Channel: Research Articles https://www.alzcn.com EN-US https://www.alzcn.com/EN/current.shtml https://www.alzcn.com 2096-5516 Objective: To investigate the prevalence of dementia and its related factors among community-dwelling elderly aged 65 years and above in Tianjin, and the general function of the dementia patients. Methods: Data were derived from the Tianjin Mental Health Survey which employed a multi-stage, probability-proportional-to-size sampling method. Screening was initially conducted using expanded version of the General Health Questionnaire (GHQ-12), followed by diagnosis of mental disorders including dementia by a psychiatrist based on the DSM-IV (The Diagnostic and Statistical Manual of Mental Disorders, fourth edition). Additionally, information on sociodemographic characteristics, physical illnesses, and family history was collected. The GAF (Global Assessment of Functioning) scale was used to evaluate the general function of the subjects. The prevalence of dementia among community elderly individuals aged 65 years and above in Tianjin was reported. Logistic regression based on complex sampling was used to identify factors associated with dementia. GAF score were used to describe the general function of community dementia patients. Results: Of the 4438 community residents who completed the diagnostic interview, 1023 were aged 65 and above, of whom 140 were diagnosed with dementia, resulting in a weighted prevalence of 7.78% (95%CI: 5.88%~10.23%). Compared with residents aged 65~69, age 75~79 (OR=4.60, 95%CI: 1.57~13.52) and age 80 and older (OR=14.48, 95%CI: 4.46~47.04) were risk factors for dementia. Less than 1 year of education (OR=2.30, 95%CI: 1.06~5.01), presence of two or more social environmental problems (OR=3.42, 95%CI: 1.65~7.08), having cerebrovascular disease (OR=9.19, 95%CI: 4.62~18.30) were also risk factors for dementia. The weighted GAF score of dementia patients was 54.2±16.5 and the weighted disability rate was 63.65% (95%CI: 50.11% ~ 75.33%) in the past month. Conclusion: The prevalence of dementia among community-dwelling elderly individuals aged 65 years and above in Tianjin is slightly higher than the national average. Risk factors for dementia include old age, without at least one year formal education, more social environment problems, and cerebrovascular disease. The disability rate of dementia patients in Tianjin communities is high. Targeted interventions should be implemented to reduce the prevalence of dementia and provide better services for the treatment and rehabilitation of dementia patients.

]]> Objective: To explore the correlation between sleep quality and anxiety, depression, and psychiatric symptoms in multiple system atrophy (MSA) patients. Methods: total of 185 MSA patients were selected and divided into two groups based on their Pittsburgh Sleep Quality Index (PSQI) scores: MSA patients with sleep disorders (MSA-SD group, PSQI > 5) and MSA patients without sleep disorders (MSA-NSD group, PSQI ≤ 5). Cognitive function, executive function, anxiety, depression, neuropsychiatric symptoms, and mild behavioral impairment were assessed using the Mini-Mental State Examination (MMSE), Frontal Assessment Battery (FAB), HamiltoAn Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Neuropsychiatric Inventory (NPI-12), and Mild Behavioral Impairment Checklist (MBI-C), respectively. The correlation between sleep quality and cognitive function, anxiety, depression, and abnormal neuropsychiatric behavior was analyzed. Results: The prevalence of sleep disorders in MSA patients was 48.11%. MSA patients with comorbid sleep disorders had poorer overall cognitive function and executive function compared to those without sleep disorders. They also exhibited more severe anxiety, depression, and abnormal neuropsychiatric behavior. Univariate analysis showed that the PSQI total score was not significantly associated with age, MMSE, or FAB, but positively correlated with NPI total score, HAMA score, HAMD score, and MBI score. Multiple linear regression analysis revealed that depression and abnormal neuropsychiatric behavior were risk factors for sleep disorders in MSA patients. Conclusion: Sleep quality, anxiety, depression, and psychiatric behavioral abnormalities are common non-motor symptoms in MSA patients. Depression and psychiatric symptoms are important factors affecting sleep quality in these patients.

]]> Objective: To investigate the effect of depression on cognitive domains in patients with Alzheimer's disease(AD). Methods: A total of 62 patients with mild to moderate AD were treated at the Department of Neurology and Memory Clinic of Rizhao People's Hospital from June 2021 to June 2023. We used the Simple mental State Examination Scale (MMSE) and the Montreal Cognitive Assessment Scale (MoCA) to assess the overall cognitive function of AD patients, and 5 different single cognitive domain including memory, language, attention, visuospatial and executive function were evaluated at the same time. Hamilton Depression Scale (HAMD) was used to evaluate the depression level of the patients. HAMD≤7 was divided into AD without depression group, and HAMD > 7 was divided into AD with depression group. The overall cognitive function and cognitive domains were compared between the two groups. Results: Among the 62 subjects, AD patient with depression accounted for 45.16%. In AD patients, HAMD score was negatively correlated with digit span test(forward recall), and positively correlated with trail making test(form B) and Stroop’s color word test time. There were significant differences in the scores of digit span test(forward recall), trail making test(form B) and Stroop color word test time among AD patients with different psychological states. Conclusion: Depression can affect attention and executive function in AD patients.

]]> Objective: Logopenic variant primary progressive aphasia (lvPPA) is rare neurodegenerative disease, and characterized by a progressive impairments of specific language functions. More recently studies have shown that some cases have underlying Alzheimer’s disease pathology. the atypical AD with non-amnesic syndrome is more likely to be misdiagnosed and missed. we report a case with a logopenic variant of primary progressive aphasia with non-fluent dyslexia as the initial symptom. The description of this case provide clinical experience in the diagnosis and treatment of atypical AD. Methods: We detail the whole clinical course, including its neurolinguistic study, magnetic resonance imaging (MRI), and treatment. In addition, we reviewed the literature and provide a summary of the characteristics, complications, treatment, and prognosis of these cases. Results: The primary progressive aphasia of early atypical AD-Logopenic variant was characterized by early spontaneous speech and difficulty in picking.

]]> Objective: To analyze the knowledge of geriatric mental health among the middle-aged and elderly population in the community of Tianjin, China, and to explore its influencing factors. Methods: A multi-stage random sampling method was used to select community residents aged 45 years and above, and a demographic information questionnaire and a questionnaire on mental health knowledge in old age were used to conduct the survey. Results: A total of 1002 study subjects were included, and the average score of the geriatric mental health knowledge questionnaire of the middle-aged and elderly community population in Tianjin was (7.97±0.95), and the mastery of geriatric mental health knowledge of the middle-aged and elderly community population of different ages varied, with the average score of the middle-aged group being (7.99±0.93), the average score of the young-elderly group being (8.04±0.94), and the score of the elderly group being (7.72±1.05), the scores of the middle-aged and young-aged groups were statistically significant when compared with the scores of the geriatric group, respectively (all P<0.05).Logistic regression analysis showed that advanced age and living alone were the factors influencing the scores of the middle-aged and elderly groups on the knowledge of geriatric mental health. Conclusion: There are differences in the degree of knowledge of geriatric mental health among middle-aged and elderly residents in Tianjin, and there exists a relative lack of knowledge of geriatric mental health among the elderly and those living alone, suggesting that publicity and education for this population group should be strengthened in the future.

]]> Objective: Observation of the therapeutic effects of high-frequency repetitive transcranial magnetic stimulation (rTMS) and intermittent complex stimulation (iTBS) on depression and cognitive improvement in elderly patients. Methods: Fifty elderly patients with depressive disorders were selected and randomly divided into a 10Hz high-frequency rTMS group and an iTBS group. After receiving treatment with 100mg/day of sertraline, 10 patients were treated with 10Hz high-frequency rTMS and iTBS, respectively. Finally, 20 patients were removed from each group. The results were compared and analyzed for the efficacy of different treatment modes between the two groups. Results: After 10 treatments, there was no statistically significant difference in the Hamilton Depression Rating Scale (HAMD) between the two treatment methods (P>0.05), while after 20 treatments, there was a statistically significant difference in HAMD between the two treatment, methods (P<0.01). Compared before and after the two treatments, the HAMD values after 10 and 20 treatments were lower than those at admission (P<0.01), and the relief of depressive symptoms was more significant after 20 treatments than after 10 treatments. There was no statistically significant difference in baseline TMT1, TMT2, MoCA, and VFT between the two groups before treatment (P>0.05), and there was no statistically significant difference in TMT1, TMT2, MoCA, and VFT after 20 treatments (P>0.05). There was a statistically significant difference between the two groups before and after treatment. Conclusion: Both modes of transcranial magnetic stimulation combined with sertraline are effective in treating elderly depression. After 20 treatments, the HAMD score of the 10Hz high-frequency group decreased significantly compared to the iTBS group. The 10Hz group had better relief of depressive symptoms than the iTBs group, and both treatments had an improvement effect on cognition, with no statistically significant difference in efficacy.

]]> Objective: The mesolimbic system plays a crucial role in weight regulation and cognitive function. Previous studies suggested that the pathology of Alzheimer's disease (AD) can lead to the atrophy of the mesolimbic system and the decline of body mass index (BMI). It remains unknown whether BMI is associated with the mesolimbic system in AD. This study aims to investigate the association of BMI with the mesolimbic system and cognition in AD patients. Methods: Data were collected from the Alzheimer’s Disease Neuroimaging Initiative database. All participants underwent Aβ PET imaging at baseline. PET imaging was carried out concurrently with brain MRI data and comprehensive neuropsychological assessments. Baseline and follow-up data were collected. Participants were divided into Aβ-positive group (standardized uptake value ratio [SUVR] > 1.11) and Aβ-negative group (SUVR ≤ 1.11) based on the SUVR of Aβ PET. Hippocampus, amygdala, accumbens, caudate, and putamen were selected as regions of interest (ROIs) in the mesolimbic system. Linear regression was conducted to assess the relationship between BMI and cognition, and the volume of the ROIs. Linear mixed-effects model was employed for longitudinal data analysis. Results: A total of 1182 participants were included in this study, including 608 cases of Aβ-positive and 574 cases of Aβ-negative. Compared with the Aβ-negative group, the Aβ-positive group exhibited a decreased volume of hippocampus, amygdala, accumbens, and putamen and lower BMI (P<0.01); In the Aβ-positive group, BMI was associated with baseline hippocampal volume (β=0.123, P<0.001), amygdala volume (β=0.063, P<0.001), accumbens volume (β=0.012, P=0.046), caudate volume (β=0.104, P=0.021), putamen volume (β=0.108, P=0.023), Mini-Mental State Examination (MMSE; β= 0.094, P= 0.002), and memory composite score (β= 0.072, P= 0.015), whereas, in the Aβ-negative group, BMI was unrelated with the volume of ROIs and cognitive performance; Longitudinal data analyses involving Aβ-positive participants also indicated that BMI was associated with the volume of hippocampus, amygdala, accumbens, putamen, MMSE, and memory function; Mediation analyses revealed that the volume of ROIs mediated the association between BMI and cognition in the Aβ -positive group. Conclusion: A lower BMI was associated with a smaller volume of the mesolimbic system and poorer cognition in AD patients.

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