Expert Consensus on the Care and Management of Patients with Cognitive Impairment in China

Han, Yuliang; Jia, Jianjun; Li, Xia; Lv, Yang; Sun, Xuan; Wang, Shanshan; Wang, Yongjun; Wang, Zhiwen; Zhang, Jintao; Zhou, Jiong; Zhou, Yuying

doi:10.1007/s12264-019-00444-y

Cited by 23 publications

(16 citation statements)

References 83 publications

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“…Like many chronic diseases, chronic stress is also considered a form of prolonged distress, which can potentially impact on individual mental health and cognitive function [5]. Individuals exposed to many stressors may also have a range of physiological and psychological responses, including distraction [6], anxiety [7], insomnia [8], muscle pain [9], hypertension, and an impaired immune system [10], and stressors can cause major diseases such as heart disease and depression [11]. Chronic stress can promote the production of dysfunctional immune Qingjin Liu and Yong Liu contributed equally to this work.…”

Section: Introductionmentioning

confidence: 99%

Impact of Chronic Stress on Attention Control: Evidence from Behavioral and Event-Related Potential Analyses

Liu

Leng

et al. 2020

Neurosci. Bull.

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Chronic stress affects brain function, so assessing its hazards is important for mental health. To overcome the limitations of behavioral data, we combined behavioral and event-related potentials (ERPs) in an attention network task. This task allowed us to differentiate between three specific aspects of attention: alerting, orienting, and execution. Forty-one participants under chronic stress and 31 non-stressed participants were enrolled. On the performance level, the chronically stressed group showed a significantly slower task response and lower accuracy. Concerning ERP measures, smaller cue-N1, cue-N2, and larger cue-P3 amplitudes were found in the stressed group, indicating that this group was less able to assign attention to effective information, i.e., they made inefficient use of cues and had difficulty in maintaining alerting. In addition, the stressed group showed larger target-N2 amplitudes, indicating that this group needed to allocate more cognitive resources to deal with the conflict targets task. Subgroup analysis revealed lower target-P3 amplitudes in the stressed than in the non-stressed group. Group differences associated with the attention networks were found at the ERP level. In the stressed group, excessive depletion of resources led to changes in attention control. In this study, we examined the effects of chronic stress on individual executive function from a neurological perspective. The results may benefit the development of interventions to improve executive function in chronically stressed individuals.

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Section: Introductionmentioning

confidence: 99%

Impact of Chronic Stress on Attention Control: Evidence from Behavioral and Event-Related Potential Analyses

Liu

Leng

et al. 2020

Neurosci. Bull.

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“…Hundreds of clinical studies on drugs targeting the etiologies and pathological changes in AD have failed in recent years. Therefore, the current clinical management of AD still focuses on managing the symptoms, delaying progression, improving the quality ,of life of patients, and reducing the burden on caregivers [ 45 ]. After three rounds of focus group discussions, we finished the ABC comprehensive management process instructions for AD patients to guide clinicians in optimizing diagnosis and treatment process based on the current situation (Fig.…”

Section: Comprehensive Ad Managementmentioning

confidence: 99%

“…For severe AD patients, caregivers should particularly focus on avoiding complications such as aspiration pneumonia, pressure sores, and deep vein thrombosis. Palliative and soothing care could be considered for end-stage AD patients [ 45 ]. BPSD care is always a tough task for caregivers.…”

Section: Comprehensive Ad Managementmentioning

confidence: 99%

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

Jia

Liu

et al. 2021

Neurosci. Bull.

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Alzheimer's disease (AD) is the most common cognitive disorder in the elderly. Its 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 symptoms. Early identification and evaluation of ABC symptoms are helpful for establishing the accurate diagnosis, comprehensive treatment, and prognosis of AD. To 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 AD. Based 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 AD. Focus group discussion was used to establish a flowchart of comprehensive ABC management for AD patients. The new consensus provides a feasible AD management process for clinicians.

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“…The high prevalence of dementia in the older population is a significant social and economic burden on patients, patient families, and the existing health care system in China. The total cost associated with dementia is increasing at an alarming rate in China and is expected to exceed US $9.12 trillion by 2050 [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Immersive Virtual Reality–Based Cognitive Intervention for the Improvement of Cognitive Function, Depression, and Perceived Stress in Older Adults With Mild Cognitive Impairment and Mild Dementia: Pilot Pre-Post Study

Zhu¹,

Zhang²,

He³

et al. 2022

JMIR Serious Games

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Background The incidence of dementia is increasing annually, resulting in varying degrees of adverse effects for individuals, families, and society. With the continuous development of computer information technology, cognitive interventions are constantly evolving. The use of immersive virtual reality (IVR) as a cognitive intervention for older adults with mild cognitive impairment (MCI) and mild dementia (MD) is promising, although only few studies have focused on its use. Objective The Chinese virtual supermarket (CVSM) IVR system was developed to provide a comprehensive and individual cognitive intervention program for older patients with MCI and MD. The aim of this study was to explore the feasibility and clinical effectiveness of this 5-week IVR-based cognitive intervention. Methods A pretest-posttest study design was conducted with 31 older adults with MCI and MD from August 2020 to January 2021. All participants participated in a 5-week immersive virtual cognitive training program using the CVSM system. Feasibility was assessed as the incidence and severity of cybersickness symptoms and participant satisfaction based on questionnaires conducted after the intervention. Clinical effectiveness was evaluated using neuropsychological assessments, including several commonly used measures of cognitive function, depression, perceived stress, and activities of daily living. Measurements were obtained at baseline and after the intervention period. Results A total of 18 patients with MCI (mean age 82.94 [SD 5.44] years; 12 females) and 13 patients with MD (mean age 85.7 [SD 4.67] years, 10 females) participated in this pilot study. Both groups showed significant improvements in all cognitive function measurements (P<.001). The MD group had a significantly greater improvement in general cognitive function compared to the MCI group in Montreal Cognitive Assessment Scale, Symbol Digit Modalities Test, Shape Trail Test, and Auditory Verbal Learning Test. Furthermore, an intervention effect was observed in the improvement of perceived stress (P=.048 for MD group, P=.03 for MCI group ). Conclusions The use of the CVSM system may be effective in enhancing the cognitive function of patients with MCI and MD, including general cognitive function, memory, executive function, and attention. IVR technology enriches cognitive intervention approaches and provides acceptable, professional, personalized, and interesting cognitive training for older adults with cognitive impairment. Trial Registration ClinicalTrials ChiCTR2100043753; https://trialsearch.who.int/Trial2.aspx?TrialID=ChiCTR2100043753

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Expert Consensus on the Care and Management of Patients with Cognitive Impairment in China

Cited by 23 publications

References 83 publications

Impact of Chronic Stress on Attention Control: Evidence from Behavioral and Event-Related Potential Analyses

Impact of Chronic Stress on Attention Control: Evidence from Behavioral and Event-Related Potential Analyses

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

Immersive Virtual Reality–Based Cognitive Intervention for the Improvement of Cognitive Function, Depression, and Perceived Stress in Older Adults With Mild Cognitive Impairment and Mild Dementia: Pilot Pre-Post Study

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