Objective To observe the relationship of serum levels of homocysteine (HCY) and chemokine C-C motifligand 2 (CCL2) with cognitive impairment in COPD patients with different degrees of emphysema. Methods Sixty-twoCOPD patients identified according to emphysema phenotype classification and admitted from January 2016 to March 2017 were recruited in the study. There were 37 cases in emphysema 1-2 grade and 25 cases in emphysema 3-4 grade. Simultaneous 30 healthy subjects undergoing physical examination were recruited as control. Montreal cognitive assessment (MoCA) scale investigation and serum HCY and CCL2 test were completed. Relationship analysis was conducted on serum HCY, CCL2 levels with cognitive impairment in the COPD patients with different degrees of emphysema. Results Compared with the 1-2 grade subgroup, the PaO2 was lower, PaCO2 was higher, the plasma HCY and CCL2 levels increased in the 3-4 grade subgroup with significant differences (all P<0.05). MoCA total score and subscores were relatively low in the COPD group with emphysema than the control group (except visuospatial ability scores in the 1-2 grade subgroup). MoCA scores were statistically lower in the 3-4 grade subgroup than those in the 1-2 grade subgroup (allP<0.05). Correlation analysis showed that HCY and CLL2 levels were negatively correlated with MoCA scores and subscores (P<0.01), and HCY and CLL2 were positively correlated (bothP<0.01). The area under the receiver operating characteristic curve of HCY and CLL2 for evaluating cognitive impairment was 0.79 and 0.97, respectively. Conclusion In patients with different degrees of emphysema phenotype, serum HCY and CCL2 levels are increased in different degree, and the degree of emphysema is closely related with cognitive dysfunction.
ObjectiveTo systematically review the factors for cognitive impairment in hypertensive patients. MethodsPubMed, Web of Science, Embase, Cochrane Library, Ovid, Scopus, EBSCO, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect studies on factors for cognitive impairment in hypertensive patients from inception to March 2023. Two reviewers independently screened literature, extracted data and evaluated the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.3 and Stata 14.0 software. ResultsA total of 26 articles involving 13 464 patients were included. The results of meta-analysis showed that antihypertensive drug use (OR=0.22, 95%CI 0.09 to 0.59, P=0.002), blood pressure was well controlled (OR=0.48, 95%CI 0.37 to 0.623, P<0.001), and social support (OR=0.94, 95%CI 0.90 to 0.97, P<0.001) were protective factors for CI in hypertensive patients. And age (OR=1.17, 95%CI 1.12 to 1.22, P<0.001), age ≥60 (OR=2.10, 95%CI 1.71 to 2.57, P<0.001), female (OR=1.55, 95%CI 1.25 to 1.93, P<0.001), single (OR=2.39, 95%CI 1.89 to 3.03, P<0.001), smoking (OR=3.40, 95%CI 2.40 to 4.82, P < 0.001), educational level (<college） (OR=3.46, 95%CI 2.73 to 4.39, P<0.001), education years (≥12 years) (OR=2.10, 95%CI 1.43 to 3.07, P<0.001), diabetes (OR=2.82, 95%CI 2.22 to 3.58, P<0.001), hyperlipidemia (OR=1.48, 95%CI 1.10 to 2.00, P=0.01), total cholesterol (OR=1.11, 95%CI 1.01 to 1.22, P=0.02), CVHI anomalies (OR=6.24, 95%CI 3.75 to 10.37, P<0.001), sleep disorder (OR=2.92, 95%CI 1.93 to 4.42, P<0.001), systolic blood pressure (OR=1.04, 95%CI 1.02 to 1.06, P<0.001), orthostatic hypotension (OR=1.39, 95%CI 1.20 to 1.62, P<0.001, grade 2 hypertension (OR=2.62,95%CI 1.83 to 3.73, P<0.001), grade 3 hypertension (OR=3.15, 95%CI 1.90 to 5.22, P<0.001), stress history (OR=4.57, 95%CI 2.86 to 7.30, P<0.001) were all risk factors. ConclusionThe current evidence shows that there are many factors affecting the incidence of CI in hypertensive patients, and the assessment of the factors affecting the incidence of cognitive dysfunction in hypertensive patients should be more comprehensive in the future.
ObjectiveTo systematically analyze the prevalence of cognitive impairment in patients with COPD.MethodsAn electronic search in PubMed, Embase, CNKI, WanFang Data and VIP databases to identify studies describing the prevalence of cognitive impairment in patients with COPD from inception to 3 May 2023. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, the meta-analysis was performed by using Stata16.0 software. ResultsA total of 40 studies involving 9, 988 patients with COPD were included. Meta-analysis showed that the total prevalence of cognitive impairment in patients with COPD was 48.26% (95%CI 42.39% to 54.20%). The results of subgroup analysis revealed that the prevalence of cognitive impairment in patients with acute exacerbation of COPD was higher than that in patients with stable-phase (58.62% vs. 49.71%). The prevalence of cognitive impairment in COPD patients was 29.07% before 2015, while the prevalence between 2015-2019 and 2020-2023 were higher, with rates of 53.06% and 48.26% respectively. The prevalence of cognitive impairment in domestic COPD patients was significantly higher than that in foreign patients (52.66% vs. 37.06%). ConclusionThe prevalence of cognitive impairment is relatively high in COPD patients, highlighting the need to strengthen the screening for cognitive impairment in COPD patients and provide early assessment and intervention.
ObjectiveTo systematically review the detection rate of cognitive impairment in Chinese patients with type 2 diabetes mellitus (T2DM).MethodsPubMed, EMbase, The Cochrane Library, CBM, CNKI, WanFang Data and VIP databases were searched to collect studies on the detection rate of cognitive impairment in Chinese patients with T2DM from inception to January 20th, 2021. Two reviewers independently screened literature, extracted data and evaluated the risk of bias of included studies. Meta-analysis was then performed using Stata 12.0 software.ResultsA total of 27 studies involving 7 920 cases were included. Meta-analysis results showed that the total detection rate of cognitive impairment in Chinese patients with T2DM was 43.2% (95%CI 36.9% to 49.6%). The results of subgroup analysis showed that in T2DM patients, the detection rate of cognitive impairment in males was 42.4% (95%CI 34.4% to 50.4%), and that in females was 48.2% (95%CI 40.9% to 55.6%). The detection rate of cognitive impairment was 25.4% (95%CI 14.7% to 36.0%) in patients under the age of 60 years, and 47.0% (95%CI 30.0% to 64.0%) in patients aged 60 years or above. The detection rate of cognitive impairment among those with primary school education level or below was 67.1% (95%CI 48.9% to 85.3%). The detection rate of cognitive impairment was 37.1% (95%CI 27.3% to 46.8%) among those with education level of junior high school or above. The detection rate of cognitive impairment in patients with disease duration less than 10 years was 28.4% (95%CI 16.0% to 40.9%) and that in patients with disease duration more than 10 years was 50.6% (95%CI 33.2% to 68.0%). The detection rate of cognitive impairment in married individuals was 45.6% (95%CI 35.8% to 55.4%) and that in singles was 68.1% (95%CI 57.5% to 78.7%). The detection rate of cognitive impairment in smokers was 38.9% (95%CI 30.7% to 47.2%) and in non-smokers was 40.9% (95%CI 32.1% to 49.6%). The detection rate of cognitive impairment in drinkers was 35.6% (95%CI 27.3% to 44.0%) and that in non-drinkers was 41.8% (95%CI 32.2% to 51.4%).ConclusionsThe detection rate of cognitive impairment in Chinese patients with T2DM is high. Due to the quantity and quality of included studies, more high-quality studies are needed to verify the above conclusions.
ObjectiveTo analyze of the extent of neuropsychological damage in post-traumatic epilepsy patients. MethodsOne hundred and thirty-five patients treated at the Department of Neurosurgery, the 904th Hospital of PLA from January 2016 to December 2018 were analyzed retrospectively, including 94 males and 41 females, with an average age of (32.94 ± 9.51) years. They were divided into 3 groups: 40 patients with post-traumatic epilepsy (epilepsy group): 53 trauma patients without post-traumatic epilepsy (trauma group) and 42 patients with health examination (control group). Neuropsychological assessment using the following scales: Mini-mental State Examination (MMSE): Montreal Cognitive Assessment-Basic (MoCA-B): Audio Verbal Memory Test (AVMT): Rey-Osterrieth Complex Figure Test (CFT): Trail Making Test (TMT): Hamilton Depression Scale (HAMD): Activity of Daily Living (ADL). ResultsThe results of one-way ANOVA showed that there was significant difference between all scales of epilepsy group, trauma group and control group (P<0.01). MMSE and MoCA-B scores: Compared with trauma group, epilepsy group decreased significantly, but there was no significant difference between groups (P>0.05); Memory and spatial structure ability: AVMT short/long delayed memory, CFT recall and copy test results showed that epilepsy group decreased more significantly than trauma group, and there was statistical significance between groups (P<0.05); Executive ability: TMT-A and TMT-B showed that epilepsy group spent longer time than trauma group, and there was significant difference between groups (P<0.01); Depressive symptoms: HAMD scale showed significant difference between epilepsy group and trauma group (P<0.01): while there was no statistical difference between trauma group and control group (P>0.05); Activity of daily living: ADL scale results showed that there was no significant difference between epilepsy group and trauma group (P>0.05). ConclusionPost-traumatic epilepsy can aggravate the cognitive impairment of patients, mainly in the decline of memory, spatial structure and executive ability, and prone to depressive symptoms. At the same time of treating epilepsy seizures, patients with post-traumatic epilepsy should be screened and assessed early in neuropsychology to improve their quality of life and return to society as soon as possible.
ObjectiveTo systematically review the association between overweight, obesity, abdominal obesity, and cognitive impairment (CI) in the elderly. MethodsThe CNKI, WanFang Data, VIP, CBM, PubMed, Web of Science, Embase, and Cochrane Library databases were electronically searched for studies on the relationship between overweight, obesity/abdominal obesity, and CI in the elderly from their inception to July 2024. Two researchers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was performed using Stata 15.0 software. ResultsA total of 38 studies involving 1 783 087 subjects were included. Meta-analysis results showed that compared with normal-weight individuals, overweight (OR=0.96, 95%CI 0.91 to 1.02, P=0.201) was not statistically significant in the risk of CI in the elderly. Obesity (OR=1.14, 95%CI 1.02 to 1.28, P=0.03) and abdominal obesity (OR=1.16, 95%CI 1.11 to 1.21, P<0.001) may be risk factors for CI in the elderly. Subgroup analysis was conducted based on study type, BMI standards, cognitive diagnostic standards, national development level, abdominal obesity diagnostic standards, and follow-up time. Among the subgroups analyzing the correlation between overweight and CI in the elderly, follow-up time ≤5 years (OR=0.68, 95%CI 0.58 to 0.80) showed a lower proportion of CI compared to other follow-up periods. In the subgroups analyzing the correlation between obesity and CI in the elderly, follow-up time ≤5 years (OR=0.71, 95%CI 0.50 to 1.01) was not statistically significant compared to other follow-up periods. For abdominal obesity, a significant association with increased CI risk in the elderly was found only in the subgroup with a follow-up time of 5-10 years (OR=1.21, 95%CI 1.15 to 1.27), compared with other follow-up periods. ConclusionCurrent evidence suggests that obesity and abdominal obesity may increase the risk of CI in the elderly. Proper weight management is crucial for preventing and delaying the progression of CI in the elderly.
Based on literatures on Meta-analysis and randomized controlled trial, drug use and some geriatrics syndromes such as cognitive impairment and depression, in elderly diabetic patients were reviewed. Insulin plus oral hypoglycemic drugs was more rational therapy for insulin resistance and islet dysfunction in type 2 diabetes mellitus. We should pay more attention to cognitive impairment and depression in elderly type 2 diabetic patients.
Objectives This study aims to examine the possible association between C-reactive protein (CRP) concentration and cognitive impairment in patients with post-stroke epilepsy. Methods Patients with post-stroke epilepsy admitted to Western China Hospital from January 2010 to June 2016 were consecutively enrolled in our study. CRP levels were assessed within one week of stroke onset, and then correlated with cognitive status assessed two years after stroke using the Six-Item Screener. Results Among the 96 patients with post-stroke epilepsy who included in our study, 24 patients were found to have cognitive impairment during the two years follow-up period. Our data showed a significant association between CRP levels and cognitive performance in these patients (31.5±36.2 vs. 11.9±19.4, P=0.029). In addition, this association persisted even after adjusting for potential confounders［OR=1.021, 95%CI (0.997, 1.206), P=0.037］. Conclusions Following ischemic stroke, higher CRP levels is associated with subsequent cognitive decline in patients with epilepsy. Association and prospective studies in larger sample size are needed in order to validate our findings, especially studies in which baseline CRP level and CRP level during follow-up are closely monitored.
ObjectivesTo systematically review the current status of cognitive impairment of the elderly in China.MethodsCNKI, VIP, CBM, WanFang Data, PubMed, EMbase and The Cochrane Library databases were electronically searched to collect studies on the current status of cognitive impairment of the elderly in China from January 1st, 2000 to March 12th, 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Then, meta-analysis was performed by using Stata 14.1 software.ResultsA total of 126 studies involving 187 115 elderly were included. The results of meta-analysis showed that the cognitive impairment rate of the elderly in China was 22.0% (95%CI 20.4% to 23.6%). Subgroup analysis showed that the cognitive impairment rate was higher in females, seniors, low education level, residing in rural area, engaging in manual labor, no spouse, living alone, monthly income less than 1 000 yuan, and suffering from chronic diseases.ConclusionsCurrent evidence shows that the cognitive impairment rate of the elderly in China is 22%, which is relatively high in females, seniors, low education level, residing in rural area, engaging in manual labor, no spouse, living alone, low-income, and suffering from chronic diseases.
Patients with autoimmune encephalitis are mainly characterized by behavioral, mental and motor abnormalities, neurological dysfunction, memory deficits and seizures. Different antibody types of autoimmune encephalitis its pathogenesis, clinical characteristics are different, in recent years found immune related epilepsy is closely related to autoimmune encephalitis, based on autoimmune encephalitis type is more, we choose more common autoimmune encephalitis, expounds its characteristics, to help clinical diagnosis.