Adapted MMSE and TYM cognitive tests: how much powerful in screening for Alzheimer�s disease in Iranian people

Alzheimer�s disease (AD) is a major global health priority and providing an efficient way for early diagnosis of people developing dementia is important. The Mini-Mental State Examination (MMSE, total score = 30) and Test Your Memory (TYM, total score = 50) are widely used as screening tests for cognitive function. In the present study 174 subjects including healthy people (CON group) and those having Alzheimer�s disease (AD group) were introduced to MMSE and TYM cognitive tests adjusted to Iranian population. Sensitivities and specificities with optimal cut-off scores, area under curve (AUC), positive predictive value (PPV) and negative predictive value (NPV) were measured for both tests. The MMSE scores of the CON and AD groups were 23.77 ± 0.327 and 10.88 ± 0.762, respectively. The TYM scores were 44.32 ± 0.389 and 14.37 ± 1.368 in the CON and AD participants, respectively. Findings in the MMSE test were: AUC = 0.962, optimal cut-off score = 18.5, sensitivity = 0.90 and specificity = 0.96. Values in the TYM test were: AUC = 0.991, optimal cut-off score = 31, sensitivity = 0.90 and specificity = 1. We found no correlation between the cognitive performance and age in the CON group but a positive correlation in the AD patients. On the other hand, t-test analysis indicated that achievement of the test scores are significantly sex dependent, with more scores attained by the females. Taken together, in regard to correct classification rate (CCR); the TYM test seems to be more appropriate for cognitive screening in our study. However, considering an analogous AUC, both tests are comparable and have high sensitivity and specificity for discriminating between people with and without AD. © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group

Does severity of Alzheimer's disease contribute to its responsiveness to modifying gut microbiota? A double blind clinical trial

Alzheimer's disease (AD) is associated with cognitive dysfunction. Evidence indicates that gut microbiota is altered in the AD and, hence, modifying the gut flora may affect the disease. In the previous clinical research we evaluated the effect of a probiotic combination on the cognitive abilities of AD patients. Since, in addition to pathological disorders, the AD is associated with changes in oxidant/antioxidant and inflammatory/anti-inflammatory biomarkers, the present work was designed to evaluate responsiveness of the inflammatory and oxidative biomarkers to the probiotic treatment. The control (CON) and probiotic (PRO) AD patients were treated for 12 weeks by the placebo and probiotic supplementation, respectively. The patients were cognitively assessed by Test Your Memory (TYM = 50 scores). Also serum concentrations of nitric oxide (NO), glutathione (GSH), total antioxidant capacity (TAC), malondialdehyde (MDA), 8-hydroxy-2' -deoxyguanosine (8-OHdG) and cytokines (TNF-α, IL-6, and IL-10) were measured. The cognitive test and the serum biomarkers were assessed pre- and post-treatment. According to TYM test 83.5 of the patients showed severe AD. The CON (12.86 ± 8.33) and PRO (-9.35 ± 16.83) groups not differently scored the cognitive test. Not pronounced change percent was found in the serum level of TNF-α (1.67 ± 1.33 vs. -0.15 ± 0.27), IL-6 (0.35 ± 0.17 vs. 2.18 ± 0.15), IL-10 (0.05 ± 0.10 vs. -0.70 ± 0.73), TAC (0.07 ± 0.07 and -0.06 ± 0.03), GSH (0.08 ± 0.05 and 0.04 ± 0.03) NO (0.11 ± 0.06 and 0.05 ± 0.09), MDA (-0.11 ± 0.03 and -0.17 ± 0.03), 8-OHdG (43.25 ± 3.01 and 42.70 ± 3.27) in the CON and PRO groups, respectively. We concluded that the cognitive and biochemical indications in the patients with severe AD are insensitive to the probiotic supplementation. Therefore, in addition to formulation and dosage of probiotic bacteria, severity of disease and time of administration deeply affects results of treatment. © 2018 Agahi, Hamidi, Daneshvar, Hamdieh, Soheili, Alinaghipour, Esmaeili Taba and Salami

Determinantes individuales y sociales del estado de salud subjetivo y bienestar de la población de la tercera edad de Portugal

This article aims to identify the main determinants of self-rated health and well-being in the elderly Portuguese population, using a set of dimensions including demographic and socioeconomic indicators, characteristics of interpersonal networks and social activities, health, sexual activity, representations of aging, and feeling of happiness. Taking socioeconomic, behavioral, and attitudinal predictors into account to analyze the explanatory value of the interrelated dimensions and weights for each factor, the author argues that social capital, activities associated with active aging, and greater optimism towards aging can contribute greatly to better self-rated health and wellbeing among the elderly, partially offsetting the effect of socioeconomic factors and illness associated with age.Neste artigo pretende-se identificar os principais determinantes da autoavaliação do estado de saúde e do bem-estar da população sênior, tendo em conta um conjunto de dimensões que reúnem indicadores demográficos e socioeconômicos, características das redes interpessoais e atividades sociais praticadas, de saúde, atividade sexual, de representações sobre o envelhecimento e sentimento de felicidade. A equação em simultâneo de preditores socioeconômicos e de caráter comportamental e atitudinal dessas várias vertentes, com o intuito de analisar o valor explicativo de cada uma das dimensões inter-relacionadas e o peso de cada um dos fatores, permite concluir que o social capital, a prática de atividades associadas ao envelhecimento ativo e um maior otimismo em relação ao envelhecimento podem contribuir em grande medida para uma melhor autoavaliação do estado de saúde e do bemestar dos mais velhos, compensando, em parte, o efeito de fatores socioeconômicos e de doença associados à idade