Newly self-administered two-step tool for screening cognitive function in an ageing Chinese population:an exploratory cross-sectional study

Background Early screening of cognitive function is critical to dementia treatment and care.However,traditional tests require face-to-face administration and are often limited by implementation costs and biases.Aims This study aimed to assess whether the Thoven Cognitive Self-Assessment(TCSA),a novel,innovative two-step touchscreen-based cognition assessment tool,could identify early cognitive impairment due to dementia in older adults.Methods The TCSA was administered to 61 healthy controls(HCs),46 participants with mild cognitive impairment(MCI)and 44 participants diagnosed with dementia recruited from Shanghai.Two outcome measures were generated from the TCSA test:the TCSA_(primary task)score and the TCSA_(secondary task)score.Results The total average scores in the control group for the TCSA_(primary task)and TCSA_(secondary task)were significantly higher than those in the MCI and dementia groups(TCSA_(primary task):HCs vs MCI group vs dementia group,8.58±1.76 vs 5.40±2.67 vs 2.74±2.11,F=75.40,p<0.001;TCSA_(secondary task):HCs vs MCI group vs dementia group,23.02±3.31 vs 17.95±4.93 vs 11.93±5.50,F=76.46,p<0.001).Moreover,receiver operating characteristic analysis showed that a score below 7.5 for the TCSA_(primary task)and a score below 22.5 for the TCSA_(secondary task)were indicators of MCI.Conclusions The TCSA appears to be efficacious for the detection of cognitive impairment in older adults.It demonstrates the potential for large-scale cognition screening in community service settings.

Validity and reliability of the Brain Health Self-Efficacy Scale for the elderly

Background With the rapid increase in ageing population,China is confronted with the daunting challenge of a growing number of patients with neurocognitive disorders(NCDs).This trend makes the maintenance of self-health and early intervention essential,highlighting the need for a tool that assesses self-efficacy of older adults in maintaining brain health or cognitive function.Aim This study aimed to design the Brain Health Self-Efficacy Scale(BHSES)to measure elderly individuals'attitudes to NCDs,motivations and future plans for controlling risks.The psychometric properties of BHSES have been validated.Methods Based on the current literature and relevant models,a 19-item scale was created during the first stage.A total of 660 older adults in the Yinhang community of Shanghai were included.The statistical approaches of item analysis,exploratory factor analysis(EFA),confirmatory factor analysis(CFA),criterion-related validity and reliability test were used to evaluate the quality of BHSES.In addition,the Geriatric Depression Scale(GDS)and the Self-Rating Anxiety Scale(SAS)were used as criteria to test the criterion-related validity.Results To test item differentiation,the study adopted item analysis and excluded item 8.Selecting a random half of the sample for EFA,the BHSES was refined to 16 items,which were categorised into the following three dimensions:'memory belief efficacy','self-care efficacy'and'future planning efficacy'.These were highly consistent with the hypothesis model.Its cumulative variance contribution rate reached 61.14%,with factor loads of all items above 0.5.The three-factor model was confirmed by the remaining data through CFA.All fit indices reached the acceptable level(x2=3.045,Goodness of Fit Index=0.898,adjusted Goodness of Fit Index=0.863,Comparative Fit Index=0.916,Incremental Fit Index=0.917,Tucker-Lewis Index=0.900,root mean square error of approximation=0.079 and root mean residual=0.068).The GDS and SAS scores revealed significant correlations with the BHSES score,indicating a high criterion-related validity.The overall Cronbach'sαcoefficient was 0.793,with theαcoefficients'distribution of subdimensions ranging from 0.748 to 0.883.Conclusions The 16-item,self-compiled BHSES is a reliable and valid measurement.It could help identify older adults with potential risks for developing NCDs or with high suspicion of cognitive impairment onset in recent periods and also offer insight into tracking brain health self-efficacy in association with cognition status.

Beliefs towards the COVID-19 pandemic among patients with emotional disorders in China

Background The novel coronavirus disease 2019(COVID-19)pandemic has given rise to fear and panic in the public.Although hospitals in China reduced outpatient visits and restricted inpatient admission to lower the risk of transmission of COVID-19,this has significantly affected patients in need of medical attention,for example,patients with emotional disorders.Aims This study aimed to compare the beliefs towards COVID-19 among outpatients with emotional disorders(ie,anxiety or depression)with those offamily caregivers and the general public and examine factors that shape the beliefs towards COVID-19 among outpatients with emotional disorders.Methods Survey data from 570 outpatients with anxiety or depression disorders,449 family caregivers and 470 general public subjects were collected.Multiple stepwise regression analyses were used to describe participants'level of concern,prevention atitude and positive expectations towards the COVID-19 outbreak.Results About 70.9%of outpatients had to postpone their mental health treatment;43.2%of patients admitted that their mental health was adversely affected by the COVID-19 outbreak--these patients tended to be older,male and less educated.After controlling for age and education level,outpatients with emotional disorders had significantly lower levels of concerns but more negative expectations towards COVID-19,compared with family caregivers and the public.Multivariate linear stepwise regression analysis showed that age,education and the perception of the impact of COVID-19 on one's existing mental ilness were significantly associated with outpatients'beliefs about the epidemic.Conclusion Outpatients with anxiety or depression disorders were relatively less focused on the COVID-19 outbreak,but the impact of the infection was found to be independently associated with their beliefs towards COVID-19.In addition,outpatients who were older and of low educational levels particularly held more negative beliefs about the epidemic,which may place them at a higher risk for poor mental health.

A perspective on therapies for amyotrophic lateral sclerosis:can disease progression be curbed?

Amyotrophic lateral sclerosis(ALS)is a progressive neurodegenerative disease involving both upper and lower motor neurons,leading to paralysis and eventually death.Symptomatic treatments such as inhibition of salivation,alleviation of muscle cramps,and relief of spasticity and pain still play an important role in enhancing the quality of life.To date,riluzole and edaravone are the only two drugs approved by the Food and Drug Administration for the treatment of ALS in a few countries.While there is adequate consensus on the modest efficacy of riluzole,there are still open questions concerning the efficacy of edaravone in slowing the disease progression.Therefore,identification of novel therapeutic strategies is urgently needed.Impaired autophagic process plays a critical role in ALS pathogenesis.In this review,we focus on therapies modulating autophagy in the context of ALS.Furthermore,stem cell therapies,gene therapies,and newly-developed biomaterials have great potentials in alleviating neurodegeneration,which might halt the disease progression.In this review,we will summarize the current and prospective therapies for ALS.

Increased expression of coronin-1a in amyotrophic lateral sclerosis: a potential diagnostic biomarker and therapeutic target

Amyotrophic lateral sclerosis(ALS)is the most common motor neuron disease.At present,no definite ALS biomarkers are available.In this study,exosomes from the plasma of patients with ALS and healthy controls were extracted,and differentially expressed exosomal proteins were compared.Among them,the expression of exosomal coronin-1a(CORO1A)was 5.3-fold higher than that in the controls.CORO1A increased with disease progression at a certain proportion in the plasma of patients with ALS and in the spinal cord of ALS mice.CORO1A was also overexpressed in NSC-34 motor neuron-like cells,and apoptosis,oxidative stress,and autophagic protein expression were evaluated.CORO1A overexpression resulted in increased apoptosis and oxidative stress,overactivated autophagy,and hindered the formation of autolysosomes.Moreover,CORO1A activated Ca^(2+)-dependent phosphatase calcineurin,thereby blocking the fusion of autophagosomes and lysosomes.The inhibition of calcineurin activation by cyclosporin A reversed the damaged autolysosomes.In conclusion,the role of CORO1A in ALS pathogenesis was discovered,potentially affecting the disease onset and progression by blocking autophagic flux.Therefore,CORO1A might be a potential biomarker and therapeutic target for ALS.

Wind tunnel test of gust load alleviation for a large-scale full aircraft model

Wind tunnel test is an important way to test the performance of Gust Load Alleviation(GLA).At present,some component-level wind tunnel tests have been carried out in big aviation countries,but there is a lack of full aircraft model GLA tests.In this study,a set of large-scale GLA test system in low-speed wind tunnel is developed,which includes a gust generator,a five-degree-of-freedom suspension system,a full elastic aircraft model with control system,and gust load measuring devices.Two control schemes based on closed-loop feedback control and open-loop feed forward control are respectively designed and verified by the full-model GLA tests in the wind tunnel.The experimental results show that the designed gust generator can generate a stable wideband,wide-area gust wind field;the suspension support system can sustain static and dynamic stability during wind tunnel test,and enables the model moving in the horizontal,vertical,pitching,rolling and yawing directions.The results show that the closed-loop feedback control can obtain good control performance of reducing the peak values of elastic vibration response induced by gust excitation,but has little effect on suppressing the rigid body motion excited by low-frequency gust,while the open-loop feed forward control presents superior performance in allevi-ating the high-frequency elastic vibration as well as the low-frequency rigid body motion with more than 40%overall reduction rate.