Can Traditional Board Games Prevent or Slow Down Cognitive Impairment? A Systematic Review and Meta-Analysis
Authors: Pozzi, Federico Emanuele | Appollonio, Ildebrando | Ferrarese, Carlo | Tremolizzo, Lucio
Article Type: Systematic Review
Abstract: Background: Traditional board games can entail significant skills encompassing several cognitive functions across different domains. Therefore, they may potentially represent effective cognitive interventions in the aging population with or without Alzheimer’s disease or other types of dementia. Objective: We aimed at verifying the hypothesis that traditional board games can prevent or slow down cognitive decline, through a systematic review on traditional board games and dementia. Methods: We searched five databases with tailored search strings. We included studies assessing the impact of board games on elderly subjects at risk of or suffering from cognitive impairment, or subjects with cognitive impairment irrespective …of age. Studies where the effect of board games was not separated by cards or other games were excluded. A meta-analysis was performed for specific cognitive and non-cognitive outcomes. Results: Board games improved mental function, as measured by Montreal Cognitive Assessment (p = 0.003) and Mini-Mental State Examination (p = 0.02). Ska and Go improved Trail Making Test –A, while Mahjong improved executive functions. There was no consistent effect across different games on Digit Span or Categorical Fluency. Chess improved quality of life measured with the WHO-QoL-OLD scale (p < 0.00001). Mahjong temporarily improved depressive symptoms. Go increased BDNF levels and left middle temporal gyrus and bilateral putamen metabolism. Conclusions: Traditional board games may slow global cognitive decline and improve the quality of life in elderly subjects. Different games have varying impacts on specific cognitive domains, possibly mediated by functional and biological factors. Show more
Keywords: Alzheimer’s disease, cognition, dementia, primary prevention, recreational games, secondary prevention, systematic review, tertiary prevention
DOI: 10.3233/JAD-230473
Citation: Journal of Alzheimer's Disease, vol. 95, no. 3, pp. 829-845, 2023
Age-related quantitative and qualitative changes in decision making ability
Authors: Isella, Valeria | Mapelli, Cristina | Morielli, Nadia | Pelati, Oriana | Franceschi, Massimo | Appollonio, Ildebrando Marco
Article Type: Research Article
Abstract: The "frontal aging hypothesis" predicts that brain senescence affects predominantly the prefrontal regions. Preliminary evidence has recently been gathered in favour of an age-related change in a typically frontal process, i.e. decision making, using the Iowa Gambling Task (IGT), but overall findings have been conflicting. Following the traditional scoring method, coupled with a qualitative analysis, in the present study we compared IGT performance of 40 young (mean age: 27.9 ± 4.7) and 40 old (mean age: 65.4 ± 8.6) healthy adults and of 18 patients affected by frontal lobe dementia of mild severity (mean age: 65.1 ± 7.4, mean MMSE …score: 24.1 ± 3.9). Quantitative findings support the notion that decision making ability declines with age; moreover, it approximates the impairment observed in executive dysfunction due to neurodegeneration. Results of the qualitative analysis did not reach statistical significance for the motivational and learning decision making components considered, but approached significance for the attentional component for elderly versus young normals, suggesting a possible decrease in the ability to maintain sustained attention during complex and prolonged tasks as the putative deficit underlying impaired decision making in normal aging. Show more
Keywords: Decision making, gambling task, aging, frontotemporal dementia
Citation: Behavioural Neurology, vol. 19, no. 1-2, pp. 59-63, 2008
TSPO Modulates Oligomeric Amyloid-β-Induced Monocyte Chemotaxis: Relevance for Neuroinflammation in Alzheimer’s Disease
Authors: Conti, Elisa | Grana, Denise | Angiulli, Federica | Karantzoulis, Aristotelis | Villa, Chiara | Combi, Romina | Appollonio, Ildebrando | Ferrarese, Carlo | Tremolizzo, Lucio
Article Type: Research Article
Abstract: Background: Neuroinflammation is one of the cardinal mechanisms of Alzheimer’s disease (AD). with amyloid-β (Aβ) playing a critical role by activating microglia to produce soluble inflammatory mediators, including several chemokines. Peripheral monocytes are, therefore, attracted into the central nervous system (CNS), where they change into blood-born microglia and participate in the attempt of removing toxic Aβ species. The translocator protein-18 kDa (TSPO) is a transmembrane protein overexpressed in response to neuroinflammation and known to regulate human monocyte chemotaxis. Objective: We aimed to evaluate the role of the oligomeric Aβ1-42 isoform at inducing peripheral monocyte chemotaxis, and the possible involvement of …TSPO in this process. Methods: In vitro cell lines, and ex vivo monocytes from consecutive AD patients (n = 60), and comparable cognitively intact controls (n = 30) were used. Chemotaxis analyses were carried out through both μ -slide chambers and Boyden assays, using 125 pM oligomeric Aβ1-42 as chemoattractant. TSPO agonists and antagonists were tested (Ro5-4864, Emapunil, PK11195). Results: Oligomeric Aβ directly promoted chemotaxis in all our models. Interestingly, AD monocytes displayed a stronger response (about twofold) with respect to controls. Aβ-induced chemotaxis was prevented by the TSPO antagonist PK11195; the expression of the TSPO and of the C-C chemokine receptor type 2 (CCR2) was unchanged by drug exposure. Conclusion: Oligomeric Aβ1-42 is able to recruit peripheral monocytes, and we provide initial evidence sustaining a role for TSPO in modulating this process. This data may be of value for future therapeutic interventions aimed at modulating monocytes motility toward the CNS. Show more
Keywords: Alzheimer’s disease, amyloid-β, chemotaxis, monocytes, neuroinflammation, PK11195, TSPO
DOI: 10.3233/JAD-230239
Citation: Journal of Alzheimer's Disease, vol. 95, no. 2, pp. 549-559, 2023
Adult-Onset Epilepsy in Presymptomatic Alzheimer’s Disease: A Retrospective Study
Authors: DiFrancesco, Jacopo C. | Tremolizzo, Lucio | Polonia, Valeria | Giussani, Giorgia | Bianchi, Elisa | Franchi, Carlotta | Nobili, Alessandro | Appollonio, Ildebrando | Beghi, Ettore | Ferrarese, Carlo
Article Type: Research Article
Abstract: Background: The prevalence of epilepsy with onset in adulthood increases with age, mainly due to the accumulation of brain damage. However, a significant proportion of patients experience seizures of unknown cause. Alzheimer’s disease (AD) is associated with an increased risk of seizures. Seizure activity is interpreted as a secondary event related to hyperexcitability caused by amyloid-β aggregation. Objective: Since neurodegenerative processes begin several years before clinical symptoms, epilepsy could be more frequent in the presymptomatic stages of dementia. Methods: We retrospectively reviewed the prevalence of epilepsy of unknown origin with adult onset before cognitive decline in a large cohort of …AD patients (EPS-AD) recruited based on clinical and neuropsychological data. Data of patients with epilepsy followed by AD were compared with two control groups: patients with AD without seizures (no EPS-AD) and a large reference population (RP). Results: In AD patients, the prevalence of epilepsy of unknown origin, with onset in the adulthood before cognitive decline is 17.1 times higher compared with the RP (95% CI: 10.3–28.3). In EPS-AD, seizures begin on average 4.6 years (median 2.0) before the onset of cognitive symptoms and cognitive decline starts 3.6 years earlier compared with noEPS-AD. Conclusions: Neurodegenerative processes of dementia could play a key role in the pathogenesis of epilepsy in a subgroup of individuals intended to develop cognitive decline. Adult-onset epilepsy of undefined cause could thus represent a risk factor for the ongoing neurodegenerative damage, even preceding by years the onset of clinical symptoms of dementia. Show more
Keywords: Alzheimer’s disease, disease modifying therapies, epilepsy, neurodegeneration, prevalence, seizure
DOI: 10.3233/JAD-170392
Citation: Journal of Alzheimer's Disease, vol. 60, no. 4, pp. 1267-1274, 2017
Learning From Mistakes: Cognitive and Metabolic Correlates of Errors on Picture Naming in the Alzheimer’s Disease Spectrum
Authors: Isella, Valeria | Rosazza, Cristina | Ferri, Francesca | Gazzotti, Maria | Impagnatiello, Valentina | Mapelli, Cristina | Morzenti, Sabrina | Crivellaro, Cinzia | Appollonio, Ildebrando M. | Ferrarese, Carlo
Article Type: Research Article
Abstract: Background: Analysis of subtypes of picture naming errors produced by patients with Alzheimer’s disease (AD) have seldom been investigated yet may clarify the cognitive and neural underpinnings of naming in the AD spectrum. Objective: To elucidate the neurocognitive bases of picture naming in AD through a qualitative analysis of errors. Methods: Over 1000 naming errors produced by 70 patients with amnestic, visuospatial, linguistic, or frontal AD were correlated with general cognitive tests and with distribution of hypometabolism on FDG-PET. Results: Principal component analysis identified 1) a Visual processing factor clustering visuospatial tests and unrecognized stimuli, pure visual errors and visual-semantic …errors, associated with right parieto-occipital hypometabolism; 2) a Concept-Lemma factor grouping language tests and anomias, circumlocutions, superordinates, and coordinates, correlated with left basal temporal hypometabolism; 3) a Lemma-Phonology factor including the digit span and phonological errors, linked with left temporo-parietal hypometabolism. Regression of brain metabolism on individual errors showed that errors due to impairment of basic and higher-order processing of object visual attributes, or of their interaction with semantics, were related with bilateral occipital and left occipito-temporal dysfunction. Omissions and superordinates were linked to degradation of broad and basic concepts in the left basal temporal cortex. Semantic-lexical errors derived from faulty semantically- and phonologically-driven lexical retrieval in the left superior and middle temporal gyri. Generation of nonwords was underpinned by impairment of phonology within the left inferior parietal cortex. Conclusion: Analysis of individual naming errors allowed to outline a comprehensive anatomo-functional model of picture naming in classical and atypical AD. Show more
Keywords: Alzheimer’s disease, aphasia, brain metabolism, dementia, FDG-PET, language, naming, naming errors
DOI: 10.3233/JAD-220053
Citation: Journal of Alzheimer's Disease, vol. 87, no. 3, pp. 1033-1053, 2022
Voluptuary Habits and Risk of Frontotemporal Dementia: A Case Control Retrospective Study
Authors: Tremolizzo, Lucio | Bianchi, Elisa | Susani, Emanuela | Pupillo, Elisabetta | Messina, Paolo | Aliprandi, Angelo | Salmaggi, Andrea | Cosseddu, Maura | Pilotto, Andrea | Borroni, Barbara | Padovani, Alessandro | Bonomini, Cristina | Zanetti, Orazio | Appollonio, Ildebrando | Beghi, Ettore | Ferrarese, Carlo
Article Type: Short Communication
Abstract: Alcohol, coffee, and tobacco consumption was assessed on 151 FTD outpatients and 151 matched controls in a multicenter retrospective case-control design. No association was found for smoking and coffee intake. The risk of FTD was decreased by alcohol consumption (adj. OR 0.30, 95% CI 0.14–0.63); risk reduction was significant in current alcohol consumers (adj. OR 0.22, 95% CI 0.10–0.51). The risk of FTD inversely correlated with the duration of exposure (adj. OR 0.88, 95% CI 0.81–0.95, for every 5 years of exposure increase). Retrospective information and the unknown amount of consumed alcohol are limits of the present work.
Keywords: Alcohol, coffee, frontotemporal dementia, risk factor, smoking, voluptuary habits
DOI: 10.3233/JAD-170260
Citation: Journal of Alzheimer's Disease, vol. 60, no. 2, pp. 335-340, 2017