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Background: Blood–brain barrier dysfunction is one characteristic of Alzheimer's disease (AD) and is recognized as both a cause and consequence of the pathological cascade leading to cognitive decline. The goal of this study was to assess markers for barrier dysfunction in postmortem tissue samples from research participants who were either cognitively normal individuals (CNI) or diagnosed with AD at the time of autopsy and determine to what extent these markers are associated with AD neuropathologic changes (ADNC) and cognitive impairment. Methods: We used postmortem brain tissue and plasma samples from 19 participants: 9 CNI and 10 AD dementia patients who had come to autopsy from the University of Kentucky AD Research Center (UK-ADRC) community-based cohort; all cases with dementia had confirmed severe ADNC. Plasma samples were obtained within 2 years of autopsy. Aβ40, Aβ42, and tau levels in brain tissue samples were quantified by ELISA. Cortical brain sections were cleared using the X-CLARITY™ system and immunostained for neurovascular unit-related proteins. Brain slices were then imaged using confocal microscopy and analyzed for microvascular diameters and immunoreactivity coverage using Fiji/ImageJ. Isolated human brain microvessels were assayed for tight-junction protein expression using the JESS™ automated Western blot system. S100 calcium-binding protein B (S100β), matrix metalloproteinase (MMP)-2, MMP-9, and neuron-specific enolase (NSE) levels in plasma were quantified by ELISA. All outcomes were assessed for linear associations with global cognitive function (MMSE, CDR) and cerebral atrophy scores by Pearson, polyserial, or polychoric correlation, as appropriate, along with generalized linear modeling or generalized linear mixed-level modeling. Results: As expected, we detected elevated Aβ and tau pathology in brain tissue sections from AD patients compared to CNI. However, we found no differences in microvascular diameters in cleared AD and CNI brain tissue sections. We also observed no differences in claudin-5 protein levels in capillaries isolated from AD and CNI tissue samples. Plasma biomarker analysis showed that AD patients had 12.4-fold higher S100β plasma levels, twofold lower NSE plasma levels, 2.4-fold higher MMP-9 plasma levels, and 1.2-fold lower MMP-2 plasma levels than CNI. Data analysis revealed that elevated S100β plasma levels were predictive of AD pathology and cognitive impairment. Conclusion: Our data suggest that among different markers relevant to barrier dysfunction, plasma S100β is the most promising diagnostic biomarker for ADNC. Further investigation is necessary to assess how plasma S100β levels relate to these changes and whether they may predict clinical outcomes, particularly in the prodromal and early stages of AD. [ABSTRACT FROM AUTHOR]

Objective: This study aims to investigate the clinical application value of the central venous-arterial carbon dioxide partial pressure difference (Pv-aCO2) in postoperative cognitive dysfunction(POCD) in patients with acute aortic dissection. Methods: A retrospective analysis was conducted on the general data of 236 patients. Blood gas samples were collected from the arterial and venous lines at various time points during the surgery, including before and after the initiation of cardiopulmonary bypass (CPB), immediately after CPB initiation, before and after deep hypothermic circulatory arrest, 30 min after rewarming, and 5 min before weaning from CPB. The partial PV-aCO2 was calculated. Based on the average PV-aCO2 value, patients were divided into an observation group (PV-aCO2 > 6 mmHg, n = 112) and a control group (PV-aCO2 < 6 mmHg, n = 124). The perioperative data and Mini-Mental State Examination (MMSE) scores were compared between the two groups to assess the incidence and severity of POCD. Additionally, the expression levels of peripheral serum S100β in the two groups were compared 6 h postoperatively. Results: The incidence of POCD was higher in the observation group compared to the control group, while MMSE scores and serum S100β levels were lower in the observation group. Additionally, the observation group patients with POCD had lower MMSE scores and serum S100β levels compared to the control group patients. In addition, logistic regression analysis revealed that advanced age, serum S100β levels, female gender, CPB time, unilateral brain perfusion time, hyperlipidemia, diabetes, and smoking history were all independent risk factors for postoperative POCD (all P < 0.05). Conclusion: Pv-aCO2 can effectively reflect the intraoperative cerebral metabolic level in patients with acute aortic dissection and can serve as an intraoperative warning indicator for cognitive dysfunction. Its clinical recommendation for use is warranted. [ABSTRACT FROM AUTHOR]

• Study examines the association between FGF-21 and post-stroke cognitive impairment. • Elevated plasma FGF-21 level was associated with PSCI at 3 months after stroke. • Plasma FGF-21 may have potential prognostic value in risk stratification of PSCI. Previous study reported that plasma fibroblast growth factor 21 (FGF-21) was associated with poor prognosis in patients with ischemic stroke. The purpose of present study was to prospectively investigate the relationship between plasma FGF-21 and post-stroke cognitive impairment (PSCI). A total of 600 patients from 7 hospitals were included in this study and plasma FGF-21 levels were examined for all the participants. Cognitive impairment was evaluated using Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) at 3 months after ischemic stroke onset. 323(53.8 %) or 419(69.8 %) participants had PSCI according to MMSE or MoCA at 3 months, respectively. After adjustment for age, National Institutes of Health stroke score, education, and other covariates, the odds ratio of PSCI defined by MMSE and MoCA for the highest vs lowest quartile of plasma FGF-21 was 1.77(1.05–2.98) and 2.40(1.35–4.29), respectively. Multiple-adjusted spline regression model showed a linear association between FGF-21 levels and PSCI (all P < 0.005 for linearity). Subgroup analyses further confirmed these results. Elevated plasma FGF-21 level was associated with PSCI at 3 months after stroke independently of established conventional risk factors, suggesting that plasma FGF-21 may have potential prognostic value in risk stratification of PSCI. [ABSTRACT FROM AUTHOR]

BACKGROUND: Cognitive impairment is common in patients with heart failure and preserved ejection fraction but its clinical correlates and prognostic associations are poorly understood. METHODS: We analyzed cognitive function, using the Mini-Mental State Examination (MMSE), in patients with heart failure and preserved ejection fraction enrolled in a prespecified substudy of the PARAGON-HF trial (Prospective Comparison of Angiotensin Receptor Neprilysin Inhibitor With Angiotensin Receptor Blocker Global Outcomes in Heart Failure With Preserved Ejection Fraction). Logistic regression analyses were performed to determine the variables associated with lower MMSE scores at baseline and postbaseline decline in MMSE scores at 48 weeks. Cox proportional hazards regression and semiparametric proportional rates models were used to examine the risk of clinical outcomes related to baseline MMSE scores, and decline in MMSE scores during follow-up, adjusted for prognostic variables including NT-proBNP (N-terminal pro-B-type natriuretic peptide). RESULTS: At baseline, cognitive function was normal (MMSE score 28–30) in 1809 of 2895 patients (62.5%), borderline (score 24–27) in 794 (27.4%), and impaired (score <24) in 292 (10.1%). Variables associated with both a lower MMSE score at baseline and a decline in score from baseline included older age, a history of stroke or transient ischemic attack, and lower serum albumin. Compared with those with baseline MMSE scores of 28 to 30, patients in the lower MMSE score categories had a stepwise increase in the risk of the composite of time to first heart failure hospitalization or cardiovascular death, with an adjusted hazard ratio of 1.27 (95% CI, 1.06–1.53) for those with scores of 24 to 27 and 1.58 (95% CI, 1.21–2.06) for those with scores <24, respectively. These associations were also found for the individual components of the composite and all-cause death. Likewise, cognitive impairment was associated with a 50% higher risk of total (first and repeat) heart failure hospitalizations and cardiovascular deaths. Examining the change in MMSE score from baseline, a decrease in MMSE score during follow-up was associated with a higher risk of death. CONCLUSIONS: In patients with heart failure and preserved ejection fraction, even modest baseline impairment of cognitive function was associated with worse outcomes, including death. A decline in MMSE score during follow-up was a strong predictor of mortality, independent of other prognostic variables. [ABSTRACT FROM AUTHOR]

Aging is accompanied by possible cognitive impairment, as well as a reduction in nitric oxide (NO) bioavailability, insulin resistance, and vitamin D deficiency. Among these Nitric oxide exhibits a dual role in brain biology, where both low and high levels can have detrimental effects on memory and neurotoxicity. In this study we aimed to investigate the role of nitric oxide, insulin resistance, and vitamin D in cognitive function of elderly individuals. This case-control study involved participants aged ≥ 60 years who were under observation in the Birjand Longitudinal Aging Study. A total of 40 participants were selected as controls, while 64 participants with cognitive impairment were identified as cases. The cases were further subdivided according to their Mini-Mental State Examination (MMSE) scores into two groups: mild and moderate cognitive impairment. Cognitive function in both cases and controls was assessed using the MMSE. The levels of total NOx, vitamin D, insulin, and blood glucose were measured using ELISA and spectrophotometric immunoassays. Insulin resistance indices, such as homeostasis model assessment of insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI) were calculated. Serum NOx levels were significantly lower in participants with cognitive impairment compared to the control group (p < 0.01). However, the mean (SD) levels of serum vitamin D, insulin, and glucose, as well as the insulin resistance markers, showed no significant differences between the groups. A positive correlation was observed between serum NOx levels and MMSE scores. NO may be an essential factor for normal brain function, as serum NOx levels were significantly higher in controls compared to those with cognitive impairment, and there was a positive correlation with MMSE scores. Other metabolic and nutritional markers, including vitamin D and insulin resistance, did not demonstrate a significant effect. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: Vitamin B12 is an essential micronutrient, aids in synthesis of neurotransmitters, and vital for cognitive function. In the current younger population with more of electronic gadgets and scientific world seems to slow down critical thinking and impairs the trick of comprehensive subjective learning. Vitamin B12 deficiency has been linked to insulin-resistant state and future cardiovascular risk. Aim: This study compared single-point insulin sensitivity estimator (SPISE) index, cognitive performance, and CVS risk in vitamin B12-adequate and -deficient young adults. Materials and Methods: Study participants were 60 young female participants, 18 to 35 years with the inclusion criteria of BMI more than 22.9 and waist circumference >85 cm. Anthropometric variables were measured. Lipid profile analytes were analyzed in an integrated Beckman Coulter AU series autoanalyzer. Based on SPISE index categorized as insulin resistant Group A <5.82 and non-insulin resistant Group B ≥5.82. Cognitive function was assessed based on Mini-Mental State Examination screening tool. Settings and Design: Analytical cross-sectional study. Results: Individuals with low vitamin B12 levels had a low SPISE index of less than 5.82 and low HDL-C levels, which indicates abnormal lipidemia and reduced insulin sensitivity. Mini-Mental State Examination was low in B12-deficient. B12 revealed positive correlation with MMSE, SPISE Index, and HDLc, whereas negative correlation with TGL and TGL/HDLc ratio. Conclusion: Individuals with low vitamin B12 levels express low SPISE index, and low performance on MMSE confirms risk of impairment of cognitive function and cardiovascular risk. [ABSTRACT FROM AUTHOR]

Objective: This study aims to examine the effect of the Mediterranean diet (MeDi) on cognitive decline among the Chinese elderly with a 3-year follow-up. Methods: This study is divided into two waves: wave-1 January 2019 to June 2019 (n = 2313); wave-2 January 2022 to March 2022 (n = 1648). MeDi scores were calculated from the Mediterranean Diet Adherence Screener (MEDAS), with the scoring of low compliance (0–6 points) and high compliance (7–14 points). The Mini-Mental State Examination (MMSE) was used to assess cognitive function. An MMSE score dropping ≥ 2 points from baseline was defined as cognitive decline. The relationships between MeDi score and cognitive decline were analyzed by linear regression models or Binary logistic regression. Results: During the 3-year follow-up, 23.8% of patients exhibited cognitive decline. The study revealed a significant difference in MMSE score changes between low and high MeDi adherence groups (p < 0.001). MeDi score was negatively correlated with cognitive deterioration (β = −0.020, p = 0.026). MeDi score was only negatively associated with cognitive decline in the female subgroup aged ≥65 years (β = −0.034, p = 0.033). The food beans (OR = 0.65, 95%CI:0.51, 0.84), fish (OR = 0.72, 95%CI:0.54, 0.97), and cooked vegetables (OR = 0.68, 95%CI:0.53, 0.84) were protective factors for cognitive decline. Conclusions: This study suggests that greater adherence to the MeDi is linked to a reduced risk of cognitive decline in elderly people. However, this is found only in women who are 65 years old or older. It also found long-term adherence to beans, fish, and vegetables are more effective in improving cognitive function. [ABSTRACT FROM AUTHOR]

Aim: The present study aimed to study the effect of COVID-19 on the quality of life in the geriatric population using ICF in and around Belagavi city. Settings and Designs: Observational study design was implemented in and around Belagavi city. SF-36 and ICF documentation were explained to the subjects and collected. Subjects and Methods: Sixty-five participants from the age group of 65 and above were taken based on the inclusion and exclusion criteria. Both SF-36 and ICF documentation was explained to them in regional language and collected from them. Statistical Analysis Used: Correlation was performed. Statistical significance was considered where the p-value (0.001) was kept as highly significant. Results: This study investigated the impact of COVID-19 on the elderly population (65+) using the International Classification of Functioning (ICF). Analysis of the SF-36 questionnaire revealed significant impairments in social functioning (56.25%), particularly community life, recreation, and spirituality (ICF codes d-910, d-920, d-930). Additionally, pain (54.3%) significantly affected all 20 ICF code sets, with d-415, d-430, and d-450 being the most impacted. General health also showed a 48% decline. These findings highlight the multifaceted negative impact of COVID-19 on the functioning of the elderly population. [ABSTRACT FROM AUTHOR]

In wireless mobile networks, the signal transmitted from the transmitter to the receiver is vulnerable to many performance-degrading factors, such as distortion, noise, fading, and nonlinear distortion, due to the physical nature of the channel. To address these factors, accurate prediction and estimation must be employed to achieve optimized performance in wireless mobile networks. Several channel estimation techniques have been developed. In this article, we provide a review of some of these techniques under various categories, highlighting their strengths and limitations in different operational environments. [ABSTRACT FROM AUTHOR]

Background: Alzheimer's disease (AD) is the commonest worldwide neurodegenerative disorder. Nevertheless, it usually face difficulties to guarantee a secured initial diagnosis. For this reason, neurologists are in dire need for developing potential biomarkers that could be relied upon confidentially in early diagnosis of AD. Hopefully, this will open the gate for novel modifying therapy to fight with all their might. In this current study, we aimed to correlate plasma levels of tau and Aβ with the changes that occur in hippocampal volume and thickness of retinal fiber layers in patients who clinically diagnosed with AD spectrum. A cross-sectional study enrolled 60 AD patients who fulfilled inclusion and exclusion criteria were subjected to cognitive, radiologic, laboratory and optical coherence tomography (OCT) assessments. Results: Tau, Aβ1–40, and Aβ1–40/Aβ1–42 ratio are significant discriminators of AD at cutoff values of >23.45, > 84.4, and > 1.95, respectively. MRI hippocampal volume in both right and left sides are also good discriminators of AD at cutoff values of ≤ 2.997, and ≤ 2.994, respectively. A significant correlations were reported between tau with Aβ1–40, Aβ1–42, MMSE and MRI right and left hippocampal volumes. On comparing moderate versus mild AD, there was a high significant levels of tau, Aβ1–42, Aβ1–40/Aβ1–42 ratio. Conclusions: We clarify that several biomarkers could be potentially used for confirming the diagnosis of AD. Assessment of plasma amyloid level, detection of hippocampal atrophy and retinal nerve fiber layer thickness changes are promising tools for early diagnosis of AD. [ABSTRACT FROM AUTHOR]

In this article, we explore the use of neural networks (NNs) to enhance the performance evaluation of Universal Filtered Multi-Carrier (UFMC) systems, a key technology for modern communication networks such as 5G and beyond. Traditional methods of evaluating the Bit Error Rate (BER) and system efficiency in UFMC system can be computationally intensive and less accurate under dynamic conditions. To address these challenges, we propose a NN based approach that not only improves the accuracy of BER prediction but also significantly optimizes the system's overall efficiency. Channel state estimation (CSE) plays a major role for UFMC system to address the phenomenon of multipath channel fading. In order to achieve a high data rate using UFMC technology, it is necessary to have an effective CSE and very accurate signal detection. Recently, there has been significant interest in utilizing deep learning (DL) to enhance channel estimations. This article introduces a new method for channel estimation (CE) in UFMC system. The suggested approach utilizes DL models to improve the CE. For the UFMC system, we propose a detector based on bidirectional long short-term memory (Bi-LSTM). To identify the transmitted symbols, the suggested detector uses DL training data directly. Currently, a significant drawback of UFMC systems is the presence of a high peak-to-average power ratio (PAPR). The approach aims to reduce the BER and enhances the efficiency of the UFMC system. This is achieved by dynamically setting the constellation mapping and symbol damping on each subcarrier and sub-symbol. The results illustrate that the proposed model can accurately and efficiently recognize UFMC signals. The suggested model is being compared to Least Square (LS), LSTM, and Minimum Mean Square Error (MMSE) channel estimators. Through extensive simulations, our results demonstrate that the NN model reduces BER and enhances efficiency. The proposed model gives more effective performance in terms of enhanced efficiency and reduction of BER. The findings offer valuable insights for the design and optimization of next-generation communication systems, where accurate and efficient performance evaluation is critical. [ABSTRACT FROM AUTHOR]

Abstract Aging is accompanied by possible cognitive impairment, as well as a reduction in nitric oxide (NO) bioavailability, insulin resistance, and vitamin D deficiency. Among these Nitric oxide exhibits a dual role in brain biology, where both low and high levels can have detrimental effects on memory and neurotoxicity. In this study we aimed to investigate the role of nitric oxide, insulin resistance, and vitamin D in cognitive function of elderly individuals. This case-control study involved participants aged ≥ 60 years who were under observation in the Birjand Longitudinal Aging Study. A total of 40 participants were selected as controls, while 64 participants with cognitive impairment were identified as cases. The cases were further subdivided according to their Mini-Mental State Examination (MMSE) scores into two groups: mild and moderate cognitive impairment. Cognitive function in both cases and controls was assessed using the MMSE. The levels of total NOx, vitamin D, insulin, and blood glucose were measured using ELISA and spectrophotometric immunoassays. Insulin resistance indices, such as homeostasis model assessment of insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI) were calculated. Serum NOx levels were significantly lower in participants with cognitive impairment compared to the control group (p

Abstract Recent studies indicate a potential link between oral health and cognitive function; however, long-term associations remain unclear. This study aimed to identify oral health factors that predict changes in cognitive function among older adults over time. The study included 583 independent older adults (201 male, 382 female) with a mean age of 72.7 years. Cognitive function was assessed using Mini-Mental State Examination (MMSE) at baseline and follow-up over two years, with relative change in MMSE (rMMSE) calculated. Baseline oral health variables included number of remaining teeth, masticatory performance, occlusal force, oral diadochokinesis and tongue pressure. Physical performance and confounding factors were also considered. The relationship between rMMSE and the variables was analyzed using Pearson’s correlation, Mann-Whitney U test, and multiple linear regression analysis. Cognitive function declined in 196 subjects, with rMMSE significantly correlated with oral diadochokinesis. Regression analysis revealed significant associations between cognitive changes and oral diadochokinesis (p = 0.020) and knee extension strength as a physical performance (p = 0.047). Our findings suggest that cognitive decline may be indicated by declines in both physical and oral motor performance. Incorporating oral diadochokinesis testing into health screenings could aid early detection of cognitive decline, improving outcomes and reducing healthcare burdens.

Recent studies indicate a potential link between oral health and cognitive function; however, long-term associations remain unclear. This study aimed to identify oral health factors that predict changes in cognitive function among older adults over time. The study included 583 independent older adults (201 male, 382 female) with a mean age of 72.7 years. Cognitive function was assessed using Mini-Mental State Examination (MMSE) at baseline and follow-up over two years, with relative change in MMSE (rMMSE) calculated. Baseline oral health variables included number of remaining teeth, masticatory performance, occlusal force, oral diadochokinesis and tongue pressure. Physical performance and confounding factors were also considered. The relationship between rMMSE and the variables was analyzed using Pearson’s correlation, Mann-Whitney U test, and multiple linear regression analysis. Cognitive function declined in 196 subjects, with rMMSE significantly correlated with oral diadochokinesis. Regression analysis revealed significant associations between cognitive changes and oral diadochokinesis (p = 0.020) and knee extension strength as a physical performance (p = 0.047). Our findings suggest that cognitive decline may be indicated by declines in both physical and oral motor performance. Incorporating oral diadochokinesis testing into health screenings could aid early detection of cognitive decline, improving outcomes and reducing healthcare burdens. [ABSTRACT FROM AUTHOR]

Background/Objectives: Cognitive impairment is an intermediate state between normal aging and dementia, and its detection in the early stages is essential to prevent dementia, an incurable pathology. The aim of this study is to screen and estimate the prevalence of cognitive impairment, including dementia, and its correlated factors in a community-based sample of the Albanian population over 50 years old. Methods: We carried out a door-to-door neuropsychological screening of Albanian residents older than 50 years from November 2023 to June 2024 in 12 Albanian districts. Participants completed the Early Dementia Questionnaire (EDQ) and the Mini Mental State Examination (MMSE). Results: The overall estimating prevalence of cognitive impairment and early dementia among the Albanian population over 50 years old was 14.04% using the MMSE, with 2.31% for MMSE ≤18 (serious cognitive impairment), 5.51% for MMSE 19–22 (mild cognitive impairment (MCI)), and 6.22 for MMSE 23–24 (suspected cognitive impairment or dementia),respectively. The prevalence of early dementia using the EDQ was significantly higher (53.99%).The number of male participants with MMSE scores of 23–24 (suspected cognitive impairment or early dementia) was 2.5 times higher with respect to female participants. Smoking and alcohol consumption decreased the MMSE scores. The number of participants with normal cognitive function (MMSE scores 25–30) was lower among participants with hypertension, diabetes, hyperlipidemia, and cerebral ischemia. Conclusions: A diagnostic evaluation, including a clinical examination, neuroimaging, and laboratory studies, is further required for a diagnosis. Despite limitations, the data provided in this study are the only ones reported for a large community-based sample of the older adult Albanian population, which can help health care providers to diagnose cognitive impairment. [ABSTRACT FROM AUTHOR]

Background: Neurocognitive disorders (NCDs) have a variable decline in cognitive function, while loneliness was associated with cognitive impairment and increased dementia risk. In the present study, we examined the associations of loneliness with functional and cognitive status in patients with minor (mild cognitive impairment) and major NCDs (dementia). Methods: We diagnosed mild NCD (n = 42) and major NCD (n = 164) through DSM-5 criteria on 206 participants aged > 65 years using the UCLA 3-Item Loneliness Scale (UCLA-3) to evaluate loneliness, the activities of daily living (ADL) and the instrumental activities of daily living (IADL) scales to measure functional status, and Mini-Mental State Examination (MMSE) to assess cognitive functions. Results: In a multivariate regression model, the effect of loneliness on cognitive functions was negative in major (β = −1.05, p < 0.0001) and minor NCD (β = −0.06, p < 0.01). In the fully adjusted multivariate regression model (sex–age–education–multimorbidity–depressive symptoms–antidementia drug treatment), the effect of loneliness remained negative for major NCD and became positive for minor NCD (β = 0.09, p < 0.001). The effect of loneliness on IADL (β = −0.26, p < 0.0001) and ADL (β = −0.24, p < 0.001) showed a negative effect for major NCD across the different models, while for minor NCD, the effect was positive (IADL: β = 0.26, p < 0.0001; ADL: β = 0.05, p = 0.01). Minor NCD displayed different levels of MMSE (β = 6.68, p < 0.001) but not ADL or IADL, compared to major NCD for the same levels of loneliness. MANOVA pill test suggested a statistically significant and different interactive effect of loneliness on functional and cognitive variables between minor and major NCDs. Conclusions: We confirmed the relationships between loneliness and cognitive and functional status in major NCD, observing a novel trend in minor NCD. [ABSTRACT FROM AUTHOR]

Informed by the biopsychosocial framework, our study uses the Chinese Longitudinal Healthy Longevity Survey (CLHLS) dataset to examine cognitive function trajectories among the oldest-old (80+). Employing K-means clustering, we identified two latent groups: High Stability (HS) and Low Stability (LS). The HS group maintained satisfactory cognitive function, while the LS group exhibited consistently low function. Lasso regression revealed predictive factors, including socioeconomic status, biological conditions, mental health, lifestyle, psychological, and behavioral factors. This data-driven approach sheds light on cognitive aging patterns and informs policies for healthy aging. Our study pioneers non-parametric machine learning methods in this context. [ABSTRACT FROM AUTHOR]

Age-related hearing loss is common among older individuals and is linked to cognitive impairment and a decrease in overall quality of life. Although hearing aids enhance auditory capabilities, their influence on cognitive performance in the Indian context has not been thoroughly investigated. This study investigates the cognitive benefits of hearing aids in elderly Indian patients with age-related hearing loss. A prospective cohort study was conducted at a tertiary care centre between January 2021 and December 2022. The study included 200 elderly patients who were fitted with behind-the-ear (BTE) or receiver-in-canal (RIC) hearing aids. The assessment of cognitive function was conducted using two standardised tests: the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). The assessment of quality of life was conducted using the WHOQOL-OLD questionnaire, while hearing acuity was examined by pure-tone audiometry and speech perception tests. Data were collected at baseline, 6 months, and 18 months. Multiple linear regression analysis identified predictors of cognitive outcomes. There were significant enhancements in MMSE, MoCA, HHIE, and WHOQOL-OLD scores across the 18-month duration (p < 0.001). The pure-tone audiometry thresholds and speech perception scores demonstrated significant improvement (p < 0.001). Regression analysis indicated that baseline cognitive function, hearing ability, and quality of life were significant predictors of cognitive outcomes at 18 months. No severe cognitive impairment or other confounding severe medical conditions were reported. This study revealed that the use of hearing aids has a substantial positive impact on cognitive function, quality of life, and hearing ability in the older Indian population suffering from age-related hearing loss. Timely intervention and the availability of hearing aids are essential for improving cognitive health and overall well-being in this demographic. Future study should look into the consequences and influence of various hearing aid models. [ABSTRACT FROM AUTHOR]

Background: Brain tissue in Alzheimer's patients is exposed to oxidative stress. Silymarin is an adjunct drug that has anti-inflammatory and antioxidant properties. Objective: This study aimed to evaluate the effect of silymarin on biomarkers of oxidative stress, inflammation, and disease severity in Alzheimer's patients. Methods: This randomized, single-blind clinical trial study was performed on 33 patients with Alzheimer's disease (AD) whose disease was confirmed by DSM-5 criteria and by brain imaging. Patients in the case group received three 250 mg silymarin capsules daily (each containing 150 mg silymarin), as an adjunctive medication in addition to the routine medication regimen. In the placebo group (control), patients received the same amount of placebo. All patients underwent Mini Mental State Exam (MMSE) and a panel of blood tests including malondialdehyde, neopterin, catalase, paraoxonase-1, total oxidative status, and total antioxidant capacity to reevaluate the changes pre/postintervention at the end of the trimester. Results: The catalase and MDA serum levels after the adjunctive silymarin treatment decreased significantly (Catalasebefore silymarin = 9.29 ± 7.02 vs Catalaseafter silymarin = 5.32 ± 2.97, p = 0.007 and MDAbefore silymarin = 4.29 ± 1.90 vs MDAafter silymarin = 1.66 ± 0.84, p < 0.001) while MMSE increased notably (MMSEbefore silymarin = 10.39 ± 6.42 vs MMSEafter silymarin = 13.37 ± 6.81, p < 0.001). Conclusion: Silymarin can be effective as an adjunct drug and a powerful antioxidant in reducing oxidative stress and improving the course of AD. [ABSTRACT FROM AUTHOR]

INTRODUCTION: We aimed to assess the impact of cholinesterase inhibitors (ChEIs) and memantine on cognition, major adverse cardiovascular events (MACE) and mortality in dementia with Lewy bodies (DLB). METHODS: A total of 1,095 incident DLB patients from the Swedish Registry on cognitive/dementia disorders were included. Using an inverse probability of treatment weighting, the effect of initiating ChEI or memantine within 90 days of DLB diagnosis and nonuse was evaluated on cognitive trajectories and risks of MACE and death. RESULTS: The use of ChEIs significantly slowed cognitive decline at follow‐ups (Mini‐Mental State Examination [MMSE] ‐0.39 points/y; 95% confidence interval [CI], ‐0.96 to 0.18) compared to memantine (‐2.49 points/y; ‐4.02 to ‐0.97) and nonuse (‐2.50 points/y; ‐4.28 to ‐0.73). Treatment groups did not differ in MACE events. ChEI use was associated with lower risk of death in the first year after DLB diagnosis (adjusted hazard ratio [HR] 0.66, 95% CI 0.46, 0.94). DISCUSSION: Our findings illuminate the potential benefits of ChEI treatment in DLB patients. Highlights: Cholinesterase inhibitors slow cognitive decline over a 5‐year follow‐up period when compared to both memantine treatment and nonuse in patients with dementia with Lewy bodies.Cholinesterase Inhibitors reduce risk of mortality within the initial year, but this effect is not sustained after 1 year in patients with dementia with Lewy bodies. [ABSTRACT FROM AUTHOR]

Background: The efficacy of DL-3-n-butylphthalide (NBP) in the treatment of post-stroke cognitive impairment (PSCI) has been reported previously. However, the course of treatment that shows curative effect and cytokines predictive of the efficacy of NBP in the treatment of PSCI have not been systematically evaluated. This study aimed to assess the efficacy, course of treatment, and cytokines that can predict the effectiveness of NBP in treating poststroke cognitive impairment PSCI. Methods: This study has been registered with PROSPERO (registration number CRD42024518768). Randomized controlled trial (RCT) data dated by November 12, 2023 were retrieved from the PubMed, Embase, Cochrane Library, Web of Science, Wanfang, CNKI, CSTJ, and SinoMed databases using medical subject terms combined with free words. The updated Cochrane RoB-I Risk of Bias tool was utilized for literature quality evaluation. Statistical analysis were carried out using Review Manager 5.4.1 software. Results: Thirty-eight original studies involving 5417 PSCI patients were analyzed. The results showed that NBP had a beneficial impact on cognitive function in PSCI patients when used alone or in combination therapy, as assessed by the Mini-mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scale. The effect sizes were significant for both monotherapy and combination therapy. Subgroup analyses based on treatment cycle indicated that NBP enhanced cognitive function in PSCI patients from 1 week after intervention: MMSE (SMD = 0.43, 95% CI [0.28, 0.58], P < 0.001), MoCA (SMD = 0.44, 95% CI [0.27, 0.61], P < 0.001). There was a cumulative enhancement in cognitive function within 6 months after NBP treatment based on the MoCA scores (SMD = 0.61, 95% CI [0.30, 0.91], P < 0.001). Furthermore, decreased levels of the cytokines Hs-CRP, TNF-α, IL-6, IL-8, Hcy, NSE, MDA, MMP-9, and Cys-C (SMD = −2.28, 95% CI [−2.97, 1.58], P < 0.001) and increased levels of BDNF, VEGF, and TIMP-1 (SMD = 2.80, 95% CI [1.66, 3.94], P < 0.001) were also predictive of treatment efficacy. Conclusion: NBP plays a beneficial role in improving cognitive function in PSCI patients, and their prognoses could be predicted by serum cytokine levels. However, high-quality, multicenter, multisample, and RCTs are still needed to confirm the clinical validity of NBP due to its low methodological quality. [ABSTRACT FROM AUTHOR]

Massive MIMO (mMIMO) is the essential technique for attaining the exponential increase in the data rate needed for future communication systems. These advancements have been significantly supported by progress in VLSI technology, which enables the integration of an enormous number of antennas and the complex signal processing essential for massive MIMO systems on a single chip. This work conducts a comprehensive analysis of the intricacy of seven matrix decomposition techniques for symbol detection in future mMIMO communication systems: ADMM-based infinity norm (ADMIN), Neumann series (NS), Newton iteration (NI), Jacobi iteration (Ja), improved Gauss-Seidel (IGS), conjugate gradient (CG), and QR decomposition (QR), against linear and near-optimal minimum mean square error (MMSE). QR, GS, Ja, and CG belong to linear algebraic methods based on matrix decomposition. MMSE and ADMIN are nonlinear optimization methods; NS and NI are iterative methods. The analysis examines into the complexity of these detection algorithms, considering the symbol error rate, the convergence rate, the initial solution vector, and the correlation factor. Performance evaluations are conducted on 8 and 16-user mMIMO systems with 64 and 128 base station antennas, modulation schemes (32-QAM and 64-QAM), iteration counts (p = 1, 2, 3, 4), correlation factors (α = 0.2, 0.4, and 0.6), and initial solution vectors (zero vector, D−1 and W2−1yMF). The result clearly shows that if the initial solution and number of iterations are chosen properly, the IGS-based linear detector achieves near-optimal performance with a lower computational complexity of O(K2) compared to the nonlinear MMSE-based detector with a computational complexity of O(K3). [ABSTRACT FROM AUTHOR]

Given the high growth rates of cognitive decline among the elderly population and the lack of effective etiological treatments, early diagnosis of cognitive impairment progression is an imperative task for modern science and medicine. It is of particular interest to identify predictors of an unfavorable subsequent course of cognitive disorders, specifically, rapid progression. Our study assessed the informative role of various risk factors on the dynamics of cognitive impairment among mild cognitive impairment (MCI) patients. The study included patients with MCI (N = 338) who underwent neuropsychological assessment, magnetic resonance imaging (MRI) examination, blood sampling for general and biochemical analysis, APOE genotyping, and polygenic risk score (PRS) evaluation. The APOE ε4/ε4 genotype was found to be associated with a diminished overall cognitive scores initial assessment and negative cognitive dynamics. No associations were found between cognitive changes and the PRS. The progression of cognitive impairment was associated with the width of the third ventricle and hematological parameters, specifically, hematocrit and erythrocyte levels. The absence of significant associations between the dynamics of cognitive decline and PRS over three years can be attributed to the provided suitable medical care for the prevention of cognitive impairment. Adding other risk factors and their inclusion in panels assessing the risk of progression of cognitive impairment should be considered. [ABSTRACT FROM AUTHOR]

Cerebrotendinous xanthomatosis is a rare and treatable metabolic disorder related to the accumulation of cholestanol. This disorder is primarily associated with motor and cognitive impairments, although the latter has not been extensively characterized. The objectives of this work were to define the cognitive profile found in cerebrotendinous xanthomatosis patients, investigate the progression of cognitive impairment over time, and search for radio‐clinical correlations. Through a multicentric chart review study, we collected cognitive and radiological data from nine children and eighteen adults with genetically proven cerebrotendinous xanthomatosis. We performed a volumetric and morphological analysis of the brain magnetic resonance imaging. In our cohort, 44% (4/9) of children and 78% (14/18) of adults exhibited cognitive impairment that can be severe. The study revealed a significant impairment in various cognitive domains, specifically executive, attentional, language, and visuo‐spatial. Among adults, 16% (3/18) developed dementia after age 50. These three patients had delayed chenodeoxycholic acid treatment and important cerebral atrophy. Besides these three cases of late‐onset cognitive decline, Mini‐Mental State Evaluation was generally stable, suggesting cognitive impairment due to a neurodevelopmental disorder and persisting in adulthood. Cognitive impairment was less common in children, possibly related to early chenodeoxycholic acid treatment in our cohort. The severity of magnetic resonance imaging abnormalities did not predict cognitive impairment in patients. Overall, in cerebrotendinous xanthomatosis, cognitive impairment can be severe and mainly neurodevelopmental. Early chenodeoxycholic acid treatment might be associated with a reduced risk of cognitive decline. [ABSTRACT FROM AUTHOR]

Background: Previous structural neuroimaging studies linked cerebellar deficits to temporal lobe epilepsy (TLE). The functions of various cerebellar regions are increasingly being valued, and their changes in TLE patients warrant further indepth investigation. In this study, we used the Spatially Unbiased Infratentorial (SUIT) toolbox with a new template to evaluate the cerebellar structural abnormalities in patients with TLE, and further explored the relationship between the changes of different cerebellar regions and cognition. Methods: Thirty-two patients with TLE were compared with 39 healthy controls (HC) matched according to age, gender, handedness, and education level. All participants underwent a high-resolution T1-weighted MRI scan on a 3.0 Tesla scanner. We used a voxel-based morphometry (VBM) approach utilizing the SUIT toolbox to provide an optimized and fine-grained exploration of cerebellar structural alterations associated with TLE. Results: Compared with HC, TLE patients showed a significant reduction in the volume of gray matter in the Left lobule VI and white matter in the Right Crus II. In the TLE patient group, we conducted partial correlation analysis between the volumes of different cerebellar regions and cognitive rating scale scores, such as MMSE and MoCA. The volume of the Left lobule VI (GM) exhibited a positive correlation with the MMSE score, but no significant correlation was found with the MoCA score. On the other hand, there was no significant correlation observed between the volume of the Right Crus II (WM) and the two cognitive scale scores mentioned above. Furthermore, it was observed that the MMSE was more effective than the MoCA in identifying epilepsy patients with cognitive impairment. Conclusion: This study supported previous research indicating that temporal lobe epilepsy (TLE) is linked to structural changes in the cerebellum, specifically affecting the volume of both gray and white matter. These findings offer valuable insights into the neurobiology of TLE and hold potential to inform the development of enhanced diagnostic methods and more effective treatment approaches. [ABSTRACT FROM AUTHOR]

Background: Mini-mental State Examination (MMSE) is widely accepted clinically for postoperative cognitive dysfunction (POCD) assessment. This study aims to investigate the post-operative cognitive changes among high-risk cardiothoracic patients and establish a standardised approach to post-surgery cognitive assessment. Methods: This is a prospective cohort study, where cognitive assessments were done 1-day before surgery, at discharge, and during 6 weeks of follow-up. Sample size calculation, accounting for an estimated 20% dropout rate, determined a minimum of 170 subjects were required for the study. Reduction of MMSE score of more than 2.5 was considered as having POCD. Score differences between groups were analysed using T-test and analysis of variance (ANOVA), while consistency between tools was analysed using correlation and regression. Results: A total of 188 patients completed the study, with a POCD prevalence of 20.2% and 6.9% at discharge and at the 6 week follow up, respectively. All cognitive tools show a significant difference between preoperative and postoperative scores. All tests show a significant moderate correlation with MMSE. Conclusions: In conclusion, it is imperative to employ a battery of cognitive assessments to evaluate cognitive changes comprehensively. [ABSTRACT FROM AUTHOR]

Idiopathic normal-pressure hydrocephalus (iNPH) is a clinic-radiological neurological syndrome presenting with cognitive deficits, gait disturbances and urinary incontinence. It often coexists with Alzheimer's disease (AD). Due to the reversible nature of iNPH when promptly treated, a lot of studies have focused on possible biomarkers, among which are cerebrospinal fluid (CSF) biomarkers. The aim of the present study was to determine the rate of beta-amyloid pathology and AD co-pathology by measuring AD CSF biomarkers, namely, amyloid beta with 42 and 40 amino acids (Aβ42), the Aβ42/Aβ40 ratio, total Tau protein (t-Tau) and phosphorylated Tau protein at threonine 181 (p-Tau), in a cohort of iNPH patients, as well as to investigate the possible associations among CSF biomarkers and iNPH neuropsychological profiles. Fifty-three patients with iNPH were included in the present study. CSF Aβ42, Aβ40, t-Tau and p-Tau were measured in duplicate with double-sandwich ELISA assays. The neuropsychological evaluation consisted of the Mini-Mental State Examination, Frontal Assessment Battery, Five-Word Test and CLOX drawing tests 1 and 2. After statistical analysis, we found that amyloid pathology and AD co-pathology are rather common in iNPH patients and that higher values of t-Tau and p-Tau CSF levels, as well as the existence of the AD CSF profile, are associated with more severe memory impairment in the study patients. In conclusion, our study has confirmed that amyloid pathology and AD-co-pathology are rather common in iNPH patients and that CSF markers of AD pathology and t-Tau are associated with a worse memory decline in these patients. [ABSTRACT FROM AUTHOR]

Background: Depressive syndrome (DS) and cognitive impairment (CI) are associated with unsuccessful aging. However, little is known about Cameroon. This study aimed to assess the factors associated with DS and CI among older adults in Cameroon. Methods: A representative sample of 599 individuals aged ≥ 60 years was selected for this cross-sectional study. Sociodemographic and health data were also collected. DS and CI were assessed using the Center for Epidemiologic Studies-Depression Scale (CES-D) and Mini-Mental State Examination (MMSE), respectively. The Rosow Mobility Scale, Activities of Daily Living (ADL), and Instrumental Activities of Daily Living (IADL) scales were used to evaluate functional abilities. Chi-2, ANOVA, and multiple regression analyses were performed to assess the factors associated with DS and CI. The threshold of statistical significance was 5 %. Results: The average age was 68.9 ± 7.2 years, sex ratio M/F = 0.93, and weight 68.5 ± 14.7 kg. DS affected 14.5 % of the population and the CI was 21.4 %. In the multivariate analysis, DS was positively associated with male gender (Odds Ratio (OR) = 1.7 [95 % Confidence Interval (CI):1.1–2.7], p = 0.031) and inactivity (OR = 1.7 [95 % CI:1.0–3.0], p = 0.043). CI was positively associated with lack of education (OR = 6.5 [95 % CI:3.5–12.2], p < 0.001), inactivity (OR = 5.3 [95 % CI:1.6–17.9], p = 0.008), single (OR = 3.7 [95 % CI:1.2–11.3], p = 0.023), and widowhood (OR = 3.3 [95 % CI:1.6–6.5], p = 0.001), and negatively associated with no IADL (OR = 0.3 [95 % CI:0.2–0.6], p = 0.001) and ADL disability (OR = 0.5 [95 % CI:0.2–0.9], p = 0.032) limitations. Conclusions: The associated factors suggest that it might be of interest to fight inactivity and encourage early and long-term education to prevent DS and/or CI among older adults.

Objective This study aims to explore the current cognitive status and identify risk factors associated with cognitive function in Tibetan hypertensive patients living at various altitudes.Methods The Simple Mental Status Scale (MMSE) was used to evaluate the cognitive function of 611 Tibetan hypertensive patients at various altitudes in Gannan Tibetan Autonomous Prefecture. Afterward, we conducted an analysis to identify the factors influencing their cognitive function.Results The study found that the prevalence of cognitive dysfunction was 22.3%, with a higher incidence at high altitude (group D 29.0%) compared to low altitude (group A 16.0%). The study conducted a binary logistic regression analysis to identify the risk factors for cognitive dysfunction. The analysis revealed that altitude, age, body mass index, marital status, education, income level, and blood pressure control level were all significant risk factors. After controlling for age, body mass index, marital status, educational level, income level, and blood pressure control level, the risk of developing cognitive dysfunction was 2.773 times higher (p

Cognitive impairment affects over one billion people globally, with elderly individuals in institutions in China being particularly impacted. This study involved 60 elderly participants with mild cognitive impairment, who were randomly assigned to one of two groups: 30 in a control group receiving traditional programs from the elderly institution and 30 in an intervention group receiving socio-therapeutic methods. Cognitive function was assessed before the intervention, and at the end of the first, second, and third months (with unsupervised interventions in the third month). Initially, both groups had similar low MMSE scores. However, the socio-therapeutic intervention led to significant cognitive improvements in the intervention group after the first and second months, with results remaining higher than the control group by the end of the third month. The study highlights the effectiveness of socio-therapeutic interventions in enhancing cognitive function and suggests that such programs should be adopted in elderly care institutions. Further research is needed to explore long-term effects and optimal program components, with personalized interventions and family/community involvement recommended to maximize benefits.

Recently, cell-free (CF) architectures, in which every user can potentially communicate with every base station, have received a lot of attention. This paper considers the uplink of fully and partially centralized CF networks where unmanned aerial vehicles serve as flying base stations (FBSs). A subset of FBSs participates in the reception of each user and a subset of users is received by each FBS. Deterministic equivalent expressions, exact asymptotically in the subset sizes and approximate for finite dimensions thereof, are derived for the spectral efficiency under Rician fading. Capitalizing on these expressions, the FBS deployment problem is investigated for different receiver architectures. The nonconvex deployment problem, tackled through a combination of gradient-based and Gibbs sampling algorithms, results in a superior performance with respect to a square grid deployment; this superiority extends to the minimum and aggregate spectral efficiency for both fully and partially centralized cell-free networks.

Objectives Methods Results Conclusions This study aims to assess and contrast cognitive and psychological aspects of patients with burning mouth syndrome (BMS‐MCI) and geriatric patients (G‐MCI) with mild cognitive impairment, focusing on potential predictors like pain, mood disorders, blood biomarkers, and age‐related white matter changes (ARWMCs).The study enrolled 40 BMS‐MCI and 40 geriatric G‐MCI, matching them by age, gender, and educational background. Participants underwent psychological, sleepiness, and cognitive assessment including the Mini‐Mental State Exam (MMSE), Trail Making Test (TMT), Corsi Block‐Tapping Task, Rey Auditory Verbal Learning Test, Copying Geometric Drawings Test, Frontal Assessment Battery, and Digit Cancellation Test.G‐MCI patients exhibited higher ARWMCs scores in right (p = 0.005**) and left (p < 0.001**) temporal regions, which may relate to specific neurodegenerative processes. Conversely, BMS‐MCI patients showed higher levels of depression and anxiety and lower MMSE scores(p < 0.001**), also struggling more with tasks requiring processing speed and executive function, as evidenced by their higher TMT‐A scores (p < 0.001**).The study highlights particular deficits in global cognition and processing speed for BMS‐MCI. The influence of educational background, pain levels, cholesterol, sleep disturbances, and anxiety on these cognitive assessments underscores the need for personalized therapeutic strategies addressing both cognitive and emotional aspects of MCI. [ABSTRACT FROM AUTHOR]

The Mini-Mental State Examination (MMSE) is widely used for dementia screening. The purpose of this study was twofold. First, to cross-culturally adapt the Moroccan Arabic version of MMSE (MA-MMSE) to screen dementia among literate and illiterate elderly Moroccans, and second to analyze its psychometric properties. The MA-MMSE was administered to 80 elderly patients, 28 were females and 52 were males. Among all the participants, 22 showed evidence of dementia. Receiver Operator Characteristic (ROC), internal consistency, and test–retest reliability were investigated. The test–retest reliability was assessed by Spearman correlation analysis. Cronbach's α coefficients for internal consistency between total scores and subscores of the test were calculated. Areas under the ROC curve in literate and illiterate elderly Moroccans participants corresponded to 0.932 and 0.936, respectively. The cutoff point of 21/22 on the MA-MMSE in literate elderly had the highest sensitivity (85.7%), specificity (94.7%), and a positive likelihood ratio of (16.29%), whereas the cutoff point of 18/19 of the screening test in illiterate elderly yielded the highest sensitivity (92.9%), specificity (95.0%), and a positive likelihood ratio of (18.57%). The Cronbach's α values of the MA-MMSE for literate and illiterate elderly Moroccans were higher than 0.7. Thirty subjects were randomly selected for participation in the test–retest protocol. Participants were retested after an interval of 4–6 weeks. The test–retest reliability for total scores was significant 0.78 (p < 0.01). The findings provide preliminary evidence that the MA-MMSE is a feasible instrument for dementia screening. [ABSTRACT FROM AUTHOR]

The Mini-Mental State Examination (MMSE) is a long-established test to screen for dementia, estimate the severity and monitor the progression of cognitive impairment. The MMSE total score is dependent upon demographic factors, particularly education, but little is known about how education influences the 6 distinct MMSE cognitive domains. The present study aims to understand how the performances in the MMSE cognitive domains reflect clinical diagnosis and educational level. The study recruited 1043 participants, comprising 388 healthy controls, 360 patients with Mild Cognitive Impairment (MCI) and 295 patients with dementia. The association of the MMSE cognitive domains scores with clinical diagnosis (healthy, MCI, dementia) and educational level (primary education, middle school, high school and university/college) was analyzed with a multivariate ordinal regression model. The scores in all MMSE domains were generally higher in healthy controls as compared to patients with MCI, and higher in these as compared to patients with dementia. The MMSE domain Constructional ability was associated to the education level, the domains Orientation, Recall and Language were associated to diagnosis, Attention and calculation was associated to both education level and diagnosis, and Registration was not associated to either education or diagnosis. In conclusion, impairment in specific MMSE domains pinpoints cognitive decline, probably indicating brain areas affected by neurodegeneration, and impairment in others reflects lower education levels and the lack of acquisition of relevant schooling abilities. [ABSTRACT FROM AUTHOR]

Several speech enhancement techniques like Spectral Subtraction, MMSE, Log-MMSE, $ \rm beta $ β -order MMSE, adaptive $ \rm beta $ β -order MMSE and compressive sensing methods are developed worldwide. Scientists, engineers and researchers have implemented, evaluated and tested all methods individually with the different speech corpus. However, we found few articles on comparative studies of various speech enhancement techniques. In the present paper, several speech enhancement techniques have been studied, and their performance in terms of speech quality measures is compared objectively and subjectively. The results have been evaluated not only through speech quality measures but also in terms of waveform and spectrogram for speech enhancement applications. For this, MATLAB is used for the simulation of all methods. After getting the enhanced speech signals, we evaluated their enhanced speech signals of the methods. Results in terms of objective evaluation parameters indicated that the adaptive $ \rm beta $ β -order MMSE-based method produces good-quality speech signals compared to the other methods. Also, we evaluated their enhanced speech signals using a listening test, i.e. subjective evaluation. In the subjective quality test through mean opinion score (using the listening test), the performance of the adaptive $ \rm beta $ β -order MMSE method and GOMP are equal. In the case of waveform and spectrogram, the visualisation of enhanced speech signal obtained from GOMP-based compressive algorithms is very close to clean speech signal. [ABSTRACT FROM AUTHOR]

A small set of pilots in underwater acoustics OFDM (UWA-OFDM) systems tends to be insufficient for recovering the channel impulse response (CIR). This may result from the fast changes in the propagation environment and the requirement for high transmission data rates. A previous work, namely PE, considered the received subcarriers whose distances to their closest constellation points below the predetermined threshold T as potential pilots. However, extracting these pilots at the same time gives no chance to use some of them to facilitate searching for others. Fixing threshold T is also another limitation for searching pilot candidates. This paper proposes a reliable pilot search (RPS) method that consists of a multi-iterations pilot searching process with an adaptive threshold T a to improve the estimator in UWA-OFDM. The pilot search process gradually extracts reliable pilots at each iteration based on the threshold T a and evaluates them by performing channel estimation. Our method is compared to the MMSE and PE estimators on a wide range of settings, including the number of channel taps, pilot spacing, and various modulation schemes (i.e., MPSK and MQAM). The experimental results show that the RPS method often outperforms the MMSE and PE methods in terms of bit error rate (BER). [ABSTRACT FROM AUTHOR]

Background: Mini-Mental State Exam (MMSE) is widely used for the cognitive assessment in Alzheimer's disease (AD), but its interpretation could be affected by acute medical conditions, depression, or anxiety. Conversely, brain magnetic resonance imaging (MRI) is an independent diagnostic tool to evaluate specific cerebral pathology. Many studies have investigated the correlation between MRI visual scales such as hippocampal atrophy and baseline MMSE in AD patients. However, the correlation between a comprehensive MRI visual scale and baseline MMSE in people with AD remains less well known. Method: We retrospectively collected records of outpatients diagnosed with probable AD according to DSM -5 criteria. The comprehensive visual rating scale (CVRS) was used to semiquantitatively measure structural changes and vascular lesions. The relationship between MRI changes and baseline MMSE was evaluated using Bayesian model averaging (BMA). Results: A total of 65 patients, among whom 21 (32.31%) had early-onset AD, were included. Lateral temporal atrophy, level of education, and late age at onset were the strongest independent predictors of baseline MMSE. Furthermore, hippocampal atrophy was only correlated with delayed recall, while temporal atrophy was correlated with orientation, attention, language, and visual-spatial items of the MMSE. The cerebral atrophy and small vessel lesions scores of the late-onset AD group were significantly higher than those of the early-onset group, despite negligible differences in education and MMSE. Conclusion: Our study suggests lateral temporal atrophy correlates with baseline MMSE scores in people with AD better than the hippocampal atrophy. Age-related atrophy and silent small vessel disease lesions may have negligible impact on AD patients' cognitive impairment. [ABSTRACT FROM AUTHOR]

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Context There is a high prevalence of vitamin D deficiency and impaired cognitive function in people with type 2 diabetes mellitus (T2DM). Objective To critically and systematically review the literature on the association between vitamin D status and cognitive performance in people with type 2 diabetes. Data Sources This review was conducted according to PRISMA recommendations. MEDLINE, SCOPUS, the Cochrane Library, and Web of Science databases were searched using the terms "Diabetes Mellitus, Type 2", "Cognitive Function", and "Vitamin D". Data Extraction Eight observational and 1 randomized study were included, containing data of 14 648 adult and elderly individuals (19–74 y). All extracted data were compiled, compared, and critically analyzed. Data Analysis There is no strong evidence that lower serum concentrations of vitamin D and vitamin D–binding protein are associated with worsening cognitive function in individuals with T2DM. Vitamin D supplementation (12 wk) improved the scores of some executive functioning tests, although there was no difference between low doses (5000 IU/wk) and high doses (50 000 IU/wk). Conclusions There is no high-quality evidence demonstrating an association between vitamin D status and cognitive function, or clinical benefits on cognition from vitamin D supplementation in individuals with T2DM. Future studies are needed. Systematic Review Registration: PROSPERO registration no. CRD42021261520. [ABSTRACT FROM AUTHOR]

Deficits in the neuroendocrine-immune network in the periphery associated with the onset and progression of mild cognitive impairment (MCI) and Alzheimer's disease (AD) have not been extensively studied. The present study correlatively examines the association between cell-mediated immune responses, stress hormones, amyloid precursor protein (APP) expression, peripheral blood mononuclear cells (PBMC), and intracellular signaling molecules in the pathophysiology of MCI and AD compared to adults. Serum APP, lymphocyte proliferation, total cholinesterase (TChE), butyrylcholinesterase (BChE) activities, cytokines (IL-2, IFN-γ, IL-6, and TNF-α), and intracellular signaling molecules (p-ERK, p-CREB, and p-Akt) were measured in the PBMCs of adult, old, MCI, and AD men and women initially and after 3 years in the same population. An age- and disease-associated decline in mini-mental state examination (MMSE) scores and lymphocyte proliferation of MCI and AD men and women were observed. An age- and disease-related increase in serum APP, cortisol levels, and TChE activity were observed in men and women. Enhanced production of Th1 cytokine, IL-2, pro-inflammatory cytokines, and suppressed intracellular transcription factors may promote the inflammatory environment in MCI and AD patients. The expression of CREB and Akt was lower in MCI and AD men, while the expression of p-ERK was higher, and p-CREB was lower in MCI and AD women after 3 years. These results suggest that changes in specific intracellular signaling pathways may influence alterations in cell-mediated immunity to promote disease progression in MCI and AD patients. [ABSTRACT FROM AUTHOR]

Purpose: Prediction of postoperative outcome following major surgery in elderly patients requires a decision-making process based on data on cognitive function, functional status and frailty. In this study, we aimed to evaluate the predictive value of these parameters for minor surgeries. Materials and Methods: Patients aged ≥65 years with American society of Anesthesiologists (ASA) score 1-3 scheduled for elective minor surgery were included in the study. Mini Mental Test (MMSE), Barthel Index (BI) and Clinical Frailty Scale (CSHA-CFS) were used to assess cognitive function, functional status and frailty at hospitalization. The associations of these parameters with postoperative hospitalization status were evaluated. Results: Ninety-nine patients were included in the study. MMSE scores, Barthel Indices and CSHA-CFS scores were similar in all groups. The number of inpatients was higher in patients with MMSE2 (n=19 (82.6%)). The number of inpatients was higher in patients with a frailty score of CSHA-CFS≥4 (n=33 (75%)) (p=0.025) or ASA >2 (n=20 (83.3%)) (p=0.023). Patients with ASA>2 were more likely to have >1 day length of stay (LOS) (p=0.036) and intensive care unit (PACU) stay (p=0.042), independent of the frailty score. Readmission within 30 days was not correlated with the parameters. Conclusion: ASA>2 and MMSE

Latar belakang: troke merupakan penyakit neurologis yang menyerang otak secara langsung. Stroke menjadi penyebab kematian dan kecacatan nomor dua di dunia. Kecacatan dapat terjadi tidak hanya pada fungsi motorik dan sensorik, tetapi juga dapat terjadi gangguan pada fungsi kognitif yang terjadi akibat adanya perkembangan Cerebral Small Vessel Disease. Penelitian ini bertujuan untuk mengetahui gambaran fungsi kognitif pada pasien pasca stroke di poliklinik neurologi RS Otak Dr. Drs. M. Hatta Bukittinggi berdasarkan karakteristik, fungsi kognitif, dan distribusi frekuensi gangguan fungsi kognitif pada pasien pasca stroke iskemik dan stroke hemoragik. Objektif: Penelitian ini merupakan penelitian deskriptif yang dilakukan di RS Otak Dr. Drs. M. Hatta Bukittinggi pada tahun 2022. Sampel diambil dengan menggunakan teknik consecutive sampling dengan total berjumlah 65 subjek. Sampel penelitian ini adalah pasien pasca stroke di Poliklinik Neurologi RS Otak Dr. Drs. M. Hatta, Bukittinggi. Sampel diambil dengan data primer menggunakan MMSE dan data sekunder dari rekam medis pasien. Hasil: Penelitian ini menunjukan dari 65 sampel didapatkan 53 pasien iskemik dan 12 pasien hemoragik dengan fungsi kognitif normal pasien iskemik 37,7% dan iskemik 33,3%, gangguan kognitif ringan pasien iskemik 37,7% dan pasien hemoragik 33,3%, dan gangguan kognitif berat pasien iskemik 24,5% dan hemoragik 33,3%. Kesimpulan: Penelitian ini mendapati hasil kejadian stroke iskemik lebih banyak daripada stroke hemoragik. Hasil karakteristik pasien pasca stroke ditemukan variatif karena perbedaan tingkat keparahan dan faktor risiko. Ditemukan frekuensi tingkat gangguan fungsi kognitif terbanyak pada pasien tanpa gangguan kognitif dan ringan. Kata kunci: fungsi kognitif, stroke, iskemik, hemoragik, MMSE

Background. Dementia has emerged as a significant contributor to declining quality of life and stands as a prominent factor in the increase of disability and dependency among elderly populations globally. This study aimed to explore the relationship between cognitive symptoms of dementia and their risk factors in individuals aged 60 years and older among Vietnamese outpatients who visited Geriatrics Clinic at University Medical Center of Ho Chi Minh city, Vietnam. Methods. 387 participants who were aged ≥ 60 years old were included in the cross-sectional study. Cognitive impairment was assessed by using the Mini Mental State Evaluation (MMSE) questionnaire. The functional limitations in activities of daily living (ADL) and Instrumental Activities of Daily Living (IADL), multimorbidity, and polypharmacy were also evaluated. Frailty was determined by The Canadian Study of Health and Aging Clinical Frailty Scale. Suffering dementia was determined when MMSE score was below 24 and IADL score less than 8. Results. People with dementia cognitive symptoms accounted for 22.74 % of the cohort. The percentage increased with age, and was higher in women than in men. Factors that increased the odds of having dementia symptoms were of older age, female, multimorbidity, Frailty Scale > Grade 4 and ADL dependency. Conclusions. Age, female gender, multimorbidity, frailty and ADL dependency were considered as risk factors of dementia cognitive symptoms among the Vietnamese people aged 60 years and older.

Abstract Background Parkinson's disease (PD) is a chronic progressive neurodegenerative disabling disease and involves about 1–3% of the worldwide population over the age of 60. A significant prevalence of psychopathological symptoms has been recorded as most patients with PD developed over their disease course neuropsychiatric symptoms such as depression, anxiety, sleep disorders, psychosis, and cognitive and behavioral abnormalities. These non-motor symptoms, which could appear decades before motor ones, become disturbing symptoms during the later phases of the disease. Hence, the current research aims to study depressive symptoms in Parkinson's disease patients. Thirty-six patients with Parkinson’s disease aged from 40 to 65 years (20 males and 16 females) and 36 age and sex-matched controls (19 males and 17 females) were included in the study. Unified Parkinson’s Disease Rating Scale (UPDRS), Hoehn and Yahr scale, Schwab and England’s scale, Mini-Mental State Examination, Cognitive Ability Screening Instrument, and Hamilton Depression Rating Scale were applied to assess depression in both groups. Results Patients were 20 males and 16 females (mean age 52.44 ± 7.45), mean duration of Parkinsonism was 3.88 years. The mean value for Hoehn and Yahr scale was 1.97 ± 1.42, for UPDRS T was 42.41 ± 20.91 and Schwab England's scale was 74.77 ± 17.78. Concerning cognition, MMSE was significantly lower among patients 25.33 ± 3.63, than in the control group and CAS total was significantly lower in patients (16 ± 71.35) than in the control group 9.81 ± 84.62. Conclusion Depressive symptoms are widespread in Parkinson's disease. Depression should be strictly determined and addressed, particularly in patients with more advanced cognitive impairment who are at a higher risk of developing or worsening depression.