Epidemiological Study Of Cognitive Impairment And The Screen & Intervention

Objectives:1.To investigate epidemiological characteristicsof cognitive impairment(CI)among elderly people living(over the age of 50)in rural and urban communities of Shanghai;2.To discuss the feasibility of clock drawing test as a community scale on screening cognitive impairment;3.To evaluate MCI patients who conducted cognitive training(playing computer games)effectiveness of cognitive function and their correlational with the event-related potentials(ERP)changes;4.To explore neurophysiological mechanisms in a MCI patients with working memory improvement.Methods:1.We have conducted a face to face survey and the MMSE with local residents aged over 50(50 inclusive)in Shanghai urban and rural area,to find the similarities and differences in prevalent features of cognitive impairment between urban and rural communities;2.We have done clock drawing test on some subjects using the MMSE as a reference.And evaluated the sensitivity and specificity of CDT through five different criteria and the “24 errors”measurement;3.We conducted randomized control trial of cognitive training for a period of six month in49 MCI patients by using self-designed computer game software;4.Analyzing ERP changes under DMS mode on MCI patients and normal control adults to find the differences between different brain regions with s LORETA.Results:1.In general,prevalence of CI is similar between rural and urban populations(p = 0.13),In the urban population,risk of having CI is associated with presence of diabetes mellitus,lacking of physical activities,and having three or more children.In contrast,factors are associated with rural populations including women,exposuring to pesticides,history of encephalitis or meningitis and head trauma;2.Except the ‘7 points system' of all five criterias in CDT,each score is statistically significant.These CDT criterias are suitable for low educated groups,but some criterias are more sensitive to high educated groups;3.The evaluation of cognitive function before and after cognitive training for Training group(n= 29)and the control group(n = 21)show the significantly difference.ERP component under DMS mode and s LORETA analysis show cognitive training helps to improve working memory encoding and retrieval(p <0.05);4.The working memory during retrieval progress was impaired in a MCI patients,and ERP components(the amplitute of P2 and P300 are deficient)change significantly,the kind of change also associates with clinical cognitive impairment.Conclusions:1.Different risk factors for CI in urban and rural communities,suggesting different preventive strategies in these areas should be performed;2.CDT can be used as a screening tool for community CI,different CDT criterias may be screened for the subjects of different cultural levels effectively;3.Difficulty adaptive multimodal cognitive training can improve integral cognitive function in patients with MCI,and the intelligent network platform technology has prospective future in the field of prevention and treatment of AD;4.The findings in the present study suggest that a MCI patients has working memory retrieval deficit,it may provide new biomarker for early detection and therapeutic evaluation for a MCI by combination of ERP detection.