Journal of Alzheimer's disease : JAD
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Neurocognitive disorders create important challenges for patients, their families, and clinicians who provide their health care. Early/timely detection in daily clinical practice allows for diagnosis and adequate treatment, psychosocial support, education, and engagement in shared decision-making related to health care, life planning, involvement in research, and financial matters. However, neurocognitive disorders, when present, are not detected or not diagnosed and not documented, in more than half of patients seen by primary care physicians. The aim of this paper is to highlight the strategies and the perspectives to improve the early/timely detection of neurocognitive disorders in daily clinical practice.
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Mild cognitive impairment (MCI), as a transitional stage between normal aging and dementia, causes cognitive decline among one-fifth of elders aged 65 years and older. Health-related lifestyles (HRL) are generally regarded as modifiable influencing factors of cognitive decline. The present study investigated how HRLs at two different life stages (one at midlife and the other at later life) affect MCI occurrence among community-dwelling elders, as part of the Diet and Healthy Aging (DaHA) study in Singapore. ⋯ Long-hour working in midlife (adjusted OR = 0.418 with 95% CI 0.215-0.812) and social engagement in later-life (adjusted OR = 0.532 with 95% CI 0.329-0.859) were associated with reduced risks of MCI, respectively. It is important to note that those elders who had both midlife long-hour working and later-life social engagement were related to the lowest risk of MCI (adjusted OR = 0.285 with 95% CI 0.143-0.565), when compared to the least active subgroup who neither had worked long hours in midlife nor participate in social activities in later-life. Therefore, the present study demonstrated that midlife long-hour working and later-life social engagement were modifiable factors for the maintenance of cognitive functions.
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Randomized Controlled Trial
An Indoor Therapeutic Garden for Behavioral Symptoms in Alzheimer's Disease: A Randomized Controlled Trial.
Behavioral and psychological symptoms of dementia (BPSD) affect 60-90% of patients with Alzheimer's disease (AD). ⋯ The indoor TG seems safe and may reduce BPSD, medication intake, and cortisol levels in AD.
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The role of chronic kidney disease (CKD) as a risk factor for cognitive impairment independent of their shared antecedents remains controversial. ⋯ Albuminuria predicted worse memory function at 12 years follow-up, whereas its effect on processing speed was driven largely by differences in cardiovascular risk. Kidney dysfunction based on eGFR predicted neither cognitive domain.
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Neurofilament light chain (NFL) as a potential biomarker of neurodegenerative diseases has been studied in a number of studies. Thus, a comprehensive meta-analysis is warranted to assess NFL performance in neurodegenerative diseases. ⋯ In our study, in addition to PD, NFL was suggested to be a global diagnostic biomarker for neurodegenerative diseases. Moreover, it could be used in differential diagnosis of PD and PD-related disorders. However, it was worth noting that NFL was not appropriate for diagnosis or differential diagnosis without clinical symptoms and other auxiliary examinations.