Alzheimer's Disease (AD) in elderly adds substantially to socio-economic burden necessitating early diagnosis. While recent studies in rodent models of AD have suggested diagnostic and therapeutic value for gamma rhythms in brain, the same has not been rigorously tested in humans. We recruited a large population (N=247; 106 females) of elderly (>49 years) individuals from the community, who viewed large gratings that induced strong gamma oscillations in their electroencephalogram (EEG). These individuals were classified as healthy (N=227), mild-cognitively-impaired (MCI; 14) or AD (6) based on clinical history and Clinical Dementia Rating scores. Surprisingly, stimulus-induced gamma rhythms, but not alpha or steady-state-visually-evoked-responses, were significantly lower in both MCI and AD patients compared to their age and gender matched controls. This reduction was not due to differences in eye movements or baseline power. Our results suggest that gamma could be used as potential diagnostic tool for MCI/AD in humans.

Background The COVID‐19 crisis brought most cohort studies around the world to a standstill. India, which had implemented one of the strictest nation‐wide lockdowns in the world, was no exception. Owing to this, recruitments and assessments in our aging cohort in rural India, namely, Srinivaspura Aging Neurosenescence and COGnition (SANSCOG), had to be abruptly suspended. Method The SANSCOG study team undertook active measures to keep our subjects engaged remotely during the COVID‐19‐related lockdown period and also, provided useful services telephonically, to address their anxiety and distress. We collaborated with a local digital health service initiative, to offer counselling on awareness about the disease and safety precautions to be adopted. To assess the psychological impact of the pandemic on our cohort, the study team’s clinicians telephonically administered the Geriatric Depression Scale (GDS‐7) and the Generalized Anxiety Disorder (GAD‐7) questionnaire to consenting subjects. These instruments are brief, validated and sensitive instruments to screen for depression and anxiety disorder, respectively. Among subjects who had pre‐COVID GDS scores (obtained from their baseline clinical assessments), the proportion of subjects having pre‐COVID versus post‐COVID depression was compared. Result A total of 1890 subjects from the rural (SANSCOG) cohort were contacted during the lockdown period. Our periodic telephone calls to enquire about the subjects’ well‐being as well as our providing of psychological support and medical advice, when necessary, were appreciated by our subjects. Our collaborative initiative to provide awareness about the pandemic was well‐received, as many of our subjects had inadequate awareness about the pandemic. Overall, these strategies resulted in better bonding between our study team and our cohort. On screening for depression and anxiety disorder, 28.4% scored above the threshold score for depressive disorder on GDS‐7, whereas 5.5% scored above the threshold score for anxiety disorder on GAD‐7. We found that the proportion of subjects with depression had quadrupled after the COVID‐19 pandemic (pre‐COVID ‐ 7.74%, post‐COVID ‐ 28.98%). Conclusion The above approaches of cohort engagement during times of crisis are deemed valuable by subjects and we envisage that this would improve subject retention. This rural Indian cohort had a severe psychological impact due to the COVID‐19 pandemic.

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Background Neuropsychiatric conditions occur more frequently among elderly. With rising proportion of elderly in India, the burden due to neuropsychiatric disorders is bound to escalate. Many of these disorders have been associated with dementia, though the relationship is complex. Method Prevalence of neuropsychiatric conditions, such as stroke, head injury, depression and early‐life stress were assessed in two parallel, longitudinal, aging cohorts, from rural and urban India, namely, the Srinivaspura Aging Neurosenescence and COGnition (SANSCOG) study and Tata Longitudinal Study of Aging (TLSA), respectively. As part of their baseline clinical assessments, subjects from both cohorts were screened for depression using the self‐rated, Geriatric Depression Scale (GDS) and the clinician‐rated, Hamilton’s Depression Rating Scale (HDRS). Past history of depression and history of early life stressors, such as parental death and parental divorce in childhood were obtained. Self‐reported history of stroke, head injury and risk for vascular dementia using Hatchinski’s Ischemic Index (HIS) were also assessed. Result Proportion of subjects diagnosed with depression using GDS was 9.77% in the rural and 9.66% in the urban cohort, whereas corresponding numbers using HDRS were 6.55% and 3.82%, with female preponderance in both cohorts. Proportion of subjects with past history of depression was 4.82% and 5.07% in the rural and urban cohorts, respectively. Early life parental death was more in the rural 10.91%) as compared with the urban cohort (3.66%). History of stroke was reported in 1.25% and 2.31% of the rural and urban cohorts, respectively. There was no significant difference in proportion of subjects with history of head injury between the rural (4.16%) and urban (4.77%) cohorts. In the rural cohort, 0.23% scored above the threshold for vascular dementia on HIS, whereas none of the subjects scored above the threshold in the urban cohort. Conclusion GDS is a more sensitive tool than HDRS at screening for depression in elderly. Neuropsychiatric conditions such as history of stroke, head injury and risk for vascular dementia did not show any consistent trend of variation between both the cohorts. Further longitudinal assessments of these neuropsychiatric conditions along with parallel monitoring of cognitive changes will help in identifying their causal relationship with dementia.

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Introduction Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality throughout the world. By 2020, the World Health Organization predicts that COPD will become the third leading cause of death and the fifth leading cause of disability worldwide. The COPD is a complex disease characterized by slowly progressive and largely irreversible airflow obstruction due to chronic bronchitis and emphysema and associated with systemic inflammation. Objective This study aimed to correlate the plasma levels of high-sensitivity C-reactive protein (hs-CRP) with severity of COPD and pulmonary function tests [PFTs; according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages] and find out the relation between hs-CRP levels and clinical parameters of age, number of pack years, and body mass index (BMI) of the patient. Materials and methods A cross-sectional study of 102 male patients with clinically and spirometrically diagnosed cases of COPD was performed. Data on patient's demographic characteristics, pack years, BMI, PFTs, and hs-CRP were analyzed. Results A total of 76 of the patients had moderate airflow obstruction (GOLD stages II and III), mild airflow obstruction was present in 14 patients (GOLD stage I), and 12 patients had severe airflow obstruction (GOLD stage IV). The hs-CRP was normal in 6 patients, while it was raised in 96 patients. The value of hs-CRP was correlated with age, pack years, BMI, and GOLD stages. There was a significant negative correlation between hs-CRP and BMI and a significant positive correlation between hs-CRP and age, pack years, and GOLD stages. Conclusion A raised level of CRP in COPD indicates reduced lung function; it plays an important role in systemic inflammation. This study supports the role of hs-CRP as a simple, cost-effective biochemical marker in the staging and determining the severity of COPD other than spirometry. How to cite this article Patil MB, Abhishek M, Pradeep BK. Role of High-sensitivity C-reactive Protein as a Predictor of Severity of Chronic Obstructive Pulmonary Disease in Correlation with Clinical Parameters. J Med Sci 2017;3(2):50-54.