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Alzheimer's disease (AD) is an accelerating neurodegenerative disorder. Dysfunction of mitochondria and oxidative stress contributes to the pathogenesis of AD. Sirtuins play a role in this pathway and can be a potential marker to study neurodegenerative changes. This study evaluated serum levels of all seven sirtuins (SIRT1 – SIRT7) proteins in three study groups: AD, Mild Cognitive Impairment (MCI), and Geriatric Control (GC) by Surface Plasmon Resonance (SPR) technique. Further, it was validated by the Western blot experiment. ROC analysis was performed to differentiate the study group based on the concentration of serum SIRT proteins. Out of seven sirtuins, serum SIRT1, SIRT3, and SIRT6 levels (mean+SD) were significantly decreased in AD (1.65±0.56, 3.15±0.28, 3.36±0.32ng/µl); compare to MCI (2.17±0.39, 3.60±0.51, 3.73±0.48ng/µl) and GC (2.84±0.47, 4.55±0.48, 4.65±0.55ng/µl). ROC analysis showed the cut-off value with high sensitivity and specificity for cognitive impairment (AD and MCI). The concentration declined significantly with the disease progression. No specific difference was observed in case of other SIRTS between the study groups. This study reveals an inverse relation of serum SIRT1, SIRT3, and SIRT6 concentration with AD. ROC analysis showed that these serum proteins have greater accuracy in diagnosing of AD. This is the first report of estimation of all seven serum sirtuins and the clinical relevance of SIRT3 and SIRT6 as serum protein markers for AD.

Background Human rights are for all, regardless of age. The older adults are seen as vulnerable because biological, psychological and social ageing predispose the ageing person to frailty, infirmity, and in many cases dependency, setting the older person apart from the rest of the population in need of special protection and rights. Although the implementation of legislation, policies, and a package of integrated programmes and projects to cater to the needs of older persons had helped them to uplift their status, more has to be done to stem the increase of the reach of laws in a more fruitful manner. Aim To develop a colloquial structured Healthcare Policies & Programmes Awareness Questionnaire and assess the awareness about the government healthcare provisions and benefits available for senior citizens among health professionals, older patients, and their caregivers. Methods This study was conducted in two phases, the development of the questionnaire consisting of relevant healthcare national policies and programmes followed by a cross sectional pilot study on 335 participants. Results The level of awareness was only 45.6% among health professionals followed by 26.4% & 22.2% of awareness among the caregivers and the older adults respectively. Conclusion There is a huge gap between the healthcare providers and healthcare takers knowledge due to which the preventive and promotive care of older adults is poor in our country. There is a need to strengthen institutions and mechanism that can more systematically promote interaction between researchers, policymakers and other stakeholders who can influence the uptake of the research findings in a synergistic manner.

Background Screening and diagnostic tests provide an objective measure of cognitive performance and also aid in distinguishing mild cognitive impairment (MCI) from major neurocognitive disorder (MNCD). Further, when such tests are culturally and educationally unbiased, it strengthens their diagnostic utility. This study aimed to validate the Hindi version of Addenbrooke's Cognitive Examination III (ACE-III) in Indian older adults and compare its validity with the Hindi Mini-Mental State Examination (HMSE). Methods A sample of 412 consenting older adults visiting a memory clinic was recruited into the study. They were categorized into three groups: healthy controls (n=222), MCI (n=70), and MNCD (n=120). The complete clinical protocol was followed. Hindi ACE-III and HMSE were administered and were statistically analyzed. Results The optimal cut-off values to detect MCI and MNCD with ACE-III were 71 and 62 (AUC: 0.849 and 0.884), respectively, which were slightly higher than with HMSE (AUC: 0.822, 0.861). Education- and age-stratified cut-offs were also computed. Conclusion Hindi ACE-III has good discriminating power at lower cut-offs than the standard scores in differentiating between MCI and MNCD.

Background: Alzheimer’s disease (AD) is the progressive brain disorder which degenerates brain cells connection and causes memory loss. Although AD is irreversible, it is not impossible to arrest or slow down the progression of the disease. However, this would only be possible if the disease is diagnosed at an early stage, and early diagnosis requires clear understanding of the pathogenesis at molecular level. Overactivity of GSK-3β and p53 accounts for tau hyperphosphorylation and the formation of amyloid-β plaques. Objective: Here, we explored GSK-3β and p53 as blood-based biomarkers for early detection of AD. Methods: The levels of GSK-3β, p53, and their phosphorylated states were measured using surface plasmon resonance and verified using western blot in serum from AD, mild cognitive impairment (MCI), and geriatric-control (GC) subjects. The neurotoxic SH-SY5Y cell line was treated with antioxidant Emblica Officinalis (EO) for rescue effect. Results: GSK-3β, p53, and their phosphorylated states were significantly over expressed (p > 0.001) in AD and MCI compared to GC and can differentiate AD and MCI from GC. The expression level of GSK-3β and p53 proteins were found to be downregulated in a dose-dependent manner after the treatment with EO in amyloid-b-induced neurotoxic cells. Conclusion: These proteins can serve as potential blood markers for the diagnosis of AD and EO can suppress their level. This work has translational value and clinical utility in the future.

Background: Cognitive aging is a complex phenomenon, which comprises various cognitive skills, broadly categorized into fluid and crystallized intelligence. Crystallized intelligence (gc) tends to be maintained, as opposed to fluid intelligence (gf), which tends to decline rapidly with age. The association of the two with cognitive decline remains a matter of conjecture requiring further research. Aim: The aim of the study was to identify the variables of gc and gf from a population data of Longitudinal Aging Study in India-Diagnostic Assessment of Dementia (LASI-DAD) study and investigate its relationship with the onset of cognitive impairment using discrepancy analysis against neuropsychological tests. Methods: This analysis of data from LASI-DAD study was carried out on a sample of 3,223 participants. They were assessed on extensive thirteen cognitive tests and one subjective test of cognition. Standardized score was used for discrepancy analysis. Fluid ability minus crystallized ability was used to assess the cognitive impairment. Any statistical significance with the score difference >0.99 SD was defined as a presence of cognitive decline. Hindi Mental Status Examination (HMSE) and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) were used as gold standard. Results: With increased discrepancy score, each cognitive parameter score declined which was found to be statistically significant. In HMSE (Normal = 25.81 ± 3.39; Impaired = 23.17 ± 3.54; p = Conclusion: Crystallized-fluid intelligence discrepancy analysis has a strong potential in predicting the onset of cognitive decline ahead of time, facilitating early intervention.

Introduction Alzheimer’s disease is a gradual and progressive disorder which cripples the person’s functionality due to cognitive decline. Many clinicopathological and pharmacological therapy has the potential to slow down the progression of the disease but has limited efficacy. One complimentary approach that has emerged is cognitive training interventions which have shown synergistic effect with the drug therapy. Nevertheless, many cognitive interventions lack on specificities of the intervention due to which its efficacy gets scrutinized. Objective To describe the foundation, content, and development of Cognitive Training Intervention for Alzheimer’s disease (CTI-AD) along with the treatment feasibility based on a pilot study. Materials and methods A culture-specific picture-based eight weeks cognitive training manual was developed based on extensive review and focused group discussions. It was standardized on 63 older participants (48 healthy controls (HC); 15 early Alzheimer’s disease cases). Results All the tasks were progressive in nature and were found effective in discriminating the cognitive performance of early Alzheimer’s disease and HC throughout the intervention period. Moreover, it also improved early Alzheimer’s disease performance on the memory (HC: 1st week/8th week = 21.6 ± 5.7/57.3 ± 19.0; early Alzheimer’s disease: 1st week/8th week = 48.5 ± 22.9/60.5 ± 21.8); attention (HC: 1st week/8th week = 90.2 ± 18.0/196.9 ± 28.0; early Alzheimer’s disease: 1st week/8th week = 216.6 ± 78.2/286.8 ± 87.0) and language (HC: 1st week/8th week = 29.8 ± 9.4/115.3 ± 31.1; early Alzheimer’s disease: 1st week/8th week = 211.8 ± 68.4/270.4 ± 104.9) domains, respectively, from the baseline level. Conclusion The current manual (CTI-AD) is one of the first promising non-pharmacological program developed nationally with a strong theoretical base to cater to the tertiary needs of the older adults with early Alzheimer’s disease.

Background Screening and diagnostic tests provide an objective measure of cognitive performance and also aid in distinguishing mild cognitive impairment (MCI) from major neurocognitive disorder (MNCD). Further, when such tests are culturally and educationally unbiased, it strengthens their diagnostic utility. This study aimed to validate the Hindi version of Addenbrooke’s Cognitive Examination III (ACE-III) in Indian older adults and compare its validity with the Hindi Mini-Mental State Examination (HMSE). Methods A sample of 412 consenting older adults visiting a memory clinic was recruited into the study. They were categorized into three groups: healthy controls (n=222), MCI (n=70), and MNCD (n=120). The complete clinical protocol was followed. Hindi ACE-III and HMSE were administered and were statistically analyzed. Results The optimal cut-off values to detect MCI and MNCD with ACE-III were 71 and 62 (AUC: 0.849 and 0.884), respectively, which were slightly higher than with HMSE (AUC: 0.822, 0.861). Education- and age-stratified cut-offs were also computed. Conclusion Hindi ACE-III has good discriminating power at lower cut-offs than the standard scores in differentiating between MCI and MNCD.

Objective: The objective of this study was to assess the effectiveness of memory stimulation intervention added to donepezil treatment as compared to donepezil alone in patients with early Alzheimer's disease (eAD). Materials and Methods: Patients in the combined treatment group (CTG = 21) received standard dosages of donepezil and weekly memory stimulation activities sessions for 2 months, whereas the treatment as usual group (TAU = 22) received only standard dosages of donepezil. Each session had extensive tasks on memory and its implied practice on instrumental activities of daily living. After 8 sessions, both groups were evaluated for changes in memory and functional outcomes by administering the mini-mental state examination (MMSE), memory (Postgraduate Institute of Memory Scale), and instrumental activities of daily living scale (IADLS). This trial was registered on the Clinical Trials Registry - India (CTRI/2014/04/004550). Results: Statistical analysis was done using independent t-test, which revealed a significant difference between the groups on MMSE, memory, and IADLS post intervention. The MMSE score in the TAU group, while it increased in the CTG group by 4 points. A similar trend was evident in the memory and IADLS scores as well. Effect size in the CTG group was relatively large as compared to the TAU group where the effects were small and negative on some outcomes. Conclusion: The CTG group showed positive treatment effect on cognitive tests suggesting that combined memory stimulation and donepezil treatment has potential to improve the cognitive and functional performance of patients with eAD.

Flynn Effect (FE) deals with the issue of how the general scores of a population change over time. The existing cognitive test was developed in 1976 and since then there have been a lot of modernization and technological changes in the country. Hence, the objective was to study the possible FE with respect to cognition in the country. A sample of 142 people was assessed in 1976 to make norms on Post Graduate Institute- Memory Scale (PGI-MS). To compare these results the present study included 140 consenting subjects in 2013 almost in the forth decade after the first study. PGIMS is an original and one of the most popular tests of cognition in India, developed by Dwarka Pershad & N.N.Wig. It measures the cognitive ability, even with the illiterate population. Comparison of the age related norms (1976 and 2013) after 37 years shows that there was FE seen in the age group 20–29 years in the domains of attention and concentration (p=0.04), delayed recall (p=0.001) and recognition (p=0.05). 30–39 years age group also shows the evidence of FE in retention for dissimilar pairs i.e. ability for new learning ability (p=0.001). Finally, in the age group of 40–49 years there was FE seen in immediate recall (p=0.0007) and retention for similar pairs i.e. ability for simple memory (p=0.01). Whereas there was no FE seen in ages between 50–69 years i.e. amongst the senior citizens. Results show there is a shift in the cognition to a higher continuum. The conclusions made on the cognitive abilities for persons between 20 to 49 years, on the bases of age old norms, is an underestimate of their present abilities. On the basis of this study it can be inferred that, there is a change in cognitive abilities over generations, as Flynn (2012) stated, human beings are not getting smarter they are just being more modern. Hence, there is a need to revise the available norms of the test, across all the ages and education level, for assessing the cognitive functioning to make them more valid and reliable for clinical and research purposes.

Epilepsy is a chronic noncommunicable disorder of the brain that affects people of all ages. Around 50 million people worldwide have epilepsy (WHO, 2012). 45,000 children under the age of 15, develop epilepsy each year (Epilepsy Foundation, 2010). Lower income was, however, associated with a higher incidence of epilepsy in all ethnic groups (Benn, et al., 2008). Neuropsychological impairment is an important co-morbidity of chronic epilepsy (Elger et al., 2004). Recent investigations have focused on the cumulative neurobiological burden associated with epilepsy and the risk of progressive cognitive impairment, but none have studied the effect of epilepsy on cognition on the developing brain, from India so far. Hence, the aim of the study was to study the effect of the temporal and extra temporal epilepsy on the cognitive functioning of children aged 7-12 years. Methodology: a cross-sectional study was carried out with a sample of 52 consenting children with an history of seizure (the 1st seizure occurred at least three months back i.e. the problem of seizure disorder was at least three months old) of neuropsychological assessment of epilepsy were administered with standardized neuropsychological tests, namely (Gesell’s Drawing Test- by Verma et al., 1972, PGI-Memory Scale for children- by Kohli et al., 1998) Results indicated significant findings in nine areas of neuropsychological functioning, namely immediate recall (p=0.001), followed by delayed recall (p=0.001), attention and concentration (p=0.001), recent memory (p=0.001), remote memory (p=0.001), visual retention (p=0.001), retention for similar pairs (p=0.001), mental balance (p=0.001), recognition (p=0.001) as compared to controls. Conclusion: results show that epilepsy does have a significant effect on cognition of children. However, a larger cohort study needs to be carried out to make substantiate claims. Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Normalni tabulka"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin;}

India has a rather unenviable distinction of having the highest rate of head injury in the world. In India, more than 100,000 lives are lost every year with over 1 million suffering from serious head injuries. Traumatic brain injury is a complex injury with a broad spectrum of symptoms and disabilities. The impact on a person and his or her family can be devastating. Cognitive difficulties are very common in people with traumatic brain injury. Studies have shown that cognitive retraining plays a crucial role in improving the cognitive and basic functioning in these patients. We report three confirmed cases of effective cognitive retraining in moderate and severe traumatic brain injury.

Neuropsychological rehabilitation is based on the nature and scope of neuropsychological symptoms identified through structured interviews and standardized tests. Here, the focus is to understand brain injury recovery phases and effectively deal with post injury grief-bereavement process. We wanted to test the effect of neuropsychological functioning of a bullet shot/penetrating injury case with cognitive/lobular impairment, social-emotional losses and severe grief-bereavement process. Holistic neuropsychological approach consisting of MMSE and other Indian standardized neuropsychological test battery (VAIS, BSS, Mukundan’s battery, WHOQOL-BREF), cognitive retraining (basic and functional), extensive- flexible Grief-Bereavement Therapy, Supportive Psychotherapy, Family Counseling, Cognitive Behavior Therapy and Person Centered Therapy. Evidence of marked improvement in orientation, comprehension, working memory, verbal and performance ability, fronto-temporal functions and quality of life (physical, psychological, environmental and social) domains in comparison to his pre-therapy. Holistic neuropsychological rehabilitative approach improved both patient’s cognitive functioning and his quality of life. However, for such generalization, extensive studies are required.

Objective Stigma associated with epilepsy has negative effects on psychosocial outcomes, affecting quality of life (QOL) and increasing disease burden in persons with epilepsy (PWEs). The aim of our study was to measure the impact of stigma on the QOL of PWEs and the prevalence of neurological disability due to stigmatized epilepsy. Method A prospective observational study with a sample of 208 PWEs was conducted. Neuropsychological Tests used were the Indian Disability Evaluation Assessment Scale (IDEAS) to measure disability, the Dysfunctional Analysis Questionnaire (DAQ) to measure QOL, and the Stigma Scale for Epilepsy (SSE) to assess stigma. Results Spearman correlation was calculated, and stigma (SSE) was highly significant with QOL (DAQ) (0.019) and disability due to stigmatized epilepsy (IDEAS) (0.011). Conclusion The present study supports the global perception of stigma associated with epilepsy and its negative impact on their overall QOL and its contribution to the escalation of the disease burden.

Due to increasing role of computers, the internet and digital data across many forms of human endeavor is the widespread uptake of the notion of “Big data.” Researchers and educators seem to explore the potential of technology to grab, analyze and utilize huge amount of data in increasingly powerful ways. analysis of educational data is not something new in the field of education but increasing interest towards the use of learning management system, collaborative learning electronic portfolio, moodle, intelligent tutoring system, gaming, sharable content object reference model (SCORM), e-learning, m-learning, e-assessment, virtual worlds and augmented reality has fueled research in the field of Big data and learning analytics. Learning analytics is a field related to educational data mining. It describes attempts to use digital data about student's background and learning behaviors in online contexts to monitor and predict student performance. This paper explores the concept of learning analytics, its dimensions, approaches and applications in detail it also describes the relationship between educational data mining, academic analytics and learning analytics.