ABSTRACT As pharmacological treatments for Alzheimer disease (AD) offer only modest symptomatic improvement, non-pharmacological interventions — including therapeutic arts — are increasingly being explored for their potential to enhance cognitive, emotional, and psychosocial well-being in individuals with AD. This mini-narrative review aimed to summarize the various neurobiological mechanisms through which therapeutic arts impact progression of AD. It also compares the findings, clinical benefits, and changing attitudes of patients and caregivers toward therapeutic arts, such as music therapy, visual arts, dance/movement therapy, and creative expression, before and after 2000. With robust studies and advanced technologies, there is growing evidence that integrating structured arts-based programs into dementia care may provide cost-effective solutions to improve patient outcomes and slow functional decline in patients with AD.
ABSTRACT. Parkinson’s disease (PD) involves significant non-motor symptoms (NMS) linked to glutamate dysregulation. Objective: This review evaluates the efficacy of N-methyl-D-aspartate (NMDA) receptor antagonists (memantine and amantadine) for treating NMS. Methods: A search was conducted in the databases PubMed and Cochrane Library (January 2000–September 2025) for controlled trials focusing on NMS in idiopathic PD. Two reviewers assessed bias using Cochrane RoB 2. Results: Of 529 records, ten studies were included. Most exhibited a high risk of bias and heterogeneity. Memantine results were mixed: improvements in attention and behavioral symptoms were observed in PD dementia, but no benefit or worsened memory occurred in mild cognitive impairment. Memantine was beneficial for REM sleep behavior disorder. Extended-release amantadine improved sleepiness and mood but increased hallucinations and cognitive impairment. Conclusion: Evidence is limited by methodological flaws. While memantine offers selective benefits for PD dementia, amantadine carries notable cognitive risks. High-quality trials are essential to clarify therapeutic roles.
ABSTRACT Dementia is a major public health concern, and culturally adapted cognitive tools are essential for accurate screening among older adults. Objective: To evaluate the discriminant validity of the Shiraz Verbal Learning Test (SVLT) in differentiating verbal memory performance among elderly women with and without dementia in Shiraz, Iran. Methods: A cross-sectional study was conducted with 60 women aged 65 years or older, recruited between 2024 and 2025 by convenience sampling in Shiraz. The sample included 30 cognitively healthy participants and 30 with mild to moderate dementia diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria and confirmed by a neurologist. Assessments included a demographic questionnaire, the Mini-Mental State Examination (MMSE), the 28-item General Health Questionnaire (GHQ-28), and the SVLT. Data were analyzed using multivariate analysis of variance (MANOVA) and univariate analysis of variance (ANOVA). Results: The dementia group scored significantly lower than the healthy group across all SVLT memory measures — learning, immediate recall, delayed free recall, delayed cued recall, and recognition (p<0.01) — demonstrating strong discriminant capacity. Conclusion: The SVLT demonstrated satisfactory psychometric validity and promising clinical usefulness in differentiating dementia-related verbal memory deficits among elderly Iranian women, indicating its potential as a culturally adapted tool for early cognitive screening in clinical and research contexts.
ABSTRACT Long-term anxiety disrupts emotional, hormonal, and cognitive systems, including elevated cortisol and impaired memory performance. Objective: This quasi-experimental study evaluated the effects of Dhikrullah breathing therapy on anxiety symptoms, serum cortisol, brain-derived neurotrophic factor (BDNF), and memory performance. Methods: Anxiety levels were assessed using the Depression Anxiety Stress Scales (DASS-42), cortisol and BDNF concentrations were measured using an enzyme-linked immunosorbent assay (ELISA), and verbal memory was evaluated using a standardized word recall task. Results: Statistical analyses using the Wilcoxon signed-rank test and the paired t-test revealed significant reductions in anxiety (p=0.001) and cortisol levels (p=0.001), as well as a significant improvement in memory performance (p=0.001). In contrast, serum BDNF levels showed a small numerical decrease that was not statistically significant (p=0.284). Correlational analysis showed a moderate positive correlation between changes in BDNF and memory performance (r=0.54; p=0.01), as well as a moderate negative correlation between changes in BDNF and cortisol (r=–0.51; p=0.04). In addition, changes in anxiety were moderately negatively correlated with changes in memory performance (r=–0.50; p=0.005), whereas the correlation between changes in anxiety and cortisol was weak and not statistically significant (r=0.39; p=0.17). Conclusion: Dhikrullah breathing therapy promotes positive changes in the emotional, hormonal, and cognitive responses of people who experience anxiety. Additional controlled studies are needed to determine the potential use of this treatment in both clinical and community mental health settings.
ABSTRACT. Dementia is an emerging public health concern in the Maldives due to population aging and increasing noncommunicable diseases. Objective: To determine the prevalence of self-reported dementia risk factors and symptoms and to estimate the proportion of individuals with suspected cognitive impairment using the Mini-Cog screening tool. Methods: A cross-sectional, communitybased screening study was conducted in four cities in the Maldives (Male’, Addu, Fuvahmulah, and Kulhudhuffushi). Individuals aged ≥60 years or 50–59 years with at least one dementia risk factor were recruited through community screening. Sociodemographic characteristics, risk factors, cognitive symptoms, and Mini-Cog scores were collected using a structured questionnaire. Suspected cognitive impairment was defined as a Mini-Cog score ≤2. Results: A total of 940 participants were included (mean age, 62.4 years; 71.2% female). Cardiometabolic risk factors were highly prevalent, including hypercholesterolemia (59.4%), hypertension (50.0%), and diabetes mellitus (36.9%), with over 60% reporting multimorbidity. Common symptoms were memory loss (46.9%) and misplacing items (46.3%); 16.8% reported functional impairment. Among 784 participants with complete Mini-Cog assessments, 278 (35.5%) had suspected cognitive impairment. Multivariable logistic regression showed that increasing age and lower educational attainment were independently associated with suspected cognitive impairment, while hypertension, diabetes mellitus, hypercholesterolemia, and previous stroke were not. Conclusion: There is a high burden of modifiable risk factors, cognitive symptoms, and suspected cognitive impairment among adults in the Maldives. Community-based screening may facilitate early identification and support dementia risk reduction strategies. Targeted screening of older adults and those with lower educational attainment may improve case detection.
