Yumi Takahashi

Decreased Physical Activity Associated with Executive Dysfunction Correlates with Cognitive Impairment among Older Adults in the Community: A Retrospective Analysis from the Kurihara Project

Background/Aims: No previous studies have explored the relationship between physical activity (PA) and executive dysfunction. Methods: We retrospectively evaluated the PA for 590 older participants in the Kurihara Project; 221 participants had a Clinical Dementia Rating (CDR) of 0 (healthy), 295 CDR 0.5 (very mild dementia), and 74 CDR 1+ (dementia). Results: In the complicated task, whether the motor intensity was high (e.g. farming) or low (e.g. shopping), PA exhibited an inverse relationship with the CDR level. By contrast, for simple tasks with high intensity (e.g. walking), no CDR group differences were noted. For PA with low intensity (e.g. cleaning), the CDR 1+ group exhibited decreased levels. Conclusion: PA was related to the burden of executive function in patients with mild cognitive impairment; however, in patients with dementia, PA was related to both the burden of executive function and motor intensity.

A Cluster Randomized Controlled Trial of Nonpharmacological Interventions for Old-Old Subjects with a Clinical Dementia Rating of 0.5: The Kurihara Project

Background: Evidence as to the benefits of nonpharmacological interventions for the boundary state between normal aging and dementia [mild cognitive impairment or a Clinical Dementia Rating (CDR) of 0.5] remains weak due to a lack of positive controls. Aims: To directly compare the effects of cognitive interventions (CI), physical activities (PA) and a group reminiscence approach (GRA), we conducted a pilot study on the basis of a cluster randomized controlled trial design. Method: A total of 127 participants aged >74 years with a CDR of 0.5 were cluster randomized into three groups for CI, PA and GRA. The intervention lasted 12 weeks and consisted of weekly group sessions and home assignments. Mini-Mental State Examination (MMSE), Trail Making Test part A (TMT-A), word fluency (WF), 6-meter walk time and Quality of Life (QOL) Face Scale scores were evaluated as primary outcomes. Results: Methodology-related benefits of CI and PA were found for MMSE scores and walk time, respectively. TMT-A, WF and QOL Face Scale scores improved irrespective of the methodologies used. Conclusions: Our findings suggest that CI and PA may be beneficial to cognitive and physical abilities, respectively. Executive functions and QOL may improve irrespective of the intervention methodologies used.

A randomized controlled trial of psychosocial interventions for old-old people with mild cognitive impairment (MCI): Patient-reported outcomes—The Kurihara project

Background: Cognitive training is beneficial for patients with Mild Cognitive Impairment (MCI). However, more studies are needed to evaluate the longitudinal benefit yielded from the cognitive training. Patients with amnesic and multiple domains Mild Cognitive Impairment (aMCImd) were followed up after long-term participation in cognitive training. Methods: Participants were 87 aMCImd patients, classified in experimental and control groups, matched in age, gender, education, cognitive and functional performance. Results: At the follow up, there were significant differences in between-groups performance, with the experimental group performing higher in verbal (p€ı,£ .009) and visual memory (p1⁄4 .018), visual constructive abilities (p1⁄4 .018), language (p1⁄4 .026), executive function (p€ı,£ .014), global cognitive function (p1⁄4 .004), executive function in ADL (p1⁄4 .014) and ADL (p1⁄4 .003). Within-group analysis for the experimental group indicated improvement of attention, (p .009), verbal memory (p .010), visual memory (p1⁄4 .038), language (p1⁄4 .000). In contrast, the control group, showed deterioration in verbal memory (p€ı,£ .021), executive function (p€ı,£ .013), executive function in ADL. Conclusions: Longitudinal cognitive training helped aMCImd patients improve their cognitive performance, generalize the primary cognitive benefit to other cognitive domains and stabilize activities of daily living (ADL).

Mouthparts in Leptotrombidium larvae (Acariformes: Trombiculidae)

Mouthparts of Leptotrombidium larvae (Acariformes: Trombiculidae), potential vectors of tsutsugamushi disease agents, were studied in detail using light microscopy, scanning electron microscopy, and transmission electron microscopy. The mouthparts incorporated within the pseudotagma gnathosoma are composed of the infracapitulum ventrally and the chelicerae dorsally. The ventral wall of the infracapitulum is formed by a wide mentum posteriorly and a narrowed malapophysis anteriorly. The malapophysis firmly envelops the distal cheliceral portions by its lateral walls. The lateral lips of the malapophysis are flexible structures hiding the cheliceral blades in inactive condition and turning back forming a type of temporary sucker closely applied to the host skin during feeding. The roof of the infracapitulum is formed by a weakly sclerotized labrum anteriorly and a cervix with the capitular apodemes extending posteriorly. The labral muscles are lacking. The capitular apodemes serve as origin for pharyngeal dilators running to the dorsal wall of the pharynx fused with the bottom of the infracapitulum. The basal cheliceral segments are separated from each other besides the very posterior portions where they are movably joined by the inner walls. The sigmoid pieces serve for insertion of the cheliceral elevators originating at the posterior portions of the basal segments. The movable digits reveal the solid basal sclerite and the cheliceral blade curved upward with a tricuspid cap on its tip. Dendrites of nerve cells run along the digits to their tips. The ganglia are placed within the basal segments just behind the movable digits. The chelicerae also reveal well developed flexible fixed digits overhanging the basal portions of the blades. The gnathosoma possesses several sets of extrinsic muscles originating at the scutum and at the soft cuticle behind it. Laterally, the gnathosoma bears five‐segmented palps with a trifurcate palpal claw. J. Morphol. 277:424–444, 2016.

Semantic Dementia Shows both Storage and Access Disorders of Semantic Memory

Objective. Previous studies have shown that some patients with semantic dementia (SD) have memory storage disorders, while others have access disorders. Here, we report three SD cases with both disorders. Methods. Ten pictures and ten words were prepared as visual stimuli to determine if the patients could correctly answer names and select pictures after hearing the names of items (Card Presentation Task, assessing memory storage disorder). In a second task, the viewing time was set at 20 or 300 msec (Momentary Presentation Task, evaluating memory access disorder) using items for which correct answers were given in the first task. The results were compared with those for 6 patients with Alzheimers disease (AD). Results. The SD patients had lower scores than the AD group for both tasks, suggesting both storage and access disorders. The AD group had almost perfect scores on the Card Presentation Task but showed impairment on the Momentary Presentation Task, although to a lesser extent than the SD cases. Conclusions. These results suggest that SD patients have both storage and access disorders and have more severe access disorder than patients with AD.

A randomized controlled trial of psychosocial interventions for old-old people with mild cognitive impairment (MCI): Physical and neuropsychological outcomes—The Kurihara project

Background: Cognitive training is beneficial for patients with Mild Cognitive Impairment (MCI). However, more studies are needed to evaluate the longitudinal benefit yielded from the cognitive training. Patients with amnesic and multiple domains Mild Cognitive Impairment (aMCImd) were followed up after long-term participation in cognitive training. Methods: Participants were 87 aMCImd patients, classified in experimental and control groups, matched in age, gender, education, cognitive and functional performance. Results: At the follow up, there were significant differences in between-groups performance, with the experimental group performing higher in verbal (p€ı,£ .009) and visual memory (p1⁄4 .018), visual constructive abilities (p1⁄4 .018), language (p1⁄4 .026), executive function (p€ı,£ .014), global cognitive function (p1⁄4 .004), executive function in ADL (p1⁄4 .014) and ADL (p1⁄4 .003). Within-group analysis for the experimental group indicated improvement of attention, (p .009), verbal memory (p .010), visual memory (p1⁄4 .038), language (p1⁄4 .000). In contrast, the control group, showed deterioration in verbal memory (p€ı,£ .021), executive function (p€ı,£ .013), executive function in ADL. Conclusions: Longitudinal cognitive training helped aMCImd patients improve their cognitive performance, generalize the primary cognitive benefit to other cognitive domains and stabilize activities of daily living (ADL).

BEHAVIORAL AND PSYCHOLOGICAL SYMPTOMS OF DEMENTIA (BPSD) IN ALZHEIMER DISEASE IS “COGNITIVE” SYMPTOMS? THE OSAKI-TAJIRI PROJECT

MINT (68) 62 (2.1) 61 (3.3) 59 (4.0) 60.8 (2.4) 45.2 (8.5) 0.01y Nouns denomination (16) 15.6 (0.5) 12.4 (6.3) 15.6 (0.8) 15 (0.7) 7.4 (6.4) 0.04y Verbs denomination (16) 13.3 (2.8) 10.4 (15.9) 13 (1.8) 13.2 (0.8) 4.4 (5.3) 0.04y Northwestern Anagrams (10) 9.6 (0.6) 9.4 (0.8) 10 (0) 6.4 (3.7) 0 <0.01y Sentence’s lecture (5) 4.9 (0.3) 5(0) 5(0) 4.8 (0.4) 1.8 (1.6) 0.017y Sentences’s repetition (5) 5(0) 5(0) 4.6 (0.5) 4.8 (0.4) 1.2 (1.6) <0.01y Animals semantic fluency 19.4 (4.9) 19 (6.8) 17.8 (3.2) 15.2 (6.6) 6.2 (3.7) 0.018y Vegetables semantic fluency 13.2 (4.3) 12.8 (3.6) 11.4 (3.0) 10.4 (4.8) 3.6 (1.5) 0.020y Phonological fluency letter M 11.6 (2.8) 11.4 (5.6) 14.2 (3.7) 10.4 (5.4) 2 (1.2) 0.019y Phonological fluency letter P 11.2 (4.1) 12.4 (8.1) 17.2 (2.5) 14.2 (7.9) 2.8 (1.3) 0.013y Semantic word picture matching test (20) 19.8 (0.6) 19.2 (1.7) 19.8 (0.4) 19.8 (0.4) 18 (1.4) 0.043y

Words are processed faster than pictures in Alzheimer’s brain: The osaki-tajiri project

Background:Protein aggregates containing b-amyloid (Ab), phosphorylated tau, and a-synuclein (aSyn) are diagnostic hallmarks of common neurodegenerative diseases. Traditional neuropathological diagnosis of Alzheimer’s disease (AD) and Lewy Body Dementia (LBD) relies on semi-quantitative estimation of the density and distribution of amyloid plaques, neurofibrillary tangles (NFT), and Lewy bodies (LB). Though historically useful, this approach cannot provide more detailed comparisons between subjects and is fraught with inter-rater variability. This study aims to examine the: (1) correlation between quantitative measures of the triple proteinopathies and their corresponding semi-quantitative staging; and (2) relationship between the proteinopathies.Methods:From the Oregon Alzheimer’s Disease Center Brain Bank, 220 subjects (68 with normal cognition at death) were selected for having: (1) age at cognitive symptom onset or age at death above 60; (2) available postmortem frozen frontal lobe brain tissue; (3) no missing data or data outside 5 standard deviations from the means; and (4) exclusion of subjects with non-AD tauopathy. Detergent-insoluble proteins were prepared and antibody capture assays were used to quantify a-Syn, Ab42, Ab40, amyloid oligomer (AO), Ab-total, phosphorylated(p-)tau-396, and tau-total. Histologic examinations of samples were done for conventional assessments of LB, NFT, neuritic plaques (NP), and diffuse plaques (DP) burdens. Multivariate regression analyses, correcting for age at death, duration of illness, and cognitive status, examined the correlation between the quantitative variables and histological stages, and the correlation between different proteinopathies. Results:Quantitative levels of aSyn, Ab42, Ab-total, p-tau-396, and tau-total correlated well with their corresponding histological assessments (LB, NP/ DP, and NFT), and AO was correlated with NP burden. Presence of LB was not correlated with NP, DP, or NFT burdens (p > 0.05). In contrast, aSyn was significantly associated with AO (p 1⁄4 0.012) and p-tau-396 (p 1⁄4 0.002). Conclusions: Quantification of aSyn, Ab, and p-tau in detergent-insoluble brain proteins correlates well with traditional semi-quantitative staging. It is more sensitive in detecting the relationships between proteinopathies that are not detected by traditional staging and can be a powerful tool for future studies. It provides a more precise and objective measure of proteinopathies in neurodegenerative disease.

Effectiveness of the Montreal Cognitive Assessment (MoCA) for assessing frontal hypoperfusion in people with vascular dementia: The Osaki-Tajiri Project

Background: The CogState brief battery consists of four card playing tasks, which assesses the cognitive domains of psychomotor function, attention, visual learning, and visual working memory. Previous studies have demonstrated the utility and sensitivity of the CogState brief battery for detection of cognitive impairment in Alzheimer’s disease (AD) and mild cognitive impairment (MCI), and for the measurement of cognitive change in the preclinical stages of AD. Thus, the CogState brief battery may be a useful screening tool to assist the management of cognitive function in clinical settings. This study aimed to determine the clinical utility of the CogState brief battery. Methods: Healthy older adults (n 1⁄4 653), adults with MCI (n 1⁄4 68), and adults with AD (n 1⁄4 44) who completed the CogState brief battery were recruited from the Australian Imaging, Biomarkers, and Lifestyle (AIBL) Study of Ageing, and the AIBL-Rate of Change sub-study (AIBL-ROCS). The four performance measures of the CogState brief battery were reduced to two composites a psychomotor/attention composite and a learning/working memory composite. Sensitivity and specificity analyses were conducted on the two composites to determine their clinical utility. Results: Large impairments inMCI (d1⁄4 1.20) and AD (d1⁄4 2.20) were identified for the learning/working memory composite but not the psychomotor/attention composite (MCI d 1⁄4 0.40; AD d 1⁄4 0.50). Using a cutscore of -1.96, the learning/working memory composite showed 85.71% sensitivity and 96.81% specificity to a clinical classification of AD. Both composite scores showed high test-retest reliability (0.95) over four months. Performance on the memory composite was also related to performance on the MMSE, with worse scores on the MMSE associated with worse performance on the CogState memory composite. Additionally, increasing severity on the CDR, sum of boxes score was also associated with worse performance on the CogState memory composite. Conclusions: The results of this study suggest that the CogState memory composite is a useful tool for the identification of AD related memory impairment, and correlates well with traditional measures of disease classification.