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Aim Methods Results Conclusions Although the use of benzodiazepine receptor agonists is a risk factor for falls and fractures, whether benzodiazepine‐avoiding hypnotic bundles are beneficial in clinical settings remains unclear.A new hospital‐wide standardized hypnotic bundle for insomnia, with suvorexant as the first choice, was created for clinical purposes. This single‐center retrospective cohort study involved a pre‐post design and adult inpatients who had had falls. The primary outcome was the total fall rate in the pre‐post groups. Additionally, the level change in the fall‐rate trend for each month at standardization of the new hypnotic bundle was analyzed. The numbers of hypnotic‐related falls and injuries requiring treatment were evaluated.There were no differences in baseline characteristics between the two groups, except for patients with COVID‐19. Overall, 31 736 patients were included in this study. The total number of falls was 924 (3.42‰) in the pre‐standardization group and 837 (3.31‰) in the post‐standardization group, with no significant difference. An interrupted time‐series analysis of the level change in the fall rate revealed that the gap in trend at standardization was –11%, with no significance. Hypnotic‐related falls were 300 (1.11‰) versus 213 (0.84‰), and the injury incidences were 251 (0.93‰) versus 181 (0.71‰) in the pre and post groups, respectively, showing a significant reduction.The standardization of the new hypnotic bundle for insomnia did not help achieve a significant reduction in total falls. However, our findings suggest that this bundle has the potential to reduce hypnotic‐related falls and injuries in inpatients who have had falls. Geriatr Gerontol Int 2024; ••: ••–••. [ABSTRACT FROM AUTHOR]

Background: The number of patients with cognitive disorders is rapidly increasing in the world, becoming not only a medical problem, but also a social problem. There have been many reports that various factors are associated with cognitive dysfunction, but the factors have not yet been fully identified. This was a community‐based complete enumeration study which aimed to identify risk and protective factors for dementia. Methods: The first phase included all residents aged 65 years or older in a town in Japan. They completed many examinations, such as living conditions questionnaires, physical examination, Mini‐Mental State Examination, and brain magnetic resonance imaging. The participants with suspected cognitive impairment underwent additional examinations for detailed evaluation in the second phase. Statistical analysis was performed to identify risk and protective factors for dementia after all participants were diagnosed. Results: There were 927 participants in the baseline evaluation; 611 (65.9%) were healthy, 165 (17.8%) had mild cognitive impairment (MCI), and 151 (16.3%) had dementia. The age‐standardised prevalence of dementia was 9.5%. Statistical analyses for amnestic MCI and Alzheimer's disease showed that risk factors for cognitive decline were diabetes mellitus, low activities of daily living, and living alone, and that protective factors were history of exercise and drinking habit. Conclusion: The present findings suggest that several lifestyle‐related diseases and factors are associated with cognitive decline. These results support similar findings from previous studies and will be helpful for preventing dementia in the future. [ABSTRACT FROM AUTHOR]

Background: The number of dementia patients is increasing worldwide, especially in Japan, which has the world's highest ageing population. The increase in the number of older people with dementia is a medical and socioeconomic problem that needs to be prevented, but the actual situation is still not fully understood. Methods: Four cross‐sectional studies on dementia were conducted in 1997, 2004, 2012, and 2016 for complete enumeration of all residents aged 65 years and older. We examined the secular trends in the prevalence of all‐cause dementia, Alzheimer's disease (AD), vascular dementia (VaD), and other/unclassified dementia. Results: The age‐standardised prevalence of all‐cause dementia significantly increased (4.5% in 1997, 5.7% in 2004, 5.3% in 2012, 9.5% in 2016; P for trend <0.05). Similar trends were observed for AD (1.7%, 3.0%, 2.5% and 4.9%, respectively; P for trend <0.05) and other/unclassified dementia (0.8%, 1.0%, 1.0% and 2.2%, respectively; P for trend <0.05), whereas no significant change in VaD was seen (2.1%, 1.8%, 1.8%, 2.4%, respectively; P for trend = 0.77). The crude prevalence of all‐cause dementia and AD increased from 1997 to 2016 among participants aged 75–79 years and ≥85 years (all P for trend <0.05). Similar trends were observed for other/unclassified dementia among participants aged ≥80 years (all P for trend <0.05), but not in VaD. Conclusions: The prevalence of dementia has increased beyond the ageing of the population, suggesting that factors in addition to ageing are involved in the increase in the number of older people with dementia. To control the increase in the number of older people with dementia, elucidation of secular trends in the incidence, mortality, and prognosis of dementia as well as the factors that promote and protect against dementia, and development of preventive strategies are necessary. [ABSTRACT FROM AUTHOR]

Aim: Despite continuing research into Alzheimer's disease (AD), its pathological mechanisms and modulating factors remain unknown. Several genes influence AD pathogenesis by affecting inflammatory pathways. Myocyte‐enhancer factor 2C (MEF2C) is one such candidate gene for AD. Methods: We examined MEF2C mRNA expression levels and methylation rates of CpG on its promoter region in peripheral leukocytes from Japanese AD patients compared with age‐ and sex‐matched control subjects. Results: In peripheral leukocytes, MEF2C mRNA expression levels in AD subjects were significantly lower than those in control subjects (0.86 ± 0.25 vs 0.99 ± 0.27, respectively, P = 0.007) and were correlated with the Alzheimer's Disease Assessment Scale (r = −0.345, P = 0.049) and the Mini Mental State Examination (r = 0.324, P = 0.02). No significant differences were found in methylation rates between AD and control subjects. Conclusion: MEF2C mRNA expression in leukocytes may be a biological marker for cognitive decline in AD. [ABSTRACT FROM AUTHOR]

Therefore, diffusion-weighted magnetic resonance imaging (MRI) was added. Keywords: abdominal ultrasonography; epigastric pain; infected hepatic cyst; percutaneous transhepatic drainage EN abdominal ultrasonography epigastric pain infected hepatic cyst percutaneous transhepatic drainage 407 408 2 11/07/22 20221101 NES 221101 An 84-year-old man presented to the hospital with epigastric pain and loss of appetite persisting for 1 month. Diffusion-weighted MRI detected fluid retention with high signal intensity within the hepatic cyst, indicating an infected hepatic cyst (Figure 2). [Extracted from the article]

Objective: Impairment of visual perception frequently occurs in Alzheimer's disease (AD) and can cause severe constraints in daily activities. The nonverbal Raven's Colored Progressive Matrices (RCPM) test consists of sets A, AB, and B and is easily performed in a short time to evaluate both visual perception and reasoning ability. The purpose of this study was to evaluate the neural basis of visual perception and reasoning ability in patients with AD using RCPM and single-photon emission computed tomography (SPECT).Methods: Fifty patients who fulfilled the National Institute on Aging/Alzheimer's Association criteria for probable AD dementia were examined with RCPM and SPECT. All SPECTs were performed using N-isopropyl-p-[123 I]-iodoamphetamine. A multiple regression model was used to perform multivariate analyses of the relationships between regional cerebral blood flow (rCBF) and RCPM scores.Results: There was a significant positive correlation between RCPM total score and rCBF in the inferior parietal lobes bilaterally, the right inferior temporal gyrus, and the right middle frontal gyrus. Set A was positively correlated with rCBF in the right temporal and right parietal lobes. Set AB was positively correlated with rCBF in the right temporal, right parietal, and right frontal lobes. Set B was positively correlated with rCBF in the right parietal and right frontal lobes.Conclusion: Our findings suggest that deteriorations of specific brain regions are associated with dysfunction of visual perception and reasoning ability in AD. RCPM is another informative assessment scale of cognition for use in patients with AD. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Glycoprotein nonmelanoma protein B (GPNMB, alias osteoactivin), a type I transmembrane glycoprotein, is cleaved by extracellular proteases, resulting in release of an extracellular fragment (ECF). GPNMB is widely expressed by neurons within the CNS, including the hippocampus; however, its function in the brain remains unknown. Here, we investigated the role of GPNMB in memory and learning by using transgenic (Tg) mice over-expressing GPNMB (Tg mice on a BDF-1 background) and ECF-treated mice. In the hippocampus of both wild-type and Tg mice, GPNMB was highly expressed in neurons and astrocytes. Tg mice exhibited memory improvements in two types of learning tasks but were impaired in a passive-avoidance test. In Tg mice, the hippocampus displayed increased levels of the a-amino-3-hydroxy-5-methylisoxazole-4-propionate receptor subunit GluA1. Intracerebroventricular administration of ECF (50 ng) to Institute of Cancer Research (ICR) mice also improved memory in a passive-avoidance test and increased hippocampal GluA1 levels 24 h after treatment. In Tg mice and ECF (0.25 ig/mL)- treated hippocampal slices, long-term potentiation was promoted. These findings suggest that GPNMB may be a novel target for research on higher order brain functions. [ABSTRACT FROM AUTHOR]

Aim It is difficult to diagnose dementia with Lewy bodies ( DLB) because it exhibits clinical and neuropathological overlap with both Alzheimer's disease and Parkinson's disease. The α-synuclein protein is a major component of Lewy bodies, and accumulation of α-synuclein aggregates causes synaptic dysfunction in DLB. Epigenetic changes at the synuclein alpha ( SNCA) gene may be involved in DLB pathogenesis. Methods We examined DNA methylation rates at 10 CpG sites located in intron 1 of SNCA and SNCA m RNA expression in peripheral leukocytes to compare DLB patients ( n = 20; nine men, 11 women; age = 78.8 ± 7.7 years) with healthy controls ( n = 20; eight men, 12 women; age = 77.0 ± 6.9 years). Results The methylation rate at CpG 4 ( P = 0.002) and the overall mean methylation rate at these sites ( P < 0.001) were significantly lower in DLB patients than in healthy controls after Bonferroni correction. Although SNCA126, a partial form of SNCA m RNA expression, was significantly increased in DLB ( P = 0.017), there was no significant difference in total SNCA m RNA expression between DLB patients and healthy controls ( P = 0.165). No correlation was observed between SCNA m RNA expression levels and blood DNA methylation rates in either DLB or healthy controls. Conclusion Our findings indicated that lower methylation rates may be a biomarker for DLB. [ABSTRACT FROM AUTHOR]

Objective: The aim was to clarify whether DRD2 methylation changes in leukocytes of dementia with Lewy bodies (DLB) or Parkinson's disease (PD) patients are seen and can be used to discriminate between them., Methods: Methylation rates were examined in 23 DLB subjects and 23 age- and sex-matched healthy controls and 37 PD patients and 37 age- and sex-matched healthy controls., Results: Significant DRD2 DNA methylation changes were found in leukocytes of DLB and PD patients compared with healthy subjects. Discriminant analysis between DLB and PD using seven CpG sites demonstrated sensitivity and specificity of 83.8% and 90.9%, respectively. None of the CpG sites were associated with sex, age, age of onset, disease duration, and any of the neuropsychological tests in DLB and PD patients., Conclusion: This is the first report showing that DRD2 DNA methylation rates in leukocytes were increased in DLB patients and decreased in PD patients. These results may be an important step in understanding epigenetic mechanisms underlying DLB and PD pathogenesis and providing a novel biomarker for discriminating between them., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)