neurocognitive methods
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BACKGROUND: Perioperative neurocognitive disorders are often neglected and undiagnosed. There are known risk factors for these disorders (e.g., higher levels of frailty, cognitive decline before surgery). However, these factors are usually not assessed in the daily clinical setting. One of the main reasons for this lack of examination is the absence of a suitable cognitive function test that can be used in acute clinical settings. The primary aim of this study was to determine correlations between preoperative and postoperative scores on three cognitive tests (the Mini Mental State Exam (MMSE), the Clock Drawing Test (CDT) and the Test of Gestures (TEGEST). METHODS: This was a prospective, monocentric, observational study that included one cohort of patients aged 65 years and older. Patients underwent acute or elective surgical operations. Preanaesthesia tests were administered. After the operation, the patients completed the same tests between the 2nd postoperative day and discharge. Preoperative and postoperative cognitive test scores were assessed. RESULTS: This study included 164 patients. The arithmetic mean age was 74.5 years. The strongest correlations were observed between MMSE scores and TEGEST scores (r = 0.830 before and 0.786 after surgery, P < 0.001). To compare the MMSE and the TEGEST, the MMSE was divided into 2 categories-normal and impaired-and good agreement was found among 76.2% of the participants (κ = 0.515). If the TEGEST scoring system was changed so that scores of 4-6 indicated normal cognition and scores of 0-3 indicated cognitive impairment, the level of agreement would be 90.8%, κ = 0.817. Only 5.5% of the patients had impaired MMSE scores and normal TEGEST scores, whereas 3.7% of the respondents normal MMSE scores and impaired TEGEST scores. CONCLUSION: According to our results, the TEGEST is a suitable option for assessing cognitive functioning before surgery among patients who are at risk of developing perioperative neurocognitive disorders. This study revealed that it is necessary to change the rating scale for the TEGEST so that scores of 4-6 indicate normal cognition and scores of 0-3 indicate cognitive impairment. In clinical practice, the use of the TEGEST may help to identify patients at risk of perioperative neurocognitive disorders.
- MeSH
- hodnocení rizik metody MeSH
- kognitivní dysfunkce diagnóza psychologie etiologie MeSH
- lidé MeSH
- neurokognitivní poruchy * diagnóza psychologie MeSH
- neuropsychologické testy MeSH
- perioperační období MeSH
- pooperační komplikace diagnóza psychologie etiologie MeSH
- prospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- testy pro posouzení mentálních funkcí a demence MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
BACKGROUND: A wide range of potentially modifiable risk factors, indicating that the onset of neurocognitive disorders can be delayed or prevented, have been identified. The region of Central and Eastern Europe has cultural, political and economic specifics that may influence the occurrence of risk factors and their link to the cognitive health of the population. OBJECTIVE: We aimed to systematically review population-based studies from Central and Eastern Europe to gather evidence on risk and protective factors for neurocognitive disorders. METHODS: We searched the electronic databases PubMed, Cochrane Database of Systematic Reviews, PsycINFO, Web of Science, and Embase. The search was performed on 26th of February 2020 and repeated at the end of the review process on 20th May 2021. RESULTS: We included 25 papers in a narrative synthesis of the evidence describing cardiovascular risk factors (n = 7), social factors (n = 5), oxidative stress (n = 2), vitamins (n = 2), genetic factors (n = 2) and other areas (n = 7). We found that there was a good body of evidence on the association between neurocognitive disorders and the history of cardiovascular disease while there were gaps in research of genetic and social risk factors. CONCLUSION: We conclude that the epidemiological evidence from this region is insufficient and population-based prospectively followed cohorts should be established to allow the development of preventive strategies at national levels.
- MeSH
- lidé MeSH
- neurokognitivní poruchy epidemiologie etiologie MeSH
- ochranné faktory MeSH
- rizikové faktory MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- systematický přehled MeSH
- Geografické názvy
- východní Evropa MeSH
The paper contains a screening of the opinions of helping professions work- ers working in a home for the elderly with individuals with neurocognitive disorders and compares it with the opinions of a younger generation of students who are just preparing for this work. The authors carried out a comparative questionnaire survey with both target groups, focusing on the analysis and comparison of possible differences in their knowledge in the field of care for elderly people with neurocognitive disorders. Specifically, they focused on knowledge and experience with approaches, methods and tools applicable within the framework of music therapy interventions, as they are un- derstood in practice in comparison with the theoretical knowledge of secondary school students focused on social work. The questionnaire was mainly aimed at assessing the knowledge of the possibilities of effective stimulation of the memory of the elderly and their communication skills using the means of music. The conducted investigation was based on research studies dealing with so-called non-pharmacological approaches to the given clientele, for professional caregivers it was followed by music therapy lessons, which the authors regularly implemented from the beginning of 2022. Its results will, among other things, serve as the basis for an upcoming study with a scoping design review.
AIM: Patients with multiple brain metastases (BM) benefit from hippocampal-avoiding whole brain radiotherapy (HA-WBRT), the challenging and less available form of WBRT. This study explores potential of pre-radiotherapy (pre-RT) hippocampal magnetic resonance spectroscopy (MRS) measuring hippocampal neuronal density as an imaging surrogate and predictive tool for assessing neurocognitive functions (NCF). METHODS: 43 BM patients underwent pre-RT hippocampal MRS. N-acetyl aspartate (NAA) concentration, a marker for neuronal density (weighted by creatine (Cr) and choline (Cho) concentrations), and neurocognitive function (NCF) tests (HVLT and BVMT) performed by certified psychologists were evaluated. Clinical variables and NAA concentrations were correlated with pre-RT NCFs. RESULTS: HVLT and BVMT subtests showed pre-RT deterioration except for BVMT recognition. Significantly better NCFs were observed in women in HVLT subsets. Significantly higher NAA/Cr + Cho was measured in women (median 0.63 vs. 0.55; P=0.048) in the left hippocampus (no difference in the right hippocampus). In men, a positive correlation (0.51, P=0.018) between total brain volume and HVLT-TR, between left hippocampal NAA/Cr + Cho and HVLT-R (0.45, P=0.063), and between right hippocampal NAA/Cr + Cho and BVMT-recognition (0.49, P=0.054) was observed. In women, a borderline significant negative correlation was observed between left hippocampal NAA/Cr + Cho and BVMT-TR (-0.43, P=0.076) and between right NAA/Cr + Cho and HVLT-DR (-0.42, P=0.051). CONCLUSION: Borderline statistically significant correlations were observed with speculative interpretation underlying the challenges of hippocampal MRS as a surrogate for neurocognitive impairment. Further studies need to be done to ascertain the opportunities for imaging predictors of benefit from memory sparing radiotherapy.
- MeSH
- cholin metabolismus MeSH
- dospělí MeSH
- hipokampus * diagnostické zobrazování patologie MeSH
- kognitivní dysfunkce etiologie MeSH
- kraniální ozáření škodlivé účinky MeSH
- kreatin metabolismus MeSH
- kyselina aspartová analogy a deriváty metabolismus MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční spektroskopie * metody MeSH
- nádory mozku * radioterapie sekundární MeSH
- neuropsychologické testy MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Cílem studie bylo prozkoumat názory pracovníků pomáhajících profesí pracujících v domově pro seniory s osobami seniorského věku s neurokognitivními poruchami. Na základě dotazníkového šetření chtěli autoři zjistit, zdali existují významnější rozdíly v možných přístupech, metodách a prostředcích aplikovatelných v rámci muzikoterapeutických intervencí. Cílem bylo rovněž posoudit, zdali dotazovaní pracovníci využívají stejný nebo podobný repertoár přístupů, metod a prostředků u cílové skupiny a u seniorů bez zdravotního postižení a zdali vnímají rozdíly u těchto skupin v rámci stimulace jejich paměti a komunikačních schopností a jak posuzují efektivitu používaných postupů. Východiskem byly poznatky z vlastních výzkumů a poznatky z rešerší studií zabývajících se nefarmakologickými přístupy k seniorům s neurokognitivními poruchami. Šetření následovalo po pravidelných muzikoterapeutických sezeních, které autoři pravidelně realizují již od počátku roku 2022. Jeho výsledky mají sloužit jako podklady k připravované studii s designem scoping review.
The article is focused on screening the opinions of workers of helping professions working in a home for the elderly with elderly people with neurocognitive disorders. On the basis of a questionnaire survey, the authors wanted to find out whether there aresignificant differences in possible approaches, methods and means applicable within the framework of music therapy interventions. The goal was also to assess whether the interviewed workers use the same or similar repertoire of approaches, methods and means in the target group and in the elderly without disabilities, and whether they perceive differences in these groups in terms of stimulating their memory and communication skills and how they assess the effectiveness of the procedures used. The starting point was findings from own research and findings from research studies dealing with non-pharmacological approaches to seniors with neurocognitive disorders. The investigation followed regular music therapy sessions, which the authors have been conducting regularly since the beginning of 2022. Its results are intended to serve as the basis for a forthcoming study with a scoping review design.
- MeSH
- domovy pro seniory MeSH
- komunikace MeSH
- komunikační poruchy terapie MeSH
- lidé MeSH
- muzikoterapie * metody MeSH
- neurokognitivní poruchy * terapie MeSH
- paměť MeSH
- pomocný zdravotnický personál MeSH
- postoj zdravotnického personálu MeSH
- průzkumy zdravotní péče MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- Publikační typ
- hodnotící studie MeSH
Výzkumný projekt "Vliv reminiscenční terapie na zdravotní stav a kvalitu života seniorů žijících v institucích", který řeší interdisciplinární tým Gerontologického centra Praha za podpory grantu IGA MZČR (č. NR 8488-3/2005), chce zhodnotit dopad cílené nefarmakologické intervence, kterou je skupinová reminiscenční terapie, na zdravotní stav a kvalitu života seniorů žijících v domovech důchodců. Měření vlivu reminiscenční terapie jako jediného faktoru v komplexním sociálním prostředí je metodologicky velmi náročné, spojené s rizikem nekontrolovaného ovlivnění výsledku. Řada studií přináší měření, která nejsou dostatečně přesvědčivá, nicméně naznačují trendy, které svědčí ve prospěch pozitivního vlivu reminiscence na projevy demence, na depresivitu, na chování, náladu a celkovou spokojenost seniorů se životem. Kvalitativní výsledky tyto trendy potvrzují. Studie Gerontologického centra Praha využívá souboru kvantitativních i kvalitativních metod, které navíc umožní sledovat vedle primárního cíle také různé aspekty života seniorů v institucích.
The research project "Impact of reminiscence therapy on the health and quality of life of seniors living in elderly care institutions," carried out with the support of grant IGA MZCR (no. NR 8488- 3/2005) by the interdisciplinary team of the Prague Gerontology Centre, evaluates the impact of targeted nonpharmacological intervention, specifically group reminiscence therapy, on the health and quality of life of elderly clients living in retirement homes. The evaluation of the impact of reminiscence therapy as the only factor in a complex social environment places high demands on the methods applied, and involves the risk of the results being influenced by factors beyond control. A number of studies have supplied measurements which still leave some doubt, yet are indicative of trends bearing evidence of a positive effect of reminiscence on symptoms of dementia, depression, behaviour, mood and life satisfaction of elderly people. Such trends are confirmed by qualitative results. The study of the Prague Gerontology Centre draws upon a set of quantitative and qualitative methods which, in addition to the primary endpoint, allows for monitoring different aspects of life of seniors in elderly care institutions.
- MeSH
- domovy pro seniory etika trendy MeSH
- finanční podpora výzkumu jako téma MeSH
- hodnota života MeSH
- kvalita života psychologie MeSH
- lidé MeSH
- neurokognitivní poruchy terapie MeSH
- průzkumy a dotazníky normy využití MeSH
- psychoterapie metody trendy MeSH
- senioři fyziologie MeSH
- výzkumný projekt MeSH
- Check Tag
- lidé MeSH
- senioři fyziologie MeSH
BACKGROUND: The hippocampus is considered as the main radiosensitive brain structure responsible for postradiotherapy cognitive decline. We prospectively assessed correlation of memory change to hippocampal N-acetylaspartate (h-tNAA) concentration, a neuronal density and viability marker, by (1)H-MR spectroscopy focused on the hippocampus. METHODS: Patients with brain metastases underwent whole brain radiotherapy (WBRT) to a dose of 30 Gy in ten fractions daily. Pre-radiotherapy (1)H-MR spectroscopy focused on the h-tNAA concentration and memory testing was performed. Memory was evaluated by Auditory Verbal Learning Test (AVLT) and Brief Visuospatial Memory Test-Revised (BVMT-R). Total recall, recognition and delayed recall were reported. The both investigation procedures were repeated 4 months after WBRT and the h-tNAA and memory changes were correlated. RESULTS: Of the 20 patients, ten passed whole protocol. The h-tNAA concentration significantly decreased from pre-WBRT 8.9, 8.86 and 8.88 [mM] in the right, left and both hippocampi to 7.16, 7.65 and 7.4 after WBRT, respectively. In the memory tests a significant decrease was observed in AVLT total-recall, BVMT-R total-recall and BVMT-R delayed-recall. Weak to moderate correlations were observed between left h-tNAA and AVLT recognition and all BVMT-R subtests and between the right h-tNAA and AVLT total-recall. CONCLUSIONS: A significant decrease in h-tNAA after WBRT was proven by (1)H-MR spectroscopy as a feasible method for the in vivo investigation of radiation injury. Continuing patient recruitment focusing on other cognitive tests and metabolites is needed.
- MeSH
- biologické markery analýza MeSH
- hipokampus účinky záření MeSH
- Kaplanův-Meierův odhad MeSH
- kognitivní poruchy diagnóza etiologie MeSH
- kraniální ozáření škodlivé účinky MeSH
- kyselina asparagová analogy a deriváty analýza MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční spektroskopie metody MeSH
- nádory mozku mortalita radioterapie sekundární MeSH
- neuropsychologické testy MeSH
- paměť MeSH
- protony MeSH
- radiační poranění diagnóza MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: Cognitive rehabilitation is a highly individualised, non-pharmacological intervention for people with mild cognitive impairment (MCI) and dementia, which in recent years has also been developed for various IT platforms. METHODS: In this study, we aim to evaluate the effectiveness of the cognitive rehabilitation software GRADIOR in a multi-centre, single-blinded randomised controlled trial with people with MCI and mild dementia. A total of 400 people with MCI and mild dementia will be randomly allocated to one of four groups. This trial will compare the cognitive rehabilitation treatment using the GRADIOR programme with a psychosocial stimulation intervention (PSS) using the ehcoBUTLER platform, with a combined treatment consisting of GRADIOR and ehcoBUTLER, and with a group receiving treatment as usual during a period of 1 year. DISCUSSION: The outcomes of this clinical trial will be to determine any relevant changes in cognition, mood, quality of life, activities of daily living and quality of patient-carer relationship after 4 months and 1 year of intervention in a cross-sectional group comparison. Participants will be followed-up for 1 year to investigate potential long-term effects of the conducted treatments. TRIAL REGISTRATION: Current Controlled Trials ISRCTN, ID: 15742788 . Registered on 12 June 2017.
- MeSH
- afekt MeSH
- časové faktory MeSH
- činnosti denního života MeSH
- demence diagnóza psychologie rehabilitace MeSH
- jednoduchá slepá metoda MeSH
- kognice * MeSH
- kognitivní dysfunkce diagnóza psychologie rehabilitace MeSH
- kvalita života MeSH
- lidé středního věku MeSH
- lidé MeSH
- multicentrické studie jako téma MeSH
- počítačem asistovaná terapie metody MeSH
- psychoterapie metody MeSH
- randomizované kontrolované studie jako téma MeSH
- senioři MeSH
- software * MeSH
- stupeň závažnosti nemoci MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- protokol klinické studie MeSH
- Geografické názvy
- Španělsko MeSH
BACKGROUND: Idiopathic generalized epilepsy (IGE) is one of the most common epilepsies and is believed to have a strong genetic origin. Patients with IGE present largely heterogeneous neurocognitive profiles and might show some neurocognitive impairments. Furthermore, IGE siblings may demonstrate worse results in neuropsychological tests as well. In our study, we aimed to map the neurocognitive profile both in patients with IGE and the siblings. We also sought to establish a neurocognitive profile for each IGE syndrome. METHODS: The research sample included 110 subjects (IGE n = 46, biological siblings BS n = 16, and healthy controls n = 48) examined. Subjects were neuropsychologically examined in domains of intelligence, attention, memory, executive, and motor functions. The data obtained from the examination were statistically processed to determine whether and how IGE patients (including distinct syndromes) and the siblings differed neurocognitively from healthy controls (adjusted z-scores by age, education, and gender, and composite z-scores of cognitive domains). Data on anti-seizure medication, including defined daily doses, were obtained and included in the analysis. RESULTS: IGE patients and their biological siblings performed significantly worse in most of the neuropsychological tests than healthy controls. The neurocognitive profile of composite z-scores showed that IGE and biological siblings had equally significantly impaired performance in executive functions. IGE group also demonstrated impaired composite attention and motor function scores. The profile of individual IGE syndromes showed that JAE, JME, and EGTCS had significantly worse performance in composite execution score and motor function score. JAE presented significantly worse performance in intelligence and attention. JME exhibited significantly worse composite score in the attention domain. Anti-seizure medication, depression, and quality of life were unrelated to cognitive performance in IGE group. The level of depression significantly predicted the overall value of quality of life in patients with IGE, while cognitive domains, sociodemographic, and clinical factors were unrelated. CONCLUSION: Our study highlights the importance to consider the neurocognitive profile of IGE patients that can lead to difficulties in their education, acceptance, and management of coping strategies. Cognitive difficulties of IGE siblings could support a hypothesis that these impairments emerge from heritable traits.
- MeSH
- epilepsie generalizovaná * MeSH
- imunoglobulin E MeSH
- kvalita života MeSH
- lidé MeSH
- neuropsychologické testy MeSH
- sourozenci * psychologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: Many clinical trials testing Ginkgo biloba extract EGb 761 in patients with mild forms of cognitive impairment were conducted before widely accepted terms and diagnostic criteria for such conditions were available. This makes it difficult to compare any results from earlier and more recent trials. The objective of this systematic review was to provide a descriptive overview of clinical trials of EGb 761 in patients who met the diagnostic criteria for mild neurocognitive disorder (mild NCD) according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). METHODS: MEDLINE, PubMed and EMBASE were searched for randomized, placebo-controlled double-blind trials of EGb 761 in mild impairment of cognitive functioning. All trials involving patients who met retrospectively applied diagnostic criteria for mild NCD were included. Trials of primary prevention of dementia and trials of combinations of medical treatments were excluded. RESULTS: Among 298 records found in databases and 76 further records related to EGb 761 in references of systematic reviews, 9 reports on clinical trials involving 946 patients met the pre-specified criteria for inclusion. Beneficial effects of EGb 761 were seen in neuropsychological tests (8 of 9 studies), scales for neuropsychiatric symptoms (3 of 3 studies), geriatric rating scales (1 of 2 studies) and global ratings of change (1 of 1 study). Significant effects were found in several domains of cognition (memory, speed of processing, attention and executive functioning). Among the neuropsychiatric symptoms, depression (2 of 3 studies) and anxiety (1 of 1 study) were significantly improved. No differences between EGb 761 treatment and placebo were seen with regard to the rates of adverse events. DISCUSSION: The included studies demonstrate treatment benefits of Ginkgo biloba extract EGb 761, mainly on cognitive deficits and neuropsychiatric symptoms, in patients with mild NCD. The drug was safe and well tolerated.
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH