[Article Review] AMES: A New Dawn in Early Detection of Cognitive Decline

Reference

Huang, L., Mei, Z., Ye, J., & Guo, Q. (2023). AMES: An Automated Self-Administered Scale to Detect Incipient Cognitive Decline in Primary Care Settings. Assessment, 30(7), 2247-2257. https://doi.org/10.1177/10731911221144774

Review

Huang, Mei, Ye, and Guo (2023) unveiled Automated Memory and Executive Screening (AMES), a self-delivered cognitive screening tool that aims to detect early signs of cognitive decline in community-based settings. This tool was designed to evaluate cognitive realms, including memory, language, and executive function. Across a cohort of 189 participants, ranging from those with diagnosed mild cognitive impairment (MCI) to normal controls, the research gauged AMES's utility and accuracy.

The tool demonstrated a commendable convergent validity with established scales. Particularly noteworthy was its proficiency in distinguishing patients with MCI from normal controls, boasting an area under the curve (AUC) of 0.88, coupled with 86% sensitivity and 80% specificity. Similarly, for obj-SCD, the AUC was 0.78, with a sensitivity of 89% and a specificity of 63%. These figures underscore the tool's promise for early identification of cognitive impairment.

The AMES tool, as presented by Huang et al. (2023), is a constructive stride in the pursuit of timely intervention for cognitive decline. Its self-administered nature could make it a more accessible and less intimidating option for individuals. However, while its efficacy in discerning MCI is applaudable, the relatively lower specificity for obj-SCD suggests a potential for false positives. As with all screening tools, ensuring a balance between sensitivity and specificity is imperative. Future iterations and validations of AMES might further refine its accuracy and reduce potential misclassifications.

[Article Review] Early SSRI Treatment in 22q11.2 Deletion Syndrome: A Promising Path for Cognition and Brain Development?

Reference

Mancini, V., Maeder, J., Bortolin, K., Schneider, M., Schaer, M., & Eliez, S. (2021). Long-term effects of early treatment with SSRIs on cognition and brain development in individuals with 22q11.2 deletion syndrome. Translational Psychiatry, 11, 336. https://doi.org/10.1038/s41398-021-01480-3

Review

The present study by Mancini et al. (2021) investigates the long-term effects of early treatment with selective serotonin reuptake inhibitors (SSRIs) on cognition and brain development in individuals with 22q11.2 deletion syndrome (22q11DS). This genetic disorder has the highest risk for schizophrenia, making it an ideal population for studying the development of individuals at risk for psychosis. The authors conducted a retrospective cohort study with 98 participants, aged 10 to 32, diagnosed with 22q11DS, and followed up 2–4 times.

The participants were divided into three groups: those without psychiatric disorders and no psychotropic medications (n = 30), those with psychotic symptoms but not treated with SSRIs (n = 30), and those receiving SSRI treatment (n = 38). The authors observed increased IQ scores and developmental trajectories in participants treated with SSRIs, including those with psychotic symptoms. Additionally, the thickness of frontal regions and hippocampal volume were relatively increased in the treated group. The magnitude of the outcomes was inversely correlated to the age at the onset of the treatment.

This study provides preliminary evidence that early long-term treatment with SSRIs may attenuate the cognitive decline associated with psychosis in 22q11DS and developmental brain abnormalities. The findings hold promise for identifying novel strategies to improve cognitive and brain development in individuals with 22q11DS, as well as other populations at risk for psychosis. However, more research is needed to confirm and expand these findings and to explore the potential benefits and risks of early SSRI treatment in this population.

[Article Review] Unlocking Potential: A New Approach to Alzheimer's Treatment

Reference

Bredesen, D. E. (2014). Reversal of cognitive decline: a novel therapeutic program. Aging (Albany NY), 6(9), 707-17.

Review

This report by Bredesen (2014) offers a refreshing insight into a comprehensive and personalized therapeutic program aimed at counteracting the underlying pathogenesis of Alzheimer's disease. The multi-modal approach, termed Metabolic Enhancement for Neurodegeneration (MEND), was applied to ten patients with varying cognitive conditions, ranging from Alzheimer's disease to subjective cognitive impairment. Encouragingly, nine out of these ten patients exhibited improvements in their cognitive abilities within a span of 3-6 months. The most promising aspect is that six of these individuals, who were either not working or struggling with their professions, managed to resume or continue their work post-therapy.

Nevertheless, it's imperative to note the limited sample size of the study. While the results are undoubtedly promising, drawing substantial conclusions from a cohort of merely ten participants is premature. Additionally, one patient with late-stage Alzheimer's did not exhibit any noticeable improvement, indicating potential limitations or the need for timely intervention. It's also commendable that Bredesen highlights the potential inadequacy of monotherapeutics in Alzheimer's treatment and raises the proposition of a more integrated system where drugs might function more effectively as components rather than standalones.

To summarize, Bredesen's (2014) study sheds light on an innovative therapeutic approach that holds potential in reversing cognitive decline, especially in its early stages. However, the results, though promising, warrant a more extensive trial to validate these findings. With the increasing global prevalence of Alzheimer's and cognitive impairments, such research initiatives underscore the importance of holistic and multi-faceted interventions.