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Associations of morphometric and metabolic biomarkers with cognitive impairment in Alzheimer's disease and Lewy body dementias
Nedelská, Zuzana ; Hort, Jakub (advisor) ; Nevrlý, Martin (referee) ; Dušek, Petr (referee)
Associations of morphometric and metabolic biomarkers with cognitive impairment in Alzheimer's disease and Lewy body dementias Abstract Dementia has become one of the major health care and socio-economic challenges. Alzheimer's disease (AD) is the most common dementia whereas dementia with Lewy bodies (DLB) is the second most common neurodegenerative after AD. However, both dementias exist in a quite heterogeneous contiua that can overlap with each other. Approaches that allow for the identification of individuals at risk of developing AD in preclinical or prodromal stages are of major interest to apply the symptomatic and newly introduced biological therapies and non- pharmacological interventions that are more effective early on. Similar efforts are undertaken in the DLB field although no causal treatment for DLB is available yet. A prerequisite for an efficacious and targeted intervention is a selection of individuals who would benefit the most from this intervention. This process includes the timely and accurate diagnosis, differential diagnosis, prognostication, and management of treatable comorbidities. This dissertation has two parts. Part one is an overview of AD and DLB. The second part summarizes author's research work. The main research aims corroborated in this thesis are three-fold: First, to...
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Cerebral hypoxia in chronic kidney disease and its relation to cognitive decline
Kalendová, Lucie ; Malík, Jan (advisor) ; Bednářová, Vladimíra (referee) ; Janečková, Jana (referee)
Cerebral hypoxia in chronic kidney disease and its relation to cognitive decline Dissertation abstract - MUDr. Lucie Kalendová Introduction: Patients with chronic kidney disease in need of regular hemodialysis treatment have high rates of cognitive impairment. In its multifactorial etiology, vascular changes, cerebral ischemia and hypoxia play a major role. In our work we first studied the association between low cerebral oxygenation and cognitive impairment in this population. Subsequently, we focused on one of the possible etiological factors in this association - the presence of a vascular shunt for hemodialysis. Methods: Chronic hemodialysis patients without overt cognitive impairment participated in the studies. We used a near-infrared spectroscopy (NIRS) device named INVOS for monitoring cerebral oxygenation (rSO2). Cognitive function was assessed with the Montreal Cognitive Assessment (MoCA). To assess the effect of vascular shunt, we performed an interventional study based on short-term ultrasound-confirmed manual compression with continuous monitoring of rSO2. Results: In 39 patients (49 % women, age 64 ± 14 years) we observed a significantly lower rSO2 in the subgroup presenting cognitive decline than in patients without this diagnosis (48 ± 9 vs. 57 ± 10; p = 0.01). The association remained...
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Exercise with elderly in residential home with special regime
Svobodová, Karolína ; Daďová, Klára (advisor) ; Majorová, Simona (referee)
Title: Exercise with seniors in a retirement home with a special regime Objective: The main aim of the study was to determine whether seniors with cognitive impairment experience improvements that have a statistical significance in selected components of physical fitness after a three-month exercise program. Furthermore, it was checked whether regular physical activity changes their attitude towards exercise. Methods: The study involved 9 probands (3 of them male) aged 72 to 90 years with cognitive impairment. The probands completed a three-month program (April-June 2022) in which they performed group and seated chair exercises twice a week for sixty minutes. At the beginning and end of the intervention program, they underwent an orientation fitness assessment using the senior fitness test and a questionnaire form on health limitations and attitudes toward exercise. Results: The results of the senior fitness test showed that there was a statistically significant improvement in the parameters of lower limb strength, and agility with dynamic balance. Some improvement was seen in the other parameters, but without the statistical significance. Most probands showed a positive change in their attitude towards physical activity. Keywords: physical activities, older people, Senior fitness test, cognitive...
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Cognitive Deterioration in Otherwise Clinically Stable Patients with Multiple Sclerosis
Motýl, Jiří ; Uher, Tomáš (advisor) ; Světlák, Miroslav (referee) ; Hradílek, Pavel (referee)
Neuropsychological assessment of cognitive functions in multiple sclerosis (MS) is increasingly considered as an important paraclinical marker of disease stability or progression in MS. Recent recommendations pro-posed an annual screening of cognitive functions in all MS patients as a standard of neuropsychological monitoring in MS. There is a clear trend to diagnose possible disease progression as early as possible, to be able to respond quickly. The theoretical part of this thesis presents the current state of knowledge on cognitive impairment in MS, its correlates, predictors, and treatment possibilities. In addition, a comprehensive overview of the neuropsychological assessment and the diagnosis of cognitive deterioration in MS is presented. The highly relevant topics such as cutoff criteria of a meaningful change on individual neuropsychological examination, possibilities of treatment of cognitive deterioration, or the so-called isolated cognitive relapses, are discussed in a particular detail. The empirical part extends current knowledge in the field of MS. I present and discuss six original publications that follow these four main objectives: first, to describe the prevalence of isolated cognitive decline in MS and to put isolated cognitive decline in context with current knowledge on MS...
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Human rights for persons with cognitive impairment in the social services
Čápová, Helena ; Dobiášová, Karolína (advisor) ; Tušková, Eva (referee)
In modern European society, there is not the slightest doubt that all people, regardless of gender, age, race, and health status have the same rights as guaranteed, which are called human rights. According to the existing laws and agreements (referred to in the work) and according to the generally accepted rules, the human rights are inalienable, with the exception of serious and precisely specified reasons. This work deals with the problem of how to balance this elementary right with the fact that for people with cognitive impairment it is sometimes necessary to carefully consider some form of restriction of their rights. The aim of this work is to find a definition of the human rights for the elderly with cognitive impairment. Secondary objectives are to describe the social services standards in relation to human rights and the subjects who are involved in supervising the observance of the rights, and the current status. The selected issues were viewed through the implementation theory, the concept of street-level bureaucracy, and the quality of life. The thesis is based on analysis of available secondary data and expert interviews. The acquired data show that although in the Czech Republic there are a number of institutions dealing with human rights, only a few of them are concerned with the rights of...
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Cognitive and psychosocial sequelae following hypoxic brain injury.
Dostálová, Veronika ; Bezdíček, Ondřej (advisor) ; Šonka, Karel (referee) ; Feketeová, Eva (referee)
Cognitive and psychosocial sequelae following hypoxic brain injury Abstract in English Hypoxic brain injury leads to neuronal necrosis and to other cerebral changes which may affect psychosocial functioning. Although the pathophysiology of cerebral hypoxia is multifactorial, and it is not possible to reliably describe the unified clinical picture of hypoxia patients, the most commonly described psychosocial consequences of cerebral hypoxia are cognitive impairment, increased anxiety and depressive symptoms. The aim of the present study is to characterize cognitive functioning and psychosocial changes of the patients exposing mild intermittent cerebral hypoxia (=chronic form of hypoxia, model of obstructive sleep apnea diagnosed by neurologist) and patients after severe one-time cerebral hypoxia (=acute form of hypoxia, model of cardiac arrest diagnosed by cardiologist). Regardless of the different etiology of particular hypoxia forms described in the theoretical part of the thesis, both forms may lead to neuronal death. In the experimental part we test a hypothesis comparing healthy individuals to patients with acute or chronic form of hypoxia in cognitive performance or anxiety and depressive symptoms. We document a decreased cognitive performance and higher level of state anxiety in a group of patients...
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Balance and gait disorders in movement disorders
Hoskovcová, Martina ; Růžička, Evžen (advisor) ; Mareš, Jan (referee) ; Čakrt, Ondřej (referee)
Gait and balance disorders and the resulting falls are a substantial part of Parkinson's disease (PD) and other movement disorders. Especially in the late stage of PD more than 80 % of the patients fall. History of falls remains the best predictor of falls nonetheless, but it can not be used in falls prevention. Dopaminergic pharmacotherapy improves postural stability and gait in PD only in the early stage and the dopaminergic responsiveness of these symptoms decreases significantly during the disease progression. The impact of this medication on future falls risk remains still unclear. The connection between balance and gait disorders and cognitive impairment in PD is also not fully understood. The current state of knowledge about gait and balance disorders and cognitive impairment in PD is not satisfactory. Therefore the aims of the experimental part of this thesis were prospective monitoring of risk factors and predictors of falls, observation of the impact of dopaminergic medication on future falls risk and verifying the relationship between gait and balance disorders and cognitive impairment in PD. The fourth aim of the thesis was to specify the type and severity of gait and balance disorders in patients with essential tremor (ET). Although ET is one of the most common neurological disorders,...
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Cognitive and psychosocial sequelae following hypoxic brain injury.
Dostálová, Veronika ; Bezdíček, Ondřej (advisor) ; Šonka, Karel (referee) ; Feketeová, Eva (referee)
Cognitive and psychosocial sequelae following hypoxic brain injury Abstract in English Hypoxic brain injury leads to neuronal necrosis and to other cerebral changes which may affect psychosocial functioning. Although the pathophysiology of cerebral hypoxia is multifactorial, and it is not possible to reliably describe the unified clinical picture of hypoxia patients, the most commonly described psychosocial consequences of cerebral hypoxia are cognitive impairment, increased anxiety and depressive symptoms. The aim of the present study is to characterize cognitive functioning and psychosocial changes of the patients exposing mild intermittent cerebral hypoxia (=chronic form of hypoxia, model of obstructive sleep apnea diagnosed by neurologist) and patients after severe one-time cerebral hypoxia (=acute form of hypoxia, model of cardiac arrest diagnosed by cardiologist). Regardless of the different etiology of particular hypoxia forms described in the theoretical part of the thesis, both forms may lead to neuronal death. In the experimental part we test a hypothesis comparing healthy individuals to patients with acute or chronic form of hypoxia in cognitive performance or anxiety and depressive symptoms. We document a decreased cognitive performance and higher level of state anxiety in a group of patients...
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Problematic Areas in the Everyday Life of Patients with Huntington's Disease. Subtitle: A Suggestion of Compensatory Strategies in Coping with Cognitive Impairment
Sýkorová, Jitka ; Zemánková, Zuzana (advisor) ; Sládková, Petra (referee)
This diploma thesis explores problematic areas of patients with Huntington's disease in their performance during activities of daily living (ADLs) from the perspective of patients and their caregivers. The aim of the research was also to assess a possible correlation between cognitive impairment and the patient's performance in ADL. Twenty-five patients with their caregivers met the selection criteria for the research. There were used standardized assessment methods available in Czech: the Montreal Cognitive Assessment (MoCA), the Canadian Occupational Performance Measure (COPM) and the questionnaire for caregivers called Bristol Activities of Daily Living Scale (BADLS-CZ). The statistical analyses consisted of methods of the nonparametric statistics, qualitative analysis was processed by data categorizing. Caregivers reported more problematic areas in ADLs which was significantly confirmed in the statistical hypothesis testing (p <0,05). A significant correlation was seen between the results of the questionnaire and the results of the MoCA assessment (rSp = -0,620; p <0,05). For various reasons, patients with Huntington's disease did not mention as many problematic areas in performing ADL as their caregivers. Therefore, it is appropriate in clinical practice to supplement the assessment of the patient's...
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