Clinical Study on the Treatment of Senile Alzheimer’s Dementia with Sodium Oligomannate Combined with Memantine Hydrochloride

Objective:To analyze the clinical effects of sodium oligomannate combined with memantine hydrochloride in the treatment of senile Alzheimer’s dementia.Methods:Sixty-eight cases of Alzheimer’s dementia treated at the Second People’s Hospital of Fujian University of Traditional Chinese Medicine from March 2020 to March 2022 were selected as the study subjects.The patients were divided into two groups based on different treatment methods:the control group(treated with memantine hydrochloride,34 cases)and the treatment group(treated with sodium oligomannate+memantine hydrochloride,34 cases).Cognitive function,activities of daily living,neurotransmitters,serum intestinal flora metabolic markers,inflammatory factors,neurotrophic factors,and adverse reactions were compared between the two groups.Results:The treatment group showed better cognitive function,quality of life scores,and levels of relevant metabolic markers in the body compared to the control group,with statistically significant differences(P<0.05).The incidence of adverse reactions between the two groups(treatment group:2%;control group:4%)was not statistically significant(χ^(2)=0.731,P=0.393).Conclusion:Sodium oligomannate combined with memantine hydrochloride has better efficacy than the control group for treating senile Alzheimer’s dementia.It significantly improves and restores cognitive function and daily living abilities,benefits neurotransmitter secretion and internal regulation,upregulates the expression of neurotrophic factors,and has fewer adverse reactions,making it a treatment worthy of further clinical promotion and application.

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.

Experience and Insights of Family Caregivers for Patients with Senile Dementia: A Qualitative Study

Background: Due to social, economic, cultural and other factors, the majority of dementia patients are taken care of by relatives or nannies at home in China. This family care model puts a heavy burden on caregivers. Objective: The main aim of this article is to explore the experience and needs of caregivers on dementia elderly, reveal the essence, and provide the basis for formulating relevant policies. Methods: A total of 10 caregivers of dementia elderly were intensively interviewed, and data were analyzed by using Colaizzi content analysis methods during May - October 2019. Results: Three themes were extracted from the interviews, including the burden and strain from the care, lack of trust in pension institutions, and experience and comprehension of care. Conclusion: The caregivers have suffered a lot of pressure from taking care of the patients with senile dementia. They lack trust in pension institutions, so it is appealed that targeted services for family caregivers of dementia patients, so as to reduce caregiver burden and improve the quality of care.

Effects of TimeSlips on Cornell Scale for Depression in Dementia scores of senile dementia patients

Objective:To investigate the influences of TimeSlips on the Cornell Scale for Depression in Dementia(CSDD)scores of mild or moderate senile dementia patients.Methods:Forty-three cases of mild or moderate senile dementia patients were selected locally for convenience sake and given the TimeSlips intervention.The patients were assessed using the scales of CSDD and the Observed Emotion Rating Scale(OERS).Results:The differences of the patients'CSDD scores between before and after the intervention were statistically significant(P<0.05).The differences of the patients'OERS scores on positive and negative emotions between before and after the intervention were also statistically significant(P<0.05).Conclusion:TimeSlips is beneficial to relieve depressive symptoms and ameliorate the emotions of mild or moderate senile dementia patients,thus improving their life quality and reducing the burden of their caregivers.A large-scale experimental research on TimeSlips with rigorous design is proposed for further studies.

A Clinical Investigation on Zhi Ling Tang for Treatment of Senile Dementia

Zhi Ling Tang (ZLT [symbol: see text], a TCM prescription designed for replenishing essence, supplementing marrow, invigorating qi, warming yang, removing blood stasis and phlegm, tonifying the brain, and invigorating mental activity) was used in 32 cases of senile dementia (SD). After treatment, the levels of serum cholesterol (Tch), triglyceride (TG), and plasma lipid peroxides (LPO) were lowered; the content of high density lipoprotein (HDL) and the activity of superoxide dismutase (SOD) in RBC significantly elevated, the cerebral blood flow was increased; latent period of P300 and P3 waves was shortened while the amplitude of P3 elevated; and topographic electroencephalogram, revised Hasegawa dementia scales (HDS) scores (P

A CLINICAL TRIAL ON YU CONG TANG IN TREATMENT OF SENILE DEMENTIA

Yu Cong Tang ([symbol: see text]), a TCM decoction, was used to treat senile dementia. It has the action of invigorating the spleen, reinforcing the kidney, nourishing yin, strengthening yang, improving blood circulation, dredging the channels, removing phlegm and restoring consciousness. CT, EEG, REG, Hb, PaO2, Tch, TG and 17-OHCS were tested, showing significant differences (P

Clinical Study on Treatment of Senile Vascular Dementia by Acupuncture

63 patients with senile vascular dementia were randomly divided into the treatment group (treated by acupuncture) and the control group (treated with piracetam). The authors observed the changes in the score of Hasegawa's dementia scale (HDS), p300, rheoencephalogram, topographic EEG, superoxide dismutase (SOD) activity in erythrocytes, and lipid peroxide (LPO) level in plasma before and after treatment. The statistical data showed that the total effective rate in the treatment group (80.6%) was significantly higher than that in the control group (25%), and the differences in the observed indexes before and after treatment were significant (P 0.05), indicating that the acupuncture treatment was superior in immediate therapeutic effect on senile vascular dementia to drug treatment.

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.

Human immunodeficiency virus-associated dementia complex with positive 14-3-3 protein in cerebrospinal fluid:A case report

BACKGROUND Human immunodeficiency virus(HIV)-associated dementia(HAD)is a subcortical form of dementia characterized by memory deficits and psychomotor slowing.However,HAD often presents with symptoms similar to those of Creutzfeldt-Jakob disease(CJD),particularly in patients with acquired immune deficiency syndrome(AIDS).CASE SUMMARY We report the case of a 54-year-old male who exhibited cognitive dysfunction and secondary behavioral changes following HIV infection and suspected prion exposure.The patient was diagnosed with HIV during hospitalization and his cerebrospinal fluid tested positive for 14-3-3 proteins.His electroencephalogram showed a borderline-abnormal periodic triphasic wave pattern.Contrast-enhanced magnetic resonance imaging revealed moderate encephalatrophy and demyelination.Initially,symptomatic treatment and administration of amantadine were pursued for presumed CJD,but the patient’s condition continued to deteriorate.By contrast,the patient’s condition improved following anti-HIV therapy.This individual is also the only patient with this prognosis to have survived over 4 years.Thus,the diagnosis was revised to HAD.CONCLUSION In the diagnostic process of rapidly progressive dementia,it is crucial to rule out as many potential causes as possible and to consider an autopsy to diminish diagnostic uncertainty.The 14-3-3 protein should not be regarded as the definitive marker for CJD.Comprehensive laboratory screening for infectious diseases is essential to enhance diagnostic precision,especially in AIDS patients with potential CJD.Ultimately,a trial of diagnostic treatment may be considered when additional testing is not feasible.

Causal relationships between gut microbiota and dementia:A twosample,bidirectional,Mendelian randomization study

BACKGROUND Existing evidence suggests that gut microbiota represent a significant environmental risk factor for various forms of dementia,including Alzheimer's dementia,vascular dementia,and dementia in other diseases classified elsewhere.However,the exact causal relationships between gut microbiota and the different forms of dementia or their subtypes remain unclear.AIM To investigate putative causal relationships between gut microbiota and dementia or its subtypes using Mendelian randomization(MR)analysis.METHODS A bidirectional,two-sample,MR analysis was conducted utilizing publicly available gut microbiota-related genome-wide association study(GWAS)summary data from the MiBioGen consortium alongside GWAS summary statistics for dementia and its subtypes from the FinnGen consortium.Instrumental variables were selected according to the fundamental tenets of MR and their strengths were evaluated using the F-statistic.Five MR methods were employed,and the robustness of our findings was validated.To account for multiple comparisons,we applied the Bonferroni method for P-value adjustment.RESULTS We identified several gut microbiota taxa exhibiting putative causal relationships with dementia or its subtypes,potentially serving as risk or protective factors for the disease.In addition,reverse MR analysis indicated that the relative abundance of several gut microbiota taxa might be influenced by dementia or its subtypes.An exhaustive sensitivity analysis confirmed the absence of heterogeneity and horizontal pleiotropy.After applying correction for multiple testing,we observed that the order Bacillales(odds ratio:0.830,95%confidence interval:0.740-0.932,P=0.00155,Padjust=0.0311)exhibited a strong association with Alzheimer’s disease-related dementia.CONCLUSION The results suggest that gut microbiota is causally associated with dementia.Our findings provide novel insights into the pathophysiology of dementia and have important implications for its treatment and prevention.

Caregivers'awareness regarding the care of dementia and the coping strategies among the caregivers of people with dementia:a cross-sectional study in Udupi District,Karnataka

Objectives:To assess the awareness and coping skills of the informal and formal caregivers of people living with dementia(PLWD).Dementia is a condition,which leads to memory loss and gradual deterioration of cognitive abilities in the affected person.The lack of awareness regarding the care of people with dementia and the caregivers'poor coping strategies can negatively impact caregivers'experiences.Methods:A cross-sectional survey was conducted among the 80 caregivers of PLWD from the psychiatric units of the selected hospitals of Udupi district,Karnataka,India.The baseline data were collected by a self-reported sociodemographic questionnaire.The“Dementia Knowledge Assessment Scale”was used to gauge participants'awareness of the care of people with dementia,while the“Brief COPE inventory,”a 28-item questionnaire,was used to gauge carers'coping mechanisms.Descriptive and inferential statistics were used for the data analysis using Jamovi(2.3.24),a graphical user interface for R programming,and Microsoft Excel.Results:Most of the caregivers(n=68,85%)had lesser awareness regarding the care of people with dementia.The mean coping strategies score was 60.9±7.71.There was a positive correlation between the awareness and the coping strategies scores among the caregivers(r=0.659,P<0.05).Conclusions:The caregivers of people with dementia often lack awareness about dementia and hence experience poor coping due to their high workload and stress.The frontline healthcare professionals and nurses need to provide appropriate interventions to the caregivers to improve their awareness about dementia and its care.

Strategies for translating proteomics discoveries into drug discovery for dementia

Tauopathies,diseases characterized by neuropathological aggregates of tau including Alzheimer's disease and subtypes of fro ntotemporal dementia,make up the vast majority of dementia cases.Although there have been recent developments in tauopathy biomarkers and disease-modifying treatments,ongoing progress is required to ensure these are effective,economical,and accessible for the globally ageing population.As such,continued identification of new potential drug targets and biomarkers is critical."Big data"studies,such as proteomics,can generate information on thousands of possible new targets for dementia diagnostics and therapeutics,but currently remain underutilized due to the lack of a clear process by which targets are selected for future drug development.In this review,we discuss current tauopathy biomarkers and therapeutics,and highlight areas in need of improvement,particularly when addressing the needs of frail,comorbid and cognitively impaired populations.We highlight biomarkers which have been developed from proteomic data,and outline possible future directions in this field.We propose new criteria by which potential targets in proteomics studies can be objectively ranked as favorable for drug development,and demonstrate its application to our group's recent tau interactome dataset as an example.

Effectiveness of Music-Based Therapeutic Intervention on People with Dementia: A Rapid Review

Background: Dementia is a condition with progressive cognitive dysfunction and manifestation of both behavioral and psychosocial symptoms. Non-pharmacological measures such as music therapy are gaining importance since efficacy and safety of people with dementia have been questionable for pharmacological measures. Patient’s response to music is persistent even in the later stage of dementia. Aim: This rapid review aims to identify, analyze, evaluate, and summarize the best available evidence on the effectiveness of music-based therapeutic interventions among people with dementia. Method: CINAHL Cochrane Library, internet websites of rapid review producers, and reference lists were searched to identify articles for inclusion. Two reviewers independently screened the literature search results. Effectiveness, music-based therapeutic intervention, dementia, Alzheimer’s disease, systematic review and systematic review with meta-analysis terms were used to abstract data from included studies. Main Findings: 11 SRs and SRs with meta-analysis were reviewed which revealed positive effect of music therapy on five major outcomes with 9 studies effect on behavioral outcome, 6 studies with positive effect on psychosocial outcome reducing anxiety, 6 with improved cognition, 1 study revealed with improved quality of life and 1 study revealed effect on physiological outcomes. Conclusion: Music therapy has positive effect on treatment of dementia but further studies with larger sample size and specified to single intervention should be conducted to provide generalisable and precise results on this topic.

An Innovative Person-Centered Model for Provision of Mental, Social and Medical Care for People Living with Dementia

Globally there is an increased digitalization going on with an increasing number of people having access to the internet, having smartphones and now also in many countries being expected to access health-related information and schedule appointments through websites, apps or web-based portals. Healthcare providers have also adopted this with an increasing number of public or private organizations providing web-based portals as well as app interfaces to some of the largest electronic healthcare systems. The benefit of this is easier access, more efficient provision of services, increased transparency and improved workflows. This may increase the population’s capability to manage their conditions and reduce the contacts to, thereby burdening healthcare professionals. But not all will be able to benefit from this digital (r)evolution. Those who will not be able to include people with dementia. For people with dementia to also be able to take advantage of digital health tools and services, it will require planning and involvement of caregivers. In 2017, we presented the Epital Care Model as a framework to organize an efficient people-centered cross-disciplinary and cross-sectoral way to organize activities, roles, responsibilities and describe geographical locations and used technologies in response to individuals’ specific diagnoses and everyday changes in their condition. In 2021, an EU-funded project was initiated to investigate how living labs and scaling up could be done building upon the ECM. One of the living labs was organized around an organization providing care to PWD in Netherlands. In the period 2021 to 2024, we have tried to identify ways for how the ECM could be used to digitally enable the services provided by the organization. In 2022, the care organization tanteLouise started a project originally named Daycare Centre2.0 (now called “Van Thuis Uit” meaning “From Home”), together with healthcare insurance company CZ, and developed a model for onboarding people with dementia and introducing them to specific interventions based on their personal goals and needs. We here present how the ECM and the “Van Thuis Uit” can be mapped within each other to create synergy in creating a healthcare setting for people with dementia. This work may serve as a model for other conditions, where individuals are likely to need more intensive support from their informal caregivers due to a relatively rapid progression of the condition or development of severe impairments. Examples here can be neurologic conditions such as multiple sclerosis and amyotrophic lateral sclerosis or the final stage of conditions that require palliation.