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Development and validation of a nutrition-related genetic-clinical-radiological nomogram associated with behavioral and psychological symptoms in Alzheimer’s disease

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中华医学杂志(英文版) 2024年第18期137卷 2023 Nov 29页

作者： Jiang Jiwei Liu Yaou Wang Anxin Zhuo Zhizheng Shi Hanping Zhang Xiaoli Li Wenyi Sun Mengfan Jiang Shirui Wang Yanli Zou Xinying Zhang Yuan Jia Ziyan Xu Jun Department of Neurology Beijing Tiantan Hospital Capital Medical University Beijing China National Clinical Research Center for Neurological Diseases Beijing China Department of Radiology Beijing Tiantan Hospital Capital Medical University Beijing China Department of Gastrointestinal Surgery Beijing Shijitan Hospital Capital Medical University Beijing China Department of Clinical Nutrition Beijing Shijitan Hospital Capital Medical University Beijing China Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition Beijing China

Background: Few evidence is available in the early prediction models of behavioral and psychological symptoms of dementia (BPSD) in Alzheimer’s disease (AD). This study aimed to develop and validate a novel genetic-clinical-radiological nomogram for evaluating BPSD in patients with AD and explore its underlying nutritional ***: This retrospective study included 165 patients with AD from the Chinese Imaging, Biomarkers, and Lifestyle (CIBL) cohort between June 1, 2021, and March 31, 2022. Data on demographics, neuropsychological assessments, single-nucleotide polymorphisms of AD risk genes, and regional brain volumes were collected. A multivariate logistic regression model identified BPSD-associated factors, for subsequently constructing a diagnostic nomogram. This nomogram was internally validated through 1000-bootstrap resampling and externally validated using a time-series split based on the CIBL cohort data between June 1, 2022, and February 1, 2023. Area under receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA) were used to assess the discrimination, calibration, and clinical applicability of the ***: Factors independently associated with BPSD were:CETP rs1800775 (odds ratio [OR] = 4.137, 95% confidence interval [CI]: 1.276-13.415,P = 0.018), decreased Mini Nutritional Assessment score (OR = 0.187, 95% CI: 0.086-0.405,P <0.001), increased caregiver burden inventory score (OR = 8.993, 95% CI: 3.830-21.119,P <0.001), and decreased brain stem volume (OR = 0.006, 95% CI: 0.001-0.191,P = 0.004). These variables were incorporated into the nomogram. The area under the ROC curve was 0.925 (95% CI: 0.884-0.967,P <0.001) in the internal validation and 0.791 (95% CI: 0.686-0.895,P <0.001) in the external validation. The calibration plots showed favorable consistency between the prediction of nomogram and actual observations, and the DCA showed that the model was clinically useful in both validatio

关键词： Alzheimer’s disease behavioral and psychological symptoms Nutrition Brain stem Cholesterol ester transfer proteins Nomogram

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Comprehensive Management of Daily Living Activities,behavioral and psychological symptoms,and Cognitive Function in Patients with Alzheimer's Disease:A Chinese Consensus on Alzheimer's Disease

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Neuroscience Bulletin 2021年第7期37卷 1025-1038页

作者： Jianjun Jia Jun Xu Jun Liu Yongjun Wang Yanjiang Wang Yunpeng Cao Qihao Guo Qiuming Qu Cuibai Wei Wenshi Wei Junjian Zhang Enyan Yu Department of Neurology The Second Medical CenterPeople’s Liberation Army General HospitalBeijing 100853China Department of Neurology Beijing Tiantan HospitalCapital Medical UniversityBeijing 100050China Department of Neurology Sun Yat-sen Memorial HospitalSun Yat-sen UniversityGuangzhou 510120China Cognitive Impairment Department Shenzhen Kangning HospitalShenzhen 518118China Department of Neurology Daping HospitalArmy Medical UniversityChongqing 400042China Department of Neurology The First Hospital of China Medical UniversityShenyang 210112China Department of Gerontology Shanghai Jiaotong University Affiliated Sixth People’s HospitalShanghai 200233China Department of Neurology The First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an 710061China Department of Neurology Xuanwu Hospital Capital Medical UniversityBeijing 100053China Department of Neurology Huadong Hospital Affiliated to Fudan UniversityShanghai 200040China Department of Neurology Zhongnan Hospital of Wuhan UniversityWuhan 430071China Department of Psychology Chinese Academy of Sciences Cancer Hospital of the University of the Chinese Academy of SciencesHangzhou 310022China

Alzheimer's disease(AD)is the most common cognitive disorder in the *** main clinical manifestations are cognitive decline(C),behavioral and psychological symptoms(B),and a decline in the activities of daily living(A),also known as ABC *** identification and evaluation of ABC symptoms are helpful for establishing the accurate diagnosis,comprehensive treatment,and prognosis of *** guide Chinese clinical practice for optimization of the comprehensive management of AD,in 2018,The Academy of Cognitive Disorder of China gathered 22 neurologists and gerontologists in China to build a consensus on the comprehensive management of *** on a review of the evidence,the consensus summarizes the pathogenesis,pathological changes,clinical manifestations,evaluation,diagnosis,drug and non-drug treatment,and patient care for *** group discussion was used to establish a flowchart of comprehensive ABC management for AD *** new consensus provides a feasible AD management process for clinicians.

关键词： Alzheimer’s disease Comprehensive management Activities of daily living behavioral and psychological symptoms Cognitive function

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A Meta-analysis of Mood Stabilizers for Alzheimer's Disease

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2010年第5期30卷 652-658页

作者：肖海兵苏颖曹旭孙圣刚梁直厚 Department of Neurology Union HospitalTongji Medical CollegeHuazhong University of Science and Technology Department of Neurology the Central Hospital of Wuhan

The objective of this study was to assess the clinical evidence for or against mood stabilizers as a treatment for Alzheimer’s disease (AD).We searched 5 databases from their inception to January *** randomized clinical trials of mood stabilizers to treat human patients suffering from AD were *** trials assessed the effectiveness of mood stabilizers as an adjunct treatment to conventional anti-dementia drugs on behavioral and psychological symptoms, especially on *** quality was assessed using the Jadad *** results suggested a significant effect in favor of placebo on the Mini-Mental Status Examination [n=270, weight mean difference (WMD), -0.89; 95% confidence intervals (CIs) -1.69 to -0.09, P=0.03] and on the Neuropsychiatric Inventory total (NPI total) (n=51, WMD, 3.71; 95% CIs 0.15 to 7.26, P=0.04).There were no significant differences in change scores on total Brief Psychiatric Rating Scale (BPRS total), NPI/BPRS agitation, Cohen-Mansfield Agitation Inventory total and Physical Self Maintenance Scale between mood stabilizers and *** one of these studies was free of methodological limittions (Jadad score=5).In conclusion, based on the existing evidence, mood stabilizers are ineffective or even harmful as a treatment for AD.

关键词： Alzheimer’s disease behavioral and psychological symptoms mood stabilizers meta-analysis

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