Search Results (402)

Background/Objectives: Early identification of preclinical Alzheimer’s disease (AD) is critically important. This study investigates whether early cognitive decline in preclinical AD can be detected through the executive functioning index R4Alz-pc by predicting memory-related worry and negative affect. Methods: A sample of 105 cognitively healthy, community-dwelling older adults (M = 59.25 years) completed the Multifactorial Memory Questionnaire (MMQ) and the R4Alz-pc index battery. Results: Lower performance on the R4Alz-pc index was significantly associated with increased negative affect related to memory. Mediation analysis indicated that memory-related worry mediated the relationship between executive dysfunction and negative affect. Conclusions: This study highlights the importance of early, objective cognitive assessment using easy-to-administer and non-invasive tools like the R4Alz-pc, enabling timely detection and intervention for preclinical AD. Such methods may reduce reliance on costly biomarker-based diagnostics. Full article

Background: COVID-19 has been associated with multisystemic sequelae, including persistent neurocognitive impairment and emerging metabolic alterations. Growing evidence suggests that glial dysfunction and inflammation may play a pivotal role in both cognitive decline and new-onset diabetes following SARS-CoV-2 infection. Objectives: This study aimed to assess the prevalence and characteristics of cognitive impairments in post-COVID-19 patients and to explore their correlation with new-onset diabetes, neuroanatomical changes, and psychological symptoms, with a specific focus on gender differences. Methods: A total of 245 patients (mean age 56.8 ± 12 years), previously diagnosed with COVID-19, were enrolled between April 2021 and August 2023. Participants underwent a comprehensive neuropsychological assessment (MMSE, Rey-Osterrieth Figure, FAB, Hamilton, STAI, IES-R), structured interviews, and, in a subset, brain MRI. Individuals with pre-existing neurological disorders were excluded. Data were analyzed for cognitive performance, neuroimaging abnormalities, and metabolic outcomes, including new-onset diabetes. Results: Cognitive dysfunction was identified in 87% of participants: mild in 47%, moderate in 21.6%, and severe in 10.8%. Glial alterations on MRI were observed in 51%, hippocampal atrophy in 9%, and temporal lobe reduction in 4%. Notably, 12% of patients developed new-onset diabetes post-COVID, of whom 80% exhibited mild to moderate cognitive deficits. Depressive symptoms were present in 80.9%, and anxiety in 93.5%, with significantly higher incidence in female patients. PTSD symptoms correlated with greater cognitive impairment. Ongoing research into the mechanisms underlying these persistent cognitive impairments in subjects with and without types 1 and 2 diabetes. This paper presents the final data of the research published in the previous article referenced in the bibliography. Conclusions: This study highlights a significant association between cognitive decline and new-onset diabetes in post-COVID patients, likely mediated by systemic inflammation and glial dysfunction. Particularly noteworthy are the findings of neuroanatomical alterations, including nonspecific glial signal changes, hippocampal atrophy, and temporal lobe volume reductions, suggesting post-infectious cerebral vulnerability with potential long-term consequences. These results support the need for integrating cognitive screening, brain neuroimaging, and metabolic monitoring into post-COVID care pathways—especially for women and individuals presenting with anxiety or depressive symptoms. An early and interdisciplinary approach is essential to address the neuro-metabolic and cerebral sequelae of long COVID. Full article

Cognitive decline among older people is a growing concern worldwide since it impacts quality of life and independence. Recently, we reported that an epicatechin-enriched product improves cardiometabolic status, physical performance/mobility, and quality of life (QoL) in over-60-year-old subjects. Here, we explored the effects of an (−)-epicatechin-enriched cacao supplement on the cognitive conditions of older and sedentary individuals residing in a community center. Twelve persons with the inclusion criteria were included in this proof-of-concept study. We evaluated reasoning, memory, attention, coordination, and perception using CogniFit software, version 4.6.18. Patients received a mixture of cacao flour and 15 mg of free (−)-epicatechin twice daily for 3 months. The main results from the trial suggested a positive and significant improvement in perception, coordination, reasoning, attention, and memory. Full article

Pain is a fundamental yet complex biological and psychosocial phenomenon. While acute pain serves as a defense mechanism, alerting the body to potential tissue damage, chronic pain loses this protective function and becomes a persistent, independent condition. Chronic pain in the elderly is particularly significant due to age-related changes in pain perception, a higher prevalence of comorbidities, and an increased susceptibility to pharmacological side effects. Diagnosing pain in older adults presents unique challenges owing to cognitive decline, multimorbidity, and impaired communication. This narrative review aims to summarize the current knowledge on chronic pain in the elderly, with a particular emphasis on diagnostic difficulties, therapeutic strategies, and the essential role of nurses in multidisciplinary management. Both objective scales and subjective assessment tools are essential for an accurate evaluation. Effective management requires a multidisciplinary approach that integrates individualized pharmacological and non-pharmacological therapies. Analgesic use must be tailored to account for altered pharmacokinetics and risks such as sedation or falls. Non-drug interventions, including physiotherapy and psychological techniques, are especially valuable in geriatric care. Nurses play a pivotal role in the recognition, assessment, and ongoing management of pain in this population. Developing age-appropriate, personalized strategies is essential for improving the quality of life in older adults living with chronic pain. Full article

Background/Objectives: Levels of lipopolysaccharide (LPS), arachidonic acid (AA), and advanced glycation end products (AGEs) are higher in the brain of subjects affected by cognitive impairment and Alzheimer’s disease (AD), compared to a healthy brain. Methods: In this narrative review, articles were selected with data on these three key dietary compounds relevant to neuroinflammation and cognitive impairment in order to provide practical dietary advice to reduce the risk of diseases affecting cognition. Results: Triggered by LPS and AGEs in food, inflammatory cytokines can enter the brain and stimulate microglial activation, inflammation, and oxidative damage. AA can elicit neuroinflammation by increasing leukotriene-A4 and prostaglandin-E2 production. Increased levels of neuroinflammation are associated with poorer cognition in AD. Discussion: A dietary reduction of LPS, AA, and AGEs could slow progression and reduce the risk of cognitive impairment and AD by reducing neuroinflammation through several mechanisms. The avoidance of foods that are highest in LPS, AGEs, and AA (dairy products, pork, poultry, beef, and seafood) and the emphasis on foods lowest in LPS, AGEs, and AA (fruits, vegetables, boiled whole grains, beans, raw nuts, and seeds) can reduce neuroinflammation and risk of cognitive impairment and AD. Conclusions: Reduction of chronic neuroinflammation with dietary changes may represent a novel approach to the treatment of AD and cognitive decline. Full article

Alzheimer’s disease (AD) is the most common cause of cognitive decline. Among the various susceptibility genes, the gene of apolipoprotein E (APOE) is probably the most important. It may be present in three allelic forms, termed ε2, ε3 and ε4, and the most common genotype is the ε3/ε3. Recently, it has been observed that subjects with the ε4/ε4 genotype may show near-full penetrance of AD biology (pathology and biomarkers), leading to the suggestion that ε4 homozygosity may represent a distinct genetic type of AD. The aim of the present study was to investigate the role of ε4 homozygosity or heterozygosity in the presence or absence of the AD biomarker profile in patients with cognitive disorders in the Greek population. A total of 274 patients were included in the study. They underwent APOE genotyping and cerebrospinal fluid (CSF) biomarker profiling. The presence of ε4 was associated with a lower age of symptom onset and decreased amyloid biomarkers (irrespective to AD or non-AD profiles), and predicted the presence of an AD profile by a positive predictive value approaching 100%. In conclusion, the ε4 allele has a significant effect on the risk and clinical parameters of cognitive impairment and AD in the Greek population, while the ε4/ε4 genotype may be highly indicative of the (co)existence of AD in cognitively impaired patients. Full article

Alzheimer’s Disease and Dementia (ADD) progresses along a continuum of cognitive decline, typically from Subjective Cognitive Impairment (SCI) to Mild Cognitive Impairment (MCI) and eventually to dementia. While many studies have focused on classifying these clinical stages, fewer have examined whether brain connectomes encode this continuum in a low-dimensional, interpretable form. Motivated by the hypothesis that structural brain connectomes undergo complex yet compact changes across cognitive decline, we propose a Graph Neural Network (GNN)-based framework that embeds these connectomes into a two-dimensional manifold to capture the evolving patterns of structural connectivity associated with cognitive deterioration. Using attention-based graph aggregation and Principal Component Analysis (PCA), we find that MCI subjects consistently occupy an intermediate position between SCI and ADD, and that the observed transitions align with known clinical biomarkers of ADD pathology. This hypothesis-driven analysis is further supported by the model’s robust separation performance, with ROC-AUC scores of 0.93 for ADD vs. SCI and 0.81 for ADD vs. MCI. These findings offer an interpretable and neurologically grounded representation of dementia progression, emphasizing structural connectome alterations as potential markers of cognitive decline. Full article

This study investigated the effects of a single-night sleep extension protocol on physical performance and cognitive function in physically active university students across different times of day. Using a within-subjects, counterbalanced crossover design, 24 physically active university students (17 males, 7 females; age: 22.7 ± 1.6 years) completed performance assessments under normal-sleep and sleep-extension conditions. Participants’ sleep was monitored via wrist actigraphy, and a comprehensive assessment battery comprising vertical jumps, Y-Balance tests, medicine-ball throws, 5 m shuttle-run tests, reaction-time tests, and digit-cancellation tests was administered at baseline (8 PM), morning (8 AM), and afternoon (4 PM). Sleep extension increased total sleep time by approximately 55 min (531.3 ± 56.8 min vs. 476.5 ± 64.2 min; p < 0.001, d = 0.91). Significant improvements were observed in 5 m shuttle-run performance at 8 AM (best distance: 102.8 ± 11.9 m vs. 93.3 ± 8.5 m, p < 0.001, d = 0.93; fatigue index: 13.1 ± 8.3% vs. 21.2 ± 9.5%, p < 0.001, d = 0.90), squat-jump heights (28.2 ± 8.0 cm vs. 26.3 ± 7.2 cm, p = 0.005, d = 0.25), simple reaction time (252.8 ± 55.3 ms vs. 296.4 ± 75.2 ms, p < 0.001, d = 0.66), and digit-cancellation performance (67.6 ± 12.6 vs. 63.0 ± 10.0 targets, p = 0.006, d = 0.40). Sleep extension significantly enhances both physical and cognitive performance in physically active individuals, with effects more pronounced during morning hours, partially attenuating typical circadian performance decline and establishing sleep extension as an effective, non-pharmacological strategy for optimizing performance capabilities. Full article

Background/Objectives: Aging is often accompanied by physical and cognitive decline, affecting older adults’ mobility. Virtual reality (VR) offers innovative opportunities to safely practice everyday tasks, such as street crossing. This study was designed as a feasibility and pilot study to explore acceptance, usability, and preliminary effects of a VR-based road-crossing intervention for older adults. It investigates the use of virtual reality (VR) as an innovative training tool to support senior citizens in safely navigating everyday challenges such as crossing roads. By providing an immersive environment with realistic traffic scenarios, VR enables participants to practice in a safe and controlled setting, minimizing the risks associated with real-world road traffic. Methods: A VR training application called “Wegfest” was developed to facilitate targeted road-crossing practice. The application simulates various scenarios commonly encountered by older adults, such as crossing busy streets or waiting at traffic lights. The study applied a single-group pre-post design. Outcomes included the Timed Up and Go test (TUG), Falls Efficacy Scale-International (FES-I), and Montreal Cognitive Assessment (MoCA). Results: The development process of “Wegfest” demonstrates how a highly realistic street environment can be created for VR-based road-crossing training. Significant improvements were found in the Timed Up and Go test (p = 0.002, d = 0.784) and fall-related self-efficacy (FES-I, p = 0.005). No change was observed in cognitive function (MoCA, p = 0.56). Participants reported increased subjective safety (p < 0.001). Discussion: The development of the VR training application “Wegfest” highlights the feasibility of creating realistic virtual environments for skill development. By leveraging immersive technology, both physical and cognitive skills required for road-crossing can be effectively trained. The findings suggest that “Wegfest” has the potential to enhance the mobility and safety of older adults in road traffic through immersive experiences and targeted training interventions. Conclusions: As an innovative training tool, the VR application not only provides an engaging and enjoyable learning environment but also fosters self-confidence and independence among older adults in traffic settings. Regular training within the virtual world enables senior citizens to continuously refine their skills, ultimately improving their quality of life. Full article

Parkinson’s Disease (PD) is a progressive neurodegenerative disorder marked by motor and non-motor symptoms, including cognitive decline, mood disturbances, and sensory deficits. While dopaminergic treatments remain the gold standard, they present long-term side effects and limited impact on non-motor symptoms. Transcranial Pulse Stimulation (TPS) has emerged as a promising adjunct therapy in neurological and psychiatric conditions, but its effects in PD remain underexplored. This open-label, single-arm trial protocol involves 14 PD participants and outlines a personalized 12-session treatment approach combined with a homogeneously distributed TPS intervention among patients with PD. The approach addresses the subject’s most prominent symptoms, as identified through validated clinical assessments, encompassing domains related to both motor and non-motor symptoms. Over 2.5 months, besides the intervention sessions, the 14 participants will undergo an MRI brain scan, a baseline assessment, a post-treatment assessment, and a 1-month follow-up assessment. The study aims to determine whether personalized TPS is a feasible and safe intervention and whether it improves PD symptoms across multiple functional domains. This study represents the first structured attempt to evaluate a multimodal, personalized TPS intervention in patients with PD. It addresses gaps in current treatment approaches and may support the development of future strategies for integrated, symptom-targeted neuromodulation. Full article

Background and Objectives: Early detection of cognitive decline (CD) is crucial for managing dementia risk factors and preventing disease progression. This study pursues two main objectives: (1) to review existing cognitive screening practices implemented in community pharmacy settings and (2) to characterize the cognitive profile of individuals eligible for screening in this context. Materials and Methods: This study was conducted in two phases. First, a scoping review of cognitive screening tools used in community pharmacies was carried out following PRISMA-ScR guidelines. Second, a cross-sectional study was performed to design and implement a CD screening protocol, assessing cognitive function. Data collection included demographic and clinical variables commonly associated with dementia risk. Decision tree analysis was applied to identify key variables contributing to the cognitive profile of patients eligible for screening. Results: The scoping review revealed that screening approaches differed by country and population, with limited pharmacy involvement suggesting implementation barriers. Cognitive screening was conducted in 18 pharmacies in Valencia, Spain (1.45%), involving 286 regular users reporting Subjective Memory Complaints (SMC). The average age of participants was 71 years, and 74.8% were women. According to the unbiased Gini impurity index, the most relevant predictors of CD—based on the corrected mean decrease in corrected impurity (MDcI), a bias-adjusted measure of variable importance—were age (MDcI: 2.60), internet and social media use (MDcI: 2.43), sleep patterns (MDcI: 1.83), and educational attainment (MDcI: 0.96). Simple decision trees can reduce the need for full screening by 53.6% while maintaining an average sensitivity of 0.707. These factors are essential for defining the profile of individuals who would benefit most from CD screening services. Conclusions: Community pharmacy-based detection of CD shows potential, though its implementation remains limited by issues of consistency and feasibility. Enhancing early dementia detection in primary care settings may be achieved by prioritizing individuals with limited internet and social media use, irregular sleep patterns, and lower education levels. Targeting these groups could significantly improve the effectiveness of CD screening programs. Full article

Background: The ageing process is associated with a decline in cognitive functions, including eye–hand coordination, attention concentration, and psychomotor reaction time. This study aimed to assess the effectiveness of virtual reality–based therapy in enhancing cognitive functions in seniors. Methods: This study was conducted on 38 cases (29 women and 9 men) with a mean age of 87.2 years, who were divided into two groups: a VR group (with a 4-week, three-time-week training program using the game “Beat Saber”) and a control group (with a standard 4-week exercise program). Assessments of eye–hand coordination and attentional concentration were conducted at the beginning (T₀) and the end (T₁) of the training. Results: Analysis of eye–hand coordination and attentional concentration showed significant improvement in both groups (T₀ vs. T₁: p = 0.0002 for the intervention group and p = 0.007 for the control group). However, the effect in the VR group was almost three times greater than in the control group (1.689 vs. 0.615 in D effect). Moreover, in the VR group, an analysis of “good cuts” indicated improvements in both parameters after 4 weeks of VR training. The percentage of correctly received stimuli increased significantly across sessions (p < 0.00001). Furthermore, 84.3% of participants experienced a twofold improvement in performance over the 12 VR sessions (42% vs. 80% accuracy in successful hits). The distribution of results also suggests a positive subjective impact of VR therapy in maintaining mental activity. Conclusions: The findings indicate that VR-related training can support elderly individuals in recovering cognitive function, potentially enhancing their independence and life quality. Full article

Background/Objectives: Cognitive impairment and vestibular dysfunction commonly co-occur in older adults and may share overlapping neuroanatomical pathways. Understanding their association may enhance the early identification of cognitive decline using clinically feasible vestibular assessments. This study aimed to examine the relationship between vestibular dysfunction and early cognitive impairment, assess the diagnostic accuracy of vestibular markers, and explore the association of subjective dizziness and balance measures with cognitive performance. Methods: Our cross-sectional study included 90 participants aged ≥60 years, classified into cognitively healthy, mild cognitive impairment (MCI), and early Alzheimer’s disease (AD) groups. Cognitive function was assessed using the MoCA and the MMSE; vestibular function was evaluated via posturography sway and horizontal vHIT gain. Subjective dizziness and balance were measured using the Dizziness Handicap Inventory (DHI), gait speed, and eyes-closed balance time. The data were analyzed using SPSS v24 with ANOVA, Pearson correlations, linear regression, and ROC curve analyses. Results: Significant group differences were found across the cognitive and vestibular scores (MoCA: p = 0.001. Sway: p = 0.001. vHIT: p = 0.001). vHIT gain and posturography sway independently predicted the MoCA and MMSE scores (adjusted R² = 0.68 and 0.65, respectively). The ROC analysis showed a strong diagnostic accuracy for posturography sway (AUC = 0.87) and vHIT gain (AUC = 0.82). Conclusions: Vestibular dysfunction is significantly associated with early cognitive impairment and may serve as a useful clinical marker for cognitive screening in older adults. Full article

Cognitive impairment in subjects with Alzheimer’s disease correlates well with the loss of synaptic plasticity. This results from mitochondrial dysfunction and production of reactive oxygen species, which damage nerve terminals causing them to release ATP and adenosine. These purines activate receptors on microglia resulting in a change in morphology and release proinflammatory cytokines that exacerbate neuronal damage. The review describes retrospective studies with naturally occurring antioxidants, vitamin E, resveratrol, Ginkgo biloba and others that suggested they reduce the incidence of Alzheimer’s disease. They have antioxidant activity in cellular systems and rodent models, but most of them failed in clinical trials, probably because they were not absorbed after oral administration or, like anti-inflammatory drugs, were not given at the right time or for long enough to detect an effect on disease progression. Ladostigil is an aminoindan derivative that is well absorbed after oral administration. It has antioxidant effects in cells and prevents cytokine release from activated microglia. In a phase 2 trial in subjects with mild cognitive impairment, ladostigil significantly reduced number of converters to Alzheimer’s disease in ApoE4-ve subjects and delayed the decline in whole brain and hippocampal volumes without causing adverse effects related to drug intake. Full article

In humans, aging is often accompanied by cognitive decline, as seen in Alzheimer’s disease. In contrast, the aging process in horses remains poorly characterized. This study aims to explore the presence of blood-based biomarkers associated with cognitive degeneration in this species. Twenty-three Arabian horses were enrolled, and 5 mL of blood was collected from each to measure serum levels of β-amyloid peptides (Aβ40 and Aβ42) and phosphorylated tau protein (pTau181), both considered reliable indicators of cognitive impairment in other species. Aβ42 was undetectable in all samples, while pTau181 ranged from 5.38 to 54.42 pg/mL and Aβ40 from 67.4 to 743.9 pg/mL. Statistical analysis of the data, performed with the non-parametric Spearman test, did not reveal any correlation between age and the concentrations of Aβ40 and pTau. The pTau/Aβ40 ratio also did not appear to be correlated with the age of the subjects. Interestingly, none of the horses exhibited behavioral changes or clinical signs suggestive of cognitive dysfunction. This absence of symptoms may be related to the undetectable levels of Aβ42, the isoform considered crucial in initiating tau phosphorylation and subsequent neurodegeneration, despite possibly being present at concentrations higher than those typically found in healthy humans. Full article