State of the Places of Senile Dementia in the Old Hospice of the City of Lubumbashi

The objective of this study was to describe the state of the scene of senile dementia in an intra-institutional environment in the city of Lubumbashi. We conducted a descriptive cross-sectional study, over a period of three months, from February 20 to May 20, 2016. The study population is made up of the residents of the 9 retirement institutions for senior citizens (old people’s home) which counts the city of Lubumbashi. Participation was voluntary with informed consent duly signed by the patient. The probable cases of dementia were detected through the CSI-D and the 5-word test. A predominance of Alzheimer’s was noted (76.92%) and most of them were widowed (69.23%). The mean age of the dementia population was 76.46 ± 9.87 years, while (69.23%) of the patients were out of school. In (23.08%) cases demented patients were male, with a sex ratio of 0.3. Nearly (46.15%) of the demented were drinking. It appears that (69.23%) of the dementias were hypertensive. There are associations between different risk factors and the presence of dementias. Alcohol with an OR (Odd Ratio) = 0.08 (95% CI [0.01 - 0.72], p < 0.05). In our environment, our results indicate a different situation with a much higher prevalence.

Clinical Observation and Mechanism Study on Treatment of Senile Dementia with Naohuandan(脑还丹)

Objective: To observe the therapeutic effect and mechanism of Naohuandan (脑还丹,NHD) in treating senile dementia (SD).Methods: Clinical study: Fifty-eight patients with SD, whose diagnosis conforms to the Diagnostic Standard of DSM-Ⅳ issued by American Association of Psychiatry, were enrolled and randomly assigned into two groups. The 30 patients in the treated group were treated with NHD, 4 capsules each time, 3 times daily. The 28 patients in the control group were treated with Piracetam, 1.6 g each time, 3 times daily. The therapeutic course for both groups was 3 months. The therapeutic efficacy was estimated and compared by comprehensive scores of memory and cognition, scores of Mini-mental State Examination (MMSE) and Activities of Daily Living (ADL). Experimental study: Rats were divided into the control group, the model group and the high-dosage and low-dosage NHD treated groups. The protective effect of NHD on the per-oxidative damage of hippocampal neurons in β-amyloid protein induced SD model was observed and the related criteria were determined. Results: Clinical study showed that both NHD and Piracetam could improve the clinical symptoms of patients, the two medicines showing insignificant difference in total effective rate. But NHD was better in elevating MMSE score and lowering ADL score in patients than Piracetam (P<0.05 and P<0.01). Experimental study showed that (1) 24 and 72 hrs after modeling, the activity of SOD and GSH were lower and the level of MDA higher in the model group than those in the control group (P<0.05 or P<0.01). Compared with the model group at the corresponding time points, in the high-dosage NHD group, SOD and GSH were higher, MDA was lower (P<0.05 or P<0.01); but in the low-dosage NHD group, SOD at the 72th hr was higher (P<0.05) and MDA at 24th and 72th hrs was lower (P<0.01). And most of the criteria in the high-dosage NHD group was improved better than that in the low-dosage NHD group. (2) The survival rates of neurons in various groups were not different significantly (P>0.05) 24 hrs after modeling, but that in the high-dosage NHD group was significantly higher than that in the model group ( P<0.01) and in the low-dosage NHD group 72 hrs after modeling(P<0.05). Conclusion: NHD is an effective Chinese herbal preparation for treatment of SD, and its mechanism is related with its inhibition on peroxidative injury and protection on neurons.

Hearing Impairment in Senile Dementia of Alzhaimer's Type

Objectives To evaluate peripheral auditory dysfunction in senile dementia of Alzheimer’s disease (AD) and its relationship with cognitive dysfunction. Methods Pure tone thresholds,word recognition scores (WRS), acoustic immittance and auditory brain-stem responses (ABR) were tested to evaluate the auditory function in 43 AD patients and 50 normal subjects. The test reliability in these subjects was examined before the test results were evaluated for their correlation with the Mini Mental State Examination(MMSE) score. Results There were no statistically significant differences in peripheral auditory functions between the two ears in the tested subjects or between the two groups when the auditometric results of the right ear were compared(P > 0.05). Also, there were no statistically significant differences between the two groups when audiometric test reliability, acoustic impedance and ABR results were compared(P > 0.05). Conclutions The pure tone audiometric threshold and WRS in AD patients are similar to those in comparable non-AD senile subjects. Peripheral auditory dysfunction is not related to cognitive dysfunction.

Advances in TCM Treatment of Senile Vascular Dementia

Senile vascular dementia refers to organic loss of intellectual function due to cerebral damages caused by insufficient blood supply. The following is a summaryon achievements in its etiology, pathogenic mechanism, type identification and treatment in TCM, and the compound formulas, special formulas and drugs, and thepatent drugs used successfully for its treatment. ……

Correlation of serum Hcy metabolism with pro-inflammatory factors, chemokines and oxidative stress response in patients with senile dementia

Objective: To investigate the correlation of serum Hcy metabolism with pro-inflammatory factors, chemokines and oxidative stress response in patients with senile dementia. Methods:A total of 50 patients who were diagnosed with senile dementia in our hospital between August 2012 and June 2016 were selected as the senile dementia group, and 50 elderly patients who underwent physical examination in this hospital during the same period were selected as normal control group. The differences in serum levels of Hcy, pro-inflammatory cytokines, chemokines and oxidative stress indexes were compared between the two groups, and Pearson test was adopted to assess the correlation between serum Hcy level and illness. Results: Serum Hcy level of senile dementia group was higher than that of control group;serum pro-inflammatory cytokines IL-1, IL-6, TNF-α and CRP levels were higher than those of control group;serum chemokines MCP-1, CCL2 and RANTES levels were higher than those of control group;serum oxidative stress indexes ROS, MDA and 4-HNE contents were higher than those of control group. Pearson test showed that the serum Hcy level in patients with senile dementia was positively correlated with the levels of pro-inflammatory factors, chemokines and oxidative stress indexes. Conclusions: The serum Hcy metabolism disorder in patients with senile dementia is closely related to the inflammatory response and oxidative stress response.

Effects of balance exercise training on chronic nerve injury, GLP-1 and inflammatory mediator secretion in patients with senile dementia

Objective: To study the effects of balance exercise training on chronic nerve injury, GLP-1 and inflammatory mediator secretion in patients with senile dementia. Methods: Patients with senile dementia who were treated in the Fourth People's Hospital of Ya'an between February 2015 and January 2018 were chosen as the research subjects and randomly divided into two groups, the experimental group received balance exercise training and the control group received routine intervention. The levels of chronic nerve injury indexes, GLP-1 and inflammatory cytokines in serum as well as the expression of inflammatory signaling molecules in peripheral blood were determined before and after intervention. Results:Compared with those of same group before intervention, serum Hcy, Aβ1-42, Tau, IL-1β, IL-18, TNF-α and IFN-γ levels as well as peripheral blood NLRP3, Caspase-1 and DOCK2 expression intensity of both groups were decreasing whereas serum SOD, PON1 and GLP-1 levels as well as peripheral blood PKA and CREB expression intensity were increasing after intervention, and serum Hcy, Aβ1-42, Tau, IL-1β, IL-18, TNF-α and IFN-γ levels as well as peripheral blood NLRP3, Caspase-1 and DOCK2 expression intensity of experimental group after intervention were lower than those of control group whereas serum SOD, PON1 and GLP-1 levels as well as peripheral blood PKA and CREB expression intensity were higher than those of control group. Conclusion: Balance exercise training can reduce the chronic nerve injury and regulate the secretion of GLP-1 and inflammatory mediators in patients with senile dementia.

Effect of Montessori method on the cognitive and behavioral intervention of senile dementia patients:a meta-analysis

Background:To evaluate the effect of Montessori method on cognitive and behavioral function in patients with senile dementia by meta-analysis.Methods:The randomized controlled trials of the effect of Montessori method on cognitive and behavioral functions of Alzheimer’s patients in PubMed,Cochrane Library,Web of Science,Excerpt Medica Database,The Cumulative Index to Nursing&Allied Health Literature,Chinese BioMedical Literature Database,China National Knowledge Infrastructure,Weipu Information Chinese Periodical Service Platformdatabase and Wanfang database were searched by computer,and the references of relevant literatures were traced.Two researchers independently conducted literature screening,data extraction,evaluation and inclusion in the literature,using RevMan 5.4.1 software for meta-analysis.Results:A total of 11 literatures were included and 936 patients were enrolled.Meta analysis shows that compared with routine nursing,Montessori method is helpful to improve the overall cognitive function(standardized mean difference=1.53,95%confidence interval(1.32,1.73),P<0.01),activities of daily living and reduce the incidence of adverse events(relative risk=0.37,95%confidence interval(0.21,0.63),P<0.01)in patients with Alzheimer’s disease.Conclusion:Montessori method is helpful to improve the overall cognitive function,activities of daily living and reduce the incidence of adverse events in patients with senile dementia.Affected by the included study,it still needs to be confirmed by multi center and large sample randomized controlled study.

Network pharmacology deciphering multiple mechanisms of volatiles of Wendan granule for treatment of senile dementia

OBJECTIVE To explore the mechanisms of the volatiles of Wendan granule for the treatment of senile dementia,network pharmacology method integrating absorption,distribution,metab.olism,and excretion(ADME) screening,target fishing,network constructing,pathway analyzing,and correlated diseases prediction was applied.METHODS Twelve small molecular compounds of WDG were selected as the objects from 74 volatiles with the relative abundances above 2%,and their ADME parameters were collected from Traditional Chinese Medicine Systems Pharmacology platform(TCMSP),and then the corresponding targets,genes,pathways and diseases were predicted according to the data provided by TCMSP,DrugBank,Uniport and the Database for Annotation,Visualization and Integrated Discovery(DAVID).The related pathways and correlation analysis were explored by the Kyoto Encyclo.pedia and Genomes(KEGG) database.Finally,the networks of compound-target,target-pathway and pathway-disease of WDG were constructed by Cytoscape software.RESULTS Twelve compounds interacted with 49 targets,of which top three targets were Gamma-aminobutyric acid receptor subunit alpha-1(GABRA1),Prostaglandin G/H synthase 2(PGHS-2) and Sodium-dependent noradrenaline transporter.Interestingly,these targets were highly associated with depression,insomnia and Alzheimer′s disease that mainly corresponded to mental and emotional illnesses.CONCLUSION The integrated network pharmacology method provides precise probe to illuminate the molecular mechanisms of volatiles of WDG for relieving senile dementia related syndromes,which will also facilitate the application of traditional Chinese medicine in modern medicine,as well as follow-up studies such as upgrading the quality stan.dard of clinical medicine and novel drug development.

Acupuncture on Gnosia and Acetylcholinesterase in Senile Dementia Patients

Purpose To observe the effect of acupuncture on gnosia and acetylcholinesterase in patients with senile dementia.Methods Eight patients diagnosed with mild or moderate senile dementia were treated by acupuncture of Sishencong (Ex-HN 1), Shenmen (HT 7) and Taixi (Kl 3) for 1 month; gnosia was evaluated by Mini-mental state examination before and after the treatment; plasma acetylcholin esterase activity was measured by fluorier before and after the treatment.Results There was a significant difference in gnosia between pre- and post-treatment with acupuncture (P<0.01); there was no significant difference in acetyl- cholinesterase activity between pre- and post-treatment (P>0.05).Conclusion Acupuncture has a certain improving effect on gnosia in senile dementia; one month’s acupuncture treatment had little effect on plasma acetyl-cholinesterase activity. Key Words Dementia, Senile - Acupuncture therapy - Gnosia Author: Tang Yong (1974-), male, attending physician and doctor

STUDY OF THE EXTERNAL COUNTERPULSATION (ECP) THERAPY FOR SENILE DEMENTIA OF THE ALZHEIMER'S TYPE (SDAT)

Ten patients with SDAT received the ECP therapy.The examination of Hasegawa’s Dementia Scale(HDS),single photor emission computed tomography (SPECT) brain imaging,and some biochemical parameters in blood and CSF were selected to evaluate the effect of ECP for SDAT.

Treatment Effects of Acupuncture and Calligraphy Training on Cognitive Abilities in Senile Demented Patients

Purpose:This study compared the relative effectiveness of Chinese calligraphy handwriting(CCH)and acupuncture in the treatment of patients with senile dementia.Materials and Methods:A randomized controlled trial(RCT)with 17 mild-to-moderate dementia patients with an average age of 77.29 years were randomly assigned with 9 to the calligraphy handwriting group and 8 to the acupuncture treatment group for a month of consecutive treatment.The participants'cognitive abilities,as well as symptoms of senile dementia,were measured by the Chinese version of the Mini-mental State Examination(CMMSE)and the Chinese Medicine Quantitative Diagnostic Survey for Senile Dementia Symptoms,respectively,before and after the treatment.Results:The calligraphy group showed a significant increase in calculation and memory as well as a decline in the symptoms of senile dementia.Patients in the acupuncture group experienced a significant growth in total CMMSE scores and the subscales in orientation to time and place,behavioral operations,as well as reduced clinical symptoms.However,no significant changes were found in their memory and calculation abilities.Conclusion:Both CCH and acupuncture treatments were found significantly effective for,respectively,enhancing the patients'cognitive abilities and reducing their clinical symptoms.Further,calligraphy handwriting also improved the level of their attention and concentration,physical relaxation,and emotional stability.

老年痴呆病人实施人手喂养的安全性及有效性的Meta分析

目的:系统评价老年痴呆病人实施人手喂养的安全性及有效性,为老年痴呆病人在其痴呆轻症期自预设医疗指示,为家属及临床医护在病人痴呆中、重度期是否实施人手喂养提供决策依据。方法:计算机检索中国知网、万方数据库、PubMed、CINAHL、EMbase、Web of Science、the Cochrane Library等数据库中关于老年痴呆病人实施人手喂养的随机对照研究、类试验研究、队列研究,检索时限为建库到2023年9月。由2名研究者进行文献筛选、资料提取及方法学质量评价,并运用RevMan 5.3软件进行统计分析。结果:纳入6项研究,涉及病人1796例,其中试验组(人手喂养)811例,对照组(鼻胃管喂养)985例。Meta分析结果显示,人手喂养可降低老年痴呆病人的肺炎发生率[RR=0.51,95%CI(0.33,0.77),P=0.002]和死亡率[RR=0.54,95%CI(0.32,0.93),P=0.030]。结论:现有证据表明,老年痴呆病人实施人手喂养,可降低其肺炎发生率及死亡率。

日本公共图书馆的轻度老年认知症读者服务探析

为优化公共图书馆的轻度老年认知症读者服务,通过网络调研与邮件访谈对日本公共图书馆的轻度老年认知症读者服务情况进行调查,并从政策、文献资源、空间与设施、服务团队以及服务方法5个方面总结建设经验,最后提出我国公共图书馆开展轻度老年认知症读者服务的建议。

老年期痴呆的BPSD非药物治疗及其与ApoE基因多态性相关性的临床研究

目的分析老年期痴呆的行为精神症状(behavioral and psychological symptom of dementia,BPSD)的非药物治疗效果及其与载脂蛋白E(apolipoprotein E,ApoE)基因多态性的关系。方法选取2016年1月至2022年12月江西省人民医院收治的90例老年期痴呆患者为研究对象,根据随机数字表法将其分为常规组、对照组和观察组,每组各30例。常规组患者给予盐酸美金刚片治疗,对照组患者在常规组基础上加以音乐疗法,观察组患者在常规组基础上加以重复经颅磁刺激治疗,三组均连续治疗12周。比较三组患者的BPSD严重程度、痴呆严重程度、认知功能、日常生活能力、ApoE基因多态性。结果治疗前,三组患者的神经精神问卷(neuropsychiatric inventory,NPI)、临床痴呆评定量表(clinical dementia rating,CDR)、简明精神状态检查量表(mini-mental state examination,MMSE)、日常生活能力评定量表(activity of daily living scale,ADL)评分比较差异均无统计学意义(P>0.05);治疗后,三组患者的NPI、CDR评分均显著低于本组治疗前,MMSE、ADL评分均显著高于本组治疗前(P<0.05);观察组和对照组患者的NPI、CDR评分均显著低于常规组,MMSE、ADL评分均显著高于常规组(P<0.05)。ApoE共有ε2、ε3、ε4三种等位基因,其中ε3表达频率最高,共55例,其次为ε4和ε2;三组患者的ApoE不同基因检出率比较差异无统计学意义(P>0.05)。ApoEε4型患者的NPI评分显著高于ApoEε3型与ApoEε2型(P<0.05)。结论非药物治疗老年期痴呆患者效果显著,可减轻BPSD和痴呆表现,提高患者的认知功能和日常生活能力,ApoEε4型基因与老年期痴呆患者的BPSD存在紧密联系。

老年痴呆患者照护者心理危机自我表露体验的质性研究

目的探索老年痴呆患者照护者心理危机自我表露的阻碍与促进因素,为缓解照护者心理危机,改善其心理健康提供依据。方法采用目的抽样法选取某三级甲等综合医院老年病科住院的老年痴呆患者的主要照护者(医院护工和家属)23名为研究对象。通过深度访谈收集资料,运用Braun和Clarke主题分析方法进行资料分析。结果老年痴呆患者照护者心理危机表露的影响因素包括6个阻碍因素及(表达能力受限、道德观念束缚、工作负担过重、家庭支持缺乏、社会支持网络不完善及缺乏安全表露环境)3个促进因素(感知表露后益处、掌握表露相关技能、积极舆论导向)。结论老年痴呆患者照护者心理危机自我表露行为受多重影响。临床护理和健康服务应从多层面着手,帮助照护者塑造良好自我认知,为照护者营造良好的自我表露氛围,以缓解其心理危机,改善心理健康状况。

Use of curcumin in diagnosis,prevention,and treatment of Alzheimer＇s disease

This review summarizes and describes the use of curcumin in diagnosis,prevention,and treatment of Alzheimer＇s disease.For diagnosis of Alzheimer＇s disease,amyloid-β and highly phosphorylated tau protein are the major biomarkers.Curcumin was developed as an early diagnostic probe based on its natural fluorescence and high binding affinity to amyloid-β.Because of its multi-target effects,curcumin has protective and preventive effects on many chronic diseases such as cerebrovascular disease,hypertension,and hyperlipidemia.For prevention and treatment of Alzheimer＇s disease,curcumin has been shown to effectively maintain the normal structure and function of cerebral vessels,mitochondria,and synapses,reduce risk factors for a variety of chronic diseases,and decrease the risk of Alzheimer＇s disease.The effect of curcumin on Alzheimer＇s disease involves multiple signaling pathways：anti-amyloid and metal iron chelating properties,antioxidation and anti-inflammatory activities.Indeed,there is a scientific basis for the rational application of curcumin in prevention and treatment of Alzheimer＇s disease.

李应存教授运用敦煌神妙补心丸治疗老年性痴呆的经验

老年性痴呆是老年人群中常见的进行性神经退行性疾病,严重影响患者的正常生活,西药治疗效果欠佳,而中医药辨证论治老年性痴呆已被证实具有显著优势。李应存教授为国家中医药管理局“十二五”重点学科敦煌医学学科带头人,甘肃省名中医。敦煌遗书中医方约一千余首,其内容丰富,组方精良,配伍严谨。李教授对敦煌佛医方药内容进行分析,探讨佛医方药的研究价值,认为其是敦煌医方的重要组成部分。英国国家图书馆所藏的“毗沙门天王奉宣和尚神妙补心丸”为敦煌佛医方书中的重要方剂,此方保存较为完整,条理分明,实出于深谙医理的高僧,具有较高的文献和临床实用价值。毗沙门天王是唐宋时期敦煌地区民间最为流行的佛教信仰之一,是守护和福佑敦煌的重要神将,原方具有益气养阴、补心安神之效。李教授将此方广泛应用于临床,治疗老年性痴呆、失眠、心悸等病,疗效显著。李教授认为老年性痴呆病位在脑,主要病机为心血亏虚无以濡养脑髓和肾精亏虚无以化生脑髓,并伴有痰瘀阻滞气机使脑脉不通。选用敦煌古医方神妙补心丸治疗此病,可养心安神、补肾填精、化痰开窍、活血祛瘀并举,临床用药灵活加减,治疗效果明显。

视听联合手指活动训练对老年痴呆患者认知功能的影响

为了探讨视听联合手指活动训练对老年痴呆患者认知功能的影响,本文选取昆明市某养老院近一年120例老年痴呆患者纳入研究,将其随机分为对照组和实验A,B,C四个组别,每组30名,对照组不做干预,A组行视听训练,B组行手部动作训练,C组行视听联合手指活动训练。干预8周,每周5次,每次2h。比较各组患者的MMSE和MoCA评分,观察其认知功能的变化。结果表明,8周后与对照组相比,三组患者评分均有提高,差异有统计学意义P<0.05,其中C组患者提升最明显。研究认为视听联合手指活动训练对改善老年痴呆患者的认知功能有较为积极的作用。

当归芍药散介导氧化-炎症通路在老年痴呆大鼠模型神经损伤保护中的机制探究

目的:探讨当归芍药散介导氧化-炎症通路在老年痴呆大鼠模型神经损伤保护中的机制。方法:72只大鼠随机分成对照组、模型组、当归芍药散低剂量组(12g/kg)、当归芍药散中剂量组(24g/kg)、当归芍药散高剂量组(36g/kg)和尼莫地平组(20mg/kg),每组12只。除对照组外,其余组大鼠均复制老年痴呆模型。建模成功后,当归芍药散不同剂量组和尼莫地平组分别灌胃不同剂量当归芍药散、尼莫地平。其余组灌胃等剂量的生理盐水,连续灌胃4周。Morris水迷宫实验检测空间学习记忆能力。高效液相色谱-电化学检测法海马组织间液去甲肾上腺素(NE)、多巴胺(DA)、5-羟色胺(5-HT)和5-羟吲哚乙酸(5-hydroxyindole acetic acid, 5-HIAA)水平。Longa法评估各组大鼠神经功能缺陷。酶联免疫吸附检测脑组织白介素1β(IL-1β)、白介素10(IL-10)、肿瘤坏死因子α(TNF-α)、超氧岐化酶(SOD)、丙二醛(MDA)、谷胱甘肽过氧化物(GSH-Px)。结果:模型组逃避潜伏期均短于对照组(P<0.05)。与模型组相比,当归芍药散不同剂量组和尼莫地平组逃避潜伏期均下降(P<0.05)。与对照组相比,模型组大鼠的神经功能缺损评分以及脑组织中TNF-α、IL-1β、IL-6水平升高(P<0.05)。当归芍药不同剂量组和尼莫地平组神经功能缺损评分以及脑组织中TNF-α、IL-1β、IL-6水平低于模型组(P<0.05)。模型组大鼠海马组织间液NE、DA、5-HT、5-HIAA水平以及脑组织SOD和GSH-Px含量均低于对照组,脑组织MDA含量高于对照组(P<0.05)。与模型组相比,当归芍药散不同剂量组和尼莫地平组大鼠海马组织间液NE、DA、5-HT、5-HIAA水平以及脑组织SOD和GSH-Px含量均升高,脑组织MDA含量降低(P<0.05)。与对照组相比,Nrf2表达下降,TLR4和NF-κB表达升高(P<0.05)。与模型组相比,当归芍药散不同剂量组和尼莫地平组Nrf2表达升高,TLR4和NF-κB表达下降(P<0.05)。结论:当归芍药散通过Nrf2/TLR4/NF-κB信号通路发挥降低氧化应激反应、抗炎作用对老年痴呆大鼠神经损伤起到保护作用。

治疗性沟通技术在轻中度老年痴呆病人中的应用效果

目的:探讨治疗性沟通技术在轻中度老年痴呆病人的应用效果。方法:将2021年2月—12月在苏州大学附属第一医院老年医学科接收的44例轻中度老年痴呆病人作为对照组,2022年2月—12月接收的46例轻中度老年痴呆病人作为观察组。对照组采用常规宣教传递认知康复训练知识;观察组采用治疗性沟通技术。采用护患关系信任度量表(NPTS)评价病人对护士的信任程度;采用科室自行设计的《沟通技巧认可评估表》评价病人对沟通方式的认可程度;采用痴呆沟通量表(CODEM)于入院时及出院前评价病人的沟通能力。结果:观察组病人出院前的NPTS量表的态度和关怀、能力和安心感维度得分及总分均高于对照组(P<0.05);观察组病人对沟通技术的有益性、亲密性、舒适性、尊重感、接受程度及推荐程度得分均高于对照组(P<0.05);观察组病人出院前CODEM量表的语言沟通维度得分、非语言沟通维度得分及总分均高于对照组(P<0.05)。结论:治疗性沟通技术能提升轻中度老年痴呆病人对护士的信任感及沟通能力,病人对治疗性沟通技术认可度更高。