Background: Frailty is a common syndrome among older adults and patients with several comorbidities. Grip strength (GS) is a representative parameter of frailty because it is a valid indicator of current and long-term physical conditions in the general population and patients with severe mental illnesses (SMIs). Physical and cognitive capacities of people with SMIs are usually impaired; however, their relationship with frailty or social functioning have not been studied to date. The current study aimed to determine if GS is a valid predictor of changes in cognitive performance and social functioning in patients with type-2 diabetes mellitus and SMIs. Methods: Assessments of social functioning, cognitive performance, and GS (measured with an electronic dynamometer) were conducted in 30 outpatients with type 2 diabetes mellitus, 35 with major depressive disorder, 42 with bipolar disorder, 30 with schizophrenia, and 28 healthy controls, twice during 1-year, follow-up period. Descriptive analyses were conducted using a one-way analysis of variance for continuous variables and the chi-squared test for categorical variables. Differences between groups for the motor, cognitive, and social variables at T1 and T2 were assessed using a one-way analysis of covariance, with sex and age as co-variates (p < 0.01). To test the predictive capacity of GS at baseline to explain the variance in cognitive performance and social functioning at T2, a linear regression analysis was performed (p < 0.05). Results: Predictive relationships were found among GS when implicated with clinical, cognitive, and social variables. These relationships explained changes in cognitive performance after one year of follow-up; the variability percentage was 67.7%, in patients with type-2 diabetes mellitus and 89.1% in patients with schizophrenia. Baseline GS along with other variables, also predicted changes in social functioning in major depressive disorder, bipolar disorder, and schizophrenia, with variability percentages of 67.3, 36, and 59%, respectively. Conclusion: GS combined with other variables significantly predicted changes in cognitive performance and social functioning in people with SMIs or type-2 diabetes mellitus. Interventions aimed to improve the overall physical conditions of patients who have poor GS could be a therapeutic option that confers positive effects on cognitive performance and social functioning.

Objective: Obesity and metabolic diseases such as metabolic syndrome (MetS) are more prevalent in people with type 2 diabetes mellitus (T2DM), major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SZ). MetS components might be associated with neurocognitive and functional impairments in these individuals. The predictive and discriminatory validity of MetS and its components regarding those outcomes were assessed from prospective and transdiagnostic perspectives.Methods: Metabolic syndrome components and neurocognitive and social functioning were assessed in 165 subjects, including 30 with SZ, 42 with BD, 35 with MDD, 30 with T2DM, and 28 healthy controls (HCs). A posteriori, individuals were classified into two groups. The MetS group consisted of those who met at least three of the following criteria: abdominal obesity (AO), elevated triglyceridesThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Visual memory dysfunction as a neurocognitive endophenotype in bipolar disorder patients and their unaffected relatives. Evidence from a 5-year follow-up Valencia study.

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BackgroundSystemic, low-grade immune–inflammatory activity, together with social and neurocognitive performance deficits are a transdiagnostic trait of people suffering from type 2 diabetes mellitus (T2DM) and severe mental illnesses (SMIs), such as schizophrenia (SZ), major depressive disorder (MDD), and bipolar disorder (BD). We aimed to determine if immune–inflammatory mediators were significantly altered in people with SMIs or T2DM compared with healthy controls (HC) and whether these biomarkers could help predict their cognition and social functioning 1 year after assessment.MethodsWe performed a prospective, 1-year follow-up cohort study with 165 participants at baseline (TB), including 30 with SZ, 42 with BD, 35 with MDD, 30 with T2DM, and 28 HC; and 125 at 1-year follow-up (TY), and determined executive domain (ED), global social functioning score (GSFS), and peripheral blood immune–inflammatory and oxidative stress biomarkers.ResultsParticipants with SMIs and T2DM showed increased peripheral levels of inflammatory markers, such as interleukin-10 (p < 0.01; η2p = 0.07) and tumor necrosis factor-α (p < 0.05; η2p = 0.08); and oxidative stress biomarkers, such as reactive oxygen species (ROS) (p < 0.05; η2p = 0.07) and mitochondrial ROS (p < 0.01; η2p = 0.08). The different combinations of the exposed biomarkers anticipated 46–57.3% of the total ED and 23.8–35.7% of GSFS for the participants with SMIs.LimitationsParticipants' treatment, as usual, was continued without no specific interventions; thus, it was difficult to anticipate substantial changes related to the psychopharmacological pattern.ConclusionPeople with SMIs show significantly increased levels of peripheral immune–inflammatory biomarkers, which may contribute to the neurocognitive and social deficits observed in SMIs, T2DM, and other diseases with systemic immune–inflammatory activation of chronic development. These parameters could help identify the subset of patients who could benefit from immune–inflammatory modulator strategies to ameliorate their functional outcomes.

La neuroplasticidad se puede definir como la capacidad del sistema nervioso para responder a estímulos intrínsecos o extrínsecos reorganizando su estructura, función y conexiones. El avance en la compresión de este tipo de conectividad y los mecanismos de adaptación del sistema nervioso, desde las moléculas hasta las conexiones sinápticas, las redes neuronales y el comportamiento humano, ha ido generando una nueva perspectiva en la investigación del funcionamiento cerebral y sus mecanismos de recuperación de regeneración. En los últimos años, los investigadores han buscado mecanismos subyacentes a esta capacidad, identificando posibles factores epigenéticos, biomarcadores y algunos procesos cognitivos relacionados, con el fin de determinar diagnósticos eficaces, prevención y pronóstico de la enfermedad y desarrollar terapias más potentes para mejorar el funcionamiento cognitivo y social, y la calidad de vida de las personas afectadas por trastornos mentales graves (TMG) como el trastorno depresivo mayor (TDM), el trastorno bipolar (TB) y la esquizofrenia (EZ), y el de otras con enfermedades crónicas que cursan con deterioro cognitivo como la diabetes mellitus tipo 2 (DMT2). Se han identificado terapias prometedoras, intervenciones neurofarmacéuticas y estimulación cerebral, que permiten optimizar el funcionamiento de estas personas, sin embargo, su eficacia para estimular la capacidad neuroplástica como tal o impedir su deterioro, sigue siendo muy limitada. La memoria, el aprendizaje, y funciones ejecutivas como la memoria de trabajo, la velocidad de procesamiento de la información y la flexibilidad cognitiva son dominios cognitivos que posibilitan que el ser humano pueda hacer cambios en su organismo para adaptarse a un entorno variable, por tanto se les podría relacionar directamente con la neuroplasticidad humana. Por esto, los nuevos métodos para evaluar y estimular la neuroplasticidad humana, además de la identificación e intervención sobre marcadores y mecanismos biológicos, deberían incluir en sus protocolos aquellos procesos cognitivos que dependen de la experiencia. El objetivo general de este trabajo fue describir la neuroplasticidad de personas con DMT2, TDM, TB, y EZ, en comparación con controles sanos (CS), desde un enfoque neuropsicológico, por medio de la evaluación de funciones cognitivas asociadas directamente a la neuroplasticidad humana como la memoria, el aprendizaje y la flexibilidad cognitiva. Se incluyeron 135 participantes: 30 con EZ, 41 con TB y 34 con TDM de acuerdo con los criterios del DSM-5 y un grupo de 30 CS; los cuales fueron evaluados en dos momentos distintos a lo largo de un año de seguimiento.   Además de evaluar el estado clínico y el funcionamiento social, se utilizó una amplia batería para evaluar el funcionamiento cognitivo, seleccionando para los análisis las variables de interés: 1) Memoria (inmediata, a corto plazo y a largo plazo) evaluada con el TAVEC, 2) Aprendizaje evaluado con el subtest Dígitos-Directo del Wais-III y la variable V3-RI-AT del TAVEC; 3) Funciones ejectivas: a) Memoria de trabajo evaluada con el subtest Dígitos-Inverso del Wais-III y el TMT-B, b) Velocidad de procesamiento evaluada con el subtes Clave de Números del Wais-III y el TMT-A, c) Flexibilidad cognitiva evaluada con el WCST. Los resultados mostraron un funcionamiento cognitivo superior en el grupo de CS, permaneciendo estable en ambos momentos. Los grupos con diagnóstico de TMG tuvieron puntuaciones más bajas que los CS, con pocas diferencias significativas entre ellos. En la mayoría de las variables, las personas con TB y con EZ tuvieron puntuaciones medias similares, en comparación con las de las personas con TDM; estos hallazgos se mantienen a lo largo del tiempo. Se puede concluir que existe evidencia para sugerir que las funciones cognitivas asociadas a la neuroplasticidad se preservan a lo largo del tiempo en una población normal, mientras que en las personas adultas diagnosticadas con TMG se presenta un deterioro cognitivo estable, relacionado con una menor neuroplasticidad, y se comporta de manera similar e inferior en los grupos diagnosticados con EZ y BD que en personas con TDM.