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Developmental fluoride neurotoxicity: an updated review
Background
After the discovery of fluoride as a caries-preventing agent in the mid-twentieth century, fluoridation of community water has become a widespread intervention, sometimes hailed as a mainstay of modern public health. However, this practice results in elevated fluoride intake and has become controversial for two reasons. First, topical fluoride application in the oral cavity appears to be a more direct and appropriate means of preventing caries. Second, systemic fluoride uptake is suspected of causing adverse effects, in particular neurotoxicity during early development. The latter is supported by experimental neurotoxicity findings and toxicokinetic evidence of fluoride passing into the brain.
Method
An integrated literature review was conducted on fluoride exposure and intellectual disability, with a main focus on studies on children published subsequent to a meta-analysis from 2012.
Results
Fourteen recent cross-sectional studies from endemic areas with naturally high fluoride concentrations in groundwater supported the previous findings of cognitive deficits in children with elevated fluoride exposures. Three recent prospective studies from Mexico and Canada with individual exposure data showed that early-life exposures were negatively associated with children’s performance on cognitive tests. Neurotoxicity appeared to be dose-dependent, and tentative benchmark dose calculations suggest that safe exposures are likely to be below currently accepted or recommended fluoride concentrations in drinking water.
Conclusion
The recent epidemiological results support the notion that elevated fluoride intake during early development can result in IQ deficits that may be considerable. Recognition of neurotoxic risks is necessary when determining the safety of fluoride-contaminated drinking water and fluoride uses for preventive dentistry purposes.
Journal Article
The Tip of the Tongue State
This book brings together the body of empirical findings and theoretical interpretations of the tip of the tongue (TOT) experience - when a well-known or familiar word cannot immediately be recalled. Although research has been published on TOTs for over a century, the experience retains its fascination for both cognitive and linguistic researchers.
After a review of various research procedures used to study TOTs, the book offers a summary of attempts to manipulate this rare cognitive experience through cue and prime procedures. Various aspects of the inaccessible target word are frequently available - such as first letter and syllable number - even in the absence of actual retrieval, and the book explores the implications of these bits of target-word information for mechanisms for word storage and retrieval. It also examines: what characteristics of a word make it potentially more vulnerable to a TOT; why words related to the target word (called \"interlopers\") often come to mind; the recovery process, when the momentarily-inaccessible word is recovered shortly after the TOT is first experienced; and efforts to evaluate individual differences in the likelihood to experience TOTs.
eBook
Overcoming unwanted intrusive thoughts : a CBT-based guide to getting over frightening, obsessive, or disturbing thoughts
People who experience unwanted, intrusive, or frightening thoughts often suffer shamefully and struggle silently for fear of what the thoughts might mean about them. In this powerful book, two anxiety disorder experts offer powerful and proven-effective cognitive behavioral therapy (CBT) skills to help readers get unstuck from disturbing thoughts, overcome intense shame, and reduce anxiety.
eBook
Validation of Addenbrooke’s cognitive examination III for detecting mild cognitive impairment and dementia in Japan
Background
Early detection of mild cognitive impairment (MCI) and dementia is very important to begin appropriate treatment promptly and to prevent disease exacerbation. We investigated the screening accuracy of the Japanese version of Addenbrooke’s Cognitive Examination III (ACE-III) to diagnose MCI and dementia.
Methods
The original ACE-III was translated and adapted to Japanese. It was then administered to a Japanese population. The Hasegawa Dementia Scale-revised (HDS-R) and Mini-mental State Examination (MMSE) were also applied to evaluate cognitive dysfunction. In total, 389 subjects (dementia = 178, MCI = 137, controls = 73) took part in our study.
Results
The optimal ACE-III cut-off scores to detect MCI and dementia were 88/89 (sensitivity 0.77, specificity 0.92) and 75/76 (sensitivity 0.82, specificity 0.90), respectively. ACE-III was superior to HDS-R and MMSE in the detection of MCI or dementia. The internal consistency, test-retest reliability, and inter-rater reliability of ACE-III were excellent.
Conclusions
ACE-III is a useful cognitive test to detect MCI and dementia. ACE-III may be widely useful in clinical practice.
Journal Article
Effects of dog-assisted therapy in adults with dementia: a systematic review and meta-analysis
Background
Dog-assisted therapy (DAT) is a non-pharmacological intervention based on the interaction between patients and dogs, which has been proposed to help adults with dementia. However, evidence to support it is lacking. Thus, we aim to evaluate the effects of DAT on this population and to assess the certainty of the evidence of the RCTs estimates.
Methods
A systematic search was performed. We included randomized controlled trials (RCTs) and quasi-experimental (QE) controlled studies published up to March 2018, which evaluated the beneficial and deleterious effects of DAT in adults with dementia. Mean differences (MD) or standardized mean differences (SMD) and their 95% confidence intervals (95% CI) were calculated and random effects meta-analyses were performed. Certainty of evidence was assessed for RCTs estimates using the
Grading of Recommendations Assessment, Development, and Evaluation
(GRADE) methodology. The study protocol has been registered in PROSPERO (CRD42018090434).
Results
Ten studies (six RCTs and four QE controlled studies) were eligible for inclusion. Meta-analysis of RCTs showed no effect of DAT in daily life activities (SMD: 0.16; 95% CI: -0.80 to 1.12), depression (SMD: -0.45; 95% CI: -2.81 to 1.91), agitation (SDM: -1.12; 95% CI: -2.67 to 0.43), quality of life (SDM: 0.16; 95% CI: -0.41 to 0.73), and cognitive impairment (SDM: -0.52; 95% CI: -1.33 to 0.30), but it found a beneficial effect in apathy (1 study,
n
= 37, MD: 1.81; 95% CI: 1.26 to 2.36). All outcomes had a very low certainty of evidence according to GRADE methodology.
Conclusions
RCTs evidence of very low certainty suggests that, in adults with dementia, DAT has no effect in daily life activities, depression, agitation, quality of life, and cognitive impairment, although one small study found an apparent beneficial effect in apathy. More well-designed and correctly reported studies are needed in order to provide a conclusion.
Trial registration
CRD42018090434
(PROSPERO).
Journal Article