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In recent years, the increasing older adult population and the high prevalence of neurocognitive disorders hace led to a significant demographic shift, resulting in greater functional dependence and challenges in end - of - life decision - making. In response to this reality, the importance of Advance Care Planning (ACP) is emphasized as a key strategy to ensure that medical management aligns with patient preferences. This study aims to analyze ACP from a family medicine perspective, identifying its benefits, barriers and implementation strategies in patients with neurocognitive disorders though an application protocol based on person - centered care and a holistic approach. Through a narrative review, 27 articles on ACP in primary care were selected. The main stakeholders identified include the patient, the surrogate decision maker, and the family physician. Furthermore, the study proposes the development of a protocol to facilitate the integration of ACP into routine medical consultations, ensuring its incorporation into clinical practice.
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http://dx.doi.org/10.1016/j.semerg.2025.102517 | DOI Listing |
Alzheimers Res Ther
September 2025
Department of Neurology, Saarland University, Kirrberger Straße, 66421, Homburg/Saar, Germany.
Background: Alzheimer's disease (AD) patients and animal models exhibit an altered gut microbiome that is associated with pathological changes in the brain. Intestinal miRNA enters bacteria and regulates bacterial metabolism and proliferation. This study aimed to investigate whether the manipulation of miRNA could alter the gut microbiome and AD pathologies.
View Article and Find Full Text PDFAlzheimers Dement
September 2025
Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA.
Introduction: Mild cognitive impairment (MCI) represents a transitional stage between normal aging and dementia. We investigate associations among cardiovascular and metabolic disorders (hypertension, diabetes mellitus, and hyperlipidemia) and diagnosis (normal; amnestic [aMCI]; and non-amnestic [naMCI]).
Methods: Multinomial logistic regressions of participant data (N = 8737; age = 70.
J Mol Neurosci
September 2025
Department of Physiology, School of Medicine, Dokuz Eylul University, Izmir, Turkey.
The ketogenic diet (KD), a high-fat, low-carbohydrate regimen, has been shown to exert neuroprotective effects in various neurological models. This study explored how KD-alone or combined with antibiotic-induced gut microbiota depletion-affects cognition and neuroinflammation in aging. Thirty-two male rats (22 months old) were assigned to four groups (n = 8): control diet (CD), ketogenic diet (KD), antibiotics with control diet (AB), and antibiotics with KD (KDAB).
View Article and Find Full Text PDFTransl Psychiatry
September 2025
Department of Human Sciences, The Ohio State University, Columbus, OH, USA.
A ketogenic diet (KD) has shown promise as an adjunctive therapy for neurological and neuropsychiatric disorders, including bipolar disorder and major depressive disorder (MDD). We examined tolerance for a KD in young adults with MDD and assessed symptoms of depression and metabolic health. Students (n = 24) with a confirmed diagnosis of MDD at baseline receiving standard of care counseling and/or medication treatment were enrolled in a 10-12 week KD intervention that included partial provision of ketogenic-appropriate food items, frequent dietary counseling, and daily morning tracking of capillary R-beta-hydroxybutyrate (R-BHB).
View Article and Find Full Text PDFSci Rep
September 2025
Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China.
Visceral adiposity has been proposed to be closely linked to cognitive impairment. This cross-sectional study aimed to evaluate the predictive value of Chinese Visceral Adiposity Index (CVAI) for mild cognitive impairment (MCI) in patients with type 2 diabetes mellitus (T2DM) and to develop a quantitative risk assessment model. A total of 337 hospitalized patients with T2DM were included and randomly assigned to a training cohort (70%, n = 236) and a validation cohort (30%, n = 101).
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