New results on exhaustive search algorithm for motion estimation using adaptive partial distortion search and successive elimination algorithm

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Higher dementia incidence in older adults with type 2 diabetes and large reduction in HbA1c

BACKGROUND: although type 2 diabetes increases risk of dementia by 2-fold, whether optimizing glycemic level in late life can reduce risk of dementia remains uncertain. We examined if achieving the glycemic goal recommended by the American Diabetes Association (ADA) within a year was associated with lower risk of dementia in 6 years. METHODS: in this population-based observational study, we examined 2246 community-living dementia-free Chinese older adults with type 2 diabetes who attended the Elderly Health Centres in Hong Kong at baseline and followed their HbA1c level and cognitive status for 6 years. In line with the ADA recommendation, we defined the glycemic goal as HbA1c < 7.5%. The study outcome was incident dementia in 6 years, diagnosed according to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) or Clinical Dementia Rating of 1-3. RESULTS: those with HbA1c ≥ 7.5% at baseline and HbA1c < 7.5% in 1 year were associated with higher rather than lower incidence of dementia, independent of severe hypoglycemia, glycemic variability and other health factors. Sensitivity analyses showed that a relative reduction of ≥10%, but not 5-10%, in HbA1c within a year was associated with higher incidence of dementia in those with high (≥8%) and moderate (6.5-7.9%) HbA1c at baseline. CONCLUSION: a large reduction in HbA1c could be a potential predictor and possibly a risk factor for dementia in older adults with type 2 diabetes. Our findings suggest that optimizing or intensifying glycemic control in this population requires caution

Diurnal cortisol slope mediates the association between affect and memory retrieval in older adults with mild cognitive impairment: a path-analytical study

Background: Memory deficits are linked to dysfunctional HPA axis activity and negative affect in older adults. This study evaluated the mediating effect of the diurnal cortisol pattern on the relationship between affect and memory in older people with mild cognitive impairment (MCI). Methods: This longitudinal study recruited 189 Chinese older adults with MCI from elderly centers in Hong Kong. The participants completed assessments of affect, salivary cortisol, and digit spans at baseline; neurocognitive assessments on verbal fluency, memory retrieval, and digit spans at 6-month follow-up; and instrumental activities of daily living (IADL) at 1-year follow-up. Structural equation modeling examined the direct and indirect effects of negative affect on memory and IADL via diurnal cortisol pattern. Results: Controlling for covariates, negative affect significantly predicted flattened diurnal cortisol slopes (β = 0.17, p < 0.05) but not memory or IADL (p = 0.23 – 0.91) directly. Diurnal cortisol slopes negatively predicted memory retrieval (β = −0.20, p < 0.05), which in turn positively predicted IADL (β = 0.22, p < 0.01). The indirect effect from negative affect to IADL via cortisol slope and memory retrieval was significant and negative (αβγ = −0.05, 95% bootstrapped CI = −0.248 to −0.001). Discussion: The present study established certain temporal linkages among affect and cortisol slopes at baseline, memory retrieval at 6 months, and functional decline 1 year later in older adults with MCI. Flattened diurnal cortisol slopes might mediate the detrimental effects of negative affect on memory retrieval and functioning across 1 year

Risk of incident dementia varies with different onset and courses of depression

Background: This study aims to examine if risk of dementia differs between adult- and late-onset depression. Methods: 16,608 community-living dementia-free older adults were followed for 6 years to the outcome of incident dementia. Depression was diagnosed according to international diagnostic guidelines. Depression in adulthood or late life was categorized using age 65 as cutoff. Hazard ratio for dementia was estimated using Cox regression analysis. Results: People with depression in adulthood only did not have higher dementia incidence, suggesting those in remission from adult-onset depression are not at greater risk of dementia. Conversely, having depression in both adulthood and late life was associated with higher dementia risk, and improvement in depression in late life was associated with lower risk, suggesting persistent or recurrent lifetime depression is a risk factor for dementia. Those with depression in late life only were not associated with higher dementia risk after controlling for the longitudinal changes in depressive symptoms, consistent with late-onset depression being a prodrome of dementia. Limitations: Reverse causation is a potential limitation. This was minimized by careful ascertainment of depression and dementia cases, exclusion of individuals with suspected dementia at baseline and those who developed dementia within 3 years after baseline, and controlling for various important confounders. Conclusions: Risk of incident dementia varies with presence and resolution of depression at different ages. Further studies are needed to test whether treating adult-onset depression may prevent dementia. Older adults with a history of depression present for an extended time should be monitored for cognitive decline

Association between vascular risk factors and incident significant cognitive impairment in Chinese older people in Hong Kong in a six-year study

Objective: This study aimed to examine the association between vascular risk factors, namely hypertension, diabetes mellitus and hypercholesterolemia, and incident significant cognitive impairment in community-dwelling Chinese older people in Hong Kong. Methods: Community-dwelling Chinese older people aged 65 years and above who attended Nam Shan Elderly Health Centre in 2005 with no history of dementia or stroke constituted the baseline sample. Retrospective data retrieval for the presence of vascular risk factors at baseline was conducted. Annual clinical assessment on cognition was offered in the 6-year study period. Significant cognitive impairment was defined by presence of dementia in accordance with DSM-IV-TR, scoring below the cut-off point on the Cantonese version of the Mini-Mental State Examination, and / or a global Clinical Dementia Rating score of 1-3. Results: A total of 1925 subjects were recruited into our study; 161 (8.4%) subjects developed significant cognitive impairment in the 6-year study period. Subjects with incident significant cognitive impairment was older (75 vs. 73 years; Mann-Whitney U test, p < 0.001) with lower education attainment (30.4% vs. 23.9% of illiteracy; χ2 test, p = 0.06). However, there was no statistically significant difference in the point prevalence of pre-existing hypertension (χ2 test, p = 0.68), diabetes mellitus (χ2 test, p = 0.21), and hypercholesterolemia (χ2 test, p = 0.31) between subjects who developed significant cognitive impairment and those who remained cognitively stable. Interestingly, baseline pulse pressure, but not systolic or diastolic blood pressure, was found to be higher among subjects with incident significant cognitive impairment (70 mm Hg vs. 66 mm Hg; Mann-Whitney U test, p = 0.03). Conclusions: This study did not have evidence to show that hypertension, diabetes mellitus, and hypercholesterolemia were associated with incident significant cognitive impairment in the Chinese older people in Hong Kong. Further studies are needed to examine the role of pulse pressure in contributing to cognitive decline in late life.published_or_final_versio

Physical health and lifestyle predictors for significant cognitive impairment in community-dwelling Chinese older adults in Hong Kong

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Emergence of macrolide-resistant Mycoplasma pneumoniae in Hong Kong is linked to increasing macrolide resistance in the multilocus variable-number tandem-repeat analysis type 4-5-7-2

Macrolide-resistant Mycoplasma pneumoniae (MRMP) is rapidly emerging in Asia, but information on the temporal relationship between the increase in macrolide resistance and changes in strain types is scarce. Between 2011 and 2014, M. pneumoniae infection was diagnosed by PCR as part of routine care in a health care region in Hong Kong. Testing was initiated by clinicians, mainly in patients with suspected M. pneumoniae pneumonia. Specimens positive for M. pneumoniae were retrospectively investigated by macrolide resistance genotyping and a four-locus (Mpn13 to-16) multilocus variable-number tandem-repeat analysis (MLVA) scheme. The overall percentage of M. pneumoniae-positive specimens was 17.9%, with annual rates ranging from 9.8% to 27.2%. The prevalence of MRMP had rapidly increased from 13.6% in 2011 to 30.7% in 2012, 36.6% in 2013, and 47.1% in 2014 (P=0.038). Two major MLVA types, 4-5-7-2 and 3-5-6-2, accounted for 75% to 85% of the infections each year. MLVA types 4-5-7-2 and 3-5-6-2 predominated among macrolide-resistant and macrolide-sensitive groups, respectively. The increase in MRMP was mainly caused by increasing macrolide resistance in the prevalent MLVA type 4-5-7-2, changing from 25.0% in 2011 to 59.1% in 2012, to 89.7% in 2013, and to 100% in 2014 (P<0.001). In conclusion, increasing MRMP in Hong Kong was linked to a single MLVA type, which was both prevalent and increasingly resistant to macrolides. Copyright © 2015, American Society for Microbiology. All Rights Reserved.postprin

Widened pulse pressure is a potential risk factor for significant cognitive impairment among community-dwelling Chinese younger old people

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Interplay of transforming growth factor beta 1 and endothelin 1 signaling in subchondral osteoblast dysfunction in osteoarthritis

Electronic Poster Presentations: P40BACKGROUND: Osteoarthritis (OA) is a common degenerative disease among elderly with some cases associated with hypertension. Endothelin-1 (ET-1) is a hypertension agonist which has been shown to induce type I collagen secretion and inhibit mineralisation in osteoblasts. Upregulation of transforming growth factor beta 1 (TGFβ-1) is associated with the onset of OA. Crosstalks between TGFβ-1 and ET-1 may increase the OA ...postprin

The Effect of Paternal Age on Relapse in First-Episode Schizophrenia

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