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| 1 | Physical exercise in the prevention and treatment of Alzheimer’s disease显示文摘Dementia is one of the greatest global challenges for health and social care in the 21st century.Alzheimer’s disease(AD),the most common type of dementia,is by no means an inevitable consequence of growing old.Several lifestyle factors may increase,or reduce,an individual’s risk of developing AD.Much has been written over the ages about the benefits of exercise and physical activity.Among the risk factors associated with AD is a low level of physical activity.The relationship between physical and mental health was established several years ago.In this review,we discuss the role of exercise(aerobic and resistance)training as a therapeutic strategy for the treatment and prevention of AD.Older adults who exercise are more likely to maintain cognition.We address the main protective mechanism on brain function modulated by physical exercise by examining both human and animal studies.We will pay especial attention to the potential role of exercise in the modulation of amyloid b turnover,inflammation,synthesis and release of neurotrophins,and improvements in cerebral blood flow.Promoting changes in lifestyle in presymptomatic and predementia disease stages may have the potential for delaying one-third of dementias worldwide.Multimodal interventions that include the adoption of an active lifestyle should be recommended for older populations. | Adrian De la Rosa Gloria Olaso-Gonzalez Coralie Arc-Chagnaud Fernando Millan Andrea Salvador-Pascual Consolacion Garcıa-Lucerga Cristina Blasco-Lafarga Esther Garcia-Dominguez Aitor Carretero Angela G.Correas Jose Vina Mari Carmen Gomez-Cabrera | 2020 | Journal of Sport and Health Science2020，9，5： | 32 |
| 2 | Diabetes mellitus and cognitive impairments显示文摘There is strong evidence that diabetes mellitus increases the risk of cognitive impairment and dementia. Insulin signaling dysregulation and small vessel disease in the base of diabetes may be important contributing factors in Alzheimer's disease and vascular dementia pathogenesis, respectively. Optimal glycemic control in type 1 diabetes and identification of diabetic risk factors and prophylactic approach in type 2 diabetes are very important in the prevention of cognitive complications. In addition, hypoglycemic attacks in children and elderly should be avoided. Anti-diabetic medications especially Insulin may have a role in the management of cognitive dysfunction and dementia but further investigation is needed to validate these findings. | Elham Saedi Mohammad Reza Gheini Firoozeh Faiz Mohammad Ali Arami | 2016 | World Journal of Diabetes2016，7，17： | 23 |
| 3 | Sex differences in cognitive impairment in Alzheimer's disease显示文摘Sex differences in neurocognitive abilities have been extensively explored both in the healthy population andin many disorders. Until recently, however, little work has examined such differences in people with Alzheimer's disease(AD). This is despite clear evidence that AD is more prevalent in women, and converging lines of evidence from brain imaging, post-mortem analyses, hormone therapy and genetics suggesting that AD affects men and women differently. We provide an overview of evidence attesting to the poorer cognitive profiles in women than in men at the same stage of AD. Indeed, men significantly outperform women in several cognitive domains, including: Language and semantic abilities, visuospatial abilities and episodic memory. These differences do not appear to be attributable to any differences in age, education, or dementia severity. Reasons posited for this female disadvantage include a reduction of estrogen in postmenopausal women, greater cognitive reserve in men, and the influence of the apolipoprotein E ε4 allele. Assessment of cognitive abilities contributes to the diagnosis of the condition and thus, it is crucial to identify the role of sex differences if potentially more accurate diagnoses and treatments are to emerge. | Keith R Laws Karen Irvine Tim M Gale | 2016 | World Journal of Psychiatry2016，6，1： | 18 |
| 4 | Formaldehyde stress显示文摘Formaldehyde,one of the most toxic organic compounds,is produced and processed in human cells.The level of human endogenous formaldehyde is maintained at a low concentration(0.01-0.08 mmol L-1 in blood) under physiological conditions,but the concentration increases during ageing(over 65 years old).Clinical trials have shown that urine formaldehyde concentrations are significantly different between elderly Alzheimer's patients(n=91) and normal elderly volunteers(n=38)(P<0.001).Abnormally high levels of intrinsic formaldehyde lead to dysfunction in cognition such as learning decline and memory loss.Excess extracellular and intracellular formaldehyde could induce metabolic response and abnormal modifications of cellular proteins such as hydroxymethylation and hyperphosphorylation,protein misfolding,nuclear translocation and even cell death.This cellular response called formaldehyde stress is dependent upon the concentration of formaldehyde.Chronic impairments of the brain resulted from formaldehyde stress could be one of the mechanisms involved in the process of senile dementia during ageing. | HE RongQiao1*,LU Jing1,2 & MIAO JunYe1,2 1State Key Laboratory of Brain and Cognitive Sciences,Institute of Biophysics,Chinese Academy of Sciences,Beijing 100101,China 2Graduate University of Chinese Academy of Sciences,Beijing 100049,China | 2010 | Science China(Life Sciences)2010，53，12： | 16 |
| 5 | The role of general anesthetics and the mechanisms of hippocampal and extra-hippocampal dysfunctions in the genesis of postoperative cognitive dysfunction显示文摘Postoperative cognitive dysfunction(POCD) is a multifactorial process with a huge number of predisposing, causal, and precipitating factors. In this scenario, the neuroinflammation and the microglial activation play a pivotal role by triggering and amplifying a complex cascade involving the immuno-hormonal activation, the micro circle alterations, the hippocampal oxidative stress activation and, finally, an increased blood-brain barrier's permeability. While the role of anesthetics in the POCD's genesis in humans is debated, a huge number of preclinical studies have been conducted on the topic and many mechanisms have been proposed to explain the potential neurodegenerative effects of general anesthetics. Probably, the problem concerns on what we are searching for and how we are searching and, surprisingly, preclinical studies showed that anesthetics may also manifest neuroprotective properties. The aim of this paper is to offer an overview on the potential impact of general anesthetics on POCD. Mechanisms of hippocampal and extra-hippocampal dysfunction due to neuroinflammation are discussed, whereas further research perspectives are also given. | Marco Cascella Sabrina Bimonte | 2017 | Neural Regeneration Research2017，12，11： | 15 |
| 6 | Biomarkers for the diagnosis of Alzheimer's disease, dementia Lewy body, frontotemporal dementia and vascular dementia显示文摘Background Dementia is a chronic brain disorder classified by four distinct diseases that impact cognition and mental degeneration. Each subgroup exhibits similar brain deficiencies and mutations. This review will focus on four dementia subgroups: Alzheimer's disease, vascular dementia, frontotemporal dementia and dementia Lewy body. Aim The aim of this systematic review is to create a concise overview of unique similarities within dementia used to locate and identify new biomarker methods in diagnosing dementia. Methods 123 300 articles published after 2010 were identified from PubMed, JSTOR, WorldCat Online Computer Library and PALNI (Private Academic Library Network of Indiana) using the following search items (in title or abstract):'Neurodegenerative Diseases' OR 'Biomarkers' OR 'Alzheimer's Disease' OR 'Frontal Temporal Lobe Dementia' OR 'Vascular Dementia, OR 'Dementia Lewy Body' OR 'Cerebral Spinal Fluid' OR 'Mental Cognitive Impairment'. 47 studies were included in the qualitative synthesis. Results Evidence suggested neuroimaging with amyloid positron emission tomography (PET) scanning and newly found PET tracers to be more effective in diagnosing Alzheimer's and amnesiac mental cognitive impairment than carbon-11 Pittsburgh compound-B radioisotope tracer. Newly created methods to make PET scans more accurate and practical in clinical settings signify a major shift in diagnosing dementia and neurodegenerative diseases. Conclusion Vast improvements in neuroimaging techniques have led to newly discovered biomarkers and diagnostics. Neuroimaging with amyloid PET scanning surpasses what had been considered the dominant method of neuroimaging and MRI. Newly created methods to make PET scans more accurate and practical in clinical settings signify a major shift in diagnosing dementia pathology. Continued research and studies must be conducted to improve current findings and streamline methods to further subcategorise neurodegenerative disorders and diagnosis. | Joshua Marvin Anthony Maclin Tao Wang Shifu Xiao | 2019 | General Psychiatry2019，32，1： | 14 |
| 7 | Vascular cognitive impairment, a cardiovascular complication显示文摘Over the past two decades, the term vascular cognitive impairment(VCI) has been used to refer to a spectrum of cognitive decline characterized by executive dysfunction, associated with vascular pathology. With 30% of stroke survivors showing cognitive impairments, it is regarded as the most common cause of cognitive impairment. This is a narrative review of available literature citing sources from Pub Med, MEDLINE and Google Scholar. VCI has a high prevalence both before and after a stroke and is associated with great economic and caregiver burden. Despite this, there is no standardized diagnostic criteria for VCI. Hypertension has been identified as a risk factor for VCI and causes changes in cerebral vessel structure and function predisposing to lacuna infarcts and small vessel haemorrhages in the frontostriatal loop leading to executive dysfunction and other cognitive impairments. Current trials have shown promising results in the use of antihypertensive medications in the management of VCI and prevention of disease progression to vascular dementia. Prevention of VCI is necessary in light of the looming dementia pandemic. All patients with cardiovascular risk factors would therefore benefit from cognitive screening with screening instruments sensitive to executive dysfunction as well as prompt and adequate control of hypertension. | Adiukwu Frances Ofori Sandra Ugbomah Lucy | 2016 | World Journal of Psychiatry2016，6，2： | 14 |
| 8 | miRNA expression profiles in cerebrospinal fluid and blood of patients with Alzheimer’s disease and other types of dementia-an exploratory study显示文摘Background:MicroRNAs(miRNAs)are small non-coding RNA molecules that function as posttranscriptional regulators of gene expression.Measurements of miRNAs in cerebrospinal fluid(CSF)and blood have just started gaining attention as a novel diagnostic tool for various neurological conditions.The purpose of this exploratory investigation was to analyze the expression of miRNAs in CSF and blood of patients with Alzheimer’s disease(AD)and other neurodegenerative disorders in order to identify potential miRNA biomarker candidates able to separate AD from other types of dementia.Methods:CSF was collected by lumbar puncture performed on 10 patients diagnosed with AD and 10 patients diagnosed with either vascular dementia,frontotemporal dementia or dementia with Lewy bodies.Blood samples were taken immediately after.Total RNA was extracted from cell free fractions of CSF and plasma,and a screening for 372 known miRNA sequences was carried out by real time quantitative polymerase chain reactions(miRCURY LNA™Universal RT miRNA PCR,Polyadenylation and cDNA synthesis kit,Exiqon).Results:Fifty-two miRNAs were detected in CSF in at least nine out of ten patients in both groups.Among these,two miRNAs(let-7i-5p and miR-15a-5p)were found significantly up-regulated and one miRNA(miR-29c-3p)was found significantly down-regulated in patients with AD compared to controls.One hundred and sixty-eight miRNAs were frequently detected in the blood,among which miR-590-5p and miR-142-5p were significantly up-regulated and miR-194-5p was significantly down-regulated in AD patients compared to controls.Conclusions:Detection of miRNA expression profiles in blood and in particular CSF of patients diagnosed with different types of dementia is feasible and it seems that several expressional differences between AD and other dementia types do exist when measured in a clinically relevant setup.In this explorative pilot study,the deregulated miRNAs in CSF of AD patients may be associated with relevant target genes related to AD pathology,including APP and BACE1,which suggests that miRNAs are interesting candidates for AD biomarkers in the future. | Sofie Sølvsten Sørensen Ann-Britt Nygaard Thomas Christensen | 2016 | Translational Neurodegeneration2016，5，1： | 14 |
| 9 | Increase of beta-amyloid and C-reactive protein in liver transplant recipients with postoperative cognitive dysfunction显示文摘BACKGROUND: Postoperative cognitive dysfunction (POCD) is an adverse condition characterized by declined cognitive functions following surgeries and anesthesia. POCD has been associated with increased hospital stay and mortality. There are histological similarities to Alzheimer's disease. Most early studies were conducted in patients receiving cardiac surgery. Since there is no information about POCD in liver transplant recipients, we measured the incidence of POCD in patients after liver transplantation and examined the correlation between neurological dysfunction and biological markers of dementia- based diseases. METHODS: We studied 25 patients who had a liver transplan- tation between July 2008 and February 2009. Patients with prior encephalopathy or risk factors associated with the development of POCD were excluded from the study. Five validated neuropsychiatric tests were used for diagnosis. The diagnosis was based on one standard deviation decline in two of the five neuropsychiatric tests. The correlation between patient variables and the development of POCD was examined. Serum levels of beta-amyloid and C-reactive protein were measured by standard ELISA and compared between patients with and without POCD. RESULTS: POCD was present in 11 (44%) of the 25 patients. Patients with POCD had significantly higher MELD scores, were more often Child-Pugh class C and received more blood transfusion during surgery. The serum beta-amyloid protein and C-reactive protein concentrations were significantly increased at 24 hours after surgery in the POCD group.CONCLUSIONS: The incidence of POCD in our group of liver transplant patients was greater than that reported in other surgical patients. The increase in the serum biomarkers of dementia in the POCD patients supports the hypothesis that chronic cognitive defects are due to a process similar to that seen in Alzheimer's disease. | Xing Li Da-Xiang Wen Yan-Hong Zhao Yan-Nan Hang M Susan Mandell | 2013 | Hepatobiliary & Pancreatic Diseases International2013，12，4： | 13 |
| 10 | Effects of music and music therapy on mood in neurological patients显示文摘Mood disorder and depressive syndromes represent a common comorbid condition in neurological disorders witha prevalence rate that ranges between 20% and 50% of patients with stroke, epilepsy, multiple sclerosis, and Parkinson's disease. Notwithstanding, these conditions are often under-diagnosed and under-treated in the clinical practice and negatively affect the functional recovery, the adherence to treatment, the quality of life, and even the mortality risk. In addition, a bidirectional association between depression and neurological disorders may be possible being that depressive syndromes may be considered as a risk factor for certain neurological diseases. Despite the large amount of evidence regarding the effects of music therapy(MT) and other musical interventions on different aspects of neurological disorders, no updated article reviewing outcomes such as mood, emotions, depression, activity of daily living and so on is actually available; for this reason, little is known about the effectiveness of music and MT on these important outcomes in neurological patients. The aim of this article is to provide a narrative review of the current literature on musical interventions and their effects on mood and depression in patients with neurological disorders. Searching on Pub Med and Psyc Info databases, 25 studies corresponding to the inclusion criteria have been selected; 11 of them assess the effects of music or MT in Dementia, 9 explore the efficacy on patients with Stroke, and 5 regard other neurological diseases like Multiple Sclerosis, Amyotrophic Lateral Sclerosis/motor neuron disease, Chronic quadriplegia, Parkinson's Disease, and Acquired Brain dysfunctions. Selected studies are based on relational and rehabilitative music therapy approaches or concern music listening interventions. Most of the studies support the efficacy of MT and other musical interventions on mood, depressive syndromes, and quality of life on neurological patients. | Alfredo Raglio Lapo Attardo Giulia Gontero Silvia Rollino Elisabetta Groppo Enrico Granieri | 2015 | World Journal of Psychiatry2015，5，1： | 13 |
| 11 | 关于中风病治疗的难点与突破口的思考 | 刘茂才 | 1997 | 中国中西医结合杂志1997，17，8： | 13 |
| 12 | Connections Between Insomnia and Cognitive Aging显示文摘Insomnia is a common sleep disorder among older adults,and a risk factor for poor physical and mental health.However,the relationship between insomnia and cognitive health is not well understood.Here,we review observational studies that have investigated whether insomnia is associated with deficits in objective cognitive performance and an increased risk of dementia,magnetic resonance imaging studies that have assessed grey matter volumes and white matter microstructure,and interventional studies that have explored whether the treatment of insomnia can improve cognitive outcomes.There are inconsistent findings regarding impaired performance in objective cognitive tests and reduced grey matter volumes,and limited,emerging,evidence that suggests that insomnia is associated with an increased risk of dementia and reduced white matter integrity.Although the interventional literature is still in its infancy,there is some indication that treatment may have an impact on vigilance.Well-powered studies examining sources of heterogeneity are warranted. | Claire E.Sexton Konstantina Sykara Elissaios Karageorgiou Jenny Zitser Talita Rosa Kristine Yaffe Yue Leng | 2020 | Neuroscience Bulletin2020，36，1： | 13 |
| 13 | Amyloid-beta peptide and tau protein crosstalk in Alzheimer’s disease显示文摘Alzheimer’s disease is a neurodegenerative disease that accounts for most of the 50-million dementia cases worldwide in 2018.A large amount of evidence supports the amyloid cascade hypothesis,which states that amyloid-beta accumulation triggers tau hyperphosphorylation and aggregation in form of neurofibrillary tangles,and these aggregates lead to inflammation,synaptic impairment,neuronal loss,and thus to cognitive decline and behavioral abnormalities.The poor correlation found between cognitive decline and amyloid plaques,have led the scientific community to question whether amyloid-beta accumulation is actually triggering neurodegeneration in Alzheimer’s disease.The occurrence of tau neurofibrillary tangles better correlates to neuronal loss and clinical symptoms and,although amyloid-beta may initiate the cascade of events,tau impairment is likely the effector molecule of neurodegeneration.Recently,it has been shown that amyloid-beta and tau cooperatively work to impair transcription of genes involved in synaptic function and,more importantly,that downregulation of tau partially reverses transcriptional perturbations.Despite mounting evidence points to an interplay between amyloid-beta and tau,some factors could independently affect both pathologies.Thus,the dual pathway hypothesis,which states that there are common upstream triggers causing both amyloid-beta and tau abnormalities has been proposed.Among others,the immune system seems to be strongly involved in amyloid-beta and tau pathologies.Other factors,as the apolipoprotein Eε4 isoform has been suggested to act as a link between amyloid-beta and tau hyperphosphorylation.Interestingly,amyloid-beta-immunotherapy reduces not only amyloid-beta but also tau levels in animal models and in clinical trials.Likewise,it has been shown that tau-immunotherapy also reduces amyloid-beta levels.Thus,even though amyloid-beta immunotherapy is more advanced than tau-immunotherapy,combined amyloid-beta and tau-directed therapies at early stages of the disease have recently been proposed as a strategy to stop the progression of Alzheimer’s disease. | Alejandro R.Roda Gabriel Serra-Mir Laia Montoliu-Gaya Lidia Tiessler Sandra Villegas | 2022 | Neural Regeneration Research2022，17，8： | 13 |
| 14 | Protective effect of Shouwu Yizhi decoction against vascular dementia by promoting angiogenesis显示文摘Shouwu is a traditional Chinese medicine(TCM)with neuroprotective effect.Shouwu Yizhi decoction(SYD)was designed based on TCM theory.However,little is known about the roles of SYD in Vascular dementia(Va D).The present study aimed to evaluate the potential effects of SYD on the vascular cognitive impairment and explore the underlying mechanism by establishing focal cerebral ischemia/reperfusion(I/R)rat model to induce Va D.SYD administration(54 mg·kg^(-1))for 40 days obviously improved the vascular cognitive impairment in the middle cerebral artery occlusion(MCAO)rats as evidenced by the declined neurological deficit score and shortened escape latency via neurological deficit assessment and Morris water maze test.Moreover,SYD decreased neuron damage-induced cell death and ameliorated the ultrastructure of endothelial cells in the MCAO rats,thereby alleviating Va D.Mechanistically,SYD caused increases in the expression of vascular endothelial growth factor(VEGF),CD34 and CD31,compared with the MCAO rats in coronal hippocampus.Simultaneously,the expression level of mi R-210 was elevated significantly after SYD administration,compared with the vehicle rats(P<0.01).The expression of Notch 4 at both m RNA and protein levels was upregulated remarkably along with the notably downregulated DLL4 expression under SYD administration compared with the vehicle rats(P<0.05).Overall,the above results indicated that SYD promoted angiogenesis by upregulating VEGF-induced mi R210 expression to activate Notch pathway,and further alleviated neuron damage and ameliorated the ultrastructure of endothelial cells in the MCAO rats,ultimately enhancing the cognition and memory of MCAO rats.Therefore,our findings preliminarily identified the effect and the mechanism of action for SYD on Va D in rats.SYD could be a potential candidate in treatment of Va D. | YANG Xiao-Ni LI Chang-Sheng CHEN Chao TANG Xiao-Yong CHENG Guang-Qing LI Xia | 2017 | Chinese Journal of Natural Medicines2017，15，10： | 11 |
| 15 | Role of the metabolism of branched-chain amino acids in the development of Alzheimer’s disease and other metabolic disorders显示文摘Alzheimer’s disease is an incurable chronic neurodegenerative disorder and the leading cause of dementia,imposing a growing economic burden upon society.The disease progression is associated with gradual deposition of amyloid plaques and the formation of neurofibrillary tangles within the brain parenchyma,yet severe dementia is the culminating phase of the enduring pathology.Converging evidence suggests that Alzheimer’s disease-related cognitive decline is the outcome of an extremely complex and persistent pathophysiological process.The disease is characterized by distinctive abnormalities apparent at systemic,histological,macromolecular,and biochemical levels.Moreover,besides the well-defined and self-evident characteristic profuse neurofibrillary tangles,dystrophic neurites,and amyloid-beta deposits,the Alzheimer’s disease-associated pathology includes neuroinflammation,substantial neuronal loss,apoptosis,extensive DNA damage,considerable mitochondrial malfunction,compromised energy metabolism,and chronic oxidative stress.Likewise,distinctive metabolic dysfunction has been named a leading cause and a hallmark of Alzheimer’s disease that is apparent decades prior to disease manifestation.State-of-theart metabolomics studies demonstrate that altered branched-chain amino acids(BCAAs)metabolism accompanies Alzheimer’s disease development.Lower plasma valine levels are correlated with accelerated cognitive decline,and,conversely,an increase in valine concentration is associated with reduced risk of Alzheimer’s disease.Additionally,a clear BCAAs-related metabolic signature has been identified in subjects with obesity,diabetes,and atherosclerosis.Also,arginine metabolism is dramatically altered in Alzheimer’s disease human brains and animal models.Accordingly,a potential role of the urea cycle in the Alzheimer’s disease development has been hypothesized,and preclinical studies utilizing intervention in the urea cycle and/or BCAAs metabolism have demonstrated clinical potential.Continual failures to offer a competent treatment strategy directed against amyloid-beta or Tau proteins-related lesions,which could face all challenges of the multifaceted Alzheimer’s disease pathology,led to the hypothesis that hyperphosphorylated Tau and deposited amyloid-beta proteins are just hallmarks or epiphenomena,but not the ultimate causes of Alzheimer’s disease.Therefore,approaches targeting amyloid-beta or Tau are not adequate to cure the disease.Accordingly,the modern scientific vision of Alzheimer’s disease etiology and pathogenesis must reach beyond the hallmarks,and look for alternative strategies and areas of research. | Baruh Polis Abraham O.Samson | 2020 | Neural Regeneration Research2020，15，8： | 10 |
| 16 | Oral frailty and neurodegeneration in Alzheimer’s disease显示文摘Frailty is a critical intermediate status of the aging process with a multidimensional and multisystem nature and at higher risk for adverse health-related outcomes,including falls,disability,hospitalizations,institutionalization,mortality,dementia,and Alzheimer’s disease.Among different frailty phenotypes,oral frailty has been recently suggested as a novel construct defined as a decrease in oral function with a coexisting decline in cognitive and physical functions.We briefly reviewed existing evidence on operational definitions of oral frailty,assessment and screening tools,and possible relationships among oral frailty,oral microbiota,and Alzheimer’s disease neurodegeneration.Several underlying mechanism may explain the oral health-frailty links including undernutrition,sarcopenia linked to both poor nutrition and frailty,psychosocial factors,and the chronic inflammation typical of oral disease.Oral microbiota may influence Alzheimer’s disease risk through circulatory or neural access to the brain and the interplay with periodontal disease,often causing tooth loss also linked to an increased Alzheimer’s disease risk.On this bases,COR388,a bacterial protease inhibitor targeting Porphyromonas gingivalis implicated in periodontal disease,is now being tested in a double-blind,placebocontrolled Phase II/III study in mild-to-moderate Alzheimer’s disease.Therefore,oral status may be an important contributor to general health,including Alzheimer’s disease and latelife cognitive disorders,suggesting the central role of preventive strategies targeting the novel oral frailty phenotype and including maintenance and improvement of oral function and nutritional status to reduce the burden of both oral dysfunction and frailty. | Vittorio Dibello Madia Lozupone Daniele Manfredini Antonio Dibello Roberta Zupo Rodolfo Sardone Antonio Daniele Frank Lobbezoo Francesco Panza | 2021 | Neural Regeneration Research2021，16，11： | 10 |
| 17 | Emerging links between type 2 diabetes and Alzheimer's disease显示文摘Type 2 diabetes mellitus and Alzheimer's disease are both associated with increasing age,and each increases the risk of development of the other.Epidemiological,clinical,biochemical and imaging studies have shown that elevated glucose levels and diabetes are associated with cognitive dysfunction,the most prevalent cause of which is Alzheimer's disease.Cross sectional studies have clearly shown such an association,whereas longitudinal studies are equivocal,reflecting the many complex ways in which the two interact.Despite the dichotomy,common risk and etiological factors(obesity,dyslipidemia,insulin resistance,and sedentary habits) are recognized;correction of these by lifestyle changes and pharmacological agents can be expected to prevent or retard the progression of both diseases.Common pathogenic factors in both conditions span a broad sweep including chronic hyperglycemia per se,hyperinsulinemia,insulin resistance,acute hypoglycemic episodes,especially in the elderly,microvascular disease,fibrillar deposits(in brain in Alzheimer's disease and in pancreas in type 2 diabetes),altered insulin processing,inflammation,obesity,dyslipidemia,altered levels of insulin like growth factor and occurrence of variant forms of the protein butyrylcholinesterase.Of interest not only do lifestyle measures have a protective effect against the development of cognitive impairment due to Alzheimer's disease,but so do some of the pharmacological agents used in the treatment of diabetes such as insulin(especially when delivered intranasally),metformin,peroxisome proliferator-activated receptors γ agonists,glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors.Diabetes must be recognized as a risk for development of Alzheimer's disease;clinicians must ensure preventive care be given to control and postpone both conditions,and to identify cognitive impairment early to manage it appropriately. | Gumpeny R Sridhar Gumpeny Lakshmi Gumpeny Nagamani | 2015 | World Journal of Diabetes2015，6，5： | 10 |
| 18 | Comparative efficacy and safety of cognitive enhancers for treating vascular cognitive impairment: systematic review and Bayesian network meta-analysis显示文摘Objective: To assess and compare the clinical efficacy and safety of cognitive enhancers(donepezil, galantamine, rivastigmine, and memantine) on cognition, behavior, function, and global status in patients with vascular cognitive impairment.Data sources: The initial literature search was performed with PubMed, EMBASE, the Cochrane Methodology Register, the Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing & Allied Health(CINAHL) from inception to January 2018 for studies regarding donepezil, galantamine, rivastigmine, and memantine for treatment of vascular cognitive impairment.Data selection: Randomized controlled trials on donepezil, galantamine, rivastigmine, and memantine as monotherapy in the treatment of vascular cognitive impairment were included. A Bayesian network meta-analysis was conducted. Outcome measures: Efficacy was assessed by changes in scores of the Alzheimer's Disease Assessment Scale, cognitive subscale, Mini-Mental State Examination, Neuropsychiatric Inventory scores and Clinician's Interview-Based Impression of Change Scale Plus Caregiver's Input, Activities of Daily Living, the Clinical Dementia Rating scale. Safety was evaluated by mortality, total adverse events(TAEs), serious adverse events(SAEs), nausea, vomiting. diarrhea, or cerebrovascular accidents(CVAs). Results: After screening 1717 citations, 12 randomized controlled trials were included. Donepezil and rivastigmine(mean difference(e) = –0.77, 95% confidence interval(CI): 0.25–1.32; MD = 1.05, 95% CI: 0.18–1.79) were significantly more effective than placebo in reducing Mini-Mental State Examination scores. Donepezil, galantamine, and memantine(MD = –1.30, 95% CI: –2.27 to –0.42; MD = –1.67, 95% CI: –3.36 to –0.06; MD = –2.27, 95% CI: –3.91 to –0.53) showed superior benefits on the Alzheimer's Disease Assessment Scale–cognitive scores compared with placebo. Memantine(MD = 2.71, 95% CI: 1.05–7.29) improved global status(Clinician's Interview-Based Impression of Change Scale Plus Caregiver's Input) more than the placebo. Safety results revealed that donepezil 10 mg(odds ratio(OR) = 3.04, 95% CI: 1.86–5.41) contributed to higer risk of adverse events than placebo. Galantamine(OR = 5.64, 95% CI: 1.31–26.71) increased the risk of nausea. Rivastigmine(OR = 16.80, 95% CI: 1.78–319.26) increased the risk of vomiting. No agents displayed a significant risk of serious adverse events, mortality, cerebrovascular accidents, or diarrhea.Conclusion: We found significant efficacy of donepezil, galantamine, and memantine on cognition. Memantine can provide significant efficacy in global status. They are all safe and well tolerated. | Bo-Ru Jin Hua-Yan Liu | 2019 | Neural Regeneration Research2019，14，5： | 9 |
| 19 | Percutaneous endoscopic gastrostomy—Too often?Too late?Who are the right patients for gastrostomy?显示文摘Percutaneous endoscopic gastrostomy is an established method to provide nutrition to patients with restricted oral uptake of fluids and calories.Here,we review the methods,indications and complications of this procedure.While gastrostomy can be safely and easily performed during gastroscopy,the right patients and timing for this intervention are not always chosen.Especially in patients with dementia,the indication for and timing of gastrostomies are often improper.In this patient group,clear data for enteral nutrition are lacking;however,some evidence suggests that patients with advanced dementia do not benefit,whereas patients with mild to moderate dementia might benefit from early enteral nutrition.Additionally,other patient groups with temporary or permanent restriction of oral uptake might be a useful target population for early enteral nutrition to maintain mobilization and muscle strength.We plead for a coordinated study program for these patient groups to identify suitable patients and the best timing for tube implantation. | Christoph G Dietrich Konrad Schoppmeyer | 2020 | World Journal of Gastroenterology2020，26，20： | 8 |
| 20 | Physical activity and cognitive function among older adults in China:A systematic review显示文摘Background: Physical activity(PA) has been shown to benefit cognitive function in older adults. However, the cognitive benefits of exercising for older Chinese adults have not been systematically documented. This study was to conduct a systematic review on evidence that PA is beneficial for cognitive functioning in older Chinese adults.Methods: Major databases, including Pub Med, EMBASE, Cochrane Library, Wan Fang, CNKI, and VIP, were searched for studies published in English or Chinese between January 2000 and December 2015. Randomized and non-randomized controlled trials(RCTs and non-RCTs), cohort,case-control and cross-sectional studies that evaluated PA and cognitive function among older Chinese adults were included in this review.Results: Of 53 studies included and reviewed, 33 were observational(22 cross-sectional, 7 case-control, and 4 cohort) and 20 were experimental(15 RCTs, 5 non-RCTs). Observational studies showed an association of reduced risk of cognitive-related diseases(i.e., mild cognitive impairment, Alzheimer's disease, and dementia) through PA, whereas experimental studies reported exercise-induced improvement in multiple domains of cognitive function(i.e., global cognitive function, memory, executive function, attention, language, and processing recourse).Conclusion: This systematic review provides initial evidence that PA may benefit cognition in older Chinese adults. Further studies of individuals with cognitive impairments and prospective and RCT studies having high scientific rigor are needed to corroborate the findings reported in this review. | Jiaojiao Lü Weijie Fu Yu Liu | 2016 | Journal of Sport and Health Science2016，5，3： | 8 |
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