adults with diabetes had cognitive impairment. This finding strongly suggests the need to include cognitive assessment in a standard clinical practice guideline for diabetic patients and to focus more on individuals who are very old, have low education, or are unable to manage their drugs by themselves.","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":"51 1","pages":"175 - 181"},"PeriodicalIF":2.4,"publicationDate":"2022-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48590115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Karin Persson, T. H. Edwin, Anne-Brita Knapskog, G. Tangen, G. Selbæk, K. Engedal
{"title":"Hippocampal Atrophy Subtypes of Alzheimer’s Disease Using Automatic MRI in a Memory Clinic Cohort: Clinical Implications","authors":"Karin Persson, T. H. Edwin, Anne-Brita Knapskog, G. Tangen, G. Selbæk, K. Engedal","doi":"10.1159/000522382","DOIUrl":"https://doi.org/10.1159/000522382","url":null,"abstract":"Introduction: One pathological hallmark of Alzheimer’s disease (AD) is atrophy of medial temporal brain regions that can be visualized on magnetic resonance imaging (MRI), but not all patients will have atrophy. The aim was to use MRI to categorize patients according to their hippocampal atrophy status and to present prevalence of the subtypes, difference in clinical symptomatology and progression, and factors associated with hippocampal subtypes. Methods: We included 215 patients with AD who had been assessed with the clinically available MRI software NeuroQuant (NQ; CorTechs labs/University of California, San Diego, CA, USA). NQ measures the hippocampus volume and calculates a normative percentile. Atrophy was regarded to be present if the percentile was ≤5. Demographics, cognitive measurements, AD phenotypes, apolipoprotein E status, and results from cerebrospinal fluid and amyloid positron emission tomography analyses were included as explanatory variables of the hippocampal subtypes. Results: Of all, 60% had no hippocampal atrophy. These patients were younger and less cognitively impaired concerning global measures, memory function, and abstraction but impaired concerning executive, visuospatial, and semantic fluency, and more of them had nonamnestic AD, compared to those with hippocampal atrophy. No difference in progression rate was observed between the two groups. In mild cognitive impairment patients, amyloid pathology was associated with the no hippocampal atrophy group. Conclusion: The results have clinical implications. Clinicians should be aware of the large proportion of AD patients presenting without atrophy of the hippocampus as measured with this clinical MRI method in the diagnostic set up and that nonamnestic phenotypes are more common in this group as compared to those with atrophy. Furthermore, the findings are relevant in clinical trials.","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":"51 1","pages":"80 - 89"},"PeriodicalIF":2.4,"publicationDate":"2022-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46896672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Öhlin, A. Toots, H. Littbrand, P. Wennberg, B. Olofsson, Y. Gustafson, C. Hörnsten, U. Werneke, P. Nordström, J. Niklasson, S. Söderberg
{"title":"Physical Activity in Late Middle- to Older-Aged People and Dementia, Cognitive, and Physical Function Two Decades Later","authors":"J. Öhlin, A. Toots, H. Littbrand, P. Wennberg, B. Olofsson, Y. Gustafson, C. Hörnsten, U. Werneke, P. Nordström, J. Niklasson, S. Söderberg","doi":"10.1159/000523726","DOIUrl":"https://doi.org/10.1159/000523726","url":null,"abstract":"Introduction: Low physical activity (PA) is a potential risk factor for dementia and cognitive impairment. However, few studies have focused on very old people (aged ≥80 years), the age group with highest prevalence of dementia. The aim was to investigate if PA associated with subsequent dementia, cognitive function, and gait speed (GS), in very old people. Methods: A population-based survey was conducted in 1999 and followed-up between 2016 and 2019 in participants ≥80 years. Altogether 541 individuals (56.2% women), 64.9 ± 4.2 years of age at baseline participated. Self-rated baseline PA was categorized into low, medium, or high. Cognitive function was assessed with the Mini-Mental State Examination (MMSE), executive function with the Frontal Assessment Battery (FAB), and GS (in meters/second) was measured over 2.4 m at follow-up. Results: During a mean of 19.0 ± 1.1 years, 175 (32.3%) developed dementia. Low or medium PA compared to high PA did not associate with subsequent dementia, and PA did not associate with future cognitive function (MMSE). PA associated with executive function (FAB) (unstandardized beta [95% confidence interval]) (0.67 [0.07–1.27]), but not after adjustments. PA associated with subsequent GS in the unadjusted model and after adjustment for age, sex, smoking, and education (0.06 [0.02–0.09], and 0.04 [0.01–0.08], respectively), but not after adding adjustment for hypertension, obesity, and glucose intolerance. Conclusion: No support was found for the hypothesis that low PA is a potential risk factor for dementia in very high age. However, PA and executive function were associated in unadjusted analyses which indicate that PA may be important for at least one aspect of cognitive function. The association between PA and GS around 2 decades later seems attenuated by cardiometabolic risk factors. Future investigations regarding PA, dementia, and cognitive decline may consider cardiometabolic risk factors such as hypertension, obesity, and glucose intolerance, and include repeated measures of PA over the life course.","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":"51 1","pages":"135 - 141"},"PeriodicalIF":2.4,"publicationDate":"2022-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45864976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Miguel Germán Borda, D. Ferreira, P. Selnes, D. A. Tovar-Rios, A. Jaramillo-Jiménez, Bjørn-Eivind Kirsebom, E. Garcia-Cifuentes, Turi O. Dalaker, K. Oppedal, H. Sønnesyn, T. Fladby, D. Aarsland
{"title":"Timed Up and Go in People with Subjective Cognitive Decline Is Associated with Faster Cognitive Deterioration and Cortical Thickness","authors":"Miguel Germán Borda, D. Ferreira, P. Selnes, D. A. Tovar-Rios, A. Jaramillo-Jiménez, Bjørn-Eivind Kirsebom, E. Garcia-Cifuentes, Turi O. Dalaker, K. Oppedal, H. Sønnesyn, T. Fladby, D. Aarsland","doi":"10.1159/000522094","DOIUrl":"https://doi.org/10.1159/000522094","url":null,"abstract":"Introduction: Early markers of neurodegeneration provide an opportunity to detect, monitor, and initiate interventions in individuals who have an increased risk of developing dementia. Here, we investigated whether the Timed Up and Go (TUG) test is associated with early brain neurodegeneration and whether the TUG test could be a marker of cognitive decline in people with subjective cognitive decline (SCD). Methods: This is a longitudinal analysis of the Dementia Disease Initiation Study, a prospective, community-based, cohort study from Norway, designed to investigate early markers of cognitive impairment and dementia. Participants were classified as SCD and healthy controls (HC). The main studied variables were the TUG test and cognition as measured by the Mini-Mental State Examination and the Consortium to Establish a Registry for Alzheimer’s Disease memory composite score. Additionally, we investigated the cross-sectional association of brain morphology with the TUG using 1.5T-MRI. Results: The sample included 45 participants (SCD = 21, HC = 24) followed during a mean time of 1.50 ± 0.70 years. At baseline, the cognitive performance did not differ between the groups, but TUG was longer in SCD. Slower baseline TUG was associated with a faster cognitive decline in both groups and it was also associated with reduced cortical thickness especially in motor, executive, associative, and somatosensory cortical regions in people with SCD. Discussion/Conclusion: TUG predicted cognitive change in individuals with SCD, and there was a negative association between TUG and cortical thickness. TUG is a promising cheap and noninvasive marker of early cognitive decline and may help initiate interventions in individuals who have an increased risk of dementia.","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":"51 1","pages":"63 - 72"},"PeriodicalIF":2.4,"publicationDate":"2022-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41564564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Senderovich, Sandra Gardner, A. Berall, R. Shultz, Brenda Grant, Vincent Santaguida
{"title":"Therapeutic Touch in the Management of Responsive Behaviors in Patients with Dementia","authors":"H. Senderovich, Sandra Gardner, A. Berall, R. Shultz, Brenda Grant, Vincent Santaguida","doi":"10.1159/000523752","DOIUrl":"https://doi.org/10.1159/000523752","url":null,"abstract":"Introduction: This study aimed to investigate the use of therapeutic touch (TT) in the management of responsive behaviors in patients with dementia. Methods: A randomized, double-blinded control trial was used to compare response to TT in a population with responsive behaviors in dementia, in 3 phases, pretreatment, treatment, and posttreatment each lasting 5 days. The participants were divided into three groups: experimental, placebo, and control. The experimental group received regular TT, the placebo group received mimic TT, and the control group received regular routine care. Behavior was observed and recorded by trained research assistants every 20 min during the study time throughout each of the phases. Modified Agitated Behavior Rating Scale (ABRS) and Revised Memory and Behavior Check (RMBC) scores were used to assess the behavioral symptoms of dementia throughout the study. Results: All groups had decreasing RMBC scores during the pretreatment period, however; the experimental TT group was the only group whose RMBC scores continued to decrease during the treatment period. All groups had a similar pattern of rates of change in ABRS scores over the 15-day period, with no differential pattern of results related to experimental TT. Conclusion: Despite limited evidence, TT should be explored as an adjunctive therapy for reducing behavioral symptoms in individuals with dementia. Further research is needed to determine the effects of TT on responsive behaviors in dementia. There is a need for studies with larger sample sizes, equal distribution of participants between groups (in terms of dementia stages), and longer post study follow-ups.","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":"51 1","pages":"142 - 149"},"PeriodicalIF":2.4,"publicationDate":"2022-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41868227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tali Elsayed Sundakov-Krumins, Sean Lubbe, A. Wand
{"title":"Homicide and Dementia: A Systematic Review","authors":"Tali Elsayed Sundakov-Krumins, Sean Lubbe, A. Wand","doi":"10.1159/000521878","DOIUrl":"https://doi.org/10.1159/000521878","url":null,"abstract":"Background: Homicide by older offenders is rare and devastating. It likely occurs due to a complex interaction of personal, social, and environmental factors. Dementia is a progressive neurological condition which may amplify behavioural disturbances such as aggression. This systematic review aims to evaluate the factors associated with homicide committed by people with dementia in order to inform clinical practice. Summary: MEDLINE, PsychINFO, Embase, and PubMed databases were searched in accordance with PRISMA guidelines for empirical studies examining the characteristics and circumstances of people with dementia who committed homicides. Data on factors associated with the homicide were extracted and the quality of each study rated using standardized criteria. A total of 499 papers were screened and thirteen studies met the inclusion criteria. Study design included case reports (seven studies), case series (four studies), and two retrospective cohort studies, indicative of low levels of evidence. Sample sizes were 1–70. Study findings were predominantly descriptive. Quality ratings ranged from 50 to 100%. Factors associated with disinhibition such as dysexecutive syndrome, alcohol use, and delirium may predispose to severe impulsive aggression. Psychosis and personality pathology appeared to influence targeted assaults resulting in homicide by people with dementia. Victim vulnerability was also a key element. Key Messages: The current evidence examining risk factors for homicide committed by people with dementia is limited. However, there are common characteristics reported in these descriptive studies including psychiatric factors and cognitive states causing disinhibition. Recommendations for clinical practice include early assessment of older people with dementia and changed behaviours to allow management of comorbidities and reversible risk factors, alongside education, and advice to carers (who may be targets of aggression). Specialized geriatric forensic psychiatry services and care settings should be developed.","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":"51 1","pages":"1 - 17"},"PeriodicalIF":2.4,"publicationDate":"2022-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42516601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Adaptation and Validation of the Person-Centred Assessment Tool for the Acute Care Setting","authors":"C. Cheong, Felicia Hui En Tay, P. Yap","doi":"10.1159/000522325","DOIUrl":"https://doi.org/10.1159/000522325","url":null,"abstract":"Introduction: Person-centred care (PCC) is synonymous with best practice in the care of persons with dementia. Despite this, PCC is not routinely assessed, and there is no validated tool for in the acute care setting. We aimed to validate the Person-Centred Assessment Tool (P-CAT) in an acute setting. Methods: P-CAT was administered independently to a total of 161 nurses (n = 16, from a specialized dementia unit with PCC training; n = 116, geriatric wards; n = 30, medical/surgical wards). The word “residents” was replaced with “patients” in P-CAT. We employed confirmatory factor analysis with principal component extraction to verify the previously reported three- and two-factor solutions. A one-way between-groups ANOVA was then used to investigate group differences in the P-CAT score (total scale and subscale). Results: Factor analysis revealed a two-factor solution (explained variance 42.28%): (i) extent of personalizing care and (ii) amount of organizational and environmental support. Out of the 13 items, only 2 items did not load as expected. The internal consistency reliability of the scale was satisfactory (Cronbach’s α = 0.77). Nurses’ P-CAT scores were significantly different across ward settings [Welch’s F(2,37.20) = 13.01, p < 0.001, ω2 = 0.09], with the highest among those PCC trained. Post hoc analyses revealed a significant difference in mean subscale scores between PCC-trained nurses and nurses from the other two ward settings. P-CAT scores were not significantly correlated with age, r(159) = 0.01, p = 0.861, or with nursing experience, r(159) = 0.04, p = 0.615. Discussion/Conclusion: P-CAT possesses adequate validity and reliability as a quantitative assessment tool of PCC in the acute care setting.","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":"51 1","pages":"73 - 79"},"PeriodicalIF":2.4,"publicationDate":"2022-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43664382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Soomin Kim, H. Jang, Sou Jin Choi, Hyung-Ji Kim, Jae-Hong Lee, M. Kwon
{"title":"Quantitative and Qualitative Differences of Action Verbal Fluency between Young and Older Adults","authors":"Soomin Kim, H. Jang, Sou Jin Choi, Hyung-Ji Kim, Jae-Hong Lee, M. Kwon","doi":"10.1159/000519070","DOIUrl":"https://doi.org/10.1159/000519070","url":null,"abstract":"Introduction: Action verbal fluency (AVF) task, a word fluency test, involves language and executive function and is known to be sensitive to fronto-striatal degeneration. However, the ability may also decrease qualitatively as well as quantitatively in normal aging. The objective of this study is to investigate the age-related quantitative and qualitative differences in AVF of Korean adults. Methods: We analyzed data from 78 participants of 40 young (mean age = 28.9) and 38 older adults (mean age = 67.7). The correct responses in the AVF task were measured for quantitative analysis. Qualitatively, the mean number of arguments required by each verb was calculated for syntactic analysis. For semantic analysis, we subclassified verbs according to their characteristics (e.g., moment vs. non-moment verbs/active vs. non-active verbs) and calculated the ratio for comparison. The results of AVF were also compared to those of semantic/phonemic fluency and the Korean version of the Montreal Cognitive Assessment (MoCA-K). Results: The older group showed quantitatively lower performance in AVF than the young group (p < 0.01). The result of the AVF task significantly correlated (p < 0.01) with both semantic/phonemic fluency and the MoCA-K. Also, the older group produced syntactically more simple verbs than the counterpart (p < 0.01). In the semantic analysis, the older group produced fewer moment verbs (p < 0.05) but more non-moment verbs (p < 0.05) than the young group. There was no difference in active or non-active verbs between two groups. Conclusion: These results indicated that the ability of AVF declines with age not only quantitatively but also qualitatively in relation to their cognitive changes.","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":"50 1","pages":"585 - 591"},"PeriodicalIF":2.4,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45600537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Natalia P Rocha, Antonio L Teixeira, Gabriela D Colpo, Michelle A Babicz, Jennifer L Thompson, Steven Paul Woods
{"title":"Blood Biomarkers of Neuronal/Axonal and Glial Injury in Human Immunodeficiency Virus-Associated Neurocognitive Disorders.","authors":"Natalia P Rocha, Antonio L Teixeira, Gabriela D Colpo, Michelle A Babicz, Jennifer L Thompson, Steven Paul Woods","doi":"10.1159/000527659","DOIUrl":"10.1159/000527659","url":null,"abstract":"<p><strong>Introduction: </strong>Approximately half of the people living with HIV (PLWH) experience HIV-associated neurocognitive disorders (HANDs). However, the neuropathogenesis of HAND is complex, and identifying reliable biomarkers has been challenging.</p><p><strong>Methods: </strong>This study included 132 participants aged 50 and older from greater San Diego County. The participants were divided into three groups: PLWH with HAND (n = 29), PLWH without HAND (n = 73), and seronegatives without cognitive impairment (n = 30). Peripheral blood was collected at the clinical assessment, and plasma levels of neurofilament light chain (NfL), phosphorylated Tau 181 (pTau181), and glial fibrillary acidic protein (GFAP) were measured by enzyme-linked immunosorbent assay (ELISA).</p><p><strong>Results: </strong>Plasma levels of NfL (but not pTau181 and GFAP) were significantly associated with HAND at a medium effect size (p = 0.039, Cohen's d = 0.45 for HAND + vs. HAND-). Notably, higher levels of NfL were significantly associated with HAND diagnosis even after adjusting for sex.</p><p><strong>Discussion: </strong>Our data suggest that neuronal degeneration (as evidenced by increased levels of NfL), but not tau pathology or glial degeneration, is related to cognitive status in PLWH. Our results corroborate the view that blood NfL is a promising biomarker of cognitive impairment in PLWH.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":"51 6","pages":"467-474"},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9992101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9196910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}