Effect of toluene on memory: A focus on humans, experimental models and treatment approaches

Advances in neurotoxicology, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 1, 2025

Language: Английский

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Association between apical periodontitis and brain inflammation: a systematic review from animals and human studies

Odontology, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 27, 2025

Language: Английский

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Dementia Medications and Their Association with Pain Medication Use in Medicare Beneficiaries with Alzheimer’s Disease/Alzheimer’s Disease-Related Dementias and Chronic Pain

Drugs & Aging, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 26, 2025

Chronic pain is prevalent among older adults with Alzheimer's disease (AD) and disease-related dementias (ADRD). Memantine acetylcholinesterase inhibitors (ACHEI; donepezil, rivastigmine, galantamine) are approved for the treatment of dementia symptoms may also have analgesic properties. However, findings on clinical utility these medications chronic mixed, little known about differences in use medication according to whether an adult AD/ADRD using medications. We selected a 20% national sample Medicare enrollees diagnosis 2020. calculated odds having any management prescription (opioids, serotonin norepinephrine reuptake, gapapentinoids, or non-steroidal anti-inflammatory drugs), opioid prescription, long-term (≥ 90 days) by (none, memantine, ACHEI, memantine ACHEI). Among 103,564 patients, 5.5% received 14.4% ACHEI 8.6% both. Over 70% all patients had prescription. The percentage who ranged from 54.5% those without 44.0% both ACHEI. Similarly, was highest (12.2%) lowest (8.8%). Having only associated lower (odds ratio [OR]: 0.94; 95% confidence interval [CI]: 0.88–1.00; p < 0.05). either (OR: 0.79; CI 0.75–0.84), 0.85; 0.82–0.89), 0.75; 0.72–0.79) (p Lastly, 0.77–0.94), 0.92; 0.86–0.98), 0.83; 0.77–0.90) Older co-occurring were being prescribed analgesics. ACHEIs should be explored as potential opioid-sparing AD/ADRD, given their relatively safe profiles. Future studies needed examine repurposing treatment.

Language: Английский

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The Effectiveness of Computerized Cognitive Training in Patients with Post-Stroke Cognitive Impairment: A Systematic Review and Meta-analysis (Preprint)

Published: Feb. 27, 2025

Stroke often triggers post-stroke cognitive impairment (PSCI) within six months, impairing memory, attention, and executive function while exacerbating physical disabilities mortality. Computerized training (CCT) is a promising treatment approach. Compared to traditional methods, CCT provides cost-effective, easily accessible, personalized repetitive rehabilitation training. Therefore, we performed systematic review of the efficacy improve in patients with PSCI supplemented findings meta-analysis. To evaluate comparison usual care or routine for PSCI, aim providing clinicians therapists more effective convenient therapeutic options. The search was conducted across multiple databases, including PubMed, Web Science, Embase, Cochrane Library, Scopus, covering publications from 2010 June 2024, focus on English-language articles. primary outcome measured function, assessed through standardized scales, secondary outcomes included daily living activities motor patients. risk bias evaluated using Risk Bias tool, quality evidence determined according GRADE framework. A total nineteen trials were meta-analysis (n = 880 participants). provided moderate high-quality indicating that significantly enhances general (15 trials, mean difference [SMD]= 0.46, 95% CI 0.21 0.71; P <.001, I2 60%), attention (11 SMD -0.41, -0.62 -0.20; 15%), (6 0.39, 0.12 0.67; =.005, 0%), life (9 0.34, 0.15 0.53; 6%). However, low very indicated has limited improvement language can enhance PROSPERO, CRD42024573594.

Language: Английский

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Lancao decoction alleviates Alzheimer’s disease: depending on activating CaMKII to protect neuronal refunction by reducing β-amyloid in the hippocampus

Journal of Ethnopharmacology, Journal Year: 2025, Volume and Issue: unknown, P. 119619 - 119619

Published: March 1, 2025

Language: Английский

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Pulling Back the Curtain on Deprescribing Interventions

Journal of the American Geriatrics Society, Journal Year: 2025, Volume and Issue: unknown

Published: March 13, 2025

Older adults living with dementia commonly experience polypharmacy and exposure to high-risk medications [1, 2]. According findings from the National Health Aging Trends Study, among people dementia, 1 in 5 believe that they may be taking one or more medicines no longer need, nearly 9 10 are willing stop of their medications, half uncomfortable five [3]. This underscores need for tailored medication optimization strategies, including carefully designed, evidence-based deprescribing interventions. ALIGN (Aligning Medications What Matters Most) was a pragmatic, pharmacist-led telehealth pilot study support primary care providers addressing who were age ≥ 65 prescribed > 7 [4, 5]. The intervention consisted educational brochure, visit by pharmacist patient-care partner dyad discuss patient's context goals preferences, recommendations conveyed provider via electronic health record. goal reduce total burden regimen complexity focusing on what matters most patients partners. With provider's approval, able implement recommended changes. pharmacists held PharmD degrees board certification Geriatric Pharmacy. Pharmacist could include both stopping starting medications; 73% received recommendation medication, dose frequency, while 42% start increase frequency. In this issue Journal American Geriatrics Society, Green colleagues complement reporting an analysis audio-recorded conversations between dyads [5]. By characterizing these conversations, authors aimed provide new insights guide future development qualitative specifically focused how elicitation medication-related priorities partners shaped discussions pharmacists. Importantly, investigator team has described actually happened during visits partners, actual language used explain recommendations. is refreshing step forward beyond usual "sterile" results reported out trials, which rarely ever extend tables figures summarizing mean numbers versus control groups [6], proportion deprescribed targeted class [7, 8]. paper, highlight important role influence have interventions; only four instances declined dyad. addition, highlights realities, practicalities, challenges carrying broad-based interventions directed at complex older complicated regimens polypharmacy. Patients participating average 13 medications. study, there prioritization classes warranted attention. Such decisions left up individual clinical pharmacist. absence strategy target specific high priority (e.g., those considered cognitive impairment [9]) consistent, evidence-based, systematic approach had implications. For example, frequently picked lowest hanging (and least impactful) "fruit" vitamins supplements) deprescribing, preference substantially challenging situations, such as use antipsychotics dementia. As mentioned above, prioritized preferences patients. theory, exactly should happen, but perhaps consideration risks associated particular drug therapy, possible availability nonpharmacologic alternatives. case behavioral symptoms sometimes it seemed if available continue antipsychotic. Yet, considerable evidence supporting nonpharmacological address persons stress [10], strategies fell outside scope intervention. Understandably, felt obligation try do something high-priority symptoms, pain. Sometimes led existing even effectiveness questionable. Examples non-evidence-based included increasing gabapentin back pain, buprenorphine patch treat pain relating neuropathy. There also missed opportunities some inconsistencies regarding recommendations, statin quoted saying partner, "The estimator says about chance heart attack stroke within next years …. That leans me toward it's worth staying cholesterol medicine prevent that." However, another patient, advice opposite: "We're now point where we don't worrying happening 15 now." practicalities spreading scaling deserve mention. time-consuming; over 90% took 20 min, majority, multiple follow-up interactions required. intensity intervention, personnel costs, pose challenge widespread adoption. summary, commended "pulling curtain" investigators acknowledge, "an unexpected finding often continuation potentially inappropriate addition not evidence-based." extraordinarily valuable guiding efforts any good lingering questions lay groundwork research. Among them: (1) Should entire pharmacopeia narrowly limited number high-priority, classes?; (2) right thing when ("what most") conflict safety therapy?; (3) How varied experiences practice styles factor into delivery consistently applied?; (4) solely broadened encompass overall optimization, regimen, appropriate?; (5) empower apply expertise non-pharmacologic further success deprescribing? To paraphrase W. Edwards Deming, "All [deprescribing interventions] perfectly designed get get." shown us just true is. Through bit closer being develop can truly enhance lives Jerry H. Gurwitz prepared manuscript. Dr. serves consultant United Healthcare. publication linked related article et al. view article, https://doi.org/10.1111/jgs.19379.

Language: Английский

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Digital technologies in rehabilitation of patients with cognitive impairment and dementia

Vestnik nevrologii psihiatrii i nejrohirurgii (Bulletin of Neurology Psychiatry and Neurosurgery), Journal Year: 2025, Volume and Issue: 2, P. 141 - 152

Published: Feb. 15, 2025

Cognitive impairment is a prevalent and socially significant issue affecting large portion of the human population. Traditional approaches to cognitive rehabilitation exhibit inconsistent limited effectiveness, especially considering rapid digitalization healthcare. This paper explores potential digital technologies in individuals with dementia assesses their effectiveness future development prospects. Computer programs can standardize automate training, offering structured delivery system. Virtual reality enable enhancement skills by simulating realistic scenarios virtual environment. Additionally, chatbots artificial intelligence offer personalized, adaptive approaches, while telemedicine addresses challenge providing access specialized neuropsychological care. Existing research demonstrates interventions rehabilitation, evidence supporting several tools. However, there dearth studies this area, integration these into clinical practice faces challenges, including sustaining patient clinician engagement, integration, rigorous validation technologies. Recent advancements reality, robotics, are undergoing active testing, application impairments holds promise for near future.

Language: Английский

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The global, regional, and national burdens of dementia in 204 countries and territories from 1990 to 2021: A trend analysis based on the Global Burden of Disease Study 2021

Medicine, Journal Year: 2025, Volume and Issue: 104(11), P. e41836 - e41836

Published: March 14, 2025

The global population is aging, and as a consequence, the prevalence of dementia increasing rapidly. This study aims to analyze trends in Global Burden Disease (GBD) health inequalities for over period 1990 2021. incidence, prevalence, disability-adjusted life year rates GBD 2021 database were analyzed at global, national, regional levels using Joinpoint 4.9.1.0 software. assessed combination age-standardized rates, average annual percentage changes (AAPCs), sociodemographic index. analysis revealed that, from 2021, AAPC years amounted 0.06 (95% confidence interval [CI]: 0.05–0.09), 0.09 CI: 0.08–0.10), 0.03 0.01–0.05), respectively. Conversely, mean mortality rate remained stable 0 −0.02 0.03). incidence exhibited positive association with index during period. 3 regions highest among 21 South Africa, Central Sub-Saharan Eastern Africa. findings indicate that burden increases age projected remain on an upward trend until 2040. has increased significantly prevention control represents long-term formidable challenge.

Language: Английский

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The Association of Dementia and Mild Cognitive Impairment With Outpatient Ambulatory Care Utilization in the Community

Journal of the American Geriatrics Society, Journal Year: 2025, Volume and Issue: unknown

Published: March 22, 2025

ABSTRACT Background Ambulatory care is critical in delivering interventions for dementia and mild cognitive impairment (MCI), from basic services to novel therapeutics. Yet, little known regarding how community‐dwelling persons with dementia/MCI interact clinicians outpatient ambulatory settings. We assessed associations of evaluation management (E&M) visits. Methods included 2116 participants Rush Alzheimer's Disease Center cohorts, linked fee‐for‐service Medicare claims. Annually 2011 2019, cohort neuropsychologic evaluations classified as dementia, MCI, or no (NCI). Across groups, we compared annual probability visiting providers number E&M visits, using repeated measures logistic generalized Poisson mixed effects models. Results 8672 person‐years (PY) follow‐up, the mean age was 82 (SD 7.6) years; 77% PYs were among females 24% Black participants. Controlling demographics comorbidity, predicted primary visits high all groups (86%–92%). Although there few dementia‐related specialists, found a higher these those (15%) MCI (17%) than NCI (12%; p = 0.009, vs. NCI; < 0.001, NCI). There striking differences other medical specialties: 40% lower ( 0.001) 10% NCI. Overall, associated 19% 4% 0.005) fewer respectively, Conclusions Older adults regularly are more likely use specialists utilization specialties, without compensatory increases care, leading overall even MCI. Together, findings may suggest lost opportunities address scope health issues vulnerable groups.

Language: Английский

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Individuals with Cognitive Impairment Entering Long-Term Care: Characteristics and Cumulative Incidence of Dementia after Care Entry

Journal of the American Medical Directors Association, Journal Year: 2025, Volume and Issue: 26(6), P. 105568 - 105568

Published: April 10, 2025

Language: Английский

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