Subhrangshu Bit, Pritam Dey, Arnab Maji, Tapan K Khan
{"title":"MRI-based mild cognitive impairment and Alzheimer's disease classification using an algorithm of combination of variational autoencoder and other machine learning classifiers.","authors":"Subhrangshu Bit, Pritam Dey, Arnab Maji, Tapan K Khan","doi":"10.1177/25424823241290694","DOIUrl":"10.1177/25424823241290694","url":null,"abstract":"<p><strong>Background: </strong>Correctly diagnosing mild cognitive impairment (MCI) and Alzheimer's disease (AD) is important for patient selection in drug discovery. Research outcomes on stage diagnosis using neuroimages combined with cerebrospinal fluid and genetic biomarkers are expensive and time-consuming. Only structural magnetic resonance imaging (sMRI) scans from two internationally recognized datasets are employed as input as well as test and independent validation to determine the classification of dementia by the machine learning algorithm.</p><p><strong>Objective: </strong>We extract the reduced dimensional latent feature vector from the sMRI scans using a variational autoencoder (VAE). The objective is to classify AD, MCI, and control (CN) using MRI and without any other information.</p><p><strong>Methods: </strong>The extracted feature vectors from MRI scans by VAE are used as input conditions for different advanced machine-learning classifiers. Classification of AD/CN/MCI are conducted using the output of VAE from MRI images and different artificial intelligence/machine learning classifier models in two cohorts.</p><p><strong>Results: </strong>Using only MRI scans, the primary goal of the study is to test the ability to classify AD from CN and MCI cases. The current study achieved classification accuracies of AD versus CN 75.45% (F1-score = 79.52%), AD versus MCI 81.41% (F1-Score = 87.06%), and autopsy-confirmed AD versus MCI 92.75% (F1-Score = 95.52%) in test sets and AD versus CN 86.16% (F1-score = 92.03%) and AD versus MCI 70.03% (F1-Score = 82.1%) in validation data set.</p><p><strong>Conclusions: </strong>By overcoming the data leakage problem, the autopsy-confirmed machine learning classification model is tested in two independent cohorts. External validation by an independent cohort improved the quality and novelty of the classification algorithm.</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"8 1","pages":"1434-1452"},"PeriodicalIF":2.8,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Investigation of the effect of green walking and intelligence games on the cognitive skills of individuals between the ages of 50-70 survived COVID-19 disease: A randomized controlled study.","authors":"Zahide Akeren, Sevilay Hintistan","doi":"10.1177/25424823241284500","DOIUrl":"10.1177/25424823241284500","url":null,"abstract":"<p><strong>Background: </strong>Mild cognitive impairment can be considered as the preclinical stage of Alzheimer's disease. With the addition of COVID-19 disease to the cognitive decline that occurs with aging, it may cause dementia with severe cognitive losses such as Alzheimer's disease in some people. Physical activity and brain-occupying practices can significantly improve the risk factors for cognitive disorders and Alzheimer's disease.</p><p><strong>Objective: </strong>The aim of study was to examine the effect of green walking and intelligence game on the cognitive skills of individuals aged 50-70 years with COVID-19.</p><p><strong>Methods: </strong>The randomized controlled study was completed with 40 individuals, 20 in the experimental and 20 in the control group. Individuals in the experimental group green walking for 30 min three days a week for one month in two groups of 10 people, accompanied by the researcher. In addition, these individuals played intelligence games (brain games-memory thinking and brain exercise) via their smartphones for 15 min every day for a month.</p><p><strong>Results: </strong>The cognitive skills and cognitive dimensions of \"attention, concentration, memory, language and orientation\" of the individuals in the experimental group were significantly increased compared to the control group individuals (p < 0.05).</p><p><strong>Conclusions: </strong>It was found that green walk and intelligence game practice increased the cognitive skills of individuals aged 50-70 years who had outpatient COVID-19.</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"8 1","pages":"1394-1404"},"PeriodicalIF":2.8,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The effect of probiotics on select cognitive domains in mild cognitive impairment and Alzheimer's disease: A systematic review and meta-analysis.","authors":"Shashank Tripathi, Meenakshi Kaushik, Rekha Dwivedi, Prabhakar Tiwari, Manjari Tripathi, Rima Dada","doi":"10.1177/25424823241289039","DOIUrl":"10.1177/25424823241289039","url":null,"abstract":"<p><strong>Background: </strong>Mild cognitive impairment (MCI) and Alzheimer's disease (AD) are progressive neurodegenerative disorders, and probiotics may offer therapeutic benefits by modulating gut microbiota and reducing inflammation.</p><p><strong>Objective: </strong>This study systematically evaluated the impact of probiotics on cognitive function in MCI and AD through a meta-analysis of randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>A systematic review and meta-analysis were performed following PRISMA 2020 guidelines. PubMed, Embase, EBSCO, and Cochrane databases were searched for RCTs (January 2000-January 2024) on probiotic interventions lasting 8-24 weeks. Cognitive outcomes included Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), language, naming, visual-spatial, memory, and attention. Data were analyzed using R with a random-effects model to calculate pooled standardized mean differences (SMDs) with 95% confidence intervals (CIs). Risk of bias was rigorously assessed.</p><p><strong>Results: </strong>Out of 2000 articles, 500 full texts were screened, and 10 studies were included. The meta-analysis showed varied effect sizes: MMSE (SMD: 0.28, 95%CI -0.35-0.91, p = 0.38), MoCA (SMD: 0.51, 95%CI -0.49-1.52, p = 0.33), language (SMD: -0.12, 95% CI -0.54-0.29, p = 0.56), naming (SMD: 0.02, 95%CI -0.69-0.74, p = 0.95), visual-spatial (SMD: 0.38, 95%CI -0.13-0.88, p = 0.14), memory (SMD: 0.20, 95%CI -0.15-0.55, p = 0.26), and attention (SMD: -0.07, 95%CI -0.44-0.30, p = 0.71). Positive SMDs suggest cognitive improvement, while non-significant negative SMDs indicate trends toward decline, inclined by probiotic strains, duration, and participant characteristics.</p><p><strong>Conclusions: </strong>Probiotics did not significantly improve cognitive function in MCI and AD patients, with variability in effects across cognitive domains, suggesting the need for tailored interventions and future studies.</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"8 1","pages":"1422-1433"},"PeriodicalIF":2.8,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Epigenetics as a link between environmental factors and dementia risk.","authors":"Adamantia Koulouri, Anthony S Zannas","doi":"10.1177/25424823241284227","DOIUrl":"10.1177/25424823241284227","url":null,"abstract":"<p><p>Dementia encompasses a broad spectrum of neuropsychiatric disease states marked by cognitive impairments that interfere with day-to-day functioning. Most dementias are complex phenotypes that result from a genome-environment interplay. Epigenetic regulation has emerged as a candidate mechanism for studying this interplay. In this narrative review, we discuss state-of-the-art evidence on environmental exposures relevant to dementia, including nutrition, physical exercise, psychosocial stress, and environmental toxins, and highlight epigenetic mechanisms that have been reported as a putative link between each exposure and dementia risk. We then discuss the clinical implications and future directions of this line of research. An improved understanding of the epigenetic mechanisms involved in dementia pathogenesis can promote the development of novel biomarkers for predicting outcomes but also targeted therapies to intervene early in the course of the disease.</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"8 1","pages":"1372-1380"},"PeriodicalIF":2.8,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maysa Cera, Paulo Henrique Ferreira Bertolucci, Nathani Cristine do Carmo Ramos, Camila de Castro Corrêa, Carla Dos Reis Piffer Vilela, Karin Zazo Ortiz
{"title":"Articulatory and phonological performance in people with mild cognitive impairment and Alzheimer's disease: A scoping review.","authors":"Maysa Cera, Paulo Henrique Ferreira Bertolucci, Nathani Cristine do Carmo Ramos, Camila de Castro Corrêa, Carla Dos Reis Piffer Vilela, Karin Zazo Ortiz","doi":"10.1177/25424823241290698","DOIUrl":"10.1177/25424823241290698","url":null,"abstract":"<p><p><b>Background:</b> Markers of phonological and articulatory processing, though at times difficult to identify, may be useful for the assessment of changes in the speech of people with mild cognitive impairment (MCI) and Alzheimer's disease (AD). <b>Objective:</b> To review the evidence on phonological and articulatory speech processing in older adults with MCI and AD and identify the most sensitive speech assessment tasks for detecting impairments in these abilities. <b>Methods:</b> This scoping review of the PubMed, Scopus, Lilacs, Web of Science, Google Scholar, ProQuest, and Embase databases was updated in April 2024. Studies of older adults with MCI and AD that evaluated articulatory or phonological aspects of speech were included in the review. Two independent reviewers used EndNote and Rayyan software to evaluate search results in a two-phase process, consisting of (1) title and abstract screening, and (2) full-text review. <b>Results:</b> Of the 163 studies retrieved, 41 were selected in Phase 1. At the end of Phase 2, 29 studies were included in the review. All studies included individuals with AD and only one also included participants with MCI. Normal phonological and articulatory performance was observed in MCI. In AD, phonological or articulatory alterations were associated with the speech assessment method, sample size, and diagnosis of atypical dementia. <b>Conclusions:</b> Phonological and articulatory changes may occur in AD but may be difficult to identify. Single repetition or naming tasks may be more sensitive for detecting these impairments.</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"8 1","pages":"1405-1421"},"PeriodicalIF":2.8,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nil Patil, Khushalika Patil, Mukul Jain, Arifullah Mohammed, Alpa Yadav, Parmdeep Singh Dhanda, Chittaranjan Kole, Kirtan Dave, Prashant Kaushik, Mohammad Khairul Azhar Abdul Razab, Zulhazman Hamzah, Norazlina Mat Nawi
{"title":"A systematic study of molecular targets of cannabidiol in Alzheimer's disease.","authors":"Nil Patil, Khushalika Patil, Mukul Jain, Arifullah Mohammed, Alpa Yadav, Parmdeep Singh Dhanda, Chittaranjan Kole, Kirtan Dave, Prashant Kaushik, Mohammad Khairul Azhar Abdul Razab, Zulhazman Hamzah, Norazlina Mat Nawi","doi":"10.1177/25424823241284464","DOIUrl":"10.1177/25424823241284464","url":null,"abstract":"<p><strong>Background: </strong>Alzheimer's disease (AD) is a prevalent, incurable, and chronic neurodegenerative condition characterized by the accumulation of amyloid-β protein (Aβ), disrupting various bodily systems. Despite the lack of a cure, phenolic compounds like cannabidiol (CBD), a non-psychoactive component of cannabis, have emerged as potential therapeutic agents for AD.</p><p><strong>Objective: </strong>This systematic review explores the impact of different types of cannabidiol on AD, unveiling their neuroprotective mechanisms.</p><p><strong>Methods: </strong>The research used PubMed, Scopus, and Web of Science databases with keywords like \"Alzheimer's disease\" and \"Cannabidiol.\" Studies were evaluated based on title, abstract, and relevance to treating AD with CBD. No restrictions on research type or publication year. Excluded were hypothesis papers, reviews, books, unavailable articles, etc.</p><p><strong>Results: </strong>Microsoft Excel identified 551 articles, with 92 included in the study, but only 22 were thoroughly evaluated. In-vivo and in-silico studies indicate that CBD may disrupt Aβ<sub>42</sub>, reduce pro-inflammatory molecule release, prevent reactive oxygen species formation, inhibit lipid oxidation, and counteract Aβ-induced increases in intracellular calcium, thereby protecting neurons from apoptosis.</p><p><strong>Conclusions: </strong>In summary, the study indicates that CBD and its analogs reduce the production of Aβ<sub>42</sub>. Overall, these findings support the potential of CBD in alleviating the underlying pathology and symptoms associated with AD, underscoring the crucial need for further rigorous scientific investigation to elucidate the therapeutic applications and mechanisms of CBD in AD.</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"8 1","pages":"1339-1360"},"PeriodicalIF":2.8,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cognitive Reserve Relationship with Physical Performance in Dementia-Free Older Adults: The MIND-China Study.","authors":"Qiwei Dong, Yuanjing Li, Yiming Song, Yu Zhang, Xiaodong Han, Yifei Ren, Jiafeng Wang, Xiaojuan Han, Yifeng Du","doi":"10.3233/ADR-240064","DOIUrl":"10.3233/ADR-240064","url":null,"abstract":"<p><strong>Background: </strong>Cognitive reserve (CR) may be beneficial to the physical function of the elderly.</p><p><strong>Objective: </strong>We aimed to examine the association of CR proxies and composite CR capacity with physical function in older adults while considering age and sex.</p><p><strong>Methods: </strong>This population-based cross-sectional study included 4,714 participants living in rural China (age≥60 years) who were dementia-free. Structural equation modeling was used to generate a composite CR score by integrating early-life education, midlife occupational complexity, and late-life mental activity and social support. The Short Physical Performance Battery (SPPB) measured physical function. Data were analyzed using linear regression models.</p><p><strong>Results: </strong>Greater educational attainment and mental activity were associated with higher composite SPPB scores and those of its three subtests (<i>p</i> < 0.05). Skilled occupations were associated with higher SPPB, chair stand, and walking speed scores, while greater social support was associated with higher scores for SPPB and chair stand (<i>p</i> < 0.05). Each 1-point increase in composite CR score (range: -0.77 to 1.03) was linearly associated with a multivariable-adjusted β-coefficient of 0.74 (95% confidence interval (CI): 0.58-0.89) for total SPPB score, 0.16 (0.10-0.22) for balance test, 0.40 (0.32-0.48) for chair stand, and 0.17 (0.12-0.23) for walking speed. The association between higher composite CR and total SPPB scores was more prominent in those≥75 years than those aged 60-74 years (<i>p</i> < 0.01). There was no statistical interaction of composite CR score and sex in physical function.</p><p><strong>Conclusions: </strong>High CR is associated with better physical function, especially among older adults (≥75 years).</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"8 1","pages":"1329-1338"},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xiwu Wang, Teng Ye, Ziye Huang, Wenjun Zhou, Jie Zhang
{"title":"Individualized and Biomarker-Based Prognosis of Longitudinal Cognitive Decline in Early Symptomatic Alzheimer's Disease.","authors":"Xiwu Wang, Teng Ye, Ziye Huang, Wenjun Zhou, Jie Zhang","doi":"10.3233/ADR-240049","DOIUrl":"10.3233/ADR-240049","url":null,"abstract":"<p><strong>Background: </strong>Although individualized models using demographic, MRI, and biological markers have recently been applied in mild cognitive impairment (MCI), a similar study is lacking for patients with early Alzheimer's disease (AD) with biomarker evidence of abnormal amyloid in the brain.</p><p><strong>Objective: </strong>We aimed to develop prognostic models for individualized prediction of cognitive change in early AD.</p><p><strong>Methods: </strong>A total of 421 individuals with early AD (MCI or mild dementia due to AD) having biomarker evidence of abnormal amyloid in the brain were included in the current study. The primary cognitive outcome was the slope of change in Alzheimer's Disease Assessment Scale-cognitive subscale-13 (ADAS-Cog-13) over a period of up to 5 years.</p><p><strong>Results: </strong>A model combining demographics, baseline cognition, neurodegenerative markers, and CSF AD biomarkers provided the best predictive performance, achieving an overfitting-corrected R<sup>2</sup> of 0.59 (bootstrapping validation). A nomogram was created to enable clinicians or trialists to easily and visually estimate the individualized magnitude of cognitive change in the context of patient characteristics. Simulated clinical trials suggested that the inclusion of our nomogram into the enrichment strategy would lead to a substantial reduction of sample size in a trial of early AD.</p><p><strong>Conclusions: </strong>Our findings may be of great clinical relevance to identify individuals with early AD who are likely to experience fast cognitive deterioration in clinical practice and in clinical trials.</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"8 1","pages":"1301-1315"},"PeriodicalIF":2.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Myriam Lesage, Karin Cinalioglu, Sabrina Chan, Sanjeev Kumar, Tarek Rajji, Ashley Melichercik, Carmen Desjardins, Jess Friedland, Amer Burhan, Sarah Colman, Li Chu, Simon Davies, Peter Derkach, Sarah Elmi, Philip Gerretsen, Ariel Graff-Guerrero, Maria Hussain, Zahinoor Ismail, Donna Kim, Linda Krisman, Rola Moghabghab, Benoit H Mulsant, Bruce G Pollock, Aviva Rostas, Lisa Van Bussel, Soham Rej
{"title":"Are Opioids Agitating? A Data Analysis of Baseline Data from the STAN Study.","authors":"Myriam Lesage, Karin Cinalioglu, Sabrina Chan, Sanjeev Kumar, Tarek Rajji, Ashley Melichercik, Carmen Desjardins, Jess Friedland, Amer Burhan, Sarah Colman, Li Chu, Simon Davies, Peter Derkach, Sarah Elmi, Philip Gerretsen, Ariel Graff-Guerrero, Maria Hussain, Zahinoor Ismail, Donna Kim, Linda Krisman, Rola Moghabghab, Benoit H Mulsant, Bruce G Pollock, Aviva Rostas, Lisa Van Bussel, Soham Rej","doi":"10.3233/ADR-240025","DOIUrl":"10.3233/ADR-240025","url":null,"abstract":"<p><p> Agitation, a common dementia symptom often arising from untreated pain, lacks comprehensive research on its connection with opioids prescribed for long-term pain. This study investigated the relationship between opioid use and agitation in dementia patients. Participants (<i>n</i> = 188) were categorized into opioid, acetaminophen PRN, or no-pain medication groups. Despite higher reported pain levels in the opioid group, no significant differences in agitation were observed among the groups. In conclusion, opioid use for pain management in older adults with dementia did not significantly impact agitation, emphasizing the ongoing importance of proper pain management in improving dementia care and addressing agitation in this population.</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"8 1","pages":"1297-1300"},"PeriodicalIF":2.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dong Bai, Junting Fan, Mengyue Li, Cuixia Dong, Yiming Gao, Min Fu, Qianfeng Liu, Huan Liu
{"title":"Cognitive Function After Stopping Folic Acid and DHA Intervention: An Extended Follow-Up Results from the Randomized, Double Blind, Placebo-Controlled Trial in Older Adults with Mild Cognitive Impairment.","authors":"Dong Bai, Junting Fan, Mengyue Li, Cuixia Dong, Yiming Gao, Min Fu, Qianfeng Liu, Huan Liu","doi":"10.3233/ADR-240033","DOIUrl":"10.3233/ADR-240033","url":null,"abstract":"<p><strong>Background: </strong>Our previously randomized controlled trial (RCT) showed daily oral folic acid (FA), docosahexaenoic acid (DHA) and their combined treatment for 6 months could significantly improve cognitive function in mild cognitive impairment (MCI) individuals.</p><p><strong>Objective: </strong>This study aimed to evaluate whether this benefit seen in the treatment group would sustain after stopping intervention when patients returned to a real-world.</p><p><strong>Methods: </strong>RCT (ChiCTR-IOR-16008351) was conducted in Tianjin, China. 160 MCI elders aged ≥60 years were randomly divided into four groups: FA + DHA, FA, DHA, and control. 138 MCI elders who completed the 6-month interventional trial underwent another 6-month follow-up without receiving nutritional therapy. Cognitive performance was measured at 6 and 12 months. Blood amyloid-β peptide (Aβ) and homocysteine (Hcy) related biomarkers were measured at baseline and 6 months.</p><p><strong>Results: </strong>In comparison to the end of nutritional therapy, all intervention groups had considerably lower full-scale IQ, arithmetic, and image completion scores during the follow-up period, while the combined intervention and DHA groups had significantly lower picture arrangement scores. Furthermore, after 6-month treatment with FA and FA + DHA, plasma Aβ<sub>40</sub>, Aβ<sub>42</sub>, and Hcy levels were significantly decreased. However, these biomarker levels at the start of follow-up were positively correlated with the degree of cognitive function change during follow-up period.</p><p><strong>Conclusions: </strong>FA and DHA supplementation enhance cognitive performance in MCI elderly following a six-month intervention by reducing Hcy or Aβ levels. However, their effects on improving cognitive decline are likely to diminish when the intervention is discontinued.</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"8 1","pages":"1285-1295"},"PeriodicalIF":2.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}