Hyperbaric oxygen preconditioning (HBO-PC) has been proposed as a safe and practical approach for neuroprotection in ischemic stroke. However, it is not known whether HPO-PC can improve cognitive deficits induced by cerebral ischemia, and the mechanistic basis for any beneficial effects remains unclear. We addressed this in the present study using rats subjected to middle cerebral artery occlusion (MCAO) as an ischemic stroke model following HBO-PC. Cognitive function and expression of phosphorylated neurofilament heavy polypeptide (pNF-H) and doublecortin (DCX) in the hippocampus were evaluated 14 days after reperfusion and after short interfering RNA-mediated knockdown of sirtuin1 (Sirt1). HBO-PC increased pNF-H and DCX expression and mitigated cognitive deficits in MCAO rats. However, these effects were abolished by Sirt1 knockdown. Our results suggest that HBO-PC can protect the brain from injury caused by ischemia-reperfusion and that Sirt1 is a potential molecular target for therapeutic approaches designed to minimize cognitive deficits caused by cerebral ischemia.

• MeSH
• časové faktory MeSH
• chování zvířat * MeSH
• doménové proteiny doublecortinu MeSH
• fosforylace MeSH
• hipokampus enzymologie   patofyziologie   MeSH
• hyperbarická oxygenace * MeSH
• infarkt arteria cerebri media enzymologie   patofyziologie   psychologie   terapie   MeSH
• kognice * MeSH
• kognitivní poruchy enzymologie   patofyziologie   prevence a kontrola   psychologie   MeSH
• modely nemocí na zvířatech MeSH
• neurofilamentové proteiny metabolismus   MeSH
• neuropeptidy metabolismus   MeSH
• potkani Sprague-Dawley MeSH
• protein doublecortin MeSH
• proteiny asociované s mikrotubuly metabolismus   MeSH
• RNA interference MeSH
• sirtuin 1 genetika   metabolismus   MeSH
• zvířata MeSH
• Check Tag
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• Dcx protein, rat MeSH Prohlížeč
• doménové proteiny doublecortinu MeSH
• neurofilament protein H MeSH Prohlížeč
• neurofilamentové proteiny MeSH
• neuropeptidy MeSH
• protein doublecortin MeSH
• proteiny asociované s mikrotubuly MeSH
• Sirt1 protein, rat MeSH Prohlížeč
• sirtuin 1 MeSH

Diabetes mellitus is associated with cognitive impairment which may convert to vascular or neurodegenerative dementia. Impairment of cognitive functions affects patients with type 1 and especially type 2 diabetes, with a number of vascular, metabolic and psychosocial factors involved in its development. As hyperglycemia and hypoglycemia also play an important role, important is the correct strategy of diabetes therapy which utilizes a combination of metformin with modern safe antidiabetics (incretin drugs, gliflozins, insulin analogues). It seems that some antidiabetic drugs (metformin, incretin drugs) and nasal form of application of insulin could improve cognition in diabetics.Key words: antidiabetic drugs - diabetes mellitus - hyperglycemia - hypoglycemia - cognition.

• MeSH
• diabetes mellitus farmakoterapie   MeSH
• hypoglykemika terapeutické užití   MeSH
• kognitivní poruchy etiologie   prevence a kontrola   MeSH
• komplikace diabetu prevence a kontrola   MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• hypoglykemika MeSH

The purpose of this study is to examine the effects of the selected non-pharmacological lifestyle activities on the delay of cognitive decline in normal aging. This was done by conducting a literature review in the four acknowledged databases Web of Science, Scopus, MEDLINE, and Springer, and consequently by evaluating the findings of the relevant studies. The findings show that physical activities, such as walking and aerobic exercises, music therapy, adherence to Mediterranean diet, or solving crosswords, seem to be very promising lifestyle intervention tools. The results indicate that non-pharmacological lifestyle intervention activities should be intense and possibly done simultaneously in order to be effective in the prevention of cognitive decline. In addition, more longitudinal randomized controlled trials are needed in order to discover the most effective types and the duration of these intervention activities in the prevention of cognitive decline, typical of aging population groups.

• Klíčová slova
• benefits, cognitive impairment, healthy older individuals, intervention,
• MeSH
• chůze MeSH
• cvičení fyziologie   MeSH
• kognitivní dysfunkce prevence a kontrola   MeSH
• kognitivní poruchy prevence a kontrola   MeSH
• lidé MeSH
• stárnutí fyziologie   MeSH
• životní styl * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

OBJECTIVES: To examine whether nursing home residents with concurrent vision and hearing impairment, dual sensory impairment (DSI), have a greater cognitive decline over time than do those without sensory impairment and whether social engagement modifies this association. METHODS: Based on the Services and Health for Elderly in Long TERm Care study, 1,989 nursing home residents who were assessed using the interRAI LTCF at 6-month intervals over 1 year were included. Multivariate linear regression models with time-variant exposure variables of sensory impairment and social engagement using generalized estimating equations were performed to predict cognitive function measured by the Cognitive Performance Scale (range 0-6). RESULTS: Residents with DSI had a greater cognitive decline [changes in Cognitive Performance Scale over 1 year = 1.12 (95% confidence interval = 0.81:1.42)] compared to those with either vision or hearing impairment [0.67 (0.53:0.64)] and those without sensory impairment [0.56 (0.48:0.64)]. A lower level of social engagement was also associated with a greater cognitive decline. The combined exposure variable of sensory impairment and social engagement revealed the greatest cognitive decline for socially disengaged residents with DSI [1.87 (1.24:2.51)] and the potential effect modification of social engagement on the association between DSI and cognitive decline; DSI was not associated with a greater cognitive decline among socially engaged residents, while it was associated among socially disengaged residents DISCUSSION: Cognitive function declines faster in nursing home residents with DSI only when residents were not socially engaged. Therefore, residents with DSI might cognitively benefit from interventions to improve involvement in social life at nursing homes.

• Klíčová slova
• Cognitive ageing, Dual sensory impairment, Nursing home., Social engagement,
• MeSH
• časové faktory MeSH
• domovy pro seniory statistika a číselné údaje   MeSH
• geriatrické hodnocení metody   MeSH
• interpersonální vztahy MeSH
• kognice * MeSH
• kognitivní poruchy * diagnóza   etiologie   prevence a kontrola   MeSH
• lidé MeSH
• lineární modely MeSH
• následné studie MeSH
• nedoslýchavost * komplikace   psychologie   MeSH
• pečovatelské domovy statistika a číselné údaje   MeSH
• poruchy zraku * komplikace   psychologie   MeSH
• prognóza MeSH
• senioři MeSH
• sociální opora MeSH
• zapojení do společnosti psychologie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa MeSH

BACKGROUND AND OBJECTIVES: The SBP values to be achieved by antihypertensive therapy in order to maximize reduction of cardiovascular outcomes are unknown; neither is it clear whether in patients with a previous cardiovascular event, the optimal values are lower than in the low-to-moderate risk hypertensive patients, or a more cautious blood pressure (BP) reduction should be obtained. Because of the uncertainty whether 'the lower the better' or the 'J-curve' hypothesis is correct, the European Society of Hypertension and the Chinese Hypertension League have promoted a randomized trial comparing antihypertensive treatment strategies aiming at three different SBP targets in hypertensive patients with a recent stroke or transient ischaemic attack. As the optimal level of low-density lipoprotein cholesterol (LDL-C) level is also unknown in these patients, LDL-C-lowering has been included in the design. PROTOCOL DESIGN: The European Society of Hypertension-Chinese Hypertension League Stroke in Hypertension Optimal Treatment trial is a prospective multinational, randomized trial with a 3 × 2 factorial design comparing: three different SBP targets (1, <145-135; 2, <135-125; 3, <125 mmHg); two different LDL-C targets (target A, 2.8-1.8; target B, <1.8 mmol/l). The trial is to be conducted on 7500 patients aged at least 65 years (2500 in Europe, 5000 in China) with hypertension and a stroke or transient ischaemic attack 1-6 months before randomization. Antihypertensive and statin treatments will be initiated or modified using suitable registered agents chosen by the investigators, in order to maintain patients within the randomized SBP and LDL-C windows. All patients will be followed up every 3 months for BP and every 6 months for LDL-C. Ambulatory BP will be measured yearly. OUTCOMES: Primary outcome is time to stroke (fatal and non-fatal). Important secondary outcomes are: time to first major cardiovascular event; cognitive decline (Montreal Cognitive Assessment) and dementia. All major outcomes will be adjudicated by committees blind to randomized allocation. A Data and Safety Monitoring Board has open access to data and can recommend trial interruption for safety. SAMPLE SIZE CALCULATION: It has been calculated that 925 patients would reach the primary outcome after a mean 4-year follow-up, and this should provide at least 80% power to detect a 25% stroke difference between SBP targets and a 20% difference between LDL-C targets.

• MeSH
• antihypertenziva terapeutické užití   MeSH
• cévní mozková příhoda prevence a kontrola   MeSH
• demence etiologie   MeSH
• hypertenze komplikace   farmakoterapie   MeSH
• kognice MeSH
• kognitivní poruchy prevence a kontrola   MeSH
• krevní tlak účinky léků   MeSH
• LDL-cholesterol krev   MeSH
• lidé MeSH
• měření krevního tlaku MeSH
• prospektivní studie MeSH
• recidiva MeSH
• sekundární prevence metody   MeSH
• senioři MeSH
• statiny terapeutické užití   MeSH
• tranzitorní ischemická ataka farmakoterapie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH
• Geografické názvy
• Čína MeSH
• Evropa MeSH
• Názvy látek
• antihypertenziva MeSH
• LDL-cholesterol MeSH
• statiny MeSH

BACKGROUND AND OBJECTIVES: It is well established by a large number of randomized controlled trials that lowering blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) by drugs are powerful means to reduce stroke incidence, but the optimal BP and LDL-C levels to be achieved are largely uncertain. Concerning BP targets, two hypotheses are being confronted: first, the lower the BP, the better the treatment outcome, and second, the hypothesis that too low BP values are accompanied by a lower benefit and even higher risk. It is also unknown whether BP lowering and LDL-C lowering have additive beneficial effects for the primary and secondary prevention of stroke, and whether these treatments can prevent cognitive decline after stroke. RESULTS: A review of existing data from randomized controlled trials confirms that solid evidence on optimal BP and LDL-C targets is missing, possible interactions between BP and LDL-C lowering treatments have never been directly investigated, and evidence in favour of a beneficial effect of BP or LDL-C lowering on cognitive decline is, at best, very weak. CONCLUSION: A new, large randomized controlled trial is needed to determine the optimal level of BP and LDL-C for the prevention of recurrent stroke and cognitive decline.

• MeSH
• cévní mozková příhoda prevence a kontrola   MeSH
• cholesterol MeSH
• hypercholesterolemie farmakoterapie   MeSH
• kognice MeSH
• kognitivní poruchy prevence a kontrola   MeSH
• krevní tlak účinky léků   MeSH
• LDL-cholesterol krev   MeSH
• lidé MeSH
• primární prevence MeSH
• randomizované kontrolované studie jako téma MeSH
• recidiva MeSH
• sekundární prevence MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• cholesterol MeSH
• LDL-cholesterol MeSH

Authors show the situation in diagnostics and treatment of cognitive deterioration in elderly. There are stressed chronic diseases influencing significantly influencing the development of dementia. Adequate treatment of these diseases was proved as a factor delaying the cognitive decline. The relationship between different groups of medications and cognitive performance are discussed. The importance of nutrition of elderly and possible microelements deficits are mentioned--specially group B vitamines, polyunsaturated fatty acids etc. Special part of the article show the importance of physical and psychical activities from the cognition point of view. Depression is discussed as a potentiating factor of dementia development. The table of recommendations to preventive, prophylactical and diagnostic measures how to improve the management of cognitive deterioration in elderly.

• MeSH
• demence etiologie   MeSH
• kognitivní poruchy diagnóza   etiologie   prevence a kontrola   MeSH
• lidé MeSH
• rizikové faktory MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

• MeSH
• antihypertenziva terapeutické užití   MeSH
• cévní mozková příhoda komplikace   prevence a kontrola   MeSH
• demence etiologie   prevence a kontrola   MeSH
• hypertenze komplikace   farmakoterapie   MeSH
• indapamid terapeutické užití   MeSH
• kognitivní poruchy etiologie   prevence a kontrola   MeSH
• lidé středního věku MeSH
• lidé MeSH
• perindopril terapeutické užití   MeSH
• randomizované kontrolované studie jako téma MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antihypertenziva MeSH
• indapamid MeSH
• perindopril MeSH