2/2/2024 0 Comments Moca test score 1530Probable Parkinson’s disease with mild cognitive impairment (PD-MCI) was diagnosed by the diagnostic criteria developed by the Movement Disorder Society Task Force for a level I or level II diagnosis. The patients with probable DLB met the consensus criteria for probable DLB (2017 version), and the patients with probable PDD met the clinical criteria for probable PDD developed by the Movement Disorder Society in 2007. LBD patients included patients with dementia with Lewy bodies (DLBs) and Parkinson’s disease dementia (PDD). Probable AD was diagnosed according to the criteria of the National Institute on Aging-Alzheimer’s Association (NIA-AA) workgroup or a cerebrospinal fluid (CSF) test for neuropathological biomarkers of AD ( n = 105). Dementia and mild cognitive impairment (MCI) were diagnosed according to the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders-Five Edition. The study included 178 hospitalized patients diagnosed with AD (n = 137) and LBD (n = 41) recruited from the Department of Cognitive Disorders of Beijing Tiantan Hospital, Capital Medical University from December 2019 to April 2023. We investigated the relationship between CSFP and cognition in patients with Lewy body dementia (LBD) and patients with AD and the possible reasons for the relationship. However, among people with cognitive impairment and further disease progression, there are no relevant studies to explain the relationship between cognition and CSFP moreover, the current study was limited to patients with AD. Additionally, patients with idiopathic intracranial hypertension (a cerebrospinal fluid pressure (CSFP) > 200–250 mmH2O) suffer from cognitive deficits, and importantly, cognitive deficits can improve with time and reduced ICP. The paper further proposed that this pressure factor may be missing in the later stage of AD. The above observations further argue for the role of elevated ICP in the pathogenesis of AD. Longitudinal studies have pointed out the cumulative effect of intermittent ICP elevation on choroid plexus and meningeal damage, reduced cerebrospinal fluid clearance of neurotoxins such as amyloid-β (Aβ) protein and direct damage to the hippocampus. In a 1994 Medical Hypotheses paper, it was proposed that high intracranial pressure (ICP) might play a role in the pathogenesis of Alzheimer’s disease (AD). However, no such relationship was found in patients with LBD.ĭementia has become a significant cause of disability in individuals over 65 years of age worldwide, and the number of patients with dementia in China accounts for approximately 25% of the entire population with dementia worldwide, which poses an enormous challenge to public health. In patients with AD, the mean cerebrospinal fluid pressure was higher in patients with MCI than in patients with dementia, and the decrease in CSFP was related to a more serious dementia level. In addition, there was a significant linear correlation between CSFP and the Mini-Mental State Examination (MMSE) score in all patients with dementia (r = 0.43, p = 0.04, Durbin-Watson test (D-W test) = 0.75). In multivariate analysis, in all patients (OR: 6.37, 95% confidential interval (CI): 1.76–23.04, p = 0.005) and patients with AD (odds ratio (OR): 5.43, 95% CI: 1.41–20.87, p = 0.005), a CSFP in the lowest quartile ([50–90) mmH2O) was associated with a higher level of severe dementia than a CSFP in the highest quartile ([170–210) mmH2O). In all patients (p value < 0.001) and in patients with AD (p value = 0.01), the mean cerebrospinal fluid pressure (CSFP) was higher in patients with MCI than in patients with dementia. A total of 76.9% of the patients had a CSFP distribution of [90–170) mmH2O, 46 patients (25.8%) had severe dementia, 83 patients (46.6%) had moderate dementia, 28 patients (15.7%) had mild dementia, and 21 patients (11.8%) had mild cognitive impairment (MCI) (including 16 patients with MCI due to AD and 5 patients with MCI due to LBD). The mean age of the included patients was 63.58 ± 8.77 years old, and the mean CSFP was 121 ± 33.72 mmH2O. Logistic and linear regression analyses were used to evaluate the associations between CSFP and cognition, the cerebrospinal fluid (CSF) / serum albumin ratio (Qalb), and CSF biomarkers of AD. CSFP was measured by lumbar puncture, and a patient-reported history and laboratory test data were collected. We included 178 participants, including 137 patients with AD and 41 patients with LBD (including dementia with Lewy bodies (DLBs) and Parkinson’s disease dementia (PDD)). The purpose of this study was to explore the relationship between CSFP and cognition in patients with Alzheimer’s disease (AD) and patients with Lewy body dementia (LBD). The relationship between cerebrospinal fluid pressure (CSFP) and cognition has received little research attention.
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