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      Recent research about mild cognitive impairment in China Translated title: 中国轻度认知功能损害的研究进展

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          Summary:

          The rapid aging of the Chinese population has spurred interest in research about the cause and prevention of dementia and its precursor, mild cognitive impairment (MCI). This review summarizes the last decade of research in China about MCI. Extensive research about the epidemiology, neuropsychological characteristics, diagnosis, genetic etiology, neuroimaging and electrophysiological changes, and treatment of MCI has provided some new insights but few breakthroughs. Further advances in the prevention and treatment of MCI will require a greater emphasis on multi-disciplinary prospective studies with large, representative samples that use standardized methods to assess and monitor changes in cognitive functioning over time.

          摘要:

          中国人口的迅速老龄化促进了对老年痴呆及其前体(轻度认知功能损害,MCI)的病因和预防的研究。本文综述了过去十年中国有关MCI的研究。有关MCI的流行病学、神经心理特征、诊断学、遗传病因学、神经影像学和电生理变化以及治疗方面的广泛研究已提供了一些新的见解,但很少有突破结果。对于MCI的预防与治疗,未来的发展方向则更注重具有代表性的大样本多学科前瞻性研究,并使用标准化方法来评估和监测认知功能随着时间的推移而产生的变化。

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          Most cited references94

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          Vascular cognitive impairment.

          Cerebrovascular disease is the second most common cause of acquired cognitive impairment and dementia and contributes to cognitive decline in the neurodegenerative dementias. The current narrow definitions of vascular dementia should be broadened to recognise the important part cerebrovascular disease plays in several cognitive disorders, including the hereditary vascular dementias, multi-infarct dementia, post-stroke dementia, subcortical ischaemic vascular disease and dementia, mild cognitive impairment, and degenerative dementias (including Alzheimer's disease, frontotemporal dementia, and dementia with Lewy bodies). Here we review the current state of scientific knowledge on the subject of vascular brain burden. Important non-cognitive features include depression, apathy, and psychosis. We propose use of the term vascular cognitive impairment, which is characterised by a specific cognitive profile involving preserved memory with impairments in attentional and executive functioning. Diagnostic criteria have been proposed for some subtypes of vascular cognitive impairment, and there is a pressing need to validate and further refine these. Clinical trials in vascular cognitive impairment are in their infancy but support the value of therapeutic interventions for symptomatic treatment.
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            Altered lymphocyte distribution in Alzheimer's disease.

            The contribution of immunological factors in the etiopathogenesis of Alzheimer's disease (AD) is increasingly noted. Apart from cerebral immunological findings, peripheral changes of the immune systems have been reported including lymphocyte function and subset distribution. As data still remain inconsistent, we investigated a sample of 43 patients with AD and of 34 healthy age-matched controls. Distribution of the T-, B- and NK cell subsets was determined by flow cytometry (FACS). We found a significant decrease of CD3(+) lymphocytes as well as of CD19(+) lymphocytes. A slight increase of the CD4(+) and a decrease of the CD8(+) subpopulation could be observed, without significant change of the CD4(+)/CD8(+) ratio. CD16(+)56(+) cells were not altered. Our findings of decreased T- and B-Cell numbers in AD sustain the hypothesis of a general decline of immune activity in AD. A putative association with premature immunosenescence in AD and possible pathogenetic implications are discussed.
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              Alzheimer's disease associated with mutations in presenilin 2 is rare and variably penetrant.

              Missense mutations in the presenilin 2 (PS-2) gene on chromosome 1 were sought by direct nucleotide sequence analysis of the open reading frame of 60 pedigrees with familial Alzheimer's disease (FAD). In the majority of these pedigrees, PS-1 and beta-amyloid precursor protein (beta APP) gene mutations had been excluded. While no additional PS-2 pathogenic mutations were detected, four silent nucleotide substitutions and alternative splicing of nucleotides 1338-1340 (Glu325) were observed. Analysis of additional members of a pedigree known to segregate a Met239Val mutation in PS-2 revealed that the age of onset of symptoms is highly variable (range 45-88 years). This variability is not attributable to differences in ApoE genotypes. These results suggest (i) that, in contrast to mutations in PS-1, mutations in PS-2 are a relatively rare cause of FAD; (ii) that other genetic or environmental factor modify the AD phenotype associated with PS-2 mutations; and (iii) that still other FAD susceptibility genes remain to be identified.
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                Author and article information

                Journal
                Shanghai Arch Psychiatry
                Shanghai Arch Psychiatry
                SAP
                Shanghai Archives of Psychiatry
                Shanghai Municipal Bureau of Publishing (Shanghai, China )
                1002-0829
                February 2014
                : 26
                : 1
                : 4-14
                Affiliations
                [1]Diagnosis and Treatment Center of Alzheimer’s Disease, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
                Author notes
                [* ]correspondence: xiaoshifu@ 123456msn.com

                The authors report no conflict of interest related to this manuscript.

                Article
                sap-26-01-004
                10.3969/j.issn.1002-0829.2014.01.002
                4117997
                25114476
                13fbd391-ff27-41b6-89ff-d8e9b4f1669c
                Copyright © 2014 by Shanghai Municipal Bureau of Publishing

                This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/

                History
                : 29 July 2013
                : 13 November 2013
                Funding
                Funded by: National Pillar Program of the Ministry of Science and Technology
                Award ID: 2009BAI77B03
                Funded by: Office of Medical Affairs, Ministry of Health
                Award ID: 2011-873
                Preparation of this manuscript was supported by the National Pillar Program (project number: 2009BAI77B03) of the Ministry of Science and Technology, and by the National Key Clinical Disciplines at Shanghai Mental Health Center (Office of Medical Affairs, Ministry of Health, 2011-873; OMA-MH, 2011-873).
                Categories
                Review

                mild cognitive impairment,dementia,research methodology,china

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