Search

Background and Objectives The risk of mild cognitive impairment (MCI) or dementia in individuals with subjective cognitive decline (SCD) and biomarkers indicating Alzheimer disease (AD) pathology in comparison with individuals with SCD without biomarker evidence for AD is critical to delineate the potential role of biomarker assessment in this group. We performed a meta-analysis of studies on this topic. Methods Three databases (PubMed, PsycINFO, and Cochrane) were searched from inception to May 7, 2021. Search strings included the terms: subjective cognitive decline, biomarker, amyloid, tau, risk, Alzheimer, mild cognitive impairment, and dementia. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Cochrane guidelines, 2 researchers independently performed literature search, data collection, and data extraction. We summarized odds ratios (ORs) in random-effects meta-analyses and calculated sensitivity, specificity, positive predictive values (PPVs) and negative predictive values (NPVs), and likelihood ratios. The primary outcome was the OR of progression from SCD to MCI or dementia in cases with biomarkers indicative of AD pathology relative to the chance of progression in cases with biomarkers indicating no AD pathology. Results Of 4,147 studies screened, 8 studies were selected. The risk of bias analysis revealed a low risk of bias in all studies. The prevalence of abnormal biomarkers ranged between 15.6% and 35.9% for amyloid, 11.1% and 33.6% for phosphorylated tau (p-tau), 12.3% and 46.3% for total tau (t-tau), and 7.8% and 24.4% for full AD pathology (amyloid pathology with either increased p-tau or t-tau). The chance of clinical progression was increased in cases of amyloid pathology only (OR 5.89, 95% CI 2.33-14.90), elevated p-tau (OR 3.99, 95% CI 2.34-6.85), elevated t-tau (OR 2.26, 95% CI 1.14-4.48), and full AD pathology (OR 11.36, 95% CI 1.97-65.41). The latter showed a PPV of 59.7% (95% CI 48.8%-69.3%) and an NPV of 89.4%

BACKGROUND: The negative impact of cognitive dysfunction on motor rehabilitation as a relearning-process is well known in stroke patients. However, evidence for combined cognitive and motor training (CMT) is lacking. OBJECTIVE: To evaluate the effects of combined CMT in early stroke rehabilitation. METHODS: In a controlled pilot study, 29 moderately affected stroke patients with low-level motor performance and cognitive impairment received motor therapy plus either cognitive (experimental group, EG) or low-frequency ergometer training (control group, CG) for eight days. RESULTS: Both groups improved their motor functioning significantly. After training, between-group comparison revealed significant differences for cognitive flexibility and trends for set-shifting, working memory, and reaction control in favor of the EG. Within-group effects showed improvement across all cognitive domains in the EG, which correlated with gains in bed-mobility, while the CG showed no significant improvement in cognition. Rather, a trend towards reaction control decline was observed, which correlated with less functional progression and recovery. Furthermore, a decline in cognitive flexibility, set-shifting, and working memory was descriptively observed. CONCLUSIONS: Combined CMT may enhance cognition and motor relearning early after stroke and is superior to single motor training. Further studies are needed to replicate these results and investigate long-term benefits.