White Matter Hyperintensities and the Course of Depressive Symptoms in Elderly People with Mild Dementia

Objectives: To explore the relationship between white matter hyperintensities (WMH) and the prevalence and course of depressive symptoms in mild Alzheimer’s disease (AD) and Lewy body dementia. Design: This is a prospective cohort study conducted in secondary care outpatient clinics in western Norway. Subjects: The study population consisted of 77 elderly people with mild dementia diagnosed according to standardised criteria. Methods: Structured clinical interviews and physical, neurological, psychiatric, and neuropsychological examinations were performed and routine blood tests were taken. Depression was assessed using the depression subitem of the Neuropsychiatric Inventory and the Montgomery-Åsberg Depression Rating Scale (MADRS). A standardised protocol for magnetic resonance imaging scan was used, and the volumes of WMH were quantified using an automated method, followed by manual editing. Results: The volumes of total and frontal deep WMH were significantly and positively correlated with baseline severity of depressive symptoms, and depressed patients had significantly higher volumes of total and frontal deep WMH than non-depressed patients. Higher volumes of WMH were also associated with having a high MADRS score and incident and persistent depression at follow-up. After adjustment for potential confounders, frontal deep WMH, in addition to prior depression and non-AD dementia, were still significantly associated with baseline depressive symptoms (p = 0.015, OR 3.703, 95% CI 1.294–10.593). Similar results emerged for total WMH. Conclusion: In elderly people with mild dementia, volumes of WMH, in particular frontal deep WMH, were positively correlated with baseline severity of depressive symptoms, and seemed to be associated with persistent and incident depression at follow-up. Further studies of the mechanisms that determine the course of depression in mild dementia are needed

Low Recruitment in a Population of Brook Trout in a Norwegian Watershed—Is It Due to Dilution of the Water Chemistry?

Dilution of the water chemistry caused by reduced acidification has lately received increased attention, both in Europe and North America. There has also been a declining trend in the supply of sea salts. Several studies have predicted detrimental effects on aquatic life due to dilution. A population of brook trout living in River Hunnedal in southwestern Norway was studied for 14 years (2006–2019).Despite acceptable water chemistry with respect to pH and inorganic Al, limited reproduction was found. With median conductivity, Ca and Na of 7.1– 8.6 μScm−1, and 0.17–0.19 and 0.9–1.0 mgL−1, respectively, the water at the study sites was found to be extremely dilute. We detected a significant positive effect of Na on the densities of brook trout fry, while a less distinct effect of Ca was found. However, due to the correlation between Ca and Na we cannot conclude that Ca is unimportant. For all samplings without catch of fry (n = 13), Na was 0.86 ± 0.15 mgL−1, suggesting a critical limit for Na slightly below 1 mgL−1.We suggest that the reproduction of brook trout was restricted by the highly dilute water and the subsequent scarcity of essential ions. Acidification recovery . Water chemistry . Dilution . Calcium. Sodium. Mountain streams . Brook troutpublishedVersio

Low Recruitment in a Population of Brook Trout in a Norwegian Watershed—Is It Due to Dilution of the Water Chemistry?

Dilution of the water chemistry caused by reduced acidification has lately received increased attention, both in Europe and North America. There has also been a declining trend in the supply of sea salts. Several studies have predicted detrimental effects on aquatic life due to dilution. A population of brook trout living in River Hunnedal in southwestern Norway was studied for 14 years (2006–2019).Despite acceptable water chemistry with respect to pH and inorganic Al, limited reproduction was found. With median conductivity, Ca and Na of 7.1– 8.6 μScm−1, and 0.17–0.19 and 0.9–1.0 mgL−1, respectively, the water at the study sites was found to be extremely dilute. We detected a significant positive effect of Na on the densities of brook trout fry, while a less distinct effect of Ca was found. However, due to the correlation between Ca and Na we cannot conclude that Ca is unimportant. For all samplings without catch of fry (n = 13), Na was 0.86 ± 0.15 mgL−1, suggesting a critical limit for Na slightly below 1 mgL−1.We suggest that the reproduction of brook trout was restricted by the highly dilute water and the subsequent scarcity of essential ions. Acidification recovery . Water chemistry . Dilution . Calcium. Sodium. Mountain streams . Brook trou

A longitudinal study of anxiety and cognitive decline in dementia with Lewy bodies and Alzheimer’ s disease

This article was originally published in the journal "Alzheimer's Research & Therapy". This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.Background Anxiety in dementia is common but not well studied. We studied the associations of anxiety longitudinally in Alzheimer’s disease (AD) and dementia with Lewy bodies (DLB). Methods In total, 194 patients with a first-time diagnosis of dementia were included (n = 122 patients with AD, n = 72 patients with DLB). Caregivers rated the patients’ anxiety using the Neuropsychiatric Inventory, and self-reported anxiety was assessed with the anxiety and tension items on the Montgomery–Åsberg Depression Rating Scale. The Mini Mental State Examination was used to assess cognitive outcome, and the Clinical Dementia Rating (CDR)-Global and CDR boxes were used for dementia severity. Linear mixed effects models were used for longitudinal analysis. Results Neither in the total sample nor in AD or DLB was caregiver-rated anxiety significantly associated with cognitive decline or dementia severity over a 4-year period. However, in patients with DLB, self-reported anxiety was associated with a slower cognitive decline than in patients with AD. No support was found for patients with DLB with clinical anxiety having a faster decline than patients with DLB without clinical anxiety. Over the course of 4 years, the level of anxiety declined in DLB and increased in AD. Conclusions Anxiety does not seem to be an important factor for the rate of cognitive decline or dementia severity over time in patients with a first-time diagnosis of dementia. Further research into anxiety in dementia is needed

Stress in School. Some Empirical Hints on the Circadian Cortisol Rhythm of Children in Outdoor and Indoor Classes

This prospective longitudinal survey compared the stress levels of students taught using an outdoor curriculum in a forest, with children in a normal school setting. We were especially interested in the effect outdoor teaching might have on the children’s normal diurnal cortisol rhythm. 48 children (mean age = 11.23; standard deviation (SD) = 0.46) were enrolled, with 37 in the intervention group (IG), and 11 in the control group (CG). The intervention consisted of one full school day per week in the forest over the school year. Stress levels were measured in cortisol with three samples of saliva per day. Furthermore, the data allowed for statistical control of physical activity (PA) values. For data analysis, we used a linear mixed-effects model (LMM) with random intercept and general correlation matrix for the within-unit residuals. The LMM yields that IG have expected greater decline of cortisol compared to CG; rate 0.069 µg/L vs. 0.0102 µg/L (log-units/2 h), p = 0.009. PA does not show a statistically significant interaction with cortisol (p = 0.857), despite being higher in the intervention group (p < 0.001). The main effect in our measures was that the IG had a steady decline of cortisol during the school day. This is in accordance with a healthy child’s diurnal rhythm, with a significant decline of cortisol from morning to noon. This effect is constant over the school year. The CG does not show this decline during either measurement day. Further research is needed to fully explain this interesting phenomenon

A Longitudinal Study of Neurocognition in Dementia with Lewy Bodies Compared to Alzheimer’s Disease

IntroductionThere are relatively few longitudinal studies on the differences in cognitive decline between Alzheimer’s disease (AD) and dementia with Lewy bodies (DLB), and the majority of existing studies have suboptimal designs.AimWe investigated the differences in cognitive decline in AD compared to DLB over 4 years and cognitive domain predictors of progression.MethodsIn a longitudinal study, 266 patients with first-time diagnosis of mild dementia were included and followed annually. The patients were tested annually with neuropsychological tests and screening instruments [MMSE (Mini-Mental Status Examination), Clinical Dementia Rating (CDR), the second edition of California Verbal Learning Test (CVLT-II), Trail Making Test A & B (TMT A & B), Stroop test, Controlled Oral Word Associations Test (COWAT) animal naming, Boston Naming Test, Visual Object and Space Perception Battery (VOSP) Cubes and Silhouettes]. Longitudinal analyses were performed with linear mixed effects (LME) models and Cox regression. Both specific neuropsychological tests and cognitive domains were analyzed.ResultsThis study sample comprised 119 AD and 67 DLB patients. In TMT A, the DLB patients had a faster decline over 4 years than patients with AD (p = 0.013). No other longitudinal differences in specific neuropsychological tests were found. Higher executive domain scores at baseline were associated with a longer time to reach severe dementia (CDR = 3) or death for the total sample (p = 0.032). High or low visuospatial function at baseline was not found to be associated with cognitive decline (MMSE) or progression of dementia severity (CDR) over time.ConclusionOver 4 years, patients with DLB had a faster decline in TMT A than patients with AD, but this should be interpreted cautiously. Beyond this, there was little support for faster decline in DLB patients neuropsychologically than in AD patients

Determinants of interindividual variation in exercise-induced cardiac troponin i levels

Background Postexercise cardiac troponin levels show considerable interindividual variations. This study aimed to identify the major determinants of this postexercise variation in cardiac troponin I (cTnI) following 3 episodes of prolonged high‐intensity endurance exercise. Methods and Results Study subjects were recruited among prior participants in a study of recreational cyclists completing a 91‐km mountain bike race in either 2013 or 2014 (first race). In 2018, study participants completed a cardiopulmonary exercise test 2 to 3 weeks before renewed participation in the same race (second race). Blood was sampled before and at 3 and 24 hours following all exercises. Blood samples were analyzed using the same Abbot high‐sensitivity cTnI STAT assay. Fifty‐nine individuals (aged 50±9 years, 13 women) without cardiovascular disease were included. Troponin values were lowest before, highest at 3 hours, and declining at 24 hours. The largest cTnI difference was at 3 hours following exercise between the most (first race) (cTnI: 200 [87–300] ng/L) and the least strenuous exercise (cardiopulmonary exercise test) (cTnI: 12 [7–23] ng/L; P<0.001). The strongest correlation between troponin values at corresponding times was before exercise (r=0.92, P<0.0001). The strongest correlations at 3 hours were between the 2 races (r=0.72, P<0.001) and at 24 hours between the cardiopulmonary exercise test and the second race (r=0.83, P<0.001). Participants with the highest or lowest cTnI levels showed no differences in race performance or baseline echocardiographic parameters. Conclusions The variation in exercise‐induced cTnI elevation is largely determined by a unique individual cTnI response that is dependent on the duration of high‐intensity exercise and the timing of cTnI sampling.publishedVersio