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Вступ. Легкий когнітивний розлад (MCD) — це гетерогенний синдром, який включає проблеми з пам’яттю, мовою та мисленням, які є непомітними та не впливають на незалежність пацієнта та повсякденне життя. У статті розглядаються подібності та відмінності нейрокогнітивних профілів пацієнтів із легкими когнітивними розладами різної етіології. Матеріали і методи. Обстежено 60 осіб: 30 осіб віком від 50 до 83 років із легким когнітивним розладом різної етіології та 30 відносно здорових осіб як контрольна група. Усім пацієнтам проводили магнітно-резонансну томографію (МРТ) головного мозку. Ми використовували психометричний метод і наступні шкали: Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment Scale (MoCA), Frontal Assessment Battery (FAB), Шкала оцінки хвороби Альцгеймера-Когнітивна субшкала (ADAS-cog) , Клінічний рейтинг деменції (CDR); результати аналізували методом статистичної обробки. Результати.За результатами нейрокогнітивного тестування не виявлено достовірних відмінностей у сумарних балах (p = 0,6209), зокрема за шкалою MMSE у пацієнтів з безанамнестичними (nMCD) та анамнестичними (aMCD) легкими когнітивними розладами та легкими когнітивними розладами. розлад (aMCD). Проте пацієнти з nMCD показали вірогідно нижчі результати з субтестами: «увага та розрахунок» (р = 0,0443). За шкалою MoCA пацієнти з nMCD мали вищий бал порівняно з пацієнтами з aMCD (p = 0,0457), а саме в субтестах «відкладеного пригадування» (p = 0,0102). Пацієнти з nMCD мали достовірно нижчі результати субтесту «увага та обчислення» (p = 0,0468). Достовірних відмінностей між групами хворих на МКД за результатами тестування за шкалою FAB не виявлено (р=0,4778). Згідно з деякими субтестами шкали ADAS-cog, пацієнти з aMCD показали гірші результати за тестами «пригадування слів» (p = 0,0069) і «розпізнавання слів» (p = 0,0350). У хворих на нМЦД нижчі показники спостерігалися за субтестами «концентрація та відволікання» (p=0,0468), «завдання на відмінювання цифр» (p=0,0217), «проходження лабіринту» (p=0,0015). Пацієнти з aMCD показали значно нижчі когнітивні здібності, ніж пацієнти з nMCD. Отже, пацієнти з aMCD можуть мати значний високий ризик прогресування до хвороби Альцгеймера. нижчі бали спостерігалися за субтестами «концентрація та відволікання» (р = 0,0468), «завдання на відмінювання цифр» (р = 0,0217), «проходження лабіринту» (р = 0,0015). Пацієнти з aMCD показали значно нижчі когнітивні здібності, ніж пацієнти з nMCD. Отже, пацієнти з aMCD можуть мати значний високий ризик прогресування до хвороби Альцгеймера. нижчі бали спостерігалися за субтестами «концентрація та відволікання» (р = 0,0468), «завдання на відмінювання цифр» (р = 0,0217), «проходження лабіринту» (р = 0,0015). Пацієнти з aMCD показали значно нижчі когнітивні здібності, ніж пацієнти з nMCD. Отже, пацієнти з aMCD можуть мати значний високий ризик прогресування до хвороби Альцгеймера. Висновки. Порівнявши дані нейрокогнітивних профілів, ми встановили, що у пацієнтів з анамнестичними легкими когнітивними розладами клінічна картина проявляється вираженим розладом пам’яті, особливо уповільненим пригадуванням, у той час як у пацієнтів з безанамнестичними легкими когнітивними розладами характерні регуляторні когнітивні порушення ( увага і рахунок, зниження швидкості мислення, порушення планування діяльності). Оцінки MoCA та ADAS-cog мали кращу діагностичну точність і специфічність для виявлення та диференціальної діагностики легких когнітивних розладів, ніж шкала MMSE. Introduction. Mild cognitive disorder (MCD) is a heterogeneous syndrome that involves problems with memory, speech, and thinking that are inconspicuous and do not affect the patient's independence and daily life. The article considers similarities and differences in the neurocognitive profiles of patients with mild cognitive disorders of various etiologies. Materials and methods. We examined 60 people: 30 subjects aged 50 to 83 years with a mild cognitive disorder of various etiologies and 30 relatively healthy individuals as the control group. All patients underwent a magnetic resonance imaging (MRI) examination of the brain. We used the psychometric method and the following scales: the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment Scale (MoCA), the Frontal Assessment Battery (FAB), the Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-cog), the Clinical Dementia Rating (CDR); the results were analyzed using the method of statistical processing. Results. According to the results of neurocognitive testing, no significant differences were found in the total scores (p = 0.6209), in particular, using the MMSE scale in patients with non-anamnestic (nMCD) and anamnestic (aMCD) мild cognitive disorder and мild cognitive disorder (aMCD). However, patients with nMCD showed significantly lower results with subtests: "attention and calculation" (p = 0.0443). According to the MoCA scale, patients with nMCD had a higher score vs. patients with aMCD (p = 0.0457), namely in the "delayed recall" subtests (p = 0.0102). Patients with nMCD had significantly lower results with the "attention and calculation" subtest (p = 0.0468). No significant differences were found between the groups of patients with MCD according to the results of testing with the FAB scale (p = 0.4778). According to some subtests of the ADAS-cog scale, patients with aMCD showed worse results with the "word recall" test (p = 0.0069) and "word recognition" (p = 0.0350). In patients with nMCD, lower scores were observed for the subtests "concentration and distractibility" (p = 0.0468), "number cancellation task" (p = 0.0217), and "passing the labyrinth" (p = 0.0015). Patients with aMCD showed significantly lower cognitive abilities than patients with nMCD. Consequently, patients with aMCD may be significantly at high risk of progression to Alzheimer's disease. Conclusions. After comparing the data of neurocognitive profiles, we established that in patients with anamnestic мild cognitive disorder, the clinical picture presented with a pronounced memory disorder, especially delayed recall, while the patients with non-anamnestic мild cognitive disorder were characterized by regulatory cognitive impairment (attention and calculation, reduced speed of thinking, impaired planning of activities). The MoCA and ADAS-cog scores had better diagnostic accuracy and specificity for the detection and differential diagnosis of mild cognitive disorders than the MMSE scale.

Introduction: Mild cognitive impairment (MCI) is defined as the symptomatic pre-dementia phase on the continuum of cognitive decline. Early recognition and application of potential interventions could prevent or delay the progression to dementia. The Rowland Universal Dementia Assessment Scale (RUDAS) shows good performance in the screening of dementia but has limited data regarding its diagnostic properties in the screening of MCI. The objectives of this study were to assess the psychometric properties of the Thai version of the RUDAS (RUDAS-Thai) in the screening of MCI, identify associated factors for the RUDAS performance, and determine the optimal cutoff point in detecting MCI. Methods: This was a cross-sectional study conducted from January 2020 to March 2021. Older patients at the outpatient clinic of an internal medicine department at a tertiary care hospital in Thailand were examined. Baseline data were collected, and the RUDAS-Thai was administered to each patient. Afterward, a geriatrician assessed each patient for MCI. Results: A total of 150 patients were included, of whom 42 cases (28%) had MCI. The overall performance of the test using an area under the receiver operating characteristic curve (AUC) was 0.82 (95% confidence interval 0.75–0.89). At the optimal cutoff point of 25/30, the AUC was 0.76 with sensitivity and specificity of 76.2 and 75%, respectively. The educational level affected the test performance according to regression analysis. For patients with years of education ≤6 and >6, the optimal cutoff points were 25/30 and 26/30, respectively. Conclusion: The RUDAS-Thai performed well in differentiating patients with MCI from normal cognition; however, it was affected by educational level. A score of 25/30 or lower for persons with ≤6 years of education or 26/30 or lower for persons with higher than 6 years of education is the optimal cutoff point for indication of developing MCI.

Background The neuroprotective role of interleukin (IL)-33 is supported by numerous preclinical studies, but it remains uninvestigated in clinical studies of Alzheimer’s disease (AD). We aimed to examine the association between human blood levels of IL-33 and cognitive preservation in amnestic mild cognitive impairment (aMCI) and AD. Methods A total of 100 participants (26 controls, 35 aMCI patients, and 39 AD patients) completed two Mini-Mental State Examinations (MMSEs) over a 1-year interval. In all 100 participants at the second MMSE, we examined the plasma levels of IL-33, IL-β, IL-1 receptor agonist (IL-1RA), beta amyloid (Aβ), and tau and apolipoprotein E (ApoE) genotyping; we also performed Hopkins Verbal Learning Test, Trail Making Test, forward and backward digit span, and Clinical Dementia Rating. Results IL-33 expression showed a positive trend among controls (1/26 = 3.8%), aMCI (9/35 = 25.7%), and AD (17/39 = 43.6%) (trend analysis: P P = 0.006). The cognitive preservation was not associated with the lower levels of Aβ, tau, and ApoE ε4, while higher levels of ApoE ε4 and phosphorylated tau were indeed associated with cognitive decline. The aMCI patients with AD conversion during study period had higher proportion of IL-33(−) than non-AD converters (90.9% vs 53.3%, P = 0.04). Conclusions IL-33 or its associated signaling pathways may represent a new treatment paradigm for aMCI and AD.

El presente trabajo estudia un caso del trastorno neurocognitivo leve debido a infección por VIH. El paciente ficticio, denominado L.B., es un varón de 50 años con estudios universitarios que trabaja como consultor en Madrid. El trastorno neurocognitivo leve debido a infección por VIH ha surgido en Europa como una secuela principal afectando a un 35% de los pacientes, con el incremento de la sobrevivencia de personas viviendo con VIH y la nueva terapia antirretrovírica combinada (TARC). Se caracteriza por afectaciones en las áreas corticales y por dificultades en la memoria y las funciones ejecutivas. En los resultados de la evaluación realizada, se observa una alteración moderada de la memoria de trabajo, la fluencia verbal fonémica, y la conceptualización, y una alteración leve de la atención alternante, la memoria inmediata, a corto plazo y a largo plazo por confrontación visual y auditiva, y las funciones ejecutivas. A nivel emocional, se observa una sintomatología depresiva leve debido a la conciencia de las alteraciones. El objetivo principal de la intervención es reducir el impacto de las alteraciones cognitivas en su vida diaria, y el trabajo. Para ello, la intervención aborda la restauración y la compensación de las funciones alteradas para reducir los déficits cognitivos, y mantener las habilidades preservadas. La intervención constará de 20 sesiones (20 horas) que incluyen dos sesiones de psicoeducación con la familia y el uso de la receta cognitiva. This paper examines a case of mild neurocognitive disorder due to HIV infection. The fictitious patient, named L.B., is a 50-year-old male with university level studies who works as a consultant in Madrid. Mild neurocognitive disorder due to HIV infection has emerged as a major sequela in Europe affecting 35% of patients, due to the increased survival of people living with HIV and the new highly active antiretroviral therapy (HAART) therapy. It is characterized by affectations in the cortical areas of the brain, as well as difficulties with memory and executive functions. The results of the evaluation showed a moderate alteration in the patient's working memory, phonemic verbal fluency, and conceptualization, as well as a mild alteration in alternating attention, immediate, short-term and long-term memory by visual and auditory confrontation, and executive functions. A mild depressive symptomatology was observed due to an awareness of the personal alterations. The main objective of the intervention is to reduce the impact of cognitive alterations on the patient's daily life and work. For this reason, the intervention addresses the restoration and compensation of the altered functions to reduce cognitive deficits and maintain preserved skills. The intervention consists of 20 sessions (20 hours) that include two sessions of psychoeducation with the family and the use of a cognitive prescription. El present treball estudia un cas de el trastorn neurocognitiu lleu a causa d'infecció per VIH. El pacient fictici, anomenat L.B., és un home de 50 anys amb estudis universitaris que treballa com a consultor a Madrid. El trastorn neurocognitiu lleu a causa d'infecció per VIH ha sorgit a Europa com una seqüela principal afectant un 35% dels pacients, amb l'increment de la supervivència de persones vivint amb VIH i la nova teràpia antirretrovírica combinada (TARC). Es caracteritza per afectacions a les àrees corticals i per dificultats en la memòria i les funcions executives. En els resultats de l'avaluació realitzada, s'observa una alteració moderada de la memòria de treball, la fluència verbal fonèmica, i la conceptualització, i una alteració lleu de l'atenció alternant, la memòria immediata, a curt termini ia llarg termini per confrontació visual i auditiva, i les funcions executives. A nivell emocional, s'observa una simptomatologia depressiva lleu a causa de la consciència de les alteracions. L'objectiu principal de la intervenció és reduir l'impacte de les alteracions cognitives en la seva vida diària, i el treball. Per a això, la intervenció aborda la restauració i la compensació de les funcions alterades per reduir els dèficits cognitius, i mantenir les habilitats preservades. La intervenció constarà de 20 sessions (20 hores) que inclouen dues sessions de psicoeducació amb la família i l'ús de la recepta cognitiva.

Cognitive disorder is one of the most disabling complications of ischemic stroke significantly impairing the patient’s commitment to rehabilitation and a life long treatment, reducing the quality of life of the patient and his relatives. This article discusses the epidemiology, etiology, pathophysiology of post-stroke cognitive impairment. Risk factors, classification, treatment and prevention of post-stroke cognitive disorders are discussed. The data of the study ARTEMIDA devoted to the possibility of therapy of post-stroke cognitive impairment and prevention of dementia after stroke with the use of the drug Actovegin are provided.

The extent and spatial location of white matter hyperintensities (WMH) on brain MRI may be relevant to the development of cognitive decline in older persons. Here, we introduce a new method, known as the Multi-atlas based Detection and Localization (MADL), to evaluate WMH on fluid-attenuated inversion recovery (FLAIR) data. This method simultaneously parcellates the whole brain into 143 structures and labels hyperintense areas within each WM structure. First, a multi-atlas library was established with FLAIR data of normal elderly brains; and then a multi-atlas fusion algorithm was developed by which voxels with locally abnormal intensities were detected as WMH. At the same time, brain segmentation maps were generated from the multi-atlas fusion process to determine the anatomical location of WMH. Areas identified using the MADL method agreed well with manual delineation, with an interclass correlation of 0.97 and similarity index (SI) between 0.55 and 0.72, depending on the total WMH load. Performance was compared to other state-of-the-art WMH detection methods, such as BIANCA and LST. MADL-based analyses of WMH in an older population revealed a significant association between age and WMH load in deep WM but not subcortical WM. The findings also suggested increased WMH load in selective brain regions in subjects with mild cognitive impairment compared to controls, including the inferior deep WM and occipital subcortical WM. The proposed MADL approach may facilitate location-dependent characterization of WMH in older individuals with memory impairment., Highlights • We proposed a multi-atlas based method for simultaneous detection and location of WMH on FLAIR images. • The method generates whole-brain segmentation for location-dependent WMH analysis. • The method showed reasonably high detection accuracy in comparison with other methods. • Results revealed a selective association between deep brain WMH and subject age. • Results suggested increased WMH in the inferior white matter in MCI patients.

ObjectiveChronic kidney disease (CKD) affects nearly 9% of global populations and is strongly associated with older age. Neurocognitive disorders (NCDs), which include mild cognitive impairment and dementia, are rising as a result of ageing populations throughout the world. This investigation’s aim is to report the frequency of mild to major NCD in a clinical cohort of adults with mild to moderate CKD and diabetes.SettingGlan Clwyd District general Hospital, North Wales, UK.ParticipantsWe enrolled 178 patients with CKD and diabetes, aged 55 years and over with an estimated glomerular filtration rate 15 mL/min/1.73 m2, attending a specialist renal and diabetic outpatient clinic.Outcome measuresFrequency of mild and major NCD and the association with the stage of CKD was assessed in all patients attending the specialist clinic. The diagnosis of NCD was based on patient and informant interview, case note review, neuropsychological assessment and application of Diagnostic and Statistical Manual of Mental Disorders version 5.ResultsThis investigation found 86/178 (48%) of the cohort with an NCD ranging from mild (n=49) to major symptoms (n=37). No association was found with NCD and the stage of CKD. Mild and major NCD was associated poorer outcomes in several cognitive domains, including, language, executive, memory, fluency and attention function (pConclusionsThis is the first UK investigation to report that cognitive changes occur in a significant number of older adults with CKD and diabetes. The unexpected finding was that prior to cognitive assessment, not any of the cohort had a pre-existing diagnosis of cognitive impairment, suggesting that the current prevalence and incidence rates of NCD in the general population are possibly significantly underestimated. Our findings also suggest that the cognitive function of patients with CKD should be screened and monitored routinely as part of their overall care management.

Objective Extrapyramidal signs (EPS) are common in patients with mild cognitive impairment (MCI). However, few studies have assessed the effect of EPS on the clinical course of MCI. We aimed to evaluate whether patients with EPS show more frequent progression from MCI to Alzheimer's disease (AD) and to other types of dementia. Methods Participants (n=882) with MCI were recruited, and were followed for up to 5 years. The EPS positive group was defined by the presence of at least one EPS based on a focused neurologic examination at baseline. Results A total of 234 converted to dementia during the follow-up period. The risk of progression to AD was lower in the patients with EPS after adjusting for potential confounders [hazard ratio (HR)=0.70, 95% confidence interval (CI)=0.53–0.93, p=0.01]. In contrast, the patients with EPS had a six-fold elevated risk of progression to dementia other than AD (HR=6.33, 95%CI=2.30–17.39, p