Some patients with type 1 and type 2 diabetes mellitus (DM) present with cognitive dysfunctions. The pathophysiology underlying this complication is not well understood. Type 1 DM has been associated with a decrease in the speed of information processing, psychomotor efficiency, attention, mental flexibility, and visual perception. Longitudinal epidemiological studies of type 1 DM have indicated that chronic hyperglycemia and microvascular disease, rather than repeated severe hypoglycemia, are associated with the pathogenesis of DM-related cognitive dysfunction. However, severe hypoglycemic episodes may contribute to cognitive dysfunction in high-risk patients with DM. Type 2 DM has been associated with memory deficits, decreased psychomotor speed, and reduced frontal lobe/executive function. In type 2 DM, chronic hyperglycemia, long duration of DM, presence of vascular risk factors (e.g., hypertension and obesity), and microvascular and macrovascular complications are associated with the increased risk of developing cognitive dysfunction. The pathophysiology of cognitive dysfunction in individuals with DM include the following: (1) role of hyperglycemia, (2) role of vascular disease, (3) role of hypoglycemia, and (4) role of insulin resistance and amyloid. Recently, some investigators have proposed that type 3 DM is correlated to sporadic Alzheimer's disease. The molecular and biochemical consequences of insulin and insulin-like growth factor resistance in the brain compromise neuronal survival, energy production, gene expression, plasticity, and white matter integrity. If patients claim that their performance is worsening or if they ask about the effects of DM on functioning, screening and assessment are recommended.
Objective : This study was designed to find the characteristics of MMPI that could influence the outcome of cognitive behavioral therapy(CBT) for panic disorder. Methods : 34 patients who met DSM-IV criteria for panic disorder with or without agoraphobia had completed 11 weekly sessions of cognitive behavioral therapy. All the patients were assessed with MMPI before the initiation of treatment. Five self-report measures including Beck Depression Inventory(BDI), Spielberger State-Trait Anxiety Inventory(STAI), Agoraphobic Cognition Questionnarie(ACQ), Body Sensation Questionnaire(BSQ), and Daily Anxiety Selfrating (0 - 8 scales) were also assessed as a pre- and post-treatment assessment. After the completion of treatment, patients were classified by the High End-State(HES) functioning group and the Low End-State(LES) functioning group for the data analysis. Results : 1) The LES group showed significantly higher scores in Hypochondriasis Scale(HS), Depression Scale(D), Hysterical Scale(Hy), Obsessive Scale(Pt), Schizophrenia Scale(Sc) and Validity Scale(F) of MMPI than the HES group. However, these differences gave impressions that the LES group had more severe symptoms rather than that they could be the factors influencing the outcome of CBT. 2) Though, the severity of symptoms of the LES group in the 5 measures of pre-assessment was basically higher than that of the HES group. The fact that both group showed the similar improvement between pre- and post-assessment supported the above interpretation. Conclusion : In regarding the above results, MMPI was not a proper tool that could provide the factors influencing the outcome of CBT. In the future study, the authors need to use a different tool that can find the personality characteristics more directly.
Objective : The Mini-Mental State Examination(MMSE) and Brief Cognitive Rating Scale(BCRS) are frequently using screening tests fur evaluating the cognitive function in clinical practice and research. The authors tried to evaluate the clinical usefulness of these tests for the patients with non-traumatic subcortical cerebrovascular disease. Method : We administered the MMSE and BCRS to 85 patients and 195 normal control group. In order to compare the test results according to the lesion site, we divided patients into left sided lesion group(21 patients), right sided lesion group(31 patients) and both sided lesion group(13 patients). Their cognitive function was evaluated by the BNA and daily living functional activity was examined by the IADLs(Instrumental Activities of Daily Living Scale)and GERRI(Geriatric Evaluation by Relative's Rating Instrument). Results : The results are as follows : 1) In the BNA, the patients scored significantly lower than control group at all items(except Right-Left Orientation and Motor Impersistence), but there were no difference in the MMSE(total score and all 5 items), and only 2 items(recent memory and self-care) were significantly different between two groups in the BCRS. 2) In the comparison by lateralization, there were significant differences among three groups at 3 items(Left Tactile Form Perception, Left Finger Localization and Right Finger Localization) in the BNA. But, there were no difference in the MMSE and BCRS. 3) In the correlation between daily living functioning and the MMSE/BCRS, control group showed no relation(except item of cognitive functioning), but patient group was significantly correlated with 3 items(social functioning, instrumental activities of daily living and cognitive functioning). Conclusions : These findings suggest that MMSE and BCRS are not useful as the test for cognitive function and discrimination of lateralization in patients with non-traumatic subcortical cerebrovascular disease. However, scores of these tests may be related with the functional level(such as daily living function) of patients.
Objectives: Cognitive impairments, ranging from mild to severe, adversely affect daily functioning, quality of life, and work capacity. Despite significant efforts in the past decade, more than 200 promising drug candidates have failed in clinical trials. Herbal remedies are gaining interest as potential treatments for dementia due to their long history and safety, making them valuable for drug development. This review aimed to examine the mechanisms behind the effect of Polygonum multiflorum on cognitive function. Methods: This study focused primarily on the effects of Polygonum multiflorum and its chemical constituents on cognitive behavioral outcomes including the Morris water maze, the passive avoidance test, and the Y maze, as well as pathogenic targets of cognitive impairment and Alzheimer's disease (AD) like amyloid deposition, amyloid precursor protein, tau hyperphosphorylation, and cognitive decline. Additionally, a thorough evaluation of the mechanisms behind Polygonum multiflorum's impact on cognitive function was conducted. We reviewed the most recent data from preclinical research done on experimental models, particularly looking at Polygonum multiflorum's effects on cognitive decline and AD. Results: According to recent research, Poligonum multiflorum and its bioactive components, stilbene, and emodin, influence cognitive behavioral results and regulate the pathological target of cognitive impairment and AD. Their mechanisms of action include reducing oxidative and mitochondrial damage, regulating neuroinflammation, halting apoptosis, and promoting increased neurogenesis and synaptogenesis. Conclusion: This review serves as a comprehensive compilation of current experiments on AD and other cognitive impairment models related to the therapeutic effects of Polygonum multiflorum. We believe that these findings can serve as a basis for future clinical trials and have potential applications in the treatment of human neurological disorders.
Chung Soon-Cheol;Kim Ik-Hyeon;Tack Gye-Rae;Lee Soo Yeol;Sohn Jin-Hun
Journal of Biomedical Engineering Research
/
v.26
no.1
/
pp.1-7
/
2005
This study aimed to investigate the hypothesis that administration of the air with 30% oxygen compared with normal air (21% oxygen) enhances cognitive functioning through increased activation in the brain. Seventeen college students (righthanded, average age of 24.3) were selected as subjects for this study. An oxygen supply equipment that provides 21% and 30% oxygen at a constant rate of 8L/min was developed. In order to measure the performance level of visuospatial and verbal cognition, two psychological tests were developed. The experiment consisted of two runs, one for cognition task with normal air (21% oxygen) and the other for cognition task with hyperoxic air (30% oxygen). Visuospatial and verbal tasks were presented while brain images were scanned by a 3T fMRI system using the single-shot EPI method. The results showed that there was an improvement in performance and also increased activation in several brain areas in the higher oxygen condition. These results suggest that while performing cognitive tasks, high concentrations of oxygen administration make oxygen administration sufficient, thus making neural network activate more, and the ability to perform cognitive tasks increase.
Background and Purpose: Each item in the instrumental activities of daily living (IADL) questionnaire has differential importance to an individual's life functioning based on gender. However, IADL has mostly been utilized for its total score alone, without gender specificity. We identify the impact of each item on the transition from amnestic mild cognitive impairment (aMCI) to Alzheimer's disease dementia (ADD), and determine if the impact of each item differs by gender. Methods: Subjects were aMCI or ADD with a global clinical dementia rating of 0.5 or 1. The sample size was 146 men and 154 women. We used logistic regression analysis to determine the effect of each item of IADL on the transition from aMCI to ADD. Results: The odds ratio (OR) for "remembering recent events" had similar values: 27.2 for men, and 27.7 for women. Gender difference was identified in the item with the highest OR value. For women, the "using transportation" item was 63.3, and for men, "conducting financial affairs" was overwhelmingly high at 89.1. Conclusions: Functional decline on items with relatively higher ORs may indicate higher probability of a transition from aMCI to ADD. The OR of "conducting financial affairs" was relatively higher for both genders. In terms of gender differences, "conducting home repair" for men, and "using transportation" for women, have relatively higher impact. This study demonstrates that during the transition from aMCI to ADD, each item of IADL shows a staggered decline in functioning, and that this decline is gender-specific.
Purpose: This study aimed to evaluate the relationships among quality of life, caregiver depression levels, and disease severity, especially motor function, in children with cerebral palsy. Methods: Data were collected through questionnaires using survey and interview from 80 caregivers of children with cerebral palsy. The caregivers' quality of life was measured using medical outcomes study 36-item short form health survey, and level of depression was scored using the beck depression inventory. In addition, children's motor function was evaluated using gross motor function measure-88 and functional independence measure scores. Results: Among 8 domains of medical outcomes study 36-item short form health survey, "physical functioning," "physical role functioning," "mental health," and "bodily pain" domains were significantly correlated to "total" percentage scores of gross motor function measure-88. In addition, "mental health" and "bodily pain" domains were correlated to each sub-dimension, including "lying and rolling," "sitting," "crawling and kneeling," "standing," and "walking, running, and jumping." Similarly, the "running" and "jumping" dimensions including motor function measures correlated with "transfer," "locomotion," and "motor subtotal" of functional independence measure scores. The beck depression inventory scores were negatively correlated to "lying and rolling," "sitting," "crawling and kneeling," and the "total" percentage scores of gross motor function measure-88. The beck depression inventory scores were negatively correlated to "sphincter control," "communication," "social cognition," "cognitive subtotal," and "total" functional independence measure scores. Conclusion: It is necessary to consider the quality of life and emotional problems of caregivers of CP children and support them both physically and psychologically with comprehensive rehabilitation.
Purpose: The purpose of this study was to examine the effects of a cognitive training program on neurocognitive task performance and activities of daily living (ADL) in patients who had a stroke. Methods: The research design for this study was a nonequivalent control group non-synchronized design. Patients were assigned to the experimental (n=21) or control group (n=21). The experimental group received a 4-week cognitive training program and usual care (i.e., rehabilitation service), while the control was received usual care only. Cognitive function was measured with a standardized neurocognitive test battery and ADL was assessed at baseline and one and two months after completion of the intervention. Repeated measures ANOVA was used to determine changes in cognitive function and ADL over 2 months. Results: The interaction of group and time was significant indicating that the experimental group showed improvement in attention, visuospatial function, verbal memory, and executive function compared to the control group which had a sustained or gradual decrease in test performance. A significant group by time interaction in instrumental ADL was also found between the experimental group with gradual improvement and the control group showing no noticeable change. Conclusion: Findings show that the cognitive training program developed in this study is beneficial in restoring cognitive function and improving ADL in patients following a stroke. Further study is needed to investigate the long-term relationship between cognitive training participation and cognitive improvement and effective functioning in daily living.
Magaji, Bello Arkilla;Moy, Foong Ming;Roslani, April Camilla;Law, Chee Wei;Sagap, Ismail
Asian Pacific Journal of Cancer Prevention
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v.16
no.18
/
pp.8107-8112
/
2016
Background and Aims: Colorectal cancer is the second most frequent cancer in Malaysia. We aimed to assess the validity and reliability of the Malaysian Chinese version of European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire core (QLQ-C30) in patients with colorectal cancer. Materials and Methods: Translated versions of the QLQ-C30 were obtained from the EORTC. A cross sectional study design was used to obtain data from patients receiving treatment at two teaching hospitals in Kuala Lumpur, Malaysia. The Malaysian Chinese version of QLQ-C30 was self-administered in 96 patients while the Karnofsky Performance Scales (KPS) was generated by attending surgeons. Statistical analysis included reliability, convergent, discriminate validity, and known-groups comparisons. Statistical significance was based on p value ${\leq}0.05$. Results: The internal consistencies of the Malaysian Chinese version were acceptable [Cronbach's alpha (${\alpha}{\geq}0.70$)] in the global health status/overall quality of life (GHS/QOL), functioning scales except cognitive scale (${\alpha}{\leq}0.32$) in all levels of analysis, and social/family functioning scale (${\alpha}=0.63$) in patients without a stoma. All questionnaire items fulfilled the criteria for convergent and discriminant validity except question number 5, with correlation with role (r = 0.62) and social/family (r = 0.41) functioning higher than with physical functioning scales (r = 0.34). The test-retest coefficients in the GHS/QOL, functioning scales and in most of the symptoms scales were moderate to high (r = 0.58 to 1.00). Patients with a stoma reported statistically significant lower physical functioning (p=0.015), social/family functioning (p=0.013), and higher constipation (p=0.010) and financial difficulty (p=0.037) compared to patients without stoma. There was no significant difference between patients with high and low KPS scores. Conclusions: Malaysian Chinese version of the QLQ-C30 is a valid and reliable measure of HRQOL in patients with colorectal cancer.
Jung, Mi Sook;Ju, Kyoung Ok;Song, Mi Soon;Lee, Kyoung Suk
Journal of the Korean Society of School Health
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v.29
no.3
/
pp.245-255
/
2016
Purpose: This study was aimed to examine the effects of smartphone overuse and individual factors including age, relationship with friends, satisfaction with school life, and time of smartphone usage on perceived cognitive functions, fatigue, and daytime sleepiness among college students. Methods: Three-hundred college students were recruited after confirming the absence of major depressive symptoms. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation, and multiple regression. Results: Smartphone overuse commonly explained the variance in perceived cognitive functions, fatigue, and daytime sleepiness, after controlling for individual factors. In addition, satisfaction with school life was significantly related with better effectiveness of cognitive functions while being male, having good relationships with friends and satisfaction with school life were relatively associated with a lower level of fatigue. Conclusion: The findings of this study revealed that the overuse of smartphone can serve as a psycho-cognitive burden leading to ineffective functioning in daily living. Students who are female and have issues regarding school life and friendship may be a high risk group for experiencing psycho-cognitive dysfunction associated with smartphone overuse. Further investigation is needed to develop effective interventions to improve psycho-cognitive health associated with the excessive use of smartphone in young adults.
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