Search

Additional file 1: eTable 1. Search strategy literature search. eTable 2. Study quality assessment. eTable 3. Characteristics of included studies. eTable 4. Meta-regression analyses prevalence specific NPS. eTable 5. Meta-regression analyses severity specific NPS. eTable 6. Publication bias measures for all meta-analyses. eTable 7. Duval and Tweedie’s trim-and-fill method to adjust for publication bias. eTable 8. Sex differences in the prevalence NPS for meta-analyses that excluded outliers. eTable 9. Sex differences in the severity of NPS for meta-analyses that excluded outliers. eFigure 1. Forest plots for meta-analyses prevalence specific NPS. eFigure 2. Forest plots for meta-analyses severity specific NPS. eFigure 3. Funnel plots for meta-analyses prevalence specific NPS. eFigure 4. Funnel plots for meta-analyses severity specific NPS.

Supplemental Digital Content is available in the text., Background: In 2015, the Quebec Ministry of Health limited palivizumab prophylaxis for respiratory syncytial virus (RSV) in premature infants to those born at

Apathy is characterized by loss of motivation, decreased initiative, and emotional blunting. It is highly prevalent in neurological and psychiatric disorders such as Alzheimer’s disease, traumatic brain injury, schizophrenia, Parkinson’s disease, Huntington’s disease, cerebrovascular disorders, and mild behavioural impairment. It has negative outcomes including impairments in activities of daily living, caregiver burden, and higher rates of institutionalization and mortality. The definition of apathy has changed over the years alongside the development of diagnostic criteria and apathy scales and measurements. Apathy is emerging as a treatment target with interest in pharmacological, non-pharmacological, and neuromodulatory treatments for apathy. There is also an increased understanding of the neurobiology of apathy with functional and structural neuroimaging research studies. This book is a comprehensive, in-depth review from experts in neurology and psychiatry. It examines the current state of apathy in these various disorders while also summarizing apathy diagnostic criteria, scales and measurements, neuropathology, and treatments.

Individuals with Alzheimer's disease (AD) present with a wide variety of symptoms, including sleep disruption and sleep disorders. Conversely, disordered sleep has been associated with an increased risk of developing AD. Both conditions individually have adverse effects on attention, which can be further divided into selective, sustained, divided, and alternating attention. The neural mechanisms underpinning sleep problems in AD involve the disruption of the circadian system. This review comprehensively discusses the types of attention impairments, the relationship between AD pathology and sleep disruption, and the effect of sleep issues on attention in AD. Recommendations for future research include addressing the lack of consistency among study designs and outcomes, and the need to continue exploring the biology of sleep and attention in AD.

Additional file 1. Participant selection flow chart, figure showing logical memory performance over time in the AD dementia group, table of respiratory medications, table of participant characteristics before propensity score matching, and tables for post-hoc analyses.

Additional file 1. Participant inclusion/exclusion flowchart, APOE ε4 carrier vs. non-carrier plots, and tables for secondary cognitive outcomes.

Additional file 1: Supplementary Table 1. 95% Confidence Intervals for standardized estimates (β) in model predicting change in executive function over one year

Additional file 2: Supplementary Table 2. 95% Confidence Intervals for standardized estimates (β) in model predicting change in memory over one year

Supplemental Material for Canadian Stroke Best Practice Recommendations: Mood, Cognition and Fatigue following Stroke, 6th edition update 2019 by Krista L Lanctôt, M Patrice Lindsay, Eric E Smith, Demetrios J Sahlas, Norine Foley, Gord Gubitz, Melissa Austin, Kristyn Ball, Sanjit Bhogal, Treena Blake, Nathan Herrmann, David Hogan, Aisha Khan, Stewart Longman, Andrea King, Carol Leonard, Tricia Shoniker, Trudy Taylor, Moira Teed, Andrea de Jong, Anita Mountain, Leanne K Casaubon, Dar Dowlatshahi, Richard H Swartz and on behalf of the Management of Mood, Cognition and Fatigue Following Stroke Best Practice Writing Group, the Heart & Stroke Canadian Stroke Best Practices and Quality Advisory Committee; in collaboration with the Canadian Stroke Consortium in International Journal of Stroke

This trial investigated the efficacy of omega-3 polyunsaturated fatty acid (n-3 PUFA) treatment for improving depressive symptoms and cognitive performance in patients with coronary artery disease (CAD) participating in cardiac rehabilitation. Patients with CAD aged 45 to 80 years were randomized to receive either 1.9-g/d n-3 PUFA treatment or placebo for 12 weeks. Depressive symptoms were measured using the Hamilton Depression Rating Scale (HAM-D, primary outcome) and the Beck Depression Inventory II (BDI-II). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria were used to identify a depressive episode at baseline. Cognitive performance was measured using a standardized battery for vascular cognitive impairment. In 92 patients (age, 61.7 ± 8.7 y; 76% male, 40% depressed; HAM-D, 6.9 ± 5.9; BDI-II, 12.3 ± 10.9; n = 45 n-3 PUFA, n = 47 placebo), depression decreased (HAM-D, F3,91 = 2.71 and P = 0.049; BDI-II, F3,91 = 6.24 and P < 0.01), and cognitive performance improved (attention/processing speed, F1,91 = 5.57, P = 0.02; executive function, F1,91 = 14.64, P < 0.01; visuospatial memory, F1,91 = 4.01, P = 0.04) over cardiac rehabilitation. Omega-3 PUFA treatment increased plasma eicosapentaenoic acid (F1,29 = 33.29, P < 0.01) and docosahexaenoic acid (F1,29 = 15.29, P < 0.01) concentrations but did not reduce HAM-D (F3,91 = 1.59, P = 0.20) or BDI-II (F3,91 = 0.46, P = 0.50) scores compared with placebo. Treatment did not improve cognitive performance; however, n-3 PUFAs significantly increased verbal memory compared with placebo in a subgroup of nondepressed patients (F1,54 = 4.16, P = 0.04). This trial suggests that n-3 PUFAs do not improve depressive and associated cognitive symptoms in those with CAD. The possible benefits of n-3 PUFAs for verbal memory may warrant investigation in well-powered studies.

Objective: To conduct a systematic revie w and meta -analysis of studies that measured cytokine and chemokine levels in individuals with major depressive disorder (MDD ) compared to healthy controls (HCs). Method: The PubMed/MEDLINE, EMBASE, and PsycINFO databases were searched up until May 30, 2016. Effect sizes were estimated wi th random-effects mod els. Result: Eighty-two studies comprising 3212 participants with MDD and 2798 HCs met inclusion criteria. Peripheral levels of interleukin-6 (IL-6), tumor necrosi s factor (TNF)-alpha, IL-10, the solubl e IL-2 receptor, C-C chemokine ligand 2, IL-13, IL-18, IL-12, the IL-1 receptor antagonist, and the soluble TNF receptor 2 were elevated in patients with MDD compared to HCs, whereas interferon-gamma levels were lower in MDD (Hedge’s g = 0.477, P = 0.043). Levels of IL-1b, IL-2, IL-4, IL-8, the soluble IL-6 receptor (sIL-6R), IL-5, CCL- 3, IL-17, and transforming growth factor-beta 1 were not significantly altered in individuals with MDD compared to HCs. Hete rogeneity was large (I 2 : 51.6–97.7%), and sources of heterogeneity were explored (e.g., age, smoking status, and body mass index). Conclusion: Our results further charact erize a cytokine/chemokine profile associated with MDD. Future studies are warranted to further elucidate sources of heterog eneity, as well as biosignature cytokines secreted by other immune cells.

Severe aortic stenosis is the most common valvular heart disease in the elderly in the Western world and contributes to a large proportion of all deaths over the age of 70. Severe aortic stenosis is conventionally treated with surgical aortic valve replacement; however, the less invasive transcatheter aortic valve implantation (TAVI) is suggested for those at high surgical risk. While TAVI has been associated with improved survival and favourable outcomes, there is a higher incidence of cerebral microembolisms in TAVI patients. This finding is of concern given mechanistic links with cognitive decline, a symptom highly prevalent in those with cardiovascular disease. This paper reviews the literature assessing the possible link between TAVI and cognitive changes. Studies to date have shown that global cognition improves or remains unchanged over 3 months following TAVI while individual cognitive domains remain preserved over time. However, the association between TAVI and cognition remains unclear due to methodological limitations. Furthermore, while these studies have largely focused on memory, cognitive impairment in this population may be predominantly of vascular origin. Therefore, cognitive assessment focusing on domains important in vascular cognitive impairment, such as executive dysfunction, may be more helpful in elucidating the association between TAVI and cognition in the long term.

Neuropsychiatric symptoms (NPS) in Alzheimer's disease (AD) are widespread and disabling. This has been known since Dr. Alois Alzheimer's first case, Frau Auguste D., presented with emotional distress and delusions of infidelity/excessive jealousy, followed by cognitive symptoms. Being cognizant of this, in 2010 the Alzheimer's Association convened a research roundtable on the topic of NPS in AD. A major outcome of the roundtable was the founding of a Professional Interest Area (PIA) within the International Society to Advance Alzheimer's Research and Treatment (ISTAART). The NPS-PIA has prepared a series of documents that are intended to summarize the literature and provide more detailed specific recommendations for NPS research. This overview paper is the first of these living documents that will be updated periodically as the science advances. The overview is followed by syndrome-specific synthetic reviews and recommendations prepared by NPS-PIA workgroups on depression, apathy, sleep, agitation, and psychosis.

Respiratory syncytial virus (RSV) is a common infection in infancy, with nearly all children affected by two years of age. Approximately 0.5% to 2.0% of all children are hospitalized with lower respiratory tract disease, of which 50% to 90% have bronchiolitis and 5% to 40% have pneumonia. Morbidity and mortality are highest in children with nosocomial infection and in those with underlying medical illnesses such as cardiac and chronic lung disease. Aboriginal children residing in remote northern regions are specifically considered to be at high risk for hospitalization due to RSV infection. Thorough hand washing and health education are the principal strategies in primary prevention. In the absence of a vaccine, palivizumab prophylaxis is currently the best intervention to reduce the burden of illness and RSV-related hospitalization in high-risk children. Health care professionals should provide palivizumab prophylaxis cost effectively in accordance with recommendations issued by pediatric societies and national advisory bodies.The present article reviews the epidemiology of RSV infection and the short- and long-term impact of disease in high-risk infants and special populations. Prevention strategies and treatment are discussed based on the existing scientific evidence, and future challenges in the management of RSV infection are addressed.

Palivizumab, a specific monoclonal antibody for respiratory syncytial virus (RSV), is available for prevention of pediatric respiratory tract infections. What are the indications for its use and can it be used for treatment of RSV infections?Most infants should not be considered for RSV prophylaxis with palivizumab. The drug is approved for use for different indications in different Canadian provinces. The drug should be administered only in the context of infants most vulnerable to severe RSV illness with a high likelihood of hospital admission, particularly in the first 6 months of life. It is not effective in the treatment of RSV disease and it is not approved or recommended for this indication.

Alzheimer's disease and related dementias (ADRDs) are a global crisis facing the aging population and society as a whole. With the numbers of people with ADRDs predicted to rise dramatically across the world, the scientific community can no longer neglect the need for research focusing on ADRDs among underrepresented ethnoracial diverse groups. The Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment (ISTAART; alz.org/ISTAART) comprises a number of professional interest areas (PIAs), each focusing on a major scientific area associated with ADRDs. We leverage the expertise of the existing international cadre of ISTAART scientists and experts to synthesize a cross-PIA white paper that provides both a concise “state-of-the-science” report of ethnoracial factors across PIA foci and updated recommendations to address immediate needs to advance ADRD science across ethnoracial populations.