Combining social cognitive treatment, cognitive remediation, and functional skills training in schizophrenia: a randomized controlled trial

PubMed Central

Peña, Javier; Ibarretxe-Bilbao, Naroa; Sánchez, Pedro; Iriarte, Maria B; Elizagarate, Edorta; Garay, Maria A; Gutiérrez, Miguel; Iribarren, Aránzazu; Ojeda, Natalia

2016-01-01

This study examined the efficacy of an integrative cognitive remediation program (REHACOP) in improving cognition and functional outcome in patients with schizophrenia. The program combines cognitive remediation, social cognitive intervention, and functional skills training. Few studies have attempted this approach. One hundred and eleven patients diagnosed with schizophrenia were randomly assigned to either the cognitive remediation group (REHACOP) or an active control group (occupational activities) for 4 months (three sessions per week, 90 min). Primary outcomes were change on general neurocognitive performance and social cognition, including theory of mind (ToM), emotion perception (EP), attributional style, and social perception (SP). Secondary outcomes included changes on clinical symptoms (Positive and Negative Syndrome Scale) and functional outcome (UCSD Performance-Based Skills Assessment and the Global Assessment of Functioning). The trial was registered with clinicaltrials.gov (NCT02796417). No baseline group differences were found. Significant differences were found in the mean change between the REHACOP group and control group in neurocognition (ηp2=0.138), SP (ηp2=0.082), ToM (ηp2=0.148), EP (ηp2=0.071), negative symptoms (ηp2=0.082), emotional distress (ηp2=0.136), Global Assessment of Functioning (ηp2=0.081), and UCSD Performance-Based Skills Assessment (ηp2=0.154). The combination of cognitive remediation, social cognitive intervention, and functional skills training demonstrated statistically significant and clinically meaningful changes in neurocognition, social cognition, negative, and functional disability. PMID:27868083

The quality of life of patients developed delirium after coronary artery bypass grafting is determined by cognitive function after discharge: A cross-sectional study.

PubMed

Chen, Yuling; Ding, Shu; Tao, Xiangjun; Feng, Xinwei; Lu, Sai; Shen, Yuzhi; Wu, Ying; An, Xiangguang

2017-10-01

Postoperative delirium (POD) and declined cognitive function were common in patients (especially elderly patients) who underwent coronary artery bypass grafting (CABG), which may affect quality of life (QoL). The aim of this study was to determine the relationships among age, POD, declined cognitive function, and QoL in patients who underwent CABG. Consecutive patients who underwent first time elective CABG and assessed for POD using Confusion Assessment Method for intensive care unit for 5 postoperative days from November 2013 to March 2015 were recruited. A cross-sectional study was conducted during April 2015 to assess their cognitive function and QoL, using the Telephone Interview for Cognitive Status Scale and Medical Outcomes Study 36-Item Short Form Health Survey. The relationships among age, POD, declined cognitive function, and QoL were tested using path analysis. Declined cognitive function was associated with poorer QoL. POD was associated with declined cognitive function but was not associated with poorer QoL. Ageing was not associated with QoL but was associated with POD and declined cognitive function. The QoL of patients developed delirium after CABG is determined by cognitive function after discharge. Necessary strategies should be implemented to prevent POD and declined cognitive function, especially in elderly patients. © 2017 John Wiley & Sons Australia, Ltd.

Fun cube based brain gym cognitive function assessment system.

PubMed

Zhang, Tao; Lin, Chung-Chih; Yu, Tsang-Chu; Sun, Jing; Hsu, Wen-Chuin; Wong, Alice May-Kuen

2017-05-01

The aim of this study is to design and develop a fun cube (FC) based brain gym (BG) cognitive function assessment system using the wireless sensor network and multimedia technologies. The system comprised (1) interaction devices, FCs and a workstation used as interactive tools for collecting and transferring data to the server, (2) a BG information management system responsible for managing the cognitive games and storing test results, and (3) a feedback system used for conducting the analysis of cognitive functions to assist caregivers in screening high risk groups with mild cognitive impairment. Three kinds of experiments were performed to evaluate the developed FC-based BG cognitive function assessment system. The experimental results showed that the Pearson correlation coefficient between the system's evaluation outcomes and the traditional Montreal Cognitive Assessment scores was 0.83. The average Technology Acceptance Model 2 score was close to six for 31 elderly subjects. Most subjects considered that the brain games are interesting and the FC human-machine interface is easy to learn and operate. The control group and the cognitive impairment group had statistically significant difference with respect to the accuracy of and the time taken for the brain cognitive function assessment games, including Animal Naming, Color Search, Trail Making Test, Change Blindness, and Forward / Backward Digit Span. Copyright © 2017 Elsevier Ltd. All rights reserved.

Status of Cognitive Testing of Adults in India

PubMed Central

Porrselvi, A. P.; Shankar, V.

2017-01-01

The assessment of cognitive function is a challenging yet an integral component of psychological, psychiatric, and neurological evaluation. Cognitive assessment tools either can be administered quickly for screening for neurocognitive disorders or can be comprehensive and detailed to identify cognitive deficits for the purpose of localization, diagnosis, and rehabilitation. This article is a comprehensive review of published research that discusses the current challenges for cognitive testing in India, available tools used for the assessment of cognitive function in India, and future directions for cognitive testing in India. PMID:29184333

Cognitive functioning and behaviour of epileptic children in parents' assessment.

PubMed

Talarska, Dorota; Steinborn, Barbara; Michalak, Michał

2011-01-01

Cognitive functioning and behaviour of chronically ill children are affected by many factors, including anxiety due to hospitalization, persistent symptoms of sickness and adverse side effects of medications. The aim of this work was to seek out parents' opinion concerning cognitive functioning and behaviour of children with epilepsy. The study comprised 156 children with epilepsy aged 7-18 and treated in the Department of Developmental Neurology at Karol Marcinkowski Poznan University of Medical Sciences and in an outpatient clinic. The research tool used was the questionnaire Quality of Life in Childhood Epilepsy (QOLCE) completed by parents. Assessment of cognitive functioning and behaviour was based on the analysis of the areas V (cognitive processes) and VII (behaviour). Parents assessed children's functioning in the areas of cognitive processes and behaviour at a similar level - 55 points. In the area of cognitive processes, concentration while performing some tasks and reading was assessed as the worst. A significant difference in caregivers' assessment was found according to age, frequency of seizures and duration of disease. In the area analysing the child's behaviour, parents indicated getting angry easily and not being upset by other people's opinions. The display of aggression towards others got the lowest number of comments. The children's functioning was assessed by parents as rather poor in both analysed areas. Parents of children treated with polytherapy noticed more difficulties in cognitive functioning and behaviour than parents of children treated with one medication.

Factors Influencing Cognitive Function in Subjects With COPD.

PubMed

Dag, Ersel; Bulcun, Emel; Turkel, Yakup; Ekici, Aydanur; Ekici, Mehmet

2016-08-01

The aim of this study was to assess the association between cognitive function and age, pulmonary function, comorbidity index, and the 6-min walk distance in subjects with COPD as well as to compare the Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) in terms of their ability to identify cognitive dysfunction in subjects with COPD. A total of 52 individuals with stable COPD were included in this study. Cognitive function was assessed using MMSE and MoCA. Age, body mass index, the Modified Cumulative Illness Rating Scale, 6-min walk distance, arterial blood gases, and pulmonary function tests were assessed and recorded. The range and SD of scores in subjects with COPD were larger with MoCA than with MMSE. MMSE and MoCA scores are associated with 6-min walk distance and comorbidity index in subjects with COPD. General cognitive function measured by MoCA was negatively correlated with the comorbidity index but was positively associated with 6-min walk distance in subjects with COPD after controlling for possible confounding factors in the multivariate model. However, general cognitive function measured by MMSE was not correlated with the comorbidity index and 6-min walk distance in subjects with COPD, after controlling for possible confounding factors in the multivariate model. MoCA may be a more reliable screening test than MMSE in detecting cognitive impairment in subjects with COPD. The addition of cognitive tests on assessment of subjects with COPD can provide further benefit. Copyright © 2016 by Daedalus Enterprises.

Lower Limb Function in Elderly Korean Adults Is Related to Cognitive Function.

PubMed

Kim, A-Sol; Ko, Hae-Jin

2018-05-01

Patients with cognitive impairment have decreased lower limb function. Therefore, we aimed to investigate the relationship between lower limb function and cognitive disorders to determine whether lower limb function can be screened to identify cognitive decline. Using Korean National Health Insurance Service-National Sample Cohort database data, we assessed the cognitive and lower limb functioning of 66-year-olds who underwent national health screening between 2010 and 2014. Cognitive function was assessed via a questionnaire. Timed Up-and-Go (TUG) and one-leg-standing (OLS) tests were performed to evaluate lower limb function. Associations between cognitive and lower limb functions were analyzed, and optimal cut-off points for these tests to screen for cognitive decline, were determined. Cognitive function was significantly correlated with TUG interval ( r = 0.414, p < 0.001) and OLS duration ( r = −0.237, p < 0.001). Optimal cut-off points for screening cognitive disorders were >11 s and ≤12 s for TUG interval and OLS duration, respectively. Among 66-year-olds who underwent national health screening, a significant correlation between lower limb and cognitive function was demonstrated. The TUG and OLS tests are useful screening tools for cognitive disorders in elderly patients. A large-scale prospective cohort study should be conducted to investigate the causal relationship between cognitive and lower limb function.

Clinical, Functional, and Biological Correlates of Cognitive Dimensions in Major Depressive Disorder – Rationale, Design, and Characteristics of the Cognitive Function and Mood Study (CoFaM-Study)

PubMed Central

Baune, Bernhard T.; Air, Tracy

2016-01-01

Cross-sectional and longitudinal studies exploring clinical, functional, and biological correlates of major depressive disorder are frequent. In this type of research, depression is most commonly defined as a categorical diagnosis based on studies using diagnostic instruments. Given the phenotypic and biological heterogeneity of depression, we chose to focus the phenotypic assessments on three cognitive dimensions of depression including (a) cognitive performance, (b) emotion processing, and (c) social cognitive functioning. Hence, the overall aim of the study is to investigate the long-term clinical course of these cognitive dimensions in depression and its functional (psychosocial) correlates. We also aim to identify biological “genomic” correlates of these three cognitive dimensions of depression. To address the above overall aim, we created the Cognition and Mood Study (CoFaMS) with the key objective to investigate the clinical, functional, and biological correlates of cognitive dimensions of depression by employing a prospective study design and including a healthy control group. The study commenced in April 2015, including patients with a primary diagnosis of a major depressive episode of major depressive disorder or bipolar disorder according to DSM-IV-TR criteria. The assessments cover the three cognitive dimensions of depression (cognitive performance, emotion processing, and social cognition), cognitive function screening instrument, plus functional scales to assess general, work place, and psychosocial function, depression symptom scales, and clinical course of illness. Blood is collected for comprehensive genomic discovery analyses of biological correlates of cognitive dimensions of depression. The CoFaM-Study represents an innovative approach focusing on cognitive dimensions of depression and its functional and biological “genomic” correlates. The CoFaMS team welcomes collaborations with both national and international researchers. PMID:27616997

Clinical, Functional, and Biological Correlates of Cognitive Dimensions in Major Depressive Disorder - Rationale, Design, and Characteristics of the Cognitive Function and Mood Study (CoFaM-Study).

PubMed

Baune, Bernhard T; Air, Tracy

2016-01-01

Cross-sectional and longitudinal studies exploring clinical, functional, and biological correlates of major depressive disorder are frequent. In this type of research, depression is most commonly defined as a categorical diagnosis based on studies using diagnostic instruments. Given the phenotypic and biological heterogeneity of depression, we chose to focus the phenotypic assessments on three cognitive dimensions of depression including (a) cognitive performance, (b) emotion processing, and (c) social cognitive functioning. Hence, the overall aim of the study is to investigate the long-term clinical course of these cognitive dimensions in depression and its functional (psychosocial) correlates. We also aim to identify biological "genomic" correlates of these three cognitive dimensions of depression. To address the above overall aim, we created the Cognition and Mood Study (CoFaMS) with the key objective to investigate the clinical, functional, and biological correlates of cognitive dimensions of depression by employing a prospective study design and including a healthy control group. The study commenced in April 2015, including patients with a primary diagnosis of a major depressive episode of major depressive disorder or bipolar disorder according to DSM-IV-TR criteria. The assessments cover the three cognitive dimensions of depression (cognitive performance, emotion processing, and social cognition), cognitive function screening instrument, plus functional scales to assess general, work place, and psychosocial function, depression symptom scales, and clinical course of illness. Blood is collected for comprehensive genomic discovery analyses of biological correlates of cognitive dimensions of depression. The CoFaM-Study represents an innovative approach focusing on cognitive dimensions of depression and its functional and biological "genomic" correlates. The CoFaMS team welcomes collaborations with both national and international researchers.

The kidney disease quality of life cognitive function subscale and cognitive performance maintenance hemodialysis patients

USDA-ARS?s Scientific Manuscript database

Background: Cognitive impairment is common but often undiagnosed in patients with end-stage renal disease, in part reflecting limited validated and easily administered tools to assess cognitive function in dialysis patients. Accordingly, we assessed the utility of the Kidney Disease Quality of Life ...

Effect of blonanserin on cognitive and social function in acute phase Japanese schizophrenia compared with risperidone.

PubMed

Hori, Hikaru; Yamada, Kenji; Kamada, Dan; Shibata, Yuka; Katsuki, Asuka; Yoshimura, Reiji; Nakamura, Jun

2014-01-01

This study aims to determine the effectiveness of blonanserin (BNS) on the cognitive and social functions of patients with schizophrenia compared with risperidone (RIS) during acute-phase (8-week) treatment. A total of 39 schizophrenia inpatients were included in this study. The subjects received either BNS (N=20) or RIS (N=19), and the clinical responses were evaluated periodically. The concomitant use of mood stabilizers was not allowed. Efficacy was assessed with the Positive and Negative Syndrome Scale for schizophrenia. Cognition was assessed using the Brief Assessment of Cognition in Schizophrenia, Japanese-language version. Social function was assessed using the Life Assessment Scale for the Mentally Ill. For both groups, each assessment exhibited a decrease in the mean change from baseline on the Positive and Negative Syndrome Scale. The depression subscale was significantly improved in the BNS group compared with the RIS group at 8 weeks after administration. BNS improved verbal fluency and executive function (cognitive function) and daily living and work skills (social function). Compared with the RIS group, BNS was observed to improve daily living. BNS may improve psychotic symptoms, cognitive function, and daily living in patients with acute-phase schizophrenia. BNS may be superior to RIS in the improvement of daily living.

Effect of blonanserin on cognitive and social function in acute phase Japanese schizophrenia compared with risperidone

PubMed Central

Hori, Hikaru; Yamada, Kenji; Kamada, Dan; Shibata, Yuka; Katsuki, Asuka; Yoshimura, Reiji; Nakamura, Jun

2014-01-01

Background This study aims to determine the effectiveness of blonanserin (BNS) on the cognitive and social functions of patients with schizophrenia compared with risperidone (RIS) during acute-phase (8-week) treatment. Methods A total of 39 schizophrenia inpatients were included in this study. The subjects received either BNS (N=20) or RIS (N=19), and the clinical responses were evaluated periodically. The concomitant use of mood stabilizers was not allowed. Efficacy was assessed with the Positive and Negative Syndrome Scale for schizophrenia. Cognition was assessed using the Brief Assessment of Cognition in Schizophrenia, Japanese-language version. Social function was assessed using the Life Assessment Scale for the Mentally Ill. Results For both groups, each assessment exhibited a decrease in the mean change from baseline on the Positive and Negative Syndrome Scale. The depression subscale was significantly improved in the BNS group compared with the RIS group at 8 weeks after administration. BNS improved verbal fluency and executive function (cognitive function) and daily living and work skills (social function). Compared with the RIS group, BNS was observed to improve daily living. Conclusion BNS may improve psychotic symptoms, cognitive function, and daily living in patients with acute-phase schizophrenia. BNS may be superior to RIS in the improvement of daily living. PMID:24707178

Can We Understand Why Cognitive Function Predicts Mortality? Results from the Caerphilly Prospective Study (CaPS)

ERIC Educational Resources Information Center

Gallacher, John; Bayer, Anthony; Dunstan, Frank; Yarnell, John; Elwood, Peter; Ben-Shlomo, Yoav

2009-01-01

The association between cognitive function and mortality is of increasing interest. We followed 1870 men aged 55-69 years at cognitive assessment for 16 years to establish associations with all case and cause specific mortality. Cognitive assessment included AH4, 4 choice reaction time (used as estimates of mid-life cognition) and the National…

Feasibility, reliability, and validity of a smartphone based application for the assessment of cognitive function in the elderly.

PubMed

Brouillette, Robert M; Foil, Heather; Fontenot, Stephanie; Correro, Anthony; Allen, Ray; Martin, Corby K; Bruce-Keller, Annadora J; Keller, Jeffrey N

2013-01-01

While considerable knowledge has been gained through the use of established cognitive and motor assessment tools, there is a considerable interest and need for the development of a battery of reliable and validated assessment tools that provide real-time and remote analysis of cognitive and motor function in the elderly. Smartphones appear to be an obvious choice for the development of these "next-generation" assessment tools for geriatric research, although to date no studies have reported on the use of smartphone-based applications for the study of cognition in the elderly. The primary focus of the current study was to assess the feasibility, reliability, and validity of a smartphone-based application for the assessment of cognitive function in the elderly. A total of 57 non-demented elderly individuals were administered a newly developed smartphone application-based Color-Shape Test (CST) in order to determine its utility in measuring cognitive processing speed in the elderly. Validity of this novel cognitive task was assessed by correlating performance on the CST with scores on widely accepted assessments of cognitive function. Scores on the CST were significantly correlated with global cognition (Mini-Mental State Exam: r = 0.515, p<0.0001) and multiple measures of processing speed and attention (Digit Span: r = 0.427, p<0.0001; Trail Making Test: r = -0.651, p<0.00001; Digit Symbol Test: r = 0.508, p<0.0001). The CST was not correlated with naming and verbal fluency tasks (Boston Naming Test, Vegetable/Animal Naming) or memory tasks (Logical Memory Test). Test re-test reliability was observed to be significant (r = 0.726; p = 0.02). Together, these data are the first to demonstrate the feasibility, reliability, and validity of using a smartphone-based application for the purpose of assessing cognitive function in the elderly. The importance of these findings for the establishment of smartphone-based assessment batteries of cognitive and motor function in the elderly is discussed.

The Role of Cognitive Content and Cognitive Processes in Chronic Pain: An Important Distinction?

PubMed

Jensen, Mark P; Thorn, Beverly E; Carmody, James; Keefe, Francis J; Burns, John W

2018-05-01

Pain-related cognitive content (what people think about pain) and cognitive processes (how people think about pain; what they do with their pain-related thoughts) and their interaction are hypothesized to play distinct roles in patient function. However, questions have been raised regarding whether it is possible or practical to assess cognitive content and cognitive process as distinct domains. The aim of this study was to determine the extent to which measures that seem to assess mostly pain-related cognitive content, cognitive processes, and content and process, are relatively independent from each other and contribute unique variance to the prediction of patient function. Individuals with chronic low back pain (N=165) participating in an ongoing RCT were administered measures of cognitions, pain, and function (depressive symptoms and pain interference) pretreatment. Analyses provided support for the hypothesis that cognitive content and cognitive process, while related, can be assessed as distinct components. However, the measure assessing a cognitive process-mindfulness-evidenced relatively weak associations with function, especially compared with the stronger and more consistent findings for the measures of content (catastrophizing and self-efficacy). The results provide preliminary evidence for the possibility that mindfulness could have both benefits and costs. Research to evaluate this possibility is warranted.

Onset Time of Inhibition of Return is a Promising Index for Assessing Cognitive Functions in Older Adults.

PubMed

Li, Tingni; Wang, Lei; Huang, Wanyi; Zhen, Yanfen; Zhong, Chupeng; Qu, Zhe; Ding, Yulong

2018-06-06

Developing efficient tools for assessing general cognitive functions in older adults is essential. Previous studies found that inhibition of return (IOR) occurred later in the older adults than in the younger (e.g., Castel, Chasteen, Scialfa, & Pratt, 2003). However, little is known about the relationship between the onset time of IOR (IOR-OT) and cognitive functions in the aging population. The present study examined this issue and investigated the potential of using IOR-OT as an index of cognitive functioning in older adults. In two studies, the IOR-OT of healthy younger and older adults was measured by a modified Posner peripheral cueing task, and cognitive functions of the older adults were evaluated with the Addenbrooke's Cognitive Examination Revised (ACE-R). Both studies showed a significant correlation (r = ~0.5) between IOR-OT and cognitive functions as assessed by ACE-R in older individuals: later IOR-OT was accompanied by a lower ACE-R score. To our knowledge, the present studies are the first to discover a relatively strong correlation between IOR-OT and cognitive functions in older adults. These findings provide new evidence supporting the inhibition deficit theory of aging and lay the foundation of using IOR-OT as an objective measure of cognitive functions in the aging population.

Mechanisms of functional improvement through cognitive rehabilitation in schizophrenia.

PubMed

Peña, J; Ibarretxe-Bilbao, N; Sánchez, P; Uriarte, J J; Elizagarate, E; Gutierrez, M; Ojeda, N

2018-06-01

Whereas the efficacy of cognitive rehabilitation in schizophrenia is widely known, studies examining mechanisms for functional improvement are still scarce. The aim of the study was to examine the mediational mechanisms through which cognitive rehabilitation improves functioning in schizophrenia. One hundred and eleven schizophrenia patients were randomly assigned to either a 4-month cognitive rehabilitation group or an active control group. Patients underwent a neurocognitive battery (including processing speed, verbal memory, working memory and executive functioning) and social cognition assessment (emotion perception, theory of mind and social perception). Functioning was assessed by the combined use of a performance-based instrument, the UCSD Performance-based Skills Assessment (UPSA) and an observer-rated instrument, the Global Assessment of Functioning (GAF). The trial was registered in clinicaltrials.gov (NCT02796417). Multiple mediational analyses revealed that the effect of cognitive rehabilitation on functional improvement was partially mediated by changes in processing speed and verbal memory, but not by the domains of social cognition and negative symptoms. More specifically, verbal memory partially mediated the treatment's effect on performance-based functioning (UPSA), whereas processing speed acted as a partial mediator for observer-rated functioning (GAF). The effect of rehabilitation on functioning did not take place through all the domains that showed significant improvement. Verbal memory and processing speed emerged as the most crucial factors. However, these complex interactions need further research. Copyright © 2018. Published by Elsevier Ltd.

The impact of aging, cognition, and symptoms on functional competence in individuals with schizophrenia across the lifespan.

PubMed

Kalache, Sawsan M; Mulsant, Benoit H; Davies, Simon J C; Liu, Angela Y; Voineskos, Aristotle N; Butters, Meryl A; Miranda, Dielle; Menon, Mahesh; Kern, Robert S; Rajji, Tarek K

2015-03-01

Life expectancy in individuals with schizophrenia continues to increase. It is not clear whether cognitive deficits associated with schizophrenia remain as strong predictors of function in older and younger individuals. Thus, we assessed the relationship between cognition and functional competence in individuals with schizophrenia across 7 decades of life. We analyzed data obtained in 232 community-dwelling participants with schizophrenia (age range: 19-79 years). Cognition was assessed using the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery. Functional competence was assessed using the UCSD Performance-based Skills Assessment, which includes measures of Comprehension and Planning of Recreational Activities Skills, Financial Skills, Communication Skills, Transportation Skills, and Household Management Skills. To assess the effects of Global Cognition on functional competence, we performed hierarchical multivariate linear or logistic regression analyses controlling for age, education, gender, and negative symptoms. Participants' mean age was 49.1 (SD = 13.2, range = 19-79 years), 161 (69%) were male, and 55 (24%) were aged ≥60. Global Cognition was a predictor of Comprehension and Planning Skills (Exp(β) = 1.048), Financial Skills (Exp(β) = 1.104), Communication Skills (ΔR (2) = .31) and Transportation Skills (Exp(β) = 1.066), but not Household Management Skills after adjusting for age, education, gender, and negative symptoms of schizophrenia. Cognition remains a strong predictor of functional competence across the lifespan. These findings suggest that treating cognitive impairment associated with schizophrenia could improve individuals' function independent of their age. © The Author 2014. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Cognitive profile in Duchenne muscular dystrophy boys without intellectual disability: The role of executive functions.

PubMed

Battini, R; Chieffo, D; Bulgheroni, S; Piccini, G; Pecini, C; Lucibello, S; Lenzi, S; Moriconi, F; Pane, M; Astrea, G; Baranello, G; Alfieri, P; Vicari, S; Riva, D; Cioni, G; Mercuri, E

2018-02-01

The aim of our prospective observational study was to assess profiles of cognitive function and a possible impairment of executive functions in a cohort of boys with Duchenne muscular dystrophy without intellectual and behavior disability. Forty Duchenne boys (range of age: 6 years to 11 years and 6 months) were assessed by Wechsler Intelligence scale and battery of tests including tasks assessing working memory and executive functions (inhibition and switching, problem solving and planning). In our cohort some aspects of cognitive function were often impaired. These included multitasking, problem solving, inhibition and working memory necessary to plan and direct goal oriented behavior. Our results support the suggestion that aspects of cognitive function could be impaired even in boys without intellectual disability and support the hypothesis that executive functions may play an important role in specific aspects of cognitive impairment in Duchenne muscular dystrophy. Copyright © 2017 Elsevier B.V. All rights reserved.

A case control study of association between cognition and functional capacity in schizophrenia.

PubMed

Narayanan, Sreelatha S; Bhatia, Triptish; Velligan, Dawn I; Nimgaonkar, Vishwajit L; Deshpande, Smita N

2015-12-01

Cognitive functions are important prognostic factors for schizophrenia (SZ), while ability to perform activities of daily living are important measures of functional capacity. The relationship between cognition and functional capacity has not been tested extensively in India. To compare persons with SZ with controls on measures of cognition and functional capacity, and evaluate correlations between cognitive performance and functional capacity. Schizophrenia outpatients and controls without psychiatric illness (DSM IV) who completed the MATRICS Consensus Cognitive Battery and Functional Assessment Battery comprised of two tests from University of California San Diego (UCSD) Performance Based Skill Assessment (UPSA), one Test of Adaptive Behavior in Schizophrenia (TABS) and one test from University of California San Diego Performance Based Skill Assessment Brief edition (UPSA-B). Cognitive and functional domains were examined using regression analyses, with relevant covariates. Cases (N=51) though younger, were more educated than controls (N=41). Adjusting for education, controls performed better than cases in 3/7 cognitive and 4/5 domains of functional capacity but similarly in 'household management'. Among both cases and controls, cognitive measures of verbal learning and speed of processing overlapped with functional capacity (3 domains). Working memory was associated with one functional domain. Consistent with other studies, Indian patients with schizophrenia performed worse than controls on several domains of cognition and functional capacity; these domains were correlated. Speed of processing and verbal learning are most frequently associated with functional capacity indices and should be targeted to improve skills of daily living among persons with SZ. Copyright © 2015. Published by Elsevier B.V.

Effects of physical exercise programs on cognitive function in Parkinson’s disease patients: A systematic review of randomized controlled trials of the last 10 years

PubMed Central

Iop, Rodrigo da Rosa; de Oliveira, Laiana Cândido; Boll, Alice Mathea; de Alvarenga, José Gustavo Souza; Gutierres Filho, Paulo José Barbosa; de Melo, Lídia Mara Aguiar Bezerra; Xavier, André Junqueira; da Silva, Rudney

2018-01-01

Background Given the relative importance of cognitive impairment, there was considerable interest in identifying the cognitive profile of PD patients, in order to ensure specific and appropriate therapeutic interventions. Purpose To determine the effects of physical exercise programs on cognitive function in PD patients, compared with the control group. Data sources Medline, Cochrane, Scopus, PEDro and Web of Science (last searched in September 2016). Study selection Randomized clinical trials examining the effects of physical exercise programs and cognitive function in PD patients. Nine studies fulfilled the selection criteria and were included in this review. Data extraction Characteristics of the publication, characteristics of the participants, test used for cognitive screening, cognitive domain assessed, tools used to assess cognitive function, characteristics of the experimental intervention, characteristics of the control group, mean results and standard deviation of function cognitive. The PEDro score was used to evaluate methodological quality. Data synthesis Most eligible studies showed good methodological quality based on the PEDro scale. Studies have shown that adapted tango for PD patients, cognitive training combined with motor training, and treadmill training promote the preservation or improvement of cognitive function in PD patients. Limitations The diversity of cognitive tests used to assess cognitive function and the high heterogeneity identified between the physical exercise programs. Conclusions Physical exercise programs promote positive and significant effects on global cognitive function, processing speed, sustained attention and mental flexibility in PD patients, at a mild to moderate stage for patients with a 6-year clinical diagnosis of PD. However, treadmill training performed 3 times a week for about 60 minutes and for a period of 24 weeks produced larger improvements in cognition. PMID:29486000

Effects of physical exercise programs on cognitive function in Parkinson's disease patients: A systematic review of randomized controlled trials of the last 10 years.

PubMed

da Silva, Franciele Cascaes; Iop, Rodrigo da Rosa; de Oliveira, Laiana Cândido; Boll, Alice Mathea; de Alvarenga, José Gustavo Souza; Gutierres Filho, Paulo José Barbosa; de Melo, Lídia Mara Aguiar Bezerra; Xavier, André Junqueira; da Silva, Rudney

2018-01-01

Given the relative importance of cognitive impairment, there was considerable interest in identifying the cognitive profile of PD patients, in order to ensure specific and appropriate therapeutic interventions. To determine the effects of physical exercise programs on cognitive function in PD patients, compared with the control group. Medline, Cochrane, Scopus, PEDro and Web of Science (last searched in September 2016). Randomized clinical trials examining the effects of physical exercise programs and cognitive function in PD patients. Nine studies fulfilled the selection criteria and were included in this review. Characteristics of the publication, characteristics of the participants, test used for cognitive screening, cognitive domain assessed, tools used to assess cognitive function, characteristics of the experimental intervention, characteristics of the control group, mean results and standard deviation of function cognitive. The PEDro score was used to evaluate methodological quality. Most eligible studies showed good methodological quality based on the PEDro scale. Studies have shown that adapted tango for PD patients, cognitive training combined with motor training, and treadmill training promote the preservation or improvement of cognitive function in PD patients. The diversity of cognitive tests used to assess cognitive function and the high heterogeneity identified between the physical exercise programs. Physical exercise programs promote positive and significant effects on global cognitive function, processing speed, sustained attention and mental flexibility in PD patients, at a mild to moderate stage for patients with a 6-year clinical diagnosis of PD. However, treadmill training performed 3 times a week for about 60 minutes and for a period of 24 weeks produced larger improvements in cognition.

The Complex Interplay Between Depression/Anxiety and Executive Functioning: Insights From the ECAS in a Large ALS Population

PubMed Central

Solca, Federica; Faini, Andrea; Madotto, Fabiana; Lafronza, Annalisa; Monti, Alessia; Zago, Stefano; Doretti, Alberto; Ciammola, Andrea; Ticozzi, Nicola; Silani, Vincenzo; Poletti, Barbara

2018-01-01

Introduction: The observed association between depressive symptoms and cognitive performances has not been previously clarified in patients with amyotrophic lateral sclerosis (pALS). In fact, the use of cognitive measures often not accommodating for motor disability has led to heterogeneous and not conclusive findings about this issue. The aim of the present study was to evaluate the relationship between cognitive and depressive/anxiety symptoms by means of the recently developed Edinburgh Cognitive and Behavioral ALS Screen (ECAS), a brief assessment specifically designed for pALS. Methods: Sample included 168 pALS (114 males, 54 females); they were administered two standard cognitive screening tools (FAB; MoCA) and the ECAS, assessing different cognitive domains, including ALS-specific (executive functions, verbal fluency, and language tests) and ALS non-specific subtests (memory and visuospatial tests). Two psychological questionnaires for depression and anxiety (BDI; STAI/Y) were also administered to patients. Pearson’s correlation coefficient was used to assess the degree of association between cognitive and psychological measures. Results: Depression assessment negatively correlated with the ECAS, more significantly with regard to the executive functions subdomain. In particular, Sentence Completion and Social Cognition subscores were negatively associated with depression levels measured by BDI total score and Somatic-Performance symptoms subscore. Conversely, no significant correlations were observed between depression level and cognitive functions as measured by traditional screening tools for frontal abilities (FAB) and global cognition (MoCA) assessment. Finally, no significant correlations were observed between state/trait anxiety and the ECAS. Discussion and conclusion: This represents the first study focusing on the relationship between cognitive and psychological components in pALS by means of the ECAS, the current gold standard for ALS cognitive-behavioral assessment. If confirmed by further investigations, the observed association between depression and executive functions suggests the need for a careful screening and treatment of depression, to avoid overestimation of cognitive involvement and possibly improve cognitive performances in ALS. PMID:29674987

Self-assessment in schizophrenia: Accuracy of evaluation of cognition and everyday functioning.

PubMed

Gould, Felicia; McGuire, Laura Stone; Durand, Dante; Sabbag, Samir; Larrauri, Carlos; Patterson, Thomas L; Twamley, Elizabeth W; Harvey, Philip D

2015-09-01

Self-assessment deficits, often referred to as impaired insight or unawareness of illness, are well established in people with schizophrenia. There are multiple levels of awareness, including awareness of symptoms, functional deficits, cognitive impairments, and the ability to monitor cognitive and functional performance in an ongoing manner. The present study aimed to evaluate the comparative predictive value of each aspect of awareness on the levels of everyday functioning in people with schizophrenia. We examined multiple aspects of self-assessment of functioning in 214 people with schizophrenia. We also collected information on everyday functioning rated by high contact clinicians and examined the importance of self-assessment for the prediction of real-world functional outcomes. The relative impact of performance-based measures of cognition, functional capacity, and metacognitive performance on everyday functioning was also examined. Misestimation of ability emerged as the strongest predictor of real-world functioning and exceeded the influences of cognitive performance, functional capacity performance, and performance-based assessment of metacognitive monitoring. The relative contribution of the factors other than self-assessment varied according to which domain of everyday functioning was being examined, but, in all cases, accounted for less predictive variance. These results underscore the functional impact of misestimating one's current functioning and relative level of ability. These findings are consistent with the use of insight-focused treatments and compensatory strategies designed to increase self-awareness in multiple functional domains. (c) 2015 APA, all rights reserved).

Self Assessment in Schizophrenia: Accuracy of Evaluation of Cognition and Everyday Functioning

PubMed Central

Gould, Felicia; McGuire, Laura Stone; Durand, Dante; Sabbag, Samir; Larrauri, Carlos; Patterson, Thomas L.; Twamley, Elizabeth W.; Harvey, Philip D.

2015-01-01

Objective Self-assessment deficits, often referred to as impaired insight or unawareness of illness, are well established in people with schizophrenia. There are multiple levels of awareness, including awareness of symptoms, functional deficits, cognitive impairments, and the ability to monitor cognitive and functional performance in an ongoing manner. The present study aimed to evaluate the comparative predictive value of each aspect of awareness on the levels of everyday functioning in people with schizophrenia. Method We examined multiple aspects of self-assessment of functioning in 214 people with schizophrenia. We also collected information on everyday functioning rated by high contact clinicians and examined the importance of self-assessment for the prediction of real world functional outcomes. The relative impact of performance based measures of cognition, functional capacity, and metacognitive performance on everyday functioning was also examined. Results Misestimation of ability emerged as the strongest predictor of real world functioning and exceeded the influences of cognitive performance, functional capacity performance, and performance-based assessment of metacognitive monitoring. The relative contribution of the factors other than self-assessment varied according to which domain of everyday functioning was being examined, but in all cases, accounted for less predictive variance. Conclusions These results underscore the functional impact of misestimating one’s current functioning and relative level of ability. These findings are consistent with the use of insight-focused treatments and compensatory strategies designed to increase self-awareness in multiple functional domains. PMID:25643212

The effects of cognitive rehabilitation on social knowledge in patients with schizophrenia.

PubMed

Matsui, Mié; Arai, Hirofumi; Yonezawa, Mineo; Sumiyoshi, Tomiki; Suzuki, Michio; Kurachi, Masayoshi

2009-07-01

This study examined the extent to which cognitive rehabilitation alleviates cognitive deficits in schizophrenia compared to treatment as usual, and explored the mediating and moderating effects on cognitive improvement. Two groups who received cognitive rehabilitation and treatment as usual were assessed at baseline, three months (immediately post-intervention) and at follow-up (three months post-intervention). Cognitive rehabilitation focused on deficits in social knowledge and was conducted once a week for three months. The principles of errorless leaning and scaffolding informed the intervention. Outcomes were assessed using Script Test measures of social cognition. Other cognitive functions (executive functions and memory) and clinical symptoms were also assessed. Script Test for social knowledge and Rule Shift Test for cognitive flexibility scores were significantly better post-intervention in the cognitive rehabilitation group, while in the control group only free recall Script Test scores improved. Cognitive rehabilitation focused on social knowledge deficits can contribute to improvements in the social cognitive abilities of schizophrenic patients. Improvements in social cognitive functioning were durable at three-month follow-up. Cognitive rehabilitation can clearly benefit schizophrenic patients, at least when combined with atypical antipsychotic medication.

Association between insulin and executive functioning in alcohol dependence: a pilot study.

PubMed

Han, Changwoo; Bae, Hwallip; Won, Sung-Doo; Lim, Jaeyoung; Kim, Dai-Jin

2015-01-01

Alcohol dependence is a disorder ascribable to multiple factors and leads to cognitive impairment. Given that insulin dysregulation can cause cognitive impairment, patients with alcohol dependence are likely to develop insulin dysregulation such as that in diabetes. The purposes of this study are to identify an association between cognitive functioning and insulin and to investigate insulin as the biomarker of cognitive functioning in alcohol-dependent patients. Serum insulin levels were measured and cognitive functions were assessed in 45 patients with chronic alcoholism. The Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K), a battery of cognitive function tests, was used to assess cognitive functioning. Serum insulin levels were not significantly correlated with most CERAD-K scores, but there was a significant negative correlation with scores on the Trail Making Test B, which is designed to measure executive functioning. Lower serum insulin levels were associated with slower executive functioning responses on the Trail Making Test B, suggesting that executive functioning may be in proportion to serum insulin levels. Thus, in patients with alcohol dependence, insulin level is associated with cognitive functioning. In addition, the present findings suggest that insulin level is a potential biomarker for determining cognitive functioning.

Trajectories of change in cognitive function in people with chronic obstructive pulmonary disease.

PubMed

Park, Soo Kyung

2018-04-01

To describe changes in cognitive function, as measured by the trail making test; to identify distinct patterns of change in cognitive function; and to examine predictors of change in cognitive function in people with severe chronic obstructive pulmonary disease. How cognitive function changes in people with chronic obstructive pulmonary disease and what factors influence those changes over time is not well known, despite the fact that it declines rapidly in this population and significantly impacts functional decline in healthy older adults. A secondary analysis and longitudinal study with a follow-up period of 3 years. A data set from the National Emphysema Treatment Trial provided participant data. Patients with severe chronic obstructive pulmonary disease (n = 307) were recruited at a clinical site. Several demographic and clinical measures were assessed at baseline. Trail making test scores were measured at baseline, 1, 2 and 3 years. Cognitive function was stable for 3 years in people with chronic obstructive pulmonary disease. However, four distinct patterns of change in cognitive function were identified. Age, education, 6-min walk distance and cognitive impairment scores at baseline on the trail making test Part B were significant predictors of worsening cognitive function and below-average cognitive function over 3 years. These findings suggest that increasing exercise capacity improves cognitive function and delays deterioration of cognitive function in people with COPD. Understanding the trajectories of change in cognitive function and predictors of change in cognitive function over 3 years may enable health care providers to identify patients at greatest risk of developing mental deterioration and those who might benefit from interventions to improve cognitive function. Health care providers should periodically assess and frequently screen people with COPD for cognitive function. © 2018 John Wiley & Sons Ltd.

Association Between Perceived Physical Activity and Cognitive Function in Older Adults.

PubMed

Loprinzi, Paul D; Frith, Emily

2018-01-01

There is irrefutable evidence that regular participation in physical activity is favorably associated with numerous positive health outcomes, including cognitive function. Emerging work suggests that perceived physical activity, independent of actual physical activity behavior, is inversely associated with mortality risk. In this study, we evaluate whether perceived physical activity, independent of actual physical activity, is associated with cognitive function, a robust indicator of mortality risk. Data from the cross-sectional 1999-2002 National Health and Nutrition Examination Survey were employed ( N = 2352; 60+ years of age). Actual physical activity was assessed via a validated survey. Perceived physical activity was assessed using the following question: "Compared with others of the same age, would you say that you are: more active, less active, or about the same?" Cognitive function was assessed from the Digit Symbol Substitution Test. When examined in separate models, both actual and perceived physical activity were positively and statistically significantly associated with cognitive function. However, when considered in the same model, actual physical activity was no longer statistically significantly associated with cognitive function, but perceived physical activity was. Perceived physical activity, independent of actual physical activity, is independently associated with cognitive function. If these findings are replicated, future work should consider evaluating perceived physical activity when examining the effects of actual physical activity behavior on cognitive function.

A battery of tests for assessing cognitive function in U.S. Chinese older adults--findings from the PINE Study.

PubMed

Chang, E-Shien; Dong, XinQi

2014-11-01

Existing methodological challenges in aging research has dampened our assessment of cognitive function among minority older adults. We aim to report the composite scores of five cognitive function tests among U.S. Chinese older adults, and examine the association between cognitive function and key sociodemographic characteristics. The Population Study of Chinese Elderly in Chicago Study enrolled an epidemiological cohort of 3,159 community-dwelling Chinese older adults. We administered five cognitive function tests, including the Chinese Mini-Mental State Examination, the immediate and delayed recall of the East Boston Memory Test, the Digit Span Backwards assessment, and the Symbol Digit Modalities Test. We used Spearman correlation coefficients to examine the correlation between cognitive function and sociodemographic variables. Linear regression models were used to report the effect of sociodemographic and health variables including age, sex, education on cognitive function. Our multivariate analysis suggested that performance in each domain of cognitive function was inversely associated with age and positively related to education. With respect to sex, after adjusted for age, education and all key variables presented in the model, being male was positively related to global cognitive score and working memory. Being married, having fewer children, having been in the United States for fewer years, having been in the community for fewer years, and better self-reported health were positively correlated with all cognitive function domains. This population-based study of U.S. Chinese older adults is among the first to examine a battery of five cognitive function tests, which in aggregate enables researchers to capture a wide range of cognitive performance. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Computer-based tools for assessing micro-longitudinal patterns of cognitive function in older adults.

PubMed

Brown, Laura J E; Adlam, Tim; Hwang, Faustina; Khadra, Hassan; Maclean, Linda M; Rudd, Bridey; Smith, Tom; Timon, Claire; Williams, Elizabeth A; Astell, Arlene J

2016-08-01

Patterns of cognitive change over micro-longitudinal timescales (i.e., ranging from hours to days) are associated with a wide range of age-related health and functional outcomes. However, practical issues of conducting high-frequency assessments make investigations of micro-longitudinal cognition costly and burdensome to run. One way of addressing this is to develop cognitive assessments that can be performed by older adults, in their own homes, without a researcher being present. Here, we address the question of whether reliable and valid cognitive data can be collected over micro-longitudinal timescales using unsupervised cognitive tests.In study 1, 48 older adults completed two touchscreen cognitive tests, on three occasions, in controlled conditions, alongside a battery of standard tests of cognitive functions. In study 2, 40 older adults completed the same two computerized tasks on multiple occasions, over three separate week-long periods, in their own homes, without a researcher present. Here, the tasks were incorporated into a wider touchscreen system (Novel Assessment of Nutrition and Ageing (NANA)) developed to assess multiple domains of health and behavior. Standard tests of cognitive function were also administered prior to participants using the NANA system.Performance on the two "NANA" cognitive tasks showed convergent validity with, and similar levels of reliability to, the standard cognitive battery in both studies. Completion and accuracy rates were also very high. These results show that reliable and valid cognitive data can be collected from older adults using unsupervised computerized tests, thus affording new opportunities for the investigation of cognitive.

Wide range of body composition measures are associated with cognitive function in community-dwelling older adults.

PubMed

Won, Huiloo; Abdul Manaf, Zahara; Mat Ludin, Arimi Fitri; Shahar, Suzana

2017-04-01

Studies of the association between body composition, both body fat and body muscle, and cognitive function are rarely reported. The aim of the present study was to determine the association between a wide range of body composition measures with cognitive function in older adults. A total of 2322 Malaysian older adults aged 60 years and older were recruited using multistage random sampling in a population-based cross-sectional study. Out of 2322 older adults recruited, 2309 (48% men) completed assessments on cognitive function and body composition. Cognitive functions were assessed using the Malay version of the Mini-Mental State Examination, the Bahasa Malaysia version of Montreal Cognitive Assessment, Digit Span Test, Digit Symbol Test and Rey Auditory Verbal Learning Test. Body composition included body mass index, mid-upper arm circumference, waist circumference, calf circumference, waist-to-hip ratio, percentage body fat and skeletal muscle mass. The association between body composition and cognitive functions was analyzed using multiple linear regression. After adjustment for age, education years, hypertension, hypercholesterolemia, diabetes mellitus, depression, smoking status and alcohol consumption, we found that calf circumference appeared as a significant predictor for all cognitive tests among both men and women (P < 0.05), except for the Rey Auditory Verbal Learning Test. Waist-to-hip ratio was detected as a significant predictor for all cognitive tests among women (P < 0.05), but was only a significant predictor for the Bahasa Malaysia version of Montreal Cognitive Assessment among men (P < 0.05). These results suggest that there is a need to maintain muscle mass and lower adipose tissue among older adults for optimal cognitive function. Geriatr Gerontol Int 2017; 17: 554-560. © 2016 Japan Geriatrics Society.

Metabolic Syndrome and Cognitive Decline Among the Oldest Old in Okinawa: In Search of a Mechanism. The KOCOA Project

PubMed Central

Todoriki, Hidemi; Higashiuesato, Yasushi; Yasura, Shotoku; Willcox, D. Craig; Ohya, Yusuke; Willcox, Bradley J.; Dodge, Hiroko H.

2012-01-01

The study aim was to test whether the metabolic syndrome or its components predicted cognitive decline among persons aged 80 years and older (mean 85.0 years). Participants were members of the “Keys to Optimal Cognitive Aging Project,” a prospective cohort study in Okinawa, Japan. Metabolic syndrome was assessed at baseline. Cognitive functions were assessed annually for up to 3 years. One hundred and forty-eight participants completed at least one follow-up with 101 participating in all three assessments and 47 participating in two of the three assessments. The mean and median duration of follow-up were 1.8 and 2 years, respectively. Metabolic syndrome and four components were not associated with decline in global and executive cognitive functions. However, high glycosylated hemoglobin was associated with decline in memory function at the second follow-up. Our study supports accumulating evidence that the positive association between metabolic syndrome and cognitive function might not hold for the oldest old. PMID:22016359

Evaluating cognition in individuals with Huntington disease: Neuro-QoL cognitive functioning measures.

PubMed

Lai, Jin-Shei; Goodnight, Siera; Downing, Nancy R; Ready, Rebecca E; Paulsen, Jane S; Kratz, Anna L; Stout, Julie C; McCormack, Michael K; Cella, David; Ross, Christopher; Russell, Jenna; Carlozzi, Noelle E

2018-03-01

Cognitive functioning impacts health-related quality of life (HRQOL) for individuals with Huntington disease (HD). The Neuro-QoL includes two patient-reported outcome (PRO) measures of cognition-Executive Function (EF) and General Concerns (GC). These measures have not previously been validated for use in HD. The purpose of this analysis is to evaluate the reliability and validity of the Neuro-QoL Cognitive Function measures for use in HD. Five hundred ten individuals with prodromal or manifest HD completed the Neuro-QoL Cognition measures, two other PRO measures of HRQOL (WHODAS 2.0 and EQ5D), and a depression measure (PROMIS Depression). Measures of functioning The Total Functional Capacity and behavior (Problem Behaviors Assessment) were completed by clinician interview. Objective measures of cognition were obtained using clinician-administered Symbol Digit Modalities Test and the Stroop Test (Word, Color, and Interference). Self-rated, clinician-rated, and objective composite scores were developed. We examined the Neuro-QoL measures for reliability, convergent validity, discriminant validity, and known-groups validity. Excellent reliabilities (Cronbach's alphas ≥ 0.94) were found. Convergent validity was supported, with strong relationships between self-reported measures of cognition. Discriminant validity was supported by less robust correlations between self-reported cognition and other constructs. Prodromal participants reported fewer cognitive problems than manifest groups, and early-stage HD participants reported fewer problems than late-stage HD participants. The Neuro-QoL Cognition measures provide reliable and valid assessments of self-reported cognitive functioning for individuals with HD. Findings support the utility of these measures for assessing self-reported cognition.

Functional impairment and cognitive performance in mood disorders: A community sample of young adults.

PubMed

Reyes, Amanda N; Cardoso, Taiane A; Jansen, Karen; Mondin, Thaíse C; Souza, Luciano D M; Magalhães, Pedro V S; Kapczinski, Flavio; Silva, Ricardo A

2017-05-01

The aim of this study was to compare the global functioning and cognitive performance in a community sample of young adults with mood disorders versus community controls. This was a cross-sectional study nested in a cohort study with a community sample. Data was collected from February 2012 to June 2014; specifically, at a mean of five years after the first phase, all young adults were invited to participate in a re-evaluation. Mini International Neuropsychiatric Interview - PLUS (MINI-PLUS) was used for the diagnosis of mood disorders. The Functional Assessment Short Test (FAST) and the Montreal Cognitive Assessment (MoCA) were used to assess the global functioning, and cognitive performance, respectively. Were included 1258 subjects. Functional impairment was greater in subjects with bipolar disorder when compared to community controls, and there were no differences between major depressive disorder and community controls. There were no significant differences in cognitive performance between young adults with mood disorders when compared to community controls. Functional impairment is a marker for bipolar disorder in young adults; however, gross cognitive impairment assessed by a screening test is not, possibly because cognition is impaired in more advanced stages of the disorder. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Effects of a Sedentary Intervention on Cognitive Function.

PubMed

Edwards, Meghan K; Loprinzi, Paul D

2018-03-01

To examine the effects of a free-living, sedentary-inducing intervention on cognitive function. Randomized controlled, parallel group intervention. University campus. Thirty-three young adults (n = 23 intervention; n = 10 control). The intervention group was asked to eliminate all exercise and minimize steps to ≤5000 steps/day for 1 week, whereas the control group was asked to continue normal physical activity (PA) levels for 1 week. Both groups completed a series of 8 cognitive function assessments (assessing multiple parameters of cognition) preintervention and immediately postintervention. The intervention group was asked to resume normal PA levels for 1 week postintervention and completed the cognitive assessments for a third time at 2 weeks postintervention. Split-plot repeated-measures analysis of variance. The results of our statistical analyses showed that the group × time interaction effect was not significant ( P > .05) for any of the evaluated cognitive parameters. These findings demonstrate the need for future experimental investigations of sedentary behavior to better understand its effects on cognitive function. However, although previous work has demonstrated favorable effects of acute and chronic PA on cognitive function, our findings suggest that a 1-week period of reduced PA does not detrimentally affect cognitive function, which may have encouraging implications for individuals going through a temporary relapse in PA.

Cognitive functioning following traumatic brain injury: A five-year follow-up.

PubMed

Marsh, Nigel V; Ludbrook, Maria R; Gaffaney, Lauren C

2016-01-01

To describe the long-term prevalence and severity of cognitive deficits following significant (i.e., ventilation required for >24 hours) traumatic brain injury. To assess a comprehensive range of cognitive functions using psychometric measures with established normative, reliability, and validity data. A group of 71 adults was assessed at approximately five years (mean = 66 months) following injury. Assessment of cognitive functioning covered the domains of intelligence, attention, verbal and visual memory, visual-spatial construction, and executive functions. Impairment was evident across all domains but prevalence varied both within and between domains. Across aspects of intelligence clinical impairment ranged from 8-25% , attention 39-62% , verbal memory 16-46% , visual memory 23-51% , visual-spatial construction 38% , and executive functions (verbal fluency) 13% . In addition, 3-23% of performances across the measures were in the borderline range, suggesting a high prevalence of subclinical deficit. Although the prevalence of impairment may vary across cognitive domains, long-term follow-up documented deficits in all six domains. These findings provide further evidence that while improvement of cognitive functioning following significant traumatic brain injury may be possible, recovery of function is unlikely.

Artificial gravity as a multi-system countermeasure: effects on cognitive function.

PubMed

Seaton, Kimberly A; Slack, Kelley J; Sipes, Walter; Bowie, Kendra

2007-07-01

The Space Flight Cognitive Assessment Tool for Windows (WinSCAT) is used on the International Space Station to evaluate cognitive functioning after physical insult or trauma. The current study uses WinSCAT to assess cognitive functioning in a space flight analog (bed rest) environment where intermittent artificial gravity (AG) is being tested as a countermeasure. Fifteen male subjects (8 treatment, 7 control), who participated in 21 days of 6 degree head-down tilt bed rest, were assessed during the acclimatization phase, bed rest phase, and recovery phase. Individual differences were found within both the treatment and control groups. The treatment group accounted for more off-nominal WinSCAT scores than the control group. The length of time spent in bed rest was not associated with a change in cognitive function. Individual differences in underlying cognitive ability and motivation level are other possible explanations for the current findings.

Cognitive Impairment Precedes and Predicts Functional Impairment in Mild Alzheimer's Disease.

PubMed

Liu-Seifert, Hong; Siemers, Eric; Price, Karen; Han, Baoguang; Selzler, Katherine J; Henley, David; Sundell, Karen; Aisen, Paul; Cummings, Jeffrey; Raskin, Joel; Mohs, Richard

2015-01-01

The temporal relationship of cognitive deficit and functional impairment in Alzheimer's disease (AD) is not well characterized. Recent analyses suggest cognitive decline predicts subsequent functional decline throughout AD progression. To better understand the relationship between cognitive and functional decline in mild AD using autoregressive cross-lagged (ARCL) panel analyses in several clinical trials. Data included placebo patients with mild AD pooled from two multicenter, double-blind, Phase 3 solanezumab (EXPEDITION/2) or semagacestat (IDENTITY/2) studies, and from AD patients participating in the Alzheimer's Disease Neuroimaging Initiative (ADNI). Cognitive and functional outcomes were assessed using AD Assessment Scale-Cognitive subscale (ADAS-Cog), AD Cooperative Study-Activities of Daily Living instrumental subscale (ADCS-iADL), or Functional Activities Questionnaire (FAQ), respectively. ARCL panel analyses evaluated relationships between cognitive and functional impairment over time. In EXPEDITION, ARCL panel analyses demonstrated cognitive scores significantly predicted future functional impairment at 5 of 6 time points, while functional scores predicted subsequent cognitive scores in only 1 of 6 time points. Data from IDENTITY and ADNI programs yielded consistent results whereby cognition predicted subsequent function, but not vice-versa. Analyses from three databases indicated cognitive decline precedes and predicts subsequent functional decline in mild AD dementia, consistent with previously proposed hypotheses, and corroborate recent publications using similar methodologies. Cognitive impairment may be used as a predictor of future functional impairment in mild AD dementia and can be considered a critical target for prevention strategies to limit future functional decline in the dementia process.

Assessment of attention and inhibitory control in rodent developmental neurotoxicity studies.

PubMed

Driscoll, Lori L; Strupp, Barbara J

2015-01-01

In designing screens to assess potential neurotoxicants, the paramount goal is that the selected assessment tools detect dysfunction if it exists. This goal is particularly challenging in the case of cognitive assessments. Cognition is not a unitary phenomenon, and indeed there is growing evidence that different aspects of cognitive functioning are subserved by distinct neural systems. As a result, if a particular neurotoxicant selectively damages certain neural systems but not others, it can impair some cognitive, sensory, or affective functions, but leave many others intact. Accordingly, studies with human subjects use batteries of cognitive tests, cognizant of the fact that no one test is capable of detecting all forms of cognitive dysfunction. In contrast, assessment of cognitive functioning in non-human animal developmental neurotoxicity (DNT) studies typically consists of a single, presumably representative, "learning and memory" task that is expected to detect all potential effects on cognitive functioning. Streamlining the cognitive assessment in these studies saves time and money, but these shortcuts can have serious consequences if the aspect of cognitive functioning that is impaired is not tapped by the single selected task. In particular, executive functioning - a constellation of cognitive functions which enables the organism to focus on multiple streams of information simultaneously, and revise plans as necessary - is poorly assessed in most animal DNT studies. The failure to adequately assess these functions - which include attention, working memory, inhibitory control, and planning - is particularly worrisome in light of evidence that the neural systems that subserve these functions may be uniquely vulnerable to early developmental insults. We illustrate the importance of tapping these areas of functioning in DNT studies by describing the pattern of effects produced by early developmental Pb exposure. Rats exposed to lead (Pb) early in development were tested on a series of automated attention tasks, as well as on a radial arm maze task. The lead-exposed rats were not impaired in this demanding radial arm maze task, despite conditions which tapped the limits of both working and long-term memory. In contrast, the automated tests designed to assess rodent executive functioning revealed selective and functionally important deficits in attention and regulation of emotion or negative affect (produced by committing an error or not receiving an expected reward). This example underscores the importance of including tasks to specifically tap executive functioning in DNT batteries. Such tasks are not only sensitive but can also shed light on the specific nature of the dysfunction, and they can implicate dysfunction of specific neural systems, information which can be used to design therapeutic interventions. Although the use of such tasks increases the time and effort needed to complete the battery, the benefits outweigh the cost, in light of the greater sensitivity of the battery and the more complete characterization of effects. Copyright © 2014 Elsevier Inc. All rights reserved.

[Cognitive plasticity in Alzheimer's disease patients receiving cognitive stimulation programs].

PubMed

Zamarrón Cassinello, Ma Dolores; Tárraga Mestre, Luis; Fernández-Ballesteros, Rocío

2008-08-01

The main purpose of this article is to examine whether cognitive plasticity increases after cognitive training in Alzheimer's disease patients. Twenty six patients participated in this study, all of them diagnosed with mild Alzheimer's disease, 17 of them received a cognitive training program during 6 months, and the other 9 were assigned to the control group. Participants were assigned to experimental or control conditions for clinical reasons. In order to assess cognitive plasticity, all patients were assessed before and after treatment with three subtests from the "Bateria de Evaluación de Potencial de Aprendizaje en Demencias" [Assessment Battery of Learning Potential in Dementia] (BEPAD). After treatment, Alzheimer's disease patients improved their performance in all the tasks assessing cognitive plasticity: viso-spatial memory, audio-verbal memory and verbal fluency. However, the cognitive plasticity scores of the patients in the control group decreased. In conclusion, this study showed that cognitive stimulation programs can improve cognitive functioning in mildly demented patients, and patients who do not receive any cognitive interventions may reduce their cognitive functioning.

Effects of compensatory cognitive training intervention for breast cancer patients undergoing chemotherapy: a pilot study.

PubMed

Park, Jin-Hee; Jung, Yong Sik; Kim, Ku Sang; Bae, Sun Hyoung

2017-06-01

Numerous breast cancer patients experience cognitive changes during and after chemotherapy. Chemotherapy-related cognitive impairment can significantly affect quality of life. This pilot study attempted to determine the effects of a compensatory cognitive training on the objective and subjective cognitive functioning of breast cancer patients receiving adjuvant chemotherapy. Fifty-four patients were assigned to either a compensatory cognitive training or waitlist condition. They were assessed at baseline (T1), the completion of the 12-week intervention (T2), and 6 months after intervention completion (T3). Outcomes were assessed using the standardized neuropsychological tests and the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog), version 3. Raw data were converted to T-scores based on baseline scores, and a repeated-measures ANCOVA, adjusting for age, intelligence, depression, and treatment, was used for analysis. The effect sizes for differences in means were calculated. The intervention group improved significantly over time compared to the waitlist group on objective cognitive function. Among ten individual neuropsychological measures, immediate memory, delayed memory, verbal fluency in category, and verbal fluency in letter showed significant group × time interaction. In subjective cognitive function, scores of the waitlist group significantly decrease over time on perceived cognitive impairments, in contrast to those of the intervention group. The 12-week compensatory cognitive training significantly improved the objective and subjective cognitive functioning of breast cancer patients. Because this was a pilot study, further research using a larger sample and longer follow-up durations is necessary.

Association of socioeconomic status and cognitive functioning change among elderly Chinese people.

PubMed

Yang, Lei; Martikainen, Pekka; Silventoinen, Karri; Konttinen, Hanna

2016-09-01

the inverse association between high socioeconomic status and impaired cognitive functioning in old age has been widely studied. However, it is still inconclusive whether higher socioeconomic status slows the rate of cognitive decline over ageing, especially in non-Western populations. We examined this association using a large population-based longitudinal survey of older Chinese persons. the sample came from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) (from the years 2002 to 2011, N = 15,798 at baseline, aged 65-105). The Mini-Mental State Examination (MMSE) based on face-to-face interviews was used to assess cognitive functioning. Socioeconomic status was assessed using educational attainment and household income per capita. Latent growth curve and selection model considering the attrition during the follow-up were utilised to assess the effect of socioeconomic status on the rate of change in cognitive functioning. at baseline, younger elderly people, urban residents and elderly people living alone had better cognitive performance in both genders. Educational attainment was positively associated with cognitive functioning at baseline but did not have a significant effect on the rate of change in cognitive functioning. Higher incomes were associated with better cognitive functioning at baseline, but this difference diminished during the follow-up. higher socioeconomic status was associated with better cognitive performance at baseline but could not protect against the rate of decline in cognitive functioning measured by MMSE in this longitudinal study for elderly Chinese people. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Trajectories of self-reported cognitive function in postmenopausal women during adjuvant systemic therapy for breast cancer.

PubMed

Merriman, John D; Sereika, Susan M; Brufsky, Adam M; McAuliffe, Priscilla F; McGuire, Kandace P; Myers, Jamie S; Phillips, Mary L; Ryan, Christopher M; Gentry, Amanda L; Jones, Lindsay D; Bender, Catherine M

2017-01-01

In a sample of 368 postmenopausal women, we (1) determined within-cohort and between-cohort relationships between adjuvant systemic therapy for breast cancer and self-reported cognitive function during the first 18 months of therapy and (2) evaluated the influence of co-occurring symptoms, neuropsychological function, and other covariates on relationships. We evaluated self-reported cognitive function, using the Patient Assessment of Own Functioning Inventory (PAOFI), and potential covariates (e.g., co-occurring symptom scores and neuropsychological function z-scores) in 158 women receiving aromatase inhibitor (AI) therapy alone, 104 women receiving chemotherapy followed by AI therapy, and 106 non-cancer controls. Patients were assessed before systemic therapy and then every 6 months, for a total of four assessments over 18 months. Controls were assessed at matched time points. Mixed-effects modeling was used to determine longitudinal relationships. Controlling for covariates, patients enrolled before chemotherapy reported poorer global cognitive function (p < 0.001), memory (p < 0.001), language and communication (p < 0.001), and sensorimotor function (p = 0.002) after chemotherapy. These patients reported poorer higher-level cognitive and intellectual functions from before chemotherapy to 12 months after initiation of AI therapy (p < 0.001). Higher levels of depressive symptoms (p < 0.001), anxiety (p < 0.001), and fatigue (p = 0.040) at enrollment were predictors of poorer cognitive function over time. PAOFI total score was a predictor of executive function (p = 0.048) and visual working memory (p = 0.005) z-scores, controlling for covariates. Findings provide further evidence of poorer self-reported cognitive function after chemotherapy and of relationships between co-occurring symptoms and cognitive changes. AI therapy alone does not have an impact on self-reported cognitive function. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

[Self-consciousness in elderly persons with cognitive impairment and vascular dementia].

PubMed

Dubinina, E A; Novikova, Yu G; Kalitskaya, A V; Finagentova, N V

2016-01-01

Self-consciousness was compared in 17 elderly (aged 65-89 years old) persons with cognitive impairment without dementia and 17 patients with vascular dementia. Neurocognitive functions and mental health complaints were evaluated. Neuropsychological assessment included evaluation of higher psychological functions, such as attention, memory, conceptualization, gnosis (optic, acoustic), manual skill, speech. Older persons with cognitive impairment assessed their neurocognitive functions adequately. Patients with vascular dementia usually denied cognitive deficit or explained it as a result of aging. Regardless of physical health, older persons with cognitive impairment have active attitude to aging. They could find ways of compensation of cognitive deficits without assistance. Patients with vascular dementia could not compensate their cognitive deficit even with support.

No lower cognitive functioning in older adults with attention-deficit/hyperactivity disorder.

PubMed

Semeijn, E J; Korten, N C M; Comijs, H C; Michielsen, M; Deeg, D J H; Beekman, A T F; Kooij, J J S

2015-09-01

Research illustrates cognitive deficits in children and younger adults with attention-deficit/hyperactivity disorder (ADHD). Few studies have focused on the cognitive functioning in older adults. This study investigates the association between ADHD and cognitive functioning in older adults. Data were collected in a cross-sectional side study of the Longitudinal Aging Study Amsterdam (LASA). A diagnostic interview to diagnose ADHD was administered among a subsample (N = 231, age 60-94). ADHD symptoms and diagnosis were assessed with the Diagnostic Interview for ADHD in Adults (DIVA) 2.0. Cognitive functioning was assessed with tests in the domains of executive functioning, information processing speed, memory, and attention/working memory. Regression analyses indicate that ADHD diagnosis and ADHD severity were only negatively associated with cognitive functioning in the attention/working memory domain. When adjusting for depression, these associations were no longer significant. The study shows that ADHD in older adults is associated with lower cognitive functioning in the attention/working memory domain. However, this was partly explained by depressive symptoms.

Cognitive function and the agreement between self-reported and accelerometer-accessed physical activity.

PubMed

Herbolsheimer, Florian; Riepe, Matthias W; Peter, Richard

2018-02-21

Numerous studies have reported weak or moderate correlations between self-reported and accelerometer-assessed physical activity. One explanation is that self-reported physical activity might be biased by demographic, cognitive or other factors. Cognitive function is one factor that could be associated with either overreporting or underreporting of daily physical activity. Difficulties in remembering past physical activities might result in recall bias. Thus, the current study examines whether the cognitive function is associated with differences between self-reported and accelerometer-assessed physical activity. Cross-sectional data from the population-based Activity and Function in the Elderly in Ulm study (ActiFE) were used. A total of 1172 community-dwelling older adults (aged 65-90 years) wore a uniaxial accelerometer (activPAL unit) for a week. Additionally, self-reported physical activity was assessed using the LASA Physical Activity Questionnaire (LAPAQ). Cognitive function was measured with four items (immediate memory, delayed memory, recognition memory, and semantic fluency) from the Consortium to Establish a Registry for Alzheimer's Disease Total Score (CERAD-TS). Mean differences of self-reported and accelerometer-assessed physical activity (MPA) were associated with cognitive function in men (r s  = -.12, p = .002) but not in women. Sex-stratified multiple linear regression analyses showed that MPA declined with high cognitive function in men (β = -.13; p = .015). Results suggest that self-reported physical activity should be interpreted with caution in older populations, as cognitive function was one factor that explained the differences between objective and subjective physical activity measurements.

Optimizing Cognitive Function in Persons With Chronic Pain.

PubMed

Baker, Katharine S; Georgiou-Karistianis, Nellie; Gibson, Stephen J; Giummarra, Melita J

2017-05-01

Cognitive functioning is commonly disrupted in people living with chronic pain, yet it is an aspect of pain that is often not routinely assessed in pain management settings, and there is a paucity of research on treatments or strategies to alleviate the problem. The purpose of this review is to outline recent research on cognitive deficits seen in chronic pain, to give an overview of the mechanisms involved, advocate cognitive functioning as an important target for treatment in pain populations, and discuss ways in which it may be assessed and potentially remediated. A narrative review. There are several options for remediation, including compensatory, restorative, and neuromodulatory approaches to directly modify cognitive functioning, as well as physical, psychological, and medication optimization methods to target secondary factors (mood, sleep, and medications) that may interfere with cognition. We highlight the potential to enhance cognitive functions and identify the major gaps in the research literature.

Progressive multiple sclerosis, cognitive function, and quality of life.

PubMed

Højsgaard Chow, Helene; Schreiber, Karen; Magyari, Melinda; Ammitzbøll, Cecilie; Börnsen, Lars; Romme Christensen, Jeppe; Ratzer, Rikke; Soelberg Sørensen, Per; Sellebjerg, Finn

2018-02-01

Patients with progressive multiple sclerosis (MS) often have cognitive impairment in addition to physical impairment. The burden of cognitive and physical impairment progresses over time, and may be major determinants of quality of life. The aim of this study was to assess to which degree quality of life correlates with physical and cognitive function in progressive MS. This is a retrospective study of 52 patients with primary progressive ( N  = 18) and secondary progressive MS ( N  = 34). Physical disability was assessed using the Expanded Disability Status Scale, Timed 25 Foot Walk (T25FW) test and 9-Hole Peg Test (9HPT). Cognitive function was assessed using Symbol Digit Modalities Test (SDMT), Paced Auditory Serial Addition Test, and Trail Making Test B (TRAIL-B). In addition, quality of life was assessed by the Short Form 36 (SF-36) questionnaire. Only measures of cognitive function correlated with the overall SF-36 quality of life score and the Mental Component Summary score from the SF-36. The only physical measure that correlated with a measure of quality of life was T25FW test, which correlated with the Physical Component Summary from the SF-36. We found no other significant correlations between the measures of cognitive function and the overall physical measures but interestingly, we found a possible relationship between the 9HPT score for the nondominant hand and the SDMT and TRAIL-B. Our findings support inclusion of measures of cognitive function in the assessment of patients with progressive MS as these correlated closer with quality of life than measures of physical impairment.

Performance on naturalistic virtual reality tasks depends on global cognitive functioning as assessed via traditional neurocognitive tests.

PubMed

Oliveira, Jorge; Gamito, Pedro; Alghazzawi, Daniyal M; Fardoun, Habib M; Rosa, Pedro J; Sousa, Tatiana; Picareli, Luís Felipe; Morais, Diogo; Lopes, Paulo

2017-08-14

This investigation sought to understand whether performance in naturalistic virtual reality tasks for cognitive assessment relates to the cognitive domains that are supposed to be measured. The Shoe Closet Test (SCT) was developed based on a simple visual search task involving attention skills, in which participants have to match each pair of shoes with the colors of the compartments in a virtual shoe closet. The interaction within the virtual environment was made using the Microsoft Kinect. The measures consisted of concurrent paper-and-pencil neurocognitive tests for global cognitive functioning, executive functions, attention, psychomotor ability, and the outcomes of the SCT. The results showed that the SCT correlated with global cognitive performance as measured with the Montreal Cognitive Assessment (MoCA). The SCT explained one third of the total variance of this test and revealed good sensitivity and specificity in discriminating scores below one standard deviation in this screening tool. These findings suggest that performance of such functional tasks involves a broad range of cognitive processes that are associated with global cognitive functioning and that may be difficult to isolate through paper-and-pencil neurocognitive tests.

Functional competency and cognitive ability in mild Alzheimer's disease: relationship between ADL assessed by a relative/ carer-rated scale and neuropsychological performance.

PubMed

Matsuda, Osamu; Saito, Masahiko

2005-06-01

Alzheimer's disease (AD) is characterized by multiple cognitive deficits and affects functional competency to perform daily activities (ADL). As this may contribute to the patient's overall disability, it is important to identify factors that compromise competency. The relationship between different cognitive domains and functional activities in AD was studied. The functional competency of 73 Japanese AD patients, most with mild dementia, was assessed using a 27-item relative/carer-rating scale covering 7 ADL: managing finances, using transportation, taking precautions, self-care, housekeeping, communication and taking medicine. Cognitive assessment used 16 neuropsychological tests from the Japanese version of the WAIS-R and COGNISTAT, covering 9 cognitive domains: orientation, attention, episodic memory, semantic memory, language, visuoperceptual and construction abilities, computational ability, abstract thinking, and psychomotor speed. Multiple regression analysis by the stepwise method indicated that functional competency could, for the most part, be predicted from test scores for orientation, abstract thinking and psychomotor speed. The results of this study suggest that impairment of these three cognitive domains plays an important role in the functional deterioration of AD.

The relationships between cognitive function and hearing loss among the elderly.

PubMed

Huh, MyungJin

2018-01-01

[Purpose] Research related to dementia has gained momentum in South Korea and studies have found that the auditory sense affects dementia. This study aims to examine the relationship between the decline in hearing function and the overall cognitive function among the elderly. [Subjects and Methods] Eighty-two older adults aged 65-90 years (mean age: 79.3, SD: 5.2) participated. The Korean Mini-Mental State Examination was used to assess cognitive function. Further, to assess the hearing function, pure-tone audiometry was performed prior to the cognitive function test. We used a paired t-test and Pearson's correlation test for the analysis. [Results] Generally, the higher the frequency band, the more hearing loss was identified among the elderly. In addition, the difference in hearing between both ears was significant; particularly, hearing loss in the right ear was significantly higher than that in the left. Cognitive function was not related to age, however, the correlation between cognitive function and hearing loss in the right ear was statistically significant. [Conclusion] Hearing loss influences cognitive function among the elderly.

Metamemory function in chemotherapy-treated patients with breast cancer: an explanation for the dissociation between subjective and objective memory measures?

PubMed

Collins, Barbara; Paquet, Lise; Dominelli, Rachelle; White, Amanda; MacKenzie, Joyce

2017-01-01

The purpose of this study was to determine if a deficit in metamemory could account for the disparity between subjective and objective measures of memory function commonly observed in patients with breast cancer (BC). Metamemory refers to the awareness and management of one's own memory function. It is considered an aspect of executive functioning, one of the most common areas of cognitive compromise associated with BC and its treatment. Fifty-four women with early stage BC who had recently completed chemotherapy were compared with 54 healthy women matched on age and education. Cognitive function was objectively assessed with a neuropsychological test battery and subjectively assessed with the Functional Assessment of Cancer Therapy Cognitive Scale. Metamemory was assessed with a Feeling of Knowing (FOK) paradigm. The patients with BC scored significantly lower than the controls on both the objective and subjective cognitive measures, as well as on free recall and recognition conditions of the FOK, suggesting some decline in primary memory functions such as working memory, encoding, and retrieval. The discrepancy between the objective and subjective measures was larger in the patients with BC than in the controls, but there was no difference between the groups on the FOK metamemory index. Discrepancy in objective and subjective measures of cognition in patients with BC cannot be accounted for in terms of a deficit in meta-cognition. Objective and subjective measures are complementary, and a comprehensive cognitive assessment in patients with BC requires both. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

The Association Between Cognitive Function and Subsequent Depression: A Systematic Review and Meta-Analysis

PubMed Central

Scult, Matthew A.; Paulli, Athelia R.; Mazure, Emily S.; Moffitt, Terrie E.; Hariri, Ahmad R.; Strauman, Timothy J.

2016-01-01

Despite a growing interest in understanding the cognitive deficits associated with major depressive disorder (MDD), it is largely unknown whether such deficits exist before disorder onset or how they might influence the severity of subsequent illness. The purpose of the present study was to conduct a systematic review and meta-analysis of longitudinal datasets to determine whether cognitive function acts as a predictor of later MDD diagnosis or change in depression symptoms. Eligible studies included longitudinal designs with baseline measures of cognitive functioning, and later unipolar MDD diagnosis or symptom assessment. The systematic review identified 29 publications, representing 34 unique samples, and 121,749 participants, that met the inclusion/exclusion criteria. Quantitative meta-analysis demonstrated that higher cognitive function was associated with decreased levels of subsequent depression (r=−0.088; 95% CI: −0.121, −0.054; p<0.001). However, sensitivity analyses revealed that this association is likely driven by concurrent depression symptoms at the time of cognitive assessment. Our review and meta-analysis indicate that the association between lower cognitive function and later depression is confounded by the presence of contemporaneous depression symptoms at the time of cognitive assessment. Thus, cognitive deficits predicting MDD likely represent deleterious effects of subclinical depression symptoms on performance rather than premorbid risk factors for disorder. PMID:27624847

Nutritional status and cognitive function in community-living rural Bangladeshi older adults: data from the poverty and health in ageing project.

PubMed

Ferdous, Tamanna; Cederholm, Tommy; Kabir, Zarina Nahar; Hamadani, Jena Derakhshani; Wahlin, Ake

2010-05-01

To investigate the association between nutritional status and general and specific (fluid and crystallized) cognitive functioning in a group of older people living in a rural area in Bangladesh. Cross-sectional study. Matlab, Bangladesh. Four hundred fifty-seven randomly selected persons aged 60 and older (mean age 69.5 +/- 6.8), 55% female. Nutritional status was evaluated using a modified form of the Mini Nutritional Assessment (MNA). General cognitive function was assessed using the Bangla Adaptation of the Mini-Mental State Examination, and a word synonym test was used to test semantic memory function (a crystallized ability). To assess cognitive processing speed (a fluid ability), "cross balls" and "complete boxes" tests (scores/time unit) were used. Clinical diagnoses were registered. Structured questionnaires were used to assess demographic and socioeconomic status of the participants. Twenty-six percent of the participants were undernourished, and 62% were at risk of malnutrition according to the MNA. The MNA scores were significantly lower in women than in men (P=.01). Women performed worse than men in all three cognitive tasks (P<.001). Poorer cognitive performance was independently associated with older age, female sex, illiteracy, visual impairment, severity of disease, and depressive symptoms. There were significant associations between better nutritional status and better cognitive performance tests of general ability and processing speed, whereas semantic memory appeared to be less affected. The association between nutritional status and cognitive function involves general and specific cognitive abilities, with fluid ability seeming to be affected but crystalized functions being relatively spared.

Reliability and Validity of Ambulatory Cognitive Assessments

PubMed Central

Sliwinski, Martin J.; Mogle, Jacqueline A.; Hyun, Jinshil; Munoz, Elizabeth; Smyth, Joshua M.; Lipton, Richard B.

2017-01-01

Mobile technologies are increasingly used to measure cognitive function outside of traditional clinic and laboratory settings. Although ambulatory assessments of cognitive function conducted in people’s natural environments offer potential advantages over traditional assessment approaches, the psychometrics of cognitive assessment procedures have been understudied. We evaluated the reliability and construct validity of ambulatory assessments of working memory and perceptual speed administered via smartphones as part of an ecological momentary assessment (EMA) protocol in a diverse adult sample (N=219). Results indicated excellent between-person reliability (≥.97) for average scores, and evidence of reliable within-person variability across measurement occasions (.41–.53). The ambulatory tasks also exhibited construct validity, as evidence by their loadings on working memory and perceptual speed factors defined by the in-lab assessments. Our findings demonstrate that averaging across brief cognitive assessments made in uncontrolled naturalistic settings provide measurements that are comparable in reliability to assessments made in controlled laboratory environments. PMID:27084835

Feasibility study for remote assessment of cognitive function in multiple sclerosis.

PubMed

George, Michaela F; Holingue, Calliope B; Briggs, Farren B S; Shao, Xiaorong; Bellesis, Kalliope H; Whitmer, Rachel A; Schaefer, Catherine; Benedict, Ralph Hb; Barcellos, Lisa F

2016-01-01

Cognitive impairment is common in multiple sclerosis (MS), and affects employment and quality of life. Large studies are needed to identify risk factors for cognitive decline. Currently, a MS-validated remote assessment for cognitive function does not exist. Studies to determine feasibility of large remote cognitive function investigations in MS have not been published. To determine whether MS patients would participate in remote cognitive studies. We utilized the Modified Telephone Interview for Cognitive Status (TICS-M), a previously validated phone assessment for cognitive function in healthy elderly populations to detect mild cognitive impairment. We identified factors that influenced participation rates. We investigated the relationship between MS risk factors and TICS-M score in cases, and score differences between cases and control individuals. The TICS-M was administered to MS cases and controls. Linear and logistic regression models were utilized. 11.5% of eligible study participants did not participate in cognitive testing. MS cases, females and individuals with lower educational status were more likely to refuse (p<0.001). Cases who did complete testing did not differ in terms of perceived cognitive deficit compared to cases that did participate. More severe disease, smoking, and being male were associated with a lower TICS-M score among cases (p<0.001). The TICS-M score was significantly lower in cases compared to controls (p=0.007). Our results demonstrate convincingly that a remotely administered cognitive assessment is quite feasible for conducting large epidemiologic studies in MS, and lay the much needed foundation for future work that will utilize MS-validated cognitive measures.

Feasibility study for remote assessment of cognitive function in multiple sclerosis

PubMed Central

George, Michaela F.; Holingue, Calliope B.; Briggs, Farren B.S.; Shao, Xiaorong; Bellesis, Kalliope H.; Whitmer, Rachel A.; Schaefer, Catherine; Benedict, Ralph HB; Barcellos, Lisa F.

2017-01-01

Background Cognitive impairment is common in multiple sclerosis (MS), and affects employment and quality of life. Large studies are needed to identify risk factors for cognitive decline. Currently, a MS-validated remote assessment for cognitive function does not exist. Studies to determine feasibility of large remote cognitive function investigations in MS have not been published. Objective To determine whether MS patients would participate in remote cognitive studies. We utilized the Modified Telephone Interview for Cognitive Status (TICS-M), a previously validated phone assessment for cognitive function in healthy elderly populations to detect mild cognitive impairment. We identified factors that influenced participation rates. We investigated the relationship between MS risk factors and TICS-M score in cases, and score differences between cases and control individuals. Methods The TICS-M was administered to MS cases and controls. Linear and logistic regression models were utilized. Results 11.5% of eligible study participants did not participate in cognitive testing. MS cases, females and individuals with lower educational status were more likely to refuse (p<0.001). Cases who did complete testing did not differ in terms of perceived cognitive deficit compared to cases that did participate. More severe disease, smoking, and being male were associated with a lower TICS-M score among cases (p<0.001). The TICS-M score was significantly lower in cases compared to controls (p=0.007). Conclusions Our results demonstrate convincingly that a remotely administered cognitive assessment is quite feasible for conducting large epidemiologic studies in MS, and lay the much needed foundation for future work that will utilize MS-validated cognitive measures. PMID:28255581

Correlation between hypertension and cognitive function in elderly

NASA Astrophysics Data System (ADS)

Fitri, F. I.; Rambe, A. S.

2018-03-01

Hypertension and cognitive impairment are common disorders among elderly adults, and their prevalences tend to rise as the population ages. This study aimed to determine the correlation between hypertension and cognitive function in elderly. It was a cross-sectional study involving 62 elderly subjects. All subjects underwent physical and neurologic examination and Montreal Cognitive Assessment-Indonesian Version (MoCA-INA) to assess cognitive function. This study included 62 subjects consisted of 26 males (41.9%) and 36 females (58.1%). There were 24 subjects (38.2%) with hypertension and 38 (61.3%) normal elderly subjects. The mean age was 65.71±4.49 years old. There were no significant differences in demographic characteristics, total MoCA-INA scores, and scores based on cognitive domains between two groups, except for visuospatial and executive function (p=0.026). There was a significant correlation between hypertension and visuospatial and executive function (r=0.301, p=0.017). Hypertension is correlated with cognitive impairment mainly on visuospatial and executive function in elderly.

Cognitive assessment in multiple sclerosis-an Italian consensus.

PubMed

Amato, Maria Pia; Morra, Vincenzo Brescia; Falautano, Monica; Ghezzi, Angelo; Goretti, Benedetta; Patti, Francesco; Riccardi, Alice; Mattioli, Flavia

2018-05-15

The aim of this consensus paper was to define the state of the art on cognitive assessment of persons with multiple sclerosis (PwMS), with the purpose of providing recommendations for the Italian centers involved in MS management. While there are no formal guidelines published regarding the assessment of cognitive function in MS, on the basis of an expert opinion meeting, held in Milan (Italy) on July 4, 2016, we report the recommendations of a panel of Italian experts including MS neurologists and neuropsychologists for the assessment and follow-up of cognitive function in adult MS subjects.

Utility of TICS-M for the assessment of cognitive function in older adults.

PubMed

de Jager, Celeste A; Budge, Marc M; Clarke, Robert

2003-04-01

Routine screening of high-risk elderly people for early cognitive impairment is constrained by the limitations of currently available cognitive function tests. The Telephone Interview of Cognitive Status is a novel instrument for assessment of cognitive function that can be administered in person or by telephone. To evaluate the determinants and utility of TICS-M (13-item modified version) for assessment of cognitive function in healthy elderly people. The utility of TICS-M was compared with more widely used MMSE and CAMCOG in a cross-sectional survey of 120 older (62 to 89 years) UK adults. The TICS-M cognitive test scores (27.97, SD 4.15) were normally distributed in contrast with those for MMSE and CAMCOG that had a negatively skewed distribution. TICS-M scores were inversely correlated with age (r = -0.21) and with the NART fullscale IQ (r = -0.35), but were independent of years of education in this cohort. TICS-M was highly correlated with MMSE (r = 0.57) and with CAMCOG (r = 0.62) scores. The time required to complete the test is comparable to MMSE and substantially less than CAMCOG. The normal distribution of TICS-M test scores suggest that this test is less constrained by the ceiling effect which limits the utility of MMSE and CAMCOG test scores in detecting early cognitive impairment. TICS-M is an appropriate instrument to assess cognitive function in both research and in clinical practice. Copyright 2003 John Wiley & Sons, Ltd.

Serum phosphate and cognitive function in older men.

PubMed

Slinin, Yelena; Vo, Tien; Taylor, Brent C; Murray, Anne M; Schousboe, John; Langsetmo, Lisa; Ensrud, Kristine

2018-01-01

Determine whether serum phosphate is associated with concurrent cognitive impairment and subsequent cognitive decline in older men independent of demographic covariates and atherosclerotic risk factors. In a prospective study of 5529 men enrolled in the Osteoporotic Fractures in Men study, we measured baseline serum phosphate, baseline cognitive function, and change in cognitive function between baseline and follow-up exams an average of 4.6 years later using the Modified Mini-Mental State (3MS) Examination and Trails B. There was no association between serum phosphate and odds of cognitive impairment as assessed by baseline 3MS score or risk of cognitive decline as assessed by longitudinal change in 3MS score. Higher baseline serum phosphate was associated with higher odds of poor executive function as assessed by Trails B with fully adjusted odds ratios 1.12 (95% confidence interval: 0.83-1.52), 1.31 (0.97-1.77), and 1.45 (1.08-1.94) for men in the second, third, and fourth versus the bottom quartile (referent group) of serum phosphate (p-trend 0.007). However, higher phosphate level was not associated with risk of decline in executive function as assessed by longitudinal change in Trails B score with fully adjusted odds ratios 0.94 (95% confidence interval 0.69-1.28), 0.96 (0.70-1.32), and 1.21 (0.89-1.66) for men in the second, third, and fourth versus the bottom quartile (referent group) of serum phosphate (p-trend 0.22). Higher serum phosphate in older men was associated with a higher likelihood of poor executive function, but not with impaired global cognitive function or decline in executive or global cognition. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Synergistic effects of aerobic exercise and cognitive training on cognition, physiological markers, daily function, and quality of life in stroke survivors with cognitive decline: study protocol for a randomized controlled trial.

PubMed

Yeh, Ting-Ting; Wu, Ching-Yi; Hsieh, Yu-Wei; Chang, Ku-Chou; Lee, Lin-Chien; Hung, Jen-Wen; Lin, Keh-Chung; Teng, Ching-Hung; Liao, Yi-Han

2017-08-31

Aerobic exercise and cognitive training have been effective in improving cognitive functions; however, whether the combination of these two can further enhance cognition and clinical outcomes in stroke survivors with cognitive decline remains unknown. This study aimed to determine the treatment effects of a sequential combination of aerobic exercise and cognitive training on cognitive function and clinical outcomes. Stroke survivors (n = 75) with cognitive decline will be recruited and randomly assigned to cognitive training, aerobic exercise, and sequential combination of aerobic exercise and cognitive training groups. All participants will receive training for 60 minutes per day, 3 days per week for 12 weeks. The aerobic exercise group will receive stationary bicycle training, the cognitive training group will receive cognitive-based training, and the sequential group will first receive 30 minutes of aerobic exercise, followed by 30 minutes of cognitive training. The outcome measures involve cognitive functions, physiological biomarkers, daily function and quality of life, physical functions, and social participation. Participants will be assessed before and immediately after the interventions, and 6 months after the interventions. Repeated measures of analysis of variance will be used to evaluate the changes in outcome measures at the three assessments. This trial aims to explore the benefits of innovative intervention approaches to improve the cognitive function, physiological markers, daily function, and quality of life in stroke survivors with cognitive decline. The findings will provide evidence to advance post-stroke cognitive rehabilitation. ClinicalTrials.gov, NCT02550990 . Registered on 6 September 2015.

Web-based cognitive rehabilitation for survivors of adult cancer: A randomised controlled trial.

PubMed

Mihuta, Mary E; Green, Heather J; Shum, David H K

2018-04-01

Cognitive dysfunction associated with cancer is frequently reported and can reduce quality of life. This study evaluated a Web-based cognitive rehabilitation therapy program (eReCog) in cancer survivors compared with a waitlist control group. Adult cancer survivors with self-reported cognitive symptoms who had completed primary treatment at least 6 months prior were recruited. Participants completed telephone screening and were randomly allocated to the 4-week online intervention or waitlist. Primary outcome was perceived cognitive impairment assessed with the Functional Assessment of Cancer Therapy-Cognitive Function version 3. Secondary outcomes were additional measures of subjective cognitive functioning, objective cognitive functioning, and psychosocial variables. Seventy-six women were allocated to the intervention (n = 40) or waitlist (n = 36). A significant interaction was found on the instrumental activities of daily living measure of self-reported prospective memory whereby the intervention group reported a greater reduction in prospective memory failures than the waitlist group. Interaction trends were noted on perceived cognitive impairments (P = .089) and executive functioning (P = .074). No significant interactions were observed on other measures of objective cognitive functioning or psychosocial variables. The Web-based intervention shows promise for improving self-reported cognitive functioning in adult cancer survivors. Further research is warranted to better understand the mechanisms by which the intervention might contribute to improved self-reported cognition. Copyright © 2017 John Wiley & Sons, Ltd.

HIV-associated cognitive disorders in perinatally infected children and adolescents: a novel composite cognitive domains score.

PubMed

Phillips, Nicole J; Hoare, Jacqueline; Stein, Dan J; Myer, Landon; Zar, Heather J; Thomas, Kevin G F

2018-04-22

Accurate assessment of HIV-associated cognitive disorders in perinatally infected children and adolescents is challenging. Assessments of general intellectual functioning, or global cognition, may not provide information regarding domain-specific strengths and weaknesses, and may therefore fail to detect, impaired trajectories of development within particular cognitive domains. We compare the efficacy of global cognitive scores to that of composite cognitive domain scores in detecting cognitive disorders in a sample of perinatally HIV-infected children, and a demographically matched HIV negative control group, drawn from the Cape Town Adolescent Antiretroviral Cohort (CTAAC) study. All children were administered a comprehensive neuropsychological test battery. Using data from that test battery, we created ten separate composite cognitive domains: general intellectual functioning, attention, working memory, visual memory, verbal memory, language, visual spatial ability, motor coordination, processing speed and executive function. Within each domain, each test bore a high level of association with each of the other tests in that domain (Cronbach's α ≥ .70 for all domains). We found that composite domain scores calculated on whole-sample data were significantly higher than those calculated using control-sample data. Our comparison of a global cognitive score to composite domain scores suggested that the latter provided more detailed information (regarding strengths, weaknesses, areas of impairment), and when compared to global scores, were more sensitive in detecting HIV-associated cognitive disorders, and were able to distinguish HIV-infected patients from uninfected controls. Hence, we recommend using this method of composite cognitive domains scores, rather than global aggregate scores, when assessing cognitive function in paediatric HIV. This method provides a convenient and relatively accurate assessment that might help with cross-cultural and cross-region comparisons as researchers try to detect cognitive impairment patterns in HIV-infected children and adolescents globally.

Association between glycemic load and cognitive function in community-dwelling older adults: Results from the Brain in Motion study.

PubMed

Garber, Anna; Csizmadi, Ilona; Friedenreich, Christine M; Sajobi, Tolulope T; Longman, Richard S; Tyndall, Amanda V; Drogos, Lauren L; Davenport, Margie H; Poulin, Marc J

2017-07-17

Impaired glucose tolerance is a risk factor for non-age-related cognitive decline and is also associated with measures of physical activity (PA) and cardiorespiratory fitness (CRF). A low glycemic load (GL) diet can aid in the management of blood glucose levels, but little is known about its effect on cognition with poor glucoregulation. We assessed the relation between GL and cognitive function by glucoregulation and possible mediatory effects by CRF and PA in older adults from the Brain in Motion Study. A cross-sectional analysis of 194 cognitively healthy adults aged ≥55 years (mean = 65.7, SD = 6.1) was conducted. GL was assessed using a quantitative food frequency questionnaire, and glucoregulation was characterized on the HOMA-IR index. Subjects also completed a cognitive assessment, CRF testing, a validated self-reported PA questionnaire, and a blood draw. Multiple linear regression models adjusted for significant covariates were used to evaluate the relation between GL and cognition, and mediation by CRF and PA was also assessed. GL was inversely associated with global cognition (β = -0.014; 95% CI -0.024, -0.004) and figural memory (β = -0.035; 95% CI -0.052, -0.018) in subjects with poor glucoregulation. Neither CRF nor PA mediated these relations. In subjects with good glucoregulation, no association was found between GL and cognitive function (p > 0.05). A low GL diet is associated with better cognitive function in older adults with poor glucoregulation. This study provides supportive evidence for the role of GL in maintaining better cognitive function during the aging process. Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Decline in Executive Control during Acute Bouts of Exercise as a Function of Exercise Intensity and Fitness Level

ERIC Educational Resources Information Center

Labelle, Veronique; Bosquet, Laurent; Mekary, Said; Bherer, Louis

2013-01-01

Studies on the effects of acute bouts of cardiovascular exercise on cognitive performances show contradictory findings due to methodological differences (e.g., exercise intensity, cognitive function assessed, participants' aerobic fitness level, etc.). The present study assessed the acute effect of exercise intensity on cognition while controlling…

[Trajectories of aging in a sample of elderly people: a longitudinal study].

PubMed

Navarro-González, Elena; Calero, María Dolores; Becerra-Reina, Dolores

2015-01-01

The present study analyzes variables associated with different trajectories of aging, and the level of cognitive functioning in a sample of older adults. Although this work is part of a broader investigation where initially 141 people were assessed, this paper only discusses the cognitive functioning and cognitive development of 64 older people who have been followed up four years after the initial assessment, with a mean age of 83.84 years (age range 65 to 99 years). In the initial assessment all the participants were assessed with a psychological battery that included the MEC, the verbal fluency task FVS, a sustained attention task, a working memory test, a Quality of Life Questionnaire, a scale of dependency, and the AVLT-Learning Potential test. In the follow up assessment, participants have been assessed with the MEC, the verbal fluency task FVS, and the verbal memory test AVLT-PA. the results show relatively stable trajectories of aging and that the variables that better predict cognitive evolution of the elderly are working memory and post-test score in the AVLT-LP. Despite the time lapse between the two assessments and the age of the participants, older adults have remained relatively stable in their cognitive functioning, which in part contradicts the idea that--especially after 80 years--a general decline of cognitive functioning occurs in old age. Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.

Subjective cognitive impairment and brain structural networks in Chinese gynaecological cancer survivors compared with age-matched controls: a cross-sectional study.

PubMed

Zeng, Yingchun; Cheng, Andy S K; Song, Ting; Sheng, Xiujie; Zhang, Yang; Liu, Xiangyu; Chan, Chetwyn C H

2017-11-28

Subjective cognitive impairment can be a significant and prevalent problem for gynaecological cancer survivors. The aims of this study were to assess subjective cognitive functioning in gynaecological cancer survivors after primary cancer treatment, and to investigate the impact of cancer treatment on brain structural networks and its association with subjective cognitive impairment. This was a cross-sectional survey using a self-reported questionnaire by the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) to assess subjective cognitive functioning, and applying DTI (diffusion tensor imaging) and graph theoretical analyses to investigate brain structural networks after primary cancer treatment. A total of 158 patients with gynaecological cancer (mean age, 45.86 years) and 130 age-matched non-cancer controls (mean age, 44.55 years) were assessed. Patients reported significantly greater subjective cognitive functioning on the FACT-Cog total score and two subscales of perceived cognitive impairment and perceived cognitive ability (all p values <0.001). Compared with patients who had received surgery only and non-cancer controls, patients treated with chemotherapy indicated the most altered global brain structural networks, especially in one of properties of small-worldness (p = 0.004). Reduced small-worldness was significantly associated with a lower FACT-Cog total score (r = 0.412, p = 0.024). Increased characteristic path length was also significantly associated with more subjective cognitive impairment (r = -0.388, p = 0.034). When compared with non-cancer controls, a considerable proportion of gynaecological cancer survivors may exhibit subjective cognitive impairment. This study provides the first evidence of brain structural network alteration in gynaecological cancer patients at post-treatment, and offers novel insights regarding the possible neurobiological mechanism of cancer-related cognitive impairment (CRCI) in gynaecological cancer patients. As primary cancer treatment can result in a more random organisation of structural brain networks, this may reduce brain functional specificity and segregation, and have implications for cognitive impairment. Future prospective and longitudinal studies are needed to build upon the study findings in order to assess potentially relevant clinical and psychosocial variables and brain network measures, so as to more accurately understand the specific risk factors related to subjective cognitive impairment in the gynaecological cancer population. Such knowledge could inform the development of appropriate treatment and rehabilitation efforts to ameliorate cognitive impairment in gynaecological cancer survivors.

Evaluation of the relationship between cognitive functioning in patients with borderline personality disorder and their general functioning.

PubMed

Mosiołek, Anna; Gierus, Jacek; Koweszko, Tytus; Szulc, Agata

2018-02-28

The purpose of the study was to examine the relation between cognitive functioning in people with borderline personality disorder and their overall functioning level, as well as psychopathology intensification specific for this type of disorders. 64 patients aged 18-55 (M = 30.09) with borderline personality disorder (emotionally unstable personality - borderline type in the ICD-10) were examined. The study used: demographic-descriptive questionnaire, SCID II, Borderline Symptom Checlist-23, and Global Assessment of Functioning (GAF). For cognitive assessment, The Rey Auditory Verbal Learning Test, The Rey-Osterrieth Complex Figure test, TMTA, TMTB, verbal fluency test, Stroop test and Frontal Assessment Battery (FAB) were used. The average GAF score in the sample was M =43.65. Significant differences between the comorbidity group and non-comorbidity group were observed with respect to the GAF scores (Mann-Whitney U = 300.500, p = 0.008) as well as a number of significant (p < 0.05) correlations between the level of cognitive functions and functioning in patients with no co-morbidity. Clinically significant disturbances in general and social functioning persisted in the group of subjects with borderline personality disorder. The obtained data seem to suggest that the cognitive functions affect the overall functioning only in patients with psychiatric co-morbidity. In people without psychiatric co-morbidity there is a relationship of cognitive functions only with certain aspects of psychopathology specific to BPD.

Cognitive remediation therapy (CRT) benefits more to patients with schizophrenia with low initial memory performances.

PubMed

Pillet, Benoit; Morvan, Yannick; Todd, Aurelia; Franck, Nicolas; Duboc, Chloé; Grosz, Aimé; Launay, Corinne; Demily, Caroline; Gaillard, Raphaël; Krebs, Marie-Odile; Amado, Isabelle

2015-01-01

Cognitive deficits in schizophrenia mainly affect memory, attention and executive functions. Cognitive remediation is a technique derived from neuropsychology, which aims to improve or compensate for these deficits. Working memory, verbal learning, and executive functions are crucial factors for functional outcome. Our purpose was to assess the impact of the cognitive remediation therapy (CRT) program on cognitive difficulties in patients with schizophrenia, especially on working memory, verbal memory, and cognitive flexibility. We collected data from clinical and neuropsychological assessments in 24 patients suffering from schizophrenia (Diagnostic and Statistical Manual of mental Disorders-Fourth Edition, DSM-IV) who followed a 3-month (CRT) program. Verbal and visuo-spatial working memory, verbal memory, and cognitive flexibility were assessed before and after CRT. The Wilcoxon test showed significant improvements on the backward digit span, on the visual working memory span, on verbal memory and on flexibility. Cognitive improvement was substantial when baseline performance was low, independently from clinical benefit. CRT is effective on crucial cognitive domains and provides a huge benefit for patients having low baseline performance. Such cognitive amelioration appears highly promising for improving the outcome in cognitively impaired patients.

Lower Cognitive Function in Older Patients with Lower Muscle Strength and Muscle Mass.

PubMed

van Dam, Romee; Van Ancum, Jeanine M; Verlaan, Sjors; Scheerman, Kira; Meskers, Carel G M; Maier, Andrea B

2018-06-18

Low muscle strength and muscle mass are associated with adverse outcomes in older hospitalized patients. The aim of this study was to assess the association between cognitive functioning and muscle strength and muscle mass in hospitalized older patients. This prospective inception cohort included 378 patients aged 70 years or older. At admission patients were assessed for cognitive functioning by use of the Six-Item Cognitive Impairment Test (6-CIT). Muscle strength and muscle mass were assessed using handheld dynamometry and segmental multifrequency bioelectrical impedance analysis, within 48 h after admission and on day 7, or earlier on the day of discharge. The data of 371 patients (mean age ± standard deviation 80.1 ± 6.4 years, 49.3% female) were available for analyses. The median (interquartile range) 6-CIT score was 4 (0-8) points. At admission, lower cognitive functioning was associated with lower muscle strength, lower skeletal muscle mass (SMM), lower appendicular lean mass, and lower SMM index. Cognitive functioning was not associated with change in muscle strength and muscle mass during hospitalization. This study further strengthens evidence for an association between lower cognitive functioning and lower muscle strength and muscle mass, but without a further decline during hospitalization. © 2018 The Author(s) Published by S. Karger AG, Basel.

Social Cognition Deficits: Current Position and Future Directions for Neuropsychological Interventions in Cerebrovascular Disease.

PubMed

Njomboro, Progress

2017-01-01

Neuropsychological assessments of cognitive dysfunction in cerebrovascular illness commonly target basic cognitive functions involving aspects of memory, attention, language, praxis, and number processing. Here, I highlight the clinical importance of often-neglected social cognition functions. These functions recruit a widely distributed neural network, making them vulnerable in most cerebrovascular diseases. Sociocognitive deficits underlie most of the problematic social conduct observed in patients and are associated with more negative clinical outcomes (compared to nonsocial cognitive deficits). In clinical settings, social cognition deficits are normally gleaned from collateral information from caregivers or from indirect inferences made from patients' performance on standard nonsocial cognitive tests. Information from these sources is however inadequate. I discuss key social cognition functions, focusing initially on deficits in emotion perception and theory of mind, two areas that have gained sizeable attention in neuroscientific research, and then extend the discussion into relatively new, less covered but crucial functions involving empathic behaviour, social awareness, social judgements, and social decision making. These functions are frequently impaired following neurological change. At present, a wide range of psychometrically robust social cognition tests is available, and this review also makes the case for their inclusion in neuropsychological assessments.

Social Cognition Deficits: Current Position and Future Directions for Neuropsychological Interventions in Cerebrovascular Disease

PubMed Central

2017-01-01

Neuropsychological assessments of cognitive dysfunction in cerebrovascular illness commonly target basic cognitive functions involving aspects of memory, attention, language, praxis, and number processing. Here, I highlight the clinical importance of often-neglected social cognition functions. These functions recruit a widely distributed neural network, making them vulnerable in most cerebrovascular diseases. Sociocognitive deficits underlie most of the problematic social conduct observed in patients and are associated with more negative clinical outcomes (compared to nonsocial cognitive deficits). In clinical settings, social cognition deficits are normally gleaned from collateral information from caregivers or from indirect inferences made from patients' performance on standard nonsocial cognitive tests. Information from these sources is however inadequate. I discuss key social cognition functions, focusing initially on deficits in emotion perception and theory of mind, two areas that have gained sizeable attention in neuroscientific research, and then extend the discussion into relatively new, less covered but crucial functions involving empathic behaviour, social awareness, social judgements, and social decision making. These functions are frequently impaired following neurological change. At present, a wide range of psychometrically robust social cognition tests is available, and this review also makes the case for their inclusion in neuropsychological assessments. PMID:28729755

Contrasting Olfaction, Vision, and Audition as Predictors of Cognitive Change and Impairment in Non-Demented Older Adults

PubMed Central

MacDonald, Stuart W.S.; Keller, Connor J.C.; Brewster, Paul W.H.; Dixon, Roger A.

2017-01-01

Objective This study examines the relative utility of a particular class of non-invasive functional biomarkers -- sensory functions -- for detecting those at risk of cognitive decline and impairment. Three central research objectives were examined including whether: (1) olfactory function, vision, and audition exhibited significant longitudinal declines in non-demented older adults, (2) multi-wave change for these sensory function indicators predicted risk of mild cognitive impairment, and (3) change within persons for each sensory measure shared dynamic time-varying associations with within-person change in cognitive functioning. Method A longitudinal sample (n=408) from the Victoria Longitudinal Study was assembled. Three cognitive status subgroups were identified: not impaired cognitively (NIC), single assessment mild cognitive impairment (SA-MCI), and multiple assessment mild cognitive impairment (MA-MCI). Results We tested independent predictive associations, contrasting change in sensory function as predictors of cognitive decline and impairment, utilizing both linear mixed models and logistic regression analysis. Olfaction and, to a lesser extent, vision were identified as the most robust predictors of cognitive status and decline; audition showed little predictive influence. Conclusions These findings underscore the potential utility of deficits in olfactory function, in particular, as an early marker of age- and pathology-related cognitive decline. Functional biomarkers may represent potential candidates for use in the early stages of a multi-step screening approach for detecting those at risk of cognitive impairment, as well as for targeted intervention. PMID:29809033

Cognitive Impairment Associated with Cancer

PubMed Central

Pendergrass, J. Cara; Harrison, John E.

2018-01-01

This brief review explores the areas of cognitive impairment that have been observed in cancer patients and survivors, the cognitive assessment tools used, and the management of the observed cognitive changes. Cognitive changes and impairment observed in patients with cancer and those in remission can be related to the direct effects of cancer itself, nonspecific factors or comorbid conditions that are independent of the actual disease, and/or the treatments or combination of treatments administered. Attention, memory, and executive functioning are the most frequently identified cognitive domains impacted by cancer. However, the prevalence and extent of impairment remains largely unknown due to marked differences in methodology, definitions of cognitive impairment, and the assessment measures used. Assessment of cognitive functioning is an important and necessary part of a comprehensive oncological care plan. Research is needed to establish a better understanding of cognitive changes and impairments associated with cancer so that optimal patient outcomes can be achieved. PMID:29497579

[Learning potential and cognitive remediation in schizophrenia].

PubMed

Raffard, S; Gely-Nargeot, M-C; Capdevielle, D; Bayard, S; Boulenger, J-P

2009-09-01

Many studies have stressed the importance of neurocognitive deficits in schizophrenia that represent a core feature of the pathology. Cognitive dysfunctions are present in 80% of schizophrenic patients, including deficits in attention, memory, speed processing and executive functioning, with well-known functional consequences on daily life, social functioning and rehabilitation outcome. Recent studies have stressed that cognitive deficits, rather than the positive or negative symptoms of schizophrenia, predict poor performance in basic activities of daily living. If it is possible to reduce psychotic symptoms and to prevent relapses with antipsychotic medication, it is not yet possible to have the same convincing impact on cognitive or functional impairments. Cognitive remediation is a new psychological treatment which has proved its efficacy in reducing cognitive deficits. A growing literature on cognitive rehabilitation suggests possibilities that in schizophrenia, specific techniques are able to enhance an individual's cognitive functioning. Presently, two distinct and complementary cognitive remediation methods have been developed: the compensatory and the restorative approaches: (A) restorative approaches attempt to improve function by recruiting relatively intact cognitive processes to fill the role of those impaired, or by using prosthetic aids to compensate for the loss of function; (B) in contrast, in the restorative approach cognitive deficits are targeted directly through repeated practice training. However, results concerning cognitive remediation remain inconsistent. It is clear that not all individuals with schizophrenia display cognitive impairment, and even among those who do, the specific pattern of cognitive functioning varies. Moreover, traditional neurocognitive assessment, with a single or static administration of cognitive measures, provides moderately good prediction of skills acquisition in schizophrenia. Among other factors such as motivation, awareness of having a disease and acuteness of symptomatology, some studies have exposed that a cognitive variable, learning potential could mediate in part the effectiveness of cognitive remediation. The concept of learning potential is used to explain some of the observed variability in cognitive functioning. Learning potential is the ability to attain and utilize cognitive skills after cognitive training: it is assessed by individual variation in performance across three consecutive administrations of the Wisconsin Card Sorting Test (WCST): a pretest with standard instruction procedures, a training phase with expanded instruction and a post test with only standard instruction. Three learner subtypes can be identified: "learners" who perform poorly at the pretest but improve performance during the post-test, "non-retainers" who perform poorly at pre-test and do not improve at post-testing and "high achievers" who perform well in the initial pretest and maintain their good performance across the other two administrations. The assessment of learning potential could predict, with other psychological measures such as insight and motivation, the most effective neurocognitive rehabilitation program for an individual patient, and could help the clinician to optimize patient outcome through appropriate individual management. Indeed, learning potential could represent a good cognitive predictor and indicator for rehabilitation in schizophrenia for clinicians and should be used in cognitive assessment practice. However, the individuals most likely to benefit from cognitive remediation, and whether changes in cognitive function translate into functional improvements, are as yet unclear.

Contrasting olfaction, vision, and audition as predictors of cognitive change and impairment in non-demented older adults.

PubMed

MacDonald, Stuart W S; Keller, Connor J C; Brewster, Paul W H; Dixon, Roger A

2018-05-01

This study examines the relative utility of a particular class of noninvasive functional biomarkers-sensory functions-for detecting those at risk of cognitive decline and impairment. Three central research objectives were examined including whether (a) olfactory function, vision, and audition exhibited significant longitudinal declines in nondemented older adults; (b) multiwave change for these sensory function indicators predicted risk of mild cognitive impairment (MCI); and (c) change within persons for each sensory measure shared dynamic time-varying associations with within-person change in cognitive functioning. A longitudinal sample (n = 408) from the Victoria Longitudinal Study was assembled. Three cognitive status subgroups were identified: not impaired cognitively, single-assessment MCI, and multiple-assessment MCI. We tested independent predictive associations, contrasting change in sensory function as predictors of cognitive decline and impairment, utilizing both linear mixed models and logistic regression analysis. Olfaction and, to a lesser extent, vision were identified as the most robust predictors of cognitive status and decline; audition showed little predictive influence. These findings underscore the potential utility of deficits in olfactory function, in particular, as an early marker of age- and pathology-related cognitive decline. Functional biomarkers may represent potential candidates for use in the early stages of a multistep screening approach for detecting those at risk of cognitive impairment, as well as for targeted intervention. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Dietary Patterns Associated with Cognitive Function among the Older People in Underdeveloped Regions: Finding from the NCDFaC Study.

PubMed

Yin, Zhaoxue; Chen, Jing; Zhang, Jian; Ren, Zeping; Dong, Kui; Kraus, Virginia B; Wang, Zhuoqun; Zhang, Mei; Zhai, Yi; Song, Pengkun; Zhao, Yanfang; Pang, Shaojie; Mi, Shengquan; Zhao, Wenhua

2018-04-09

Although dietary patterns are crucial to cognitive function, associations of dietary patterns with cognitive function have not yet been fully understood. This cross-sectional study explored dietary patterns associated with cognitive function among the older adults in underdeveloped regions, using 1504 community-dwelling older adults aged 60 and over. Diet was assessed using a food frequency questionnaire and 24-h dietary recall. Factor analysis was used to extract dietary patterns. Global cognitive function was assessed using the Mini-Mental State Examination (MMSE). Two dietary patterns, a "mushroom, vegetable, and fruits" (MVF) pattern and a "meat and soybean products" (MS) pattern, were identified. The MVF pattern, characterized by high consumption of mushrooms, vegetables, and fruits was significantly positively associated with cognitive function ( p < 0.05), with an odds ratio of (95% CIs) 0.60 (0.38, 0.94) for cognitive impairment and β (95% CIs) 0.15 (0.02, 0.29) for -log (31-MMSE score). The MS pattern, characterized by high consumption of soybean products and meat, was also associated with better cognitive function, with an odds ratio of 0.47 (95% CIs 0.30, 0.74) for cognitive impairment and β (95% CIs) 0.34 (0.21, 0.47) for -log (31-MMSE score). Our results suggested that both the MVF and MS patterns were positively associated with better cognitive function among older adults in underdeveloped regions.

A study into the automation of cognitive assessment tasks for delivery via the telephone: lessons for developing remote monitoring applications for the elderly.

PubMed

D'Arcy, Shona; Rapcan, Viliam; Gali, Alessandra; Burke, Nicola; O'Connell, Gloria Crispino; Robertson, Ian H; Reilly, Richard B

2013-01-01

Cognitive assessments are valuable tools in assessing neurological conditions. They are critical in measuring deficits in cognitive function in an array of neurological disorders and during the ageing process. Automation of cognitive assessments is one way to address the increasing burden on medical resources for an ever increasing ageing population. This study investigated the suitability of using automated Interactive Voice Response (IVR) technology to deliver a suite of cognitive assessments to older adults using speech as the input modality. Several clinically valid and gold-standard cognitive assessments were selected for implementation in the IVR application. The IVR application was designed using human centred design principles to ensure the experience was as user friendly as possible. Sixty one participants completed two IVR assessments and one face to face (FF) assessment with a neuropsychologist. Completion rates for individual tests were inspected to identify those tests that are most suitable for administration via IVR technology. Interclass correlations were calculated to assess the reliability of the automated administration of the cognitive assessments across delivery modes. While all participants successfully completed all automated assessments, variability in the completion rates for different cognitive tests was observed. Statistical analysis found significant interclass correlations for certain cognitive tests between the different modes of administration. Analysis also suggests that an initial FF assessment reduces the variability in cognitive test scores when introducing automation into such an assessment. [corrected] This study has demonstrated the functional and cognitive reliability of administering specific cognitive tests using an automated, speech driven application. This study has defined the characteristics of existing cognitive tests that are suitable for such an automated delivery system and also informs on the limitations of other cognitive tests for this modality. This study presents recommendations for developing future large scale cognitive assessments.

Efficacy of cognitive rehabilitation using computer software with individuals living with schizophrenia: A randomized controlled trial in Japan.

PubMed

Iwata, Kazuhiko; Matsuda, Yasuhiro; Sato, Sayaka; Furukawa, Shunichi; Watanabe, Yukako; Hatsuse, Norifumi; Ikebuchi, Emi

2017-03-01

Cognitive impairment is common in schizophrenia, and is associated with poor psychosocial functioning. Previous studies had inconsistently shown improvement in cognitive functions with cognitive remediation therapy. This study examined whether cognitive remediation is effective in improving both cognitive and social functions in schizophrenia in outpatient settings that provide learning-based psychiatric rehabilitation. This study is the first randomized controlled trial of cognitive remediation in Japan. Study participants were individuals with schizophrenia from 6 outpatient psychiatric medical facilities who were randomly assigned either a cognitive remediation program or treatment as usual. The cognitive remediation intervention includes Cognitive training using computer software (CogPack; Japanese version) administered twice a week and a weekly group over 12 weeks and was based on the Thinking Skills for Work program. Most study participants were attending day treatment services where social skills training, psychoeducation for knowledge about schizophrenia, group activities such as recreation and sport, and other psychosocial treatment were offered. Cognitive and social functioning were assessed using the Brief Assessment of Cognition in Schizophrenia (BACS) and Life Assessment Scale for Mentally Ill (LASMI) at pre- and postintervention. Of the 60 people with schizophrenia enrolled, 29 were allocated to the cognitive remediation group and 31 were allocated to the treatment as usual group. Processing speed, executive function, and the composite score of the BACS showed significantly greater improvement for the cognitive remediation group than the treatment as usual group. In addition, there was significant improvement in interpersonal relationships and work skills on the LASMI for the cognitive remediation group compared with the treatment as usual group. Changes from pretreatment to posttreatment in verbal fluency and interpersonal relationships were significantly correlated, as well as changes in attention and work skills. The present findings showed that providing cognitive remediation on addition to psychiatric rehabilitation contributed to greater improvement in both cognitive and social functioning than psychiatric rehabilitation alone. Cognitive remediation may enhance the efficacy of psychiatric rehabilitation improving social functioning. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Self-Reported Decline in Everyday Function, Cognitive Symptoms, and Cognitive Function in People With HIV.

PubMed

Laverick, Rosanna; Haddow, Lewis; Daskalopoulou, Marina; Lampe, Fiona; Gilson, Richard; Speakman, Andrew; Antinori, Andrea; Bruun, Tina; Vassilenko, Anna; Collins, Simon; Rodger, Alison

2017-11-01

We determined factors associated with self-reported decline in activities of daily living (ADLs) and symptoms of cognitive impairment in HIV positive adults in 5 European clinics. HIV+ adults underwent computerized and pen-and-paper neuropsychological tests and questionnaires of cognitive symptoms and ADLs. We considered cognitive function in 5 domains, psychosocial factors, and clinical parameters as potentially associated with symptoms. Separate regression analyses were used to determine factors associated with a decline in ADL (defined as self-reported decline affecting ≥2 ADLs and attributed to cognitive difficulties) and self-reported frequency of symptoms of cognitive impairment. We also estimated the diagnostic accuracy of both questionnaires as tests for cognitive impairment. Four hundred forty-eight patients completed the assessments [mean age 45.8 years, 84% male, 87% white, median CD4 count 550 cells/mm, median time since HIV diagnosis 9.9 years, 81% virologically suppressed (HIV-1 plasma RNA <50 copies/mL)]. Ninety-six (21.4%) reported decline in ADLs and attributed this to cognitive difficulties. Self-reported decline in ADLs and increased symptoms of cognitive impairment were both associated with worse performance on some cognitive tests. There were also strong associations with financial difficulties, depressive and anxiety symptoms, unemployment, and longer time since HIV diagnosis. Both questionnaires performed poorly as diagnostic tests for cognitive impairment. Patients' own assessments of everyday function and symptoms were associated with objectively measured cognitive function. However, there were strong associations with other psychosocial issues including mood and anxiety disorders and socioeconomic hardship. This should be considered when assessing HIV-associated cognitive impairment in clinical care or research studies.

Cognitive Variability in Adults with ADHD and AS: Disentangling the Roles of Executive Functions and Social Cognition

ERIC Educational Resources Information Center

Gonzalez-Gadea, Maria Luz; Baez, Sandra; Torralva, Teresa; Castellanos, Francisco Xavier; Rattazzi, Alexia; Bein, Victoria; Rogg, Katharina; Manes, Facundo; Ibanez, Agustin

2013-01-01

Attention-deficit/hyperactivity disorder (ADHD) and Asperger's Syndrome (AS) share a heterogeneous cognitive profile. Studies assessing executive functions (EF) and social cognition in both groups have found preserved and impaired performances. These inconsistent findings would be partially explained by the cognitive variability reported in these…

A new computerized cognitive and social cognition training specifically designed for patients with schizophrenia/schizoaffective disorder in early stages of illness: A pilot study.

PubMed

Fernandez-Gonzalo, Sol; Turon, Marc; Jodar, Merce; Pousa, Esther; Hernandez Rambla, Carla; García, Rebeca; Palao, Diego

2015-08-30

People with schizophrenia/schizoaffective disorders at early stages of the illness present cognitive and social cognition deficits that have a great impact in functional outcomes. Cognitive Remediation Therapy (CRT) has demonstrated consistent effect in cognitive performance, symptoms and psychosocial functioning. However, any CRT intervention or social cognition training have been specifically designed for patients in the early stages of psychosis. The aim of this pilot study is to assess the efficacy of a new computerized cognitive and social cognition program for patients with schizophrenia/schizoaffective disorder with recent diagnosis. A comprehensive assessment of clinical, social and non-social cognitive and functional measures was carried out in 53 randomized participants before and after the 4-months treatment. Significant results were observed in Spatial Span Forwards, Immediate Logical Memory and Pictures of Facial Affect (POFA) total score. None of these results were explained by medication, premorbid social functioning or psychopathological symptoms. No impact of the intervention was observed in other cognitive and social cognition outcome neither in clinical and functional outcomes. This new computerized intervention may result effective ameliorating visual attention, logical memory and emotional processing in patients in the early stages of schizophrenia/schizoaffective disorder. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Cognitive functioning following stabilisation from first episode mania.

PubMed

Daglas, Rothanthi; Allott, Kelly; Yücel, Murat; Henry, Lisa P; Macneil, Craig A; Hasty, Melissa K; Berk, Michael; Cotton, Sue M

2017-12-18

The purpose of this study was to examine cognitive functioning in people following first-episode mania relative to a demographically similar healthy control group. Forty-one patients, who had recently stabilised from a first manic episode, and twenty-one healthy controls, were compared in an extensive cognitive assessment. First-episode mania participants had significantly lower Full-Scale IQ (FSIQ) relative to healthy controls; however, this finding could be driven by premorbid differences in intellectual functioning. There were no significant differences between groups in Verbal IQ (VIQ) and Performance IQ (PIQ). First-episode mania participants performed significantly poorer than healthy controls in processing speed, verbal learning and memory, working memory, and cognitive flexibility with medium-to-large effects. There were no group differences in other measures of cognition. Participants following first-episode mania have poorer global intelligence than healthy controls, and have cognitive difficulties in some, but not all areas of cognitive functioning. This highlights the importance of early intervention and cognitive assessment in the early course of the disorder.

Impact of Androgen Deprivation Therapy on Self-Reported Cognitive Function in Men with Prostate Cancer.

PubMed

Marzouk, Shireen; Naglie, Gary; Tomlinson, George; Duff Canning, Sarah; Breunis, Henriette; Timilshina, Narhari; Alibhai, Shabbir M H

2018-03-01

Although androgen deprivation therapy is widely used to treat prostate cancer, its effects on cognitive function are unclear. To our knowledge no prior report has examined the impact of androgen deprivation therapy on self-reported cognitive function. Three groups of men 50 years old or older who were matched on age and education were enrolled in the study, including 81 with prostate cancer starting on continuous androgen deprivation therapy, 84 controls with prostate cancer not receiving androgen deprivation therapy and 85 healthy controls. Two scales from the FACT-Cog (Functional Assessment of Cancer Therapy-Cognitive subscale) version 3 were used to assess self-reported cognitive function. Changes in cognitive scores with time were analyzed by 2 approaches, including 1) multivariable regression and 2) calculation of the proportion of subjects per group with a decrease of 1 SD or more. Multivariable regression was applied to assess predictors of a decline in self-reported cognitive function. We also examined relationships between the FACT-Cog and a neuropsychological battery of 15 tests. Mean participant age was 69 years (range 50 to 87). The mean educational level was 15 years (range 8 to 24). FACT-Cog scores were similar at baseline across the cohorts. Neither analytical approach revealed that androgen deprivation therapy was associated with changes in self-reported cognitive function on either FACT-Cog scale. Mood and fatigue correlated with changes in self-reported cognitive function. The relationship between self-reported and objective cognitive measures was weak (maximum Spearman correlation coefficient 0.14) and only 2 of 30 correlations were statistically significant. A total of 12 months of androgen deprivation therapy were not associated with self-reported cognitive function changes in older men with nonmetastatic prostate cancer. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Cognitive function in Japanese women with posttraumatic stress disorder: Association with exercise habits.

PubMed

Narita-Ohtaki, Ryoko; Hori, Hiroaki; Itoh, Mariko; Lin, Mingming; Niwa, Madoka; Ino, Keiko; Imai, Risa; Ogawa, Sei; Sekiguchi, Atsushi; Matsui, Mie; Kunugi, Hiroshi; Kamo, Toshiko; Kim, Yoshiharu

2018-08-15

Posttraumatic stress disorder (PTSD) has been associated with cognitive impairments, yet little is documented on the cognitive function of PTSD patients in Asian countries. It is shown that regular exercise can reduce PTSD symptoms, while no study has investigated the association between exercise and cognition in PTSD patients. This study aimed to examine cognitive functions of Japanese women with PTSD, and to explore the association between regular exercise and cognitive functions. Forty-two women with DSM-IV PTSD and 66 demographically matched healthy control women participated in this study. Most of the patients developed PTSD after experiencing interpersonal violence. Cognitive functions were assessed by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Regular exercise habit was assessed by a self-reported questionnaire. Compared to controls, PTSD patients performed significantly more poorly in all cognitive domains examined, including immediate memory, visuospatial construction, language, attention, delayed memory, as well as the total score of RBANS (all p < 0.001). Compared to PTSD patients without the habit of exercise, those who habitually exercised showed significantly better performance on delayed memory (p = 0.006), which survived after controlling for potentially confounding variables in a multiple regression model. The cross-sectional design and relatively small sample size limited our findings. PTSD in Japanese women is associated with pervasively impaired cognitive functions, including notable impairments in verbal memory. Such memory deficits might be improved by regular exercise, although further studies are needed to investigate the causal relationship between exercise and cognition in PTSD. Copyright © 2018 Elsevier B.V. All rights reserved.

Differential Item Functioning Comparisons on a Performance-Based Alternate Assessment for Students with Severe Cognitive Impairments, Autism and Orthopedic Impairments

ERIC Educational Resources Information Center

Laitusis, Cara Cahalan; Maneckshana, Behroz; Monfils, Lora; Ahlgrim-Delzell, Lynn

2009-01-01

The purpose of this study was to examine Differential Item Functioning (DIF) by disability groups on an on-demand performance assessment for students with severe cognitive impairments. Researchers examined the presence of DIF for two comparisons. One comparison involved students with severe cognitive impairments who served as the reference group…

The Parkin'Play study: protocol of a phase II randomized controlled trial to assess the effects of a health game on cognition in Parkinson's disease.

PubMed

van de Weijer, Sjors C F; Duits, Annelien A; Bloem, Bastiaan R; Kessels, Roy P; Jansen, Jacobus F A; Köhler, Sebastian; Tissingh, Gerrit; Kuijf, Mark L

2016-11-03

In Parkinson's disease (PD), cognitive impairment is an important non-motor symptom heralding the development of dementia. Effective treatments to slow down the rate of cognitive decline in PD patients with mild cognitive impairment are lacking. Here, we describe the design of the Parkin'Play study, which assesses the effects of a cognitive health game intervention on cognition in PD. This study is a multicentre, phase-II, open-randomized clinical trial that aims to recruit 222 PD patients with mild cognitive impairment. Eligible patients have PD, Hoehn & Yahr stages I-III, are aged between 40 and 75 years, and have cognitive impairment but no dementia. The intervention group (n = 111) will be trained using a web-based health game targeting multiple cognitive domains. The control group (n = 111) will be placed on a waiting list. In order to increase compliance the health game adapts to the subjects' performance, is enjoyable, and can be played at home. From each group, 20 patients will undergo fMRI to test for potential functional brain changes underlying treatment. The primary outcome after 12 weeks of training is cognitive function, as assessed by a standard neuropsychological assessment battery and an online cognitive assessment. The neuropsychological assessment battery covers the following domains: executive function, memory, visual perception, visuoconstruction and language. A compound score for overall cognitive function will be calculated as the mean score of all test Z-scores based on the distribution of scores for both groups taken together. Secondary outcomes at follow-up visits up to 24 weeks include various motor and non-motor symptoms, compliance, and biological endpoints (fMRI). This study aims at evaluating whether a cognitive intervention among PD patients leads to an increased cognitive performance on targeted domains. Strengths of this study are a unique web-based health game intervention, the large sample size, a control group without intervention and innovations designed to increase compliance. NTR5637 on 7-jan-2016.

A Reanalysis of Cognitive-Functional Performance in Older Adults: Investigating the Interaction Between Normal Aging, Mild Cognitive Impairment, Mild Alzheimer's Disease Dementia, and Depression

PubMed Central

de Paula, Jonas J.; Bicalho, Maria A.; Ávila, Rafaela T.; Cintra, Marco T. G.; Diniz, Breno S.; Romano-Silva, Marco A.; Malloy-Diniz, Leandro F.

2016-01-01

Depressive symptoms are associated with cognitive-functional impairment in normal aging older adults (NA). However, less is known about this effect on people with mild Cognitive Impairment (MCI) and mild Alzheimer's disease dementia (AD). We investigated this relationship along with the NA-MCI-AD continuum by reanalyzing a previously published dataset. Participants (N = 274) underwent comprehensive neuropsychological assessment including measures of Executive Function, Language/Semantic Memory, Episodic Memory, Visuospatial Abilities, Activities of Daily Living (ADL), and the Geriatric Depression Scale. MANOVA, logistic regression and chi-square tests were performed to assess the association between depression and cognitive-functional performance in each group. In the NA group, depressed participants had a lower performance compared to non-depressed participants in all cognitive and functional domains. However, the same pattern was not observed in the MCI group or in AD. The results suggest a progressive loss of association between depression and worse cognitive-functional performance along the NA-MCI-AD continuum. PMID:26858666

An innovative intervention for the treatment of cognitive impairment–Emisymmetric bilateral stimulation improves cognitive functions in Alzheimer’s disease and mild cognitive impairment: an open-label study

PubMed Central

Guerriero, Fabio; Botarelli, Emanuele; Mele, Gianni; Polo, Lorenzo; Zoncu, Daniele; Renati, Paolo; Sgarlata, Carmelo; Rollone, Marco; Ricevuti, Giovanni; Maurizi, Niccolo; Francis, Matthew; Rondanelli, Mariangela; Perna, Simone; Guido, Davide; Mannu, Piero

2015-01-01

Background and aims In the last decade, the development of different methods of brain stimulation by electromagnetic fields (EMF) provides a promising therapeutic tool for subjects with impaired cognitive functions. Emisymmetric bilateral stimulation (EBS) is a novel and innovative EMF brain stimulation, whose working principle is to introduce very weak noise-like stimuli through EMF to trigger self-arrangements in the cortex of treated subjects, thereby improving cognitive faculties. The aim of this pilot study was to investigate in patients with cognitive impairment the effectiveness of EBS treatment with respect to global cognitive function, episodic memory, and executive functions. Methods Fourteen patients with cognitive decline (six with mild cognitive impairment and eight with Alzheimer’s disease) underwent three EBS applications per week to both the cerebral cortex and auricular-specific sites for a total of 5 weeks. At baseline, after 2 weeks and 5 weeks, a neuropsychological assessment was performed through mini–mental state examination, free and cued selective reminding tests, and trail making test. As secondary outcomes, changes in behavior, functionality, and quality of life were also evaluated. Results After 5 weeks of standardized EBS therapy, significant improvements were observed in all neurocognitive assessments. Mini–mental state examination score significantly increased from baseline to end treatment (+3.19, P=0.002). Assessment of episodic memory showed an improvement both in immediate and delayed recalls (immediate recall =+7.57, P=0.003; delayed recall =+4.78, P<0.001). Executive functions significantly improved from baseline to end stimulation (trail making test A −53.35 seconds; P=0.001). Of note, behavioral disorders assessed through neuropsychiatric inventory significantly decreased (−28.78, P<0.001). The analysis concerning the Alzheimer’s disease and mild cognitive impairment group confirmed a significant improvement of cognitive functions and behavior after EBS treatment. Conclusion This pilot study has shown EBS to be a promising, effective, and safe tool to treat cognitive impairment, in addition to the drugs presently available. Further investigations and controlled clinical trials are warranted. PMID:26425094

Associations Between Ankle-Brachial Index and Cognitive Function: Results From the Lifestyle Interventions and Independence for Elders Trial.

PubMed

Espeland, Mark A; Newman, Anne B; Sink, Kaycee; Gill, Thomas M; King, Abby C; Miller, Michael E; Guralnik, Jack; Katula, Jeff; Church, Timothy; Manini, Todd; Reid, Kieran F; McDermott, Mary M

2015-08-01

The objective of this study was to evaluate cross-sectional and longitudinal associations between ankle-brachial index (ABI) and indicators of cognitive function. Randomized clinical trial (Lifestyle Interventions and Independence for Elders Trial). Eight US academic centers. A total of 1601 adults ages 70-89 years, sedentary, without dementia, and with functional limitations. Baseline ABI and interviewer- and computer-administered cognitive function assessments were obtained. These assessments were used to compare a physical activity intervention with a health education control. Cognitive function was reassessed 24 months later (interviewer-administered) and 18 or 30 months later (computer-administered) and central adjudication was used to classify individuals as having mild cognitive impairment, probable dementia, or neither. Lower ABI had a modest independent association with poorer cognitive functioning at baseline (partial r = 0.09; P < .001). Although lower baseline ABI was not associated with overall changes in cognitive function test scores, it was associated with higher odds for 2-year progression to a composite of either mild cognitive impairment or probable dementia (odds ratio 2.60 per unit lower ABI; 95% confidence interval 1.06-6.37). Across 2 years, changes in ABI were not associated with changes in cognitive function. In an older cohort sedentary individuals with dementia and with functional limitations, lower baseline ABI was independently correlated with cognitive function and associated with greater 2-year risk for progression to mild cognitive impairment or probable dementia. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Endogenous sex hormones and cognitive function in the elderly.

PubMed

Boss, Lisa; Kang, Duck-Hee; Bergstrom, Nancy; Leasure, J Leigh

2015-08-01

Estrogen and testosterone may influence cognitive function in the older adult, but the relationship between sex hormones and cognitive function is complex. To examine associations of sex hormones and cognitive function among older adults ≥65 years old. Using a cross-sectional research design, data were collected once from 71 elderly (mean age 86.4 years). Global cognitive function and executive function were measured with standardized instruments, and saliva samples were collected for salivary estradiol and testosterone. Estradiol was significantly and positively correlated with global cognitive function in men only (r = 0.54, p < 0.05). Testosterone was not significantly correlated with global cognitive function or executive function in either gender. Associations between sex hormones and cognitive function were mostly non-significant. However, higher estradiol was significantly correlated with better global cognitive function in men, suggesting gender-specific differences. Along with sex hormones, other comorbidity may need to be assessed together in relation to cognitive function in the elderly. Accordingly, clinicians play an important role in educating and promoting beneficial actions to preserve cognitive function.

Evidence-based Assessment of Cognitive Functioning in Pediatric Psychology

PubMed Central

Brown, Ronald T.; Cavanagh, Sarah E.; Vess, Sarah F.; Segall, Mathew J.

2008-01-01

Objective To review the evidence base for measures of cognitive functioning frequently used within the field of pediatric psychology. Methods From a list of 47 measures identified by the Society of Pediatric Psychology (Division 54) Evidence-Based Assessment Task Force Workgroup, 27 measures were included in the review. Measures were organized, reviewed, and evaluated according to general domains of functioning (e.g., attention/executive functioning, memory). Results Twenty-two of 27 measures reviewed demonstrated psychometric properties that met “Well-established” criteria as set forth by the Assessment Task Force. Psychometric properties were strongest for measures of general cognitive ability and weakest for measures of visual-motor functioning and attention. Conclusions We report use of “Well-established” measures of overall cognitive functioning, nonverbal intelligence, academic achievement, language, and memory and learning. For several specific tests in the domains of visual-motor functioning and attention, additional psychometric data are needed for measures to meet criteria as “Well established.” PMID:18194973

Alzheimer's Disease Assessment Scale - Cognitive Subscale (ADAS-Cog): Normative Data for the Portuguese Population.

PubMed

Nogueira, Joana; Freitas, Sandra; Duro, Diana; Tábuas-Pereira, Miguel; Guerreiro, Manuela; Almeida, Jorge; Santana, Isabel

2018-02-28

The Alzheimer's Disease Assessment Scale - Cognitive Subscale is a brief battery developed to assess cognitive functioning in Alzheimer's disease that encompasses the core characteristics of cognitive decline (e.g. memory, language, praxis, constructive ability and orientation). The early detection, as well as the monitoring of cognitive decline along disease progression, is extremely important in clinical care and interventional research. The main goals of the present study were to analyze the psychometric properties of the Portuguese version of the Alzheimer's Disease Assessment Scale - Cognitive Subscale, and to establish normative values for the Portuguese population. The Portuguese version of Alzheimer's Disease Assessment Scale - Cognitive Subscale was administered to 223 cognitively healthy participants according to a standard assessment protocol consisting of the Mini-Mental State Examination, the Montreal Cognitive Assessment and the Adults and Older Adults Functional Assessment Inventory. Normal performance on the assessment protocol was the inclusion criteria for the study. The Alzheimer's Disease Assessment Scale - Cognitive Subscale revealed good psychometric properties when used in the Portuguese population. Age was the main predictor of the Alzheimer's Disease Assessment Scale - Cognitive Subscale total score (R2 = 0.123), whereas the influence of education level was lower (R2 = 0.027). These two variables explained 14.4% of the variance on the Alzheimer's Disease Assessment Scale - Cognitive Subscale scores and were used to stratify the normative values for the Portuguese population presented here. On the total sample, the average total score in the Alzheimer's Disease Assessment Scale - Cognitive Subscale was 6 points. The normative data were determined according to age and educational level as these were the sociodemographic variables that significantly contributed to the prediction of the Alzheimer's Disease Assessment Scale - Cognitive Subscale total scores, explaining 14.4% of their variance. The normative data are of the utmost importance to ensure proper use of this battery in Portugal.

Cognitive performance of people with traumatic spinal cord injury: a cross-sectional study comparing people with subacute and chronic injuries.

PubMed

Molina, B; Segura, A; Serrano, J P; Alonso, F J; Molina, L; Pérez-Borrego, Y A; Ugarte, M I; Oliviero, A

2018-02-22

Cross-sectional study. To assess the impact of spinal cord injury (SCI) on cognitive function in individuals with subacute and chronic SCI. National Hospital for SCI patients (Spain). The present investigation was designed to determine the nature, pattern, and extent of cognitive deficits in a group of participants with subacute (n = 32) and chronic (n = 34) SCI, using a comprehensive battery of reliable and validated neuropsychological assessments to study a broad range of cognitive functions. Twenty-seven able-bodied subjects matched to the groups with SCI for age and educational level formed the control group. The neuropsychological assessment showed alterations in the domain of attention, processing speed, memory and learning, executive functions, and in recognition in participants with SCI. The prevalence of cognitive dysfunction in the chronic stage was also confirmed at the individual level. The comparison of the neuropsychological assessment between the groups with subacute and chronic SCI showed a worsening of cognitive functions in those with chronic SCI compared to the group with subacute SCI. In participants with SCI, cognitive dysfunctions are present in the subacute stage and worsen over time. From a clinical point of view, we confirmed the presence of cognitive dysfunction that may interfere with the first stage of rehabilitation which is the most intense and important. Moreover, cognitive dysfunction may be important beyond the end of the first stage of rehabilitation as it can affect an individual's quality of life and possible integration to society.

Expression of DISC1-interactome members correlates with cognitive phenotypes related to schizophrenia.

PubMed

Rampino, Antonio; Walker, Rosie May; Torrance, Helen Scott; Anderson, Susan Maguire; Fazio, Leonardo; Di Giorgio, Annabella; Taurisano, Paolo; Gelao, Barbara; Romano, Raffaella; Masellis, Rita; Ursini, Gianluca; Caforio, Grazia; Blasi, Giuseppe; Millar, J Kirsty; Porteous, David John; Thomson, Pippa Ann; Bertolino, Alessandro; Evans, Kathryn Louise

2014-01-01

Cognitive dysfunction is central to the schizophrenia phenotype. Genetic and functional studies have implicated Disrupted-in-Schizophrenia 1 (DISC1), a leading candidate gene for schizophrenia and related psychiatric conditions, in cognitive function. Altered expression of DISC1 and DISC1-interactors has been identified in schizophrenia. Dysregulated expression of DISC1-interactome genes might, therefore, contribute to schizophrenia susceptibility via disruption of molecular systems required for normal cognitive function. Here, the blood RNA expression levels of DISC1 and DISC1-interacting proteins were measured in 63 control subjects. Cognitive function was assessed using neuropsychiatric tests and functional magnetic resonance imaging was used to assess the activity of prefrontal cortical regions during the N-back working memory task, which is abnormal in schizophrenia. Pairwise correlations between gene expression levels and the relationship between gene expression levels and cognitive function and N-back-elicited brain activity were assessed. Finally, the expression levels of DISC1, AKAP9, FEZ1, NDEL1 and PCM1 were compared between 63 controls and 69 schizophrenic subjects. We found that DISC1-interactome genes showed correlated expression in the blood of healthy individuals. The expression levels of several interactome members were correlated with cognitive performance and N-back-elicited activity in the prefrontal cortex. In addition, DISC1 and NDEL1 showed decreased expression in schizophrenic subjects compared to healthy controls. Our findings highlight the importance of the coordinated expression of DISC1-interactome genes for normal cognitive function and suggest that dysregulated DISC1 and NDEL1 expression might, in part, contribute to susceptibility for schizophrenia via disruption of prefrontal cortex-dependent cognitive functions.

Expression of DISC1-Interactome Members Correlates with Cognitive Phenotypes Related to Schizophrenia

PubMed Central

Rampino, Antonio; Walker, Rosie May; Torrance, Helen Scott; Anderson, Susan Maguire; Fazio, Leonardo; Di Giorgio, Annabella; Taurisano, Paolo; Gelao, Barbara; Romano, Raffaella; Masellis, Rita; Ursini, Gianluca; Caforio, Grazia; Blasi, Giuseppe; Millar, J. Kirsty; Porteous, David John; Thomson, Pippa Ann; Bertolino, Alessandro; Evans, Kathryn Louise

2014-01-01

Cognitive dysfunction is central to the schizophrenia phenotype. Genetic and functional studies have implicated Disrupted-in-Schizophrenia 1 (DISC1), a leading candidate gene for schizophrenia and related psychiatric conditions, in cognitive function. Altered expression of DISC1 and DISC1-interactors has been identified in schizophrenia. Dysregulated expression of DISC1-interactome genes might, therefore, contribute to schizophrenia susceptibility via disruption of molecular systems required for normal cognitive function. Here, the blood RNA expression levels of DISC1 and DISC1-interacting proteins were measured in 63 control subjects. Cognitive function was assessed using neuropsychiatric tests and functional magnetic resonance imaging was used to assess the activity of prefrontal cortical regions during the N-back working memory task, which is abnormal in schizophrenia. Pairwise correlations between gene expression levels and the relationship between gene expression levels and cognitive function and N-back-elicited brain activity were assessed. Finally, the expression levels of DISC1, AKAP9, FEZ1, NDEL1 and PCM1 were compared between 63 controls and 69 schizophrenic subjects. We found that DISC1-interactome genes showed correlated expression in the blood of healthy individuals. The expression levels of several interactome members were correlated with cognitive performance and N-back-elicited activity in the prefrontal cortex. In addition, DISC1 and NDEL1 showed decreased expression in schizophrenic subjects compared to healthy controls. Our findings highlight the importance of the coordinated expression of DISC1-interactome genes for normal cognitive function and suggest that dysregulated DISC1 and NDEL1 expression might, in part, contribute to susceptibility for schizophrenia via disruption of prefrontal cortex-dependent cognitive functions. PMID:24940743

Validation analysis of informant's ratings of cognitive function in African Americans and Nigerians

PubMed Central

Shen, Jianzhao; Gao, Sujuan; Unverzagt, Frederick W.; Ogunniyi, Adesola; Baiyewu, Olusegun; Gureje, Oye; Hendrie, Hugh C.; Hall, Kathleen S.

2011-01-01

SUMMARY Objectives To examine informant validity using the Community Screening Interview for Dementia (CSI ‘D’) both cross-sectionally and longitudinally in two very different cultures and to explore the effects of informants and study participants’ characteristics on the validity of informants’ reports. Methods Elderly African Americans age 65 years and older residing in Indianapolis, USA and elderly Yoruba Nigerians age 65 years and older residing in Ibadan, Nigeria were assessed on cognitive functioning using the CSI ‘D’ at baseline (1992–1993) and five-year follow-up (1997–1998). At baseline, the informant validity in both samples was evaluated against participants’ cognitive tests using Pearson correlation and regular regression models. At follow-up, informants ratings on cognitive decline were assessed against participants’ cognitive decline scores from baseline to follow-up using biserial correlation and logistic regressions. Results At baseline, informants’ reports on cognitive functioning significantly correlated with cognitive scores in both samples (Indianapolis:r = –0.43, p < 0.001; Ibadan:r = –0.47, p < 0.001). The participant–informant relationships significantly affected the informants’ reports in the two samples with different patterns (p = 0.005 for Indianapolis and p < 0.001 for Ibadan) at a given level of cognitive functioning. African Americans spouses reported more cognitive problems, while siblings reported more problems for the Yoruba Nigerians. At follow-up, informants’ ratings on cognitive decline significantly correlated with the cognitive decline scores (Indianapolis r = 0.38, p < 0.001; Ibadan r = 0.32, p < 0.001). The characteristics of study participants and informants had little impact on the informants’ ratings on cognitive decline. Conclusions Informant reports are valid in assessing the cognitive functioning of study participants both cross-sectionally and longitudinally in two very different cultures, languages and environments. PMID:16802282

Clinical and cognitive factors affecting psychosocial functioning in remitted patients with bipolar disorder.

PubMed

Konstantakopoulos, G; Ioannidi, N; Typaldou, M; Sakkas, D; Oulis, P

2016-01-01

Impaired interpersonal, social, and occupational functioning is very often observed in patients with bipolar disorder, not only at the acute stages of the illness but in remission as well. This finding raises the question of multiple factors that might affect psychosocial functioning in bipolar patients, such as residual subsyndromal symptoms and neuropsychological deficits. Social cognition impairment, especially impaired Theory of Mind (ToM), might also play an important role in bipolar patients' every-day functioning, similarly to what was found in patients with schizophrenia. The present study aimed to investigate the potential effect of clinical and cognitive factors on the psychosocial functioning of patients with bipolar disorder during remission, assessing ToM along with a broad range of basic cognitive functions. Forty-nine patients with bipolar disorder type I in remission and 53 healthy participants were assessed in general intelligence, working memory, attention, speed processing, verbal learning and memory, and executive functions using a comprehensive battery of neuropsychological tests. The Faux Pas Recognition Test was used to assess ToM. The two groups were matched for gender, age and education level. The Hamilton Rating Scale for Depression (HDRS), the Young Mania Rating Scale (YMRS), and the Brief Psychiatric Rating Scale (BPRS) were also administered to the patients. Every-day functioning was assessed with the Global Assessment of Functioning (GAF). In order to examine the contribution of many factors in psychosocial functioning, we used hierarchical multiple regression analysis. Bipolar patients presented significant impairment compared to healthy participants in all the basic cognitive functions tested with the exception of verbal memory. Moreover, patients had significant poorer performance than healthy controls in overall psyand cognitive ToM but not in affective ToM as measured by Faux Pas. Psychosocial functioning in patient group was significantly correlated to symptom severity-especially depressive (p<0.001) and psychotic symptoms (p=0.001), history of psychotic episodes (p=0.031) and ToM, overall (p=0.001) as well as its cognitive (p=0.023) and affective (p=0.004) components. Only the contribution of ToM in psychosocial functioning remained significant in the final multiple regression model. The findings of the current study indicate that residual symptoms and cognitive dysfunctions, especially deficits in social cognition, negatively affect psychosocial functioning of remitted patients with bipolar disorder. Moreover, our results suggest that ToM may play a central role in these patients' functioning. ToM is a mediator of the relationship between other clinical or cognitive variables and functioning, while it has also significant effect on social skills independently of other factors. Therefore, specific therapeutic interventions targeting social cognitive dysfunction might improve functional outcome in bipolar disorder. Putative contribution of other clinical characteristics (comorbid personality disorders, substance abuse, anxiety) and psychosocial factors (stigma, self-stigma, lack of social network) in bipolar patients' functioning should be examined in future studies.

Cognitive functioning in dyskinetic cerebral palsy: Its relation to motor function, communication and epilepsy.

PubMed

Ballester-Plané, Júlia; Laporta-Hoyos, Olga; Macaya, Alfons; Póo, Pilar; Meléndez-Plumed, Mar; Toro-Tamargo, Esther; Gimeno, Francisca; Narberhaus, Ana; Segarra, Dolors; Pueyo, Roser

2018-01-01

Cerebral palsy (CP) is a disorder of motor function often accompanied by cognitive impairment. There is a paucity of research focused on cognition in dyskinetic CP and on the potential effect of related factors. To describe the cognitive profile in dyskinetic CP and to assess its relationship with motor function and associated impairments. Fifty-two subjects with dyskinetic CP (28 males, mean age 24 y 10 mo, SD 13 y) and 52 typically-developing controls (age- and gender-matched) completed a comprehensive neuropsychological assessment. Gross Motor Function Classification System (GMFCS), Communication Function Classification System (CFCS) and epilepsy were recorded. Cognitive performance was compared between control and CP groups, also according different levels of GMFCS. The relationship between cognition, CFCS and epilepsy was examined through partial correlation coefficients, controlling for GMFCS. Dyskinetic CP participants performed worse than controls on all cognitive functions except for verbal memory. Milder cases (GMFCS I) only showed impairment in attention, visuoperception and visual memory. Participants with GMFCS II-III also showed impairment in language-related functions. Severe cases (GMFCS IV-V) showed impairment in intelligence and all specific cognitive functions but verbal memory. CFCS was associated with performance in receptive language functions. Epilepsy was related to performance in intelligence, visuospatial abilities, visual memory, grammar comprehension and learning. Cognitive performance in dyskinetic CP varies with the different levels of motor impairment, with more cognitive functions impaired as motor severity increases. This study also demonstrates the relationship between communication and epilepsy and cognitive functioning, even controlling for the effect of motor severity. Copyright © 2017 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Association of subjective memory complaint and depressive symptoms with objective cognitive functions in prodromal Alzheimer's disease including pre-mild cognitive impairment.

PubMed

Seo, Eun Hyun; Kim, Hoowon; Choi, Kyu Yeong; Lee, Kun Ho; Choo, Il Han

2017-08-01

Subjective memory complaints (SMC) and depressive symptoms (SDS) are common in the elderly population. However, the relationship among SMC, SDS, and cognitive function remains unclear. We investigated these associations in the elderly from cognitively normal (CN), pre-mild cognitive impairment (MCI), and amnestic MCI (aMCI) groups. Participants (CN, 299; pre-MCI, 106; aMCI, 267) underwent comprehensive clinical and neuropsychological assessment. and self-report SMC and SDS questionnaires. SMC and SDS were administered in a self-report format. For each neuropsychological test z-score, stepwise multiple linear regressions were performed to assess the relative contribution of SMC, SDS, and their interactions. SMC are associated with lower objective memory, while SDS are associated with lower psychomotor speed. Interactions between SMC and SDS were significant for tests of memory, executive function, psychomotor speed, and global cognition. Additional analyses revealed that SDS moderated the SMC-cognition relationship such that only individuals with higher SDS showed significant SMC-cognition associations. Due to the cross-sectional design, associations among SMC, SDS, and cognitive function was rather weak, albeit significant. Additionally, future biomarker studies, such as those assessing amyloid burden, are needed to explore the mechanisms underlying the relationship among SMC, SDS, and cognitive function. Early identification of individuals at risk for developing abnormal cognitive changes is critical. Our findings from the study involving a large sample of carefully selected participants suggest that SMC and SDS could be used as early detection markers of Alzheimer's disease. Copyright © 2017. Published by Elsevier B.V.

Effects of digital Cognitive Behavioural Therapy for Insomnia on cognitive function: study protocol for a randomised controlled trial.

PubMed

Kyle, Simon D; Hurry, Madeleine E D; Emsley, Richard; Luik, Annemarie I; Omlin, Ximena; Spiegelhalder, Kai; Espie, Colin A; Sexton, Claire E

2017-06-17

The daytime effects of insomnia pose a significant burden to patients and drive treatment seeking. In addition to subjective deficits, meta-analytic data show that patients experience reliable objective impairments across several cognitive domains. While Cognitive Behavioural Therapy for Insomnia (CBT-I) is an effective and scalable treatment, we know little about its impact upon cognitive function. Trials of CBT-I have typically used proxy measures for cognitive functioning, such as fatigue or work performance scales, and no study has assessed self-reported impairment in cognitive function as a primary outcome. Moreover, only a small number of studies have assessed objective cognitive performance, pre-to-post CBT-I, with mixed results. This study specifically aims to (1) investigate the impact of CBT-I on cognitive functioning, assessed through both self-reported impairment and objective performance measures, and (2) examine whether change in sleep mediates this impact. We propose a randomised controlled trial of 404 community participants meeting criteria for Insomnia Disorder. In the DISCO trial (D efining the I mpact of improved S leep on CO gnitive function (DISCO)) participants will be randomised to digital automated CBT-I delivered by a web and/or mobile platform (in addition to treatment as usual (TAU)) or to a wait-list control (in addition to TAU). Online assessments will take place at 0 (baseline), 10 (post-treatment), and 24 (follow-up) weeks. At week 25, all participants allocated to the wait-list group will be offered digital CBT-I, at which point the controlled element of the trial will be complete. The primary outcome is self-reported cognitive impairment at post-treatment (10 weeks). Secondary outcomes include objective cognitive performance, insomnia severity, sleepiness, fatigue, and self-reported cognitive failures and emotional distress. All main analyses will be carried out on completion of follow-up assessments and will be based on the intention-to-treat principle. Further analyses will determine to what extent observed changes in self-reported cognitive impairment and objective cognitive performance are mediated by changes in sleep. The trial is supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC) based at Oxford University Hospitals NHS Trust and University of Oxford, and by the NIHR Oxford Health BRC. This study will be the first large-scale examination of the impact of digital CBT-I on self-reported cognitive impairment and objective cognitive performance. ISRCTN, ID: ISRCTN89237370 . Registered on 17 October 2016.

Cognitive functioning and social problem-solving skills in schizophrenia.

PubMed

Hatashita-Wong, Michi; Smith, Thomas E; Silverstein, Steven M; Hull, James W; Willson, Deborah F

2002-05-01

This study examined the relationships between symptoms, cognitive functioning, and social skill deficits in schizophrenia. Few studies have incorporated measures of cognitive functioning and symptoms in predictive models for social problem solving. For our study, 44 participants were recruited from consecutive outpatient admissions. Neuropsychological tests were given to assess cognitive function, and social problem solving was assessed using structured vignettes designed to evoke the participant's ability to generate, evaluate, and apply solutions to social problems. A sequential model-fitting method of analysis was used to incorporate social problem solving, symptom presentation, and cognitive impairment into linear regression models. Predictor variables were drawn from demographic, cognitive, and symptom domains. Because this method of analysis was exploratory and not intended as hierarchical modelling, no a priori hypotheses were proposed. Participants with higher scores on tests of cognitive flexibility were better able to generate accurate, appropriate, and relevant responses to the social problem-solving vignettes. The results suggest that cognitive flexibility is a potentially important mediating factor in social problem-solving competence. While other factors are related to social problem-solving skill, this study supports the importance of cognition and understanding how it relates to the complex and multifaceted nature of social functioning.

Trace Element Levels and Cognitive Function in Rural Elderly Chinese

PubMed Central

Gao, Sujuan; Jin, Yinlong; Unverzagt, Frederick W.; Ma, Feng; Hall, Kathleen S.; Murrell, Jill R.; Cheng, Yibin; Shen, Jianzhao; Ying, Bo; Ji, Rongdi; Matesan, Janetta; Liang, Chaoke; Hendrie, Hugh C.

2009-01-01

Background Trace elements are involved in metabolic processes and oxidation-reduction reactions in the central nervous system and could have a possible effect on cognitive function. The relationship between trace elements measured in individual biological samples and cognitive function in an elderly population had not been investigated extensively. Methods The participant population is part of a large cohort study of 2000 rural elderly Chinese persons. Six cognitive assessment tests were used to evaluate cognitive function in this population, and a composite score was created to represent global cognitive function. Trace element levels of aluminum, calcium, cadmium, copper, iron, lead, and zinc were analyzed in plasma samples of 188 individuals who were randomly selected and consented to donating fasting blood. Analysis of covariance models were used to assess the association between each trace element and the composite cognitive score adjusting for demographics, medical history of chronic diseases, and the apolipoprotein E (APOE) genotype. Results Three trace elements—calcium, cadmium, and copper—were found to be significantly related to the composite cognitive score. Increasing plasma calcium level was associated with higher cognitive score (p < .0001). Increasing cadmium and copper, in contrast, were significantly associated with lower composite score (p = .0044 and p = .0121, respectively). Other trace elements did not show significant association with the composite cognitive score. Conclusions Our results suggest that calcium, cadmium, and copper may be associated with cognitive function in the elderly population. PMID:18559640

Trace element levels and cognitive function in rural elderly Chinese.

PubMed

Gao, Sujuan; Jin, Yinlong; Unverzagt, Frederick W; Ma, Feng; Hall, Kathleen S; Murrell, Jill R; Cheng, Yibin; Shen, Jianzhao; Ying, Bo; Ji, Rongdi; Matesan, Janetta; Liang, Chaoke; Hendrie, Hugh C

2008-06-01

Trace elements are involved in metabolic processes and oxidation-reduction reactions in the central nervous system and could have a possible effect on cognitive function. The relationship between trace elements measured in individual biological samples and cognitive function in an elderly population had not been investigated extensively. The participant population is part of a large cohort study of 2000 rural elderly Chinese persons. Six cognitive assessment tests were used to evaluate cognitive function in this population, and a composite score was created to represent global cognitive function. Trace element levels of aluminum, calcium, cadmium, copper, iron, lead, and zinc were analyzed in plasma samples of 188 individuals who were randomly selected and consented to donating fasting blood. Analysis of covariance models were used to assess the association between each trace element and the composite cognitive score adjusting for demographics, medical history of chronic diseases, and the apolipoprotein E (APOE) genotype. Three trace elements-calcium, cadmium, and copper-were found to be significantly related to the composite cognitive score. Increasing plasma calcium level was associated with higher cognitive score (p <.0001). Increasing cadmium and copper, in contrast, were significantly associated with lower composite score (p =.0044 and p =.0121, respectively). Other trace elements did not show significant association with the composite cognitive score. Our results suggest that calcium, cadmium, and copper may be associated with cognitive function in the elderly population.

Decreasing self-reported cognitive biases and increasing clinical insight through meta-cognitive training in patients with chronic schizophrenia.

PubMed

Gawęda, Łukasz; Krężołek, Martyna; Olbryś, Joanna; Turska, Agnieszka; Kokoszka, Andrzej

2015-09-01

The aim of this study was to assess the impact of meta-cognitive training (MCT) on cognitive biases, symptoms, clinical insight, and general functioning among low-level functioning persons diagnosed with chronic schizophrenia who were attending a daily Community Social Support Group Program; we compared the treatment-as-usual (TAU) condition with the MCT + TAU condition. Forty-four patients diagnosed with chronic schizophrenia were allocated to either the MCT + treatment-as-usual condition or the treatment-as-usual (TAU) condition. Delusion and hallucination severity, cognitive biases, clinical insight, and global functioning were assessed pre- and post-treatment (clinical trial NCT02187692). No significant changes were found in symptom severity as measured with the PSYRATS. Conversely, a medium to large effect size was observed for delusional ideation changes when assessed by the self-report measure (Paranoia Checklist). MCT was found to ameliorate cognitive biases as measured by the self-report scale at large effect size, however, no changes in jumping to conclusions (the Fish Task) and theory of mind deficits ("Reading the Mind in the Eyes" Test) were found in the behavioral tasks. MCT increased insight at large effect size. No changes in global functioning were found between the two conditions. Low intensity intervention. No follow-up assessment was provided. Only PSYRATS was assessed blind to patient allocation. MCT has a beneficial effect on low-functioning chronic schizophrenic patients in ameliorating cognitive biases and increasing clinical insight. Copyright © 2015 Elsevier Ltd. All rights reserved.

Influence of Aerobic Training and Combinations of Interventions on Cognition and Neuroplasticity after Stroke

PubMed Central

Constans, Annabelle; Pin-barre, Caroline; Temprado, Jean-Jacques; Decherchi, Patrick; Laurin, Jérôme

2016-01-01

Stroke often aggravated age-related cognitive impairments that strongly affect several aspects of quality of life. However, few studies are, to date, focused on rehabilitation strategies that could improve cognition. Among possible interventions, aerobic training is well known to enhance cardiovascular and motor functions but may also induce beneficial effects on cognitive functions. To assess the effectiveness of aerobic training on cognition, it seems necessary to know whether training promotes the neuroplasticity in brain areas involved in cognitive functions. In the present review, we first explore in both human and animal how aerobic training could improve cognition after stroke by highlighting the neuroplasticity mechanisms. Then, we address the potential effect of combinations between aerobic training with other interventions, including resistance exercises and pharmacological treatments. In addition, we postulate that classic recommendations for aerobic training need to be reconsidered to target both cognition and motor recovery because the current guidelines are only focused on cardiovascular and motor recovery. Finally, methodological limitations of training programs and cognitive function assessment are also developed in this review to clarify their effectiveness in stroke patients. PMID:27445801

Mental exercising through simple socializing: social interaction promotes general cognitive functioning.

PubMed

Ybarra, Oscar; Burnstein, Eugene; Winkielman, Piotr; Keller, Matthew C; Manis, Melvin; Chan, Emily; Rodriguez, Joel

2008-02-01

Social interaction is a central feature of people's life and engages a variety of cognitive resources. Thus, social interaction should facilitate general cognitive functioning. Previous studies suggest such a link, but they used special populations (e.g., elderly with cognitive impairment), measured social interaction indirectly (e.g., via marital status), and only assessed effects of extended interaction in correlational designs. Here the relation between mental functioning and direct indicators of social interaction was examined in a younger and healthier population. Study 1 using survey methodology found a positive relationship between social interaction, assessed via amount of actual social contact, and cognitive functioning in people from three age groups including younger adults. Study 2 using an experimental design found that a small amount of social interaction (10 min) can facilitate cognitive performance. The findings are discussed in the context of the benefits social relationships have for so many aspects of people's lives.

The association between atrial fibrillation and cognitive function in patients with heart failure.

PubMed

Yang, Huifeng; Niu, Weihua; Zang, Xiaoying; Lin, Mei; Zhao, Yue

2017-02-01

Atrial fibrillation (AF) is associated with cognitive impairment in heart failure (HF). The purpose of this study was to examine whether AF independently predicted cognitive function in HF patients after controlling for more demographic, medical and psychological characteristics, and whether the timing of AF onset in relation to HF diagnosis independently contributed to cognitive function in HF patients with AF. A total of 188 hospitalized HF patients (62.8% male, age 66.3±10.6 years) completed cognitive function assessment with the Montreal Cognitive Assessment (MoCA). A history of AF, along with other medical characteristics, was ascertained through a review of participants' medical charts. The timing of AF onset in relation to HF diagnosis was categorized into AF occurring prior to HF diagnosis (i.e. prior AF) and AF developing after HF diagnosis (i.e. incident AF). Altogether 72 participants had a positive diagnostic history of AF. Specifically, 41 had prior AF, and 31 developed AF subsequently. In HF patients, AF was associated with poorer performance on cognitive function after controlling for more confounders (β=-0.112, ΔR 2 =0.010, p=0.046). Among HF patients with AF, incident AF independently predicted poorer cognitive function (β=-0.238, ΔR 2 =0.027, p=0.047). AF independently contributes to cognitive function in HF patients after adjusting for more confounding variables. The timing of AF onset in relation to HF diagnosis independently predicts cognitive function in HF patients with AF. Prospective studies are needed to elucidate possible mechanisms for the association between AF and cognitive function in HF populations.

PARANOID INDIVIDUALS WITH SCHIZOPHRENIA SHOW GREATER SOCIAL COGNITIVE BIAS AND WORSE SOCIAL FUNCTIONING THAN NON-PARANOID INDIVIDUALS WITH SCHIZOPHRENIA.

PubMed

Pinkham, Amy E; Harvey, Philip D; Penn, David L

2016-03-01

Paranoia is a common symptom of schizophrenia that may be related to how individuals process and respond to social stimuli. Previous investigations support a link between increased paranoia and greater social cognitive impairments, but these studies have been limited to single domains of social cognition, and no studies have examined how paranoia may influence functional outcome. Data from 147 individuals with schizophrenia were used to examine whether actively paranoid and non-paranoid individuals with schizophrenia differ in social cognition and functional outcomes. On measures assessing social cognitive bias, paranoid individuals endorsed more hostile and blaming attributions and identified more faces as untrustworthy; however, paranoid and non-paranoid individuals did not differ on emotion recognition and theory of mind tasks assessing social cognitive ability. Likewise, paranoid individuals showed greater impairments in real-world interpersonal relationships and social acceptability as compared to non-paranoid patients, but these differences did not extend to performance based tasks assessing functional capacity and social competence. These findings isolate specific social cognitive disparities between paranoid and non-paranoid subgroups and suggest that paranoia may exacerbate the social dysfunction that is commonly experienced by individuals with schizophrenia.

Cardiac function and cognition in older community-dwelling cardiac patients.

PubMed

Eggermont, Laura H P; Aly, Mohamed F A; Vuijk, Pieter J; de Boer, Karin; Kamp, Otto; van Rossum, Albert C; Scherder, Erik J A

2017-11-01

Cognitive deficits have been reported in older cardiac patients. An underlying mechanism for these findings may be reduced cardiac function. The relationship between cardiac function as represented by different echocardiographic measures and different cognitive function domains in older cardiac patients remains unknown. An older (≥70 years) heterogeneous group of 117 community-dwelling cardiac patients under medical supervision by a cardiologist underwent thorough echocardiographic assessment including left ventricular ejection fraction, cardiac index, left atrial volume index, left ventricular mass index, left ventricular diastolic function, and valvular calcification. During a home visit, a neuropsychological assessment was performed within 7.1 ± 3.8 months after echocardiographic assessment; the neuropsychological assessment included three subtests of a word-learning test (encoding, recall, recognition) to examine one memory function domain and three executive function tests, including digit span backwards, Trail Making Test B minus A, and the Stroop colour-word test. Regression analyses showed no significant linear or quadratic associations between any of the echocardiographic functions and the cognitive function measures. None of the echocardiographic measures as representative of cardiac function was correlated with memory or executive function in this group of community-dwelling older cardiac patients. These findings contrast with those of previous studies. © 2017 Japanese Psychogeriatric Society.

Assessing Mild Cognitive Impairment among Older African Americans

PubMed Central

Gamaldo, Alyssa A.; Allaire, Jason C.; Sims, Regina C.; Whitfield, Keith E.

2009-01-01

OBJECTIVES To examine the frequency of MCI in African American older adults. The study also plans to explore the specific cognitive domains of impairment as well as whether there are differences in demographics, health, and cognitive performance between MCI and normal participants. DESIGN Cross-sectional. SETTING Independent-living sample of urban dwelling elders in Baltimore, Maryland. PARTICIPANTS The sample consisted of 554 subjects ranging in age from 50 to 95 (mean = 68.79 ± 9.60). MEASUREMENTS Socio-demographics and health were assessed. Several cognitive measures were administered to assess inductive reasoning, declarative memory, perceptual speed, working memory, executive functioning, language, global cognitive functioning. RESULTS Approximately 22% of participants were considered MCI (i.e. 18% non-amnestic vs. 4% amnestic). A majority of the non-amnestic MCI participants had impairment in one cognitive domain, particularly language and executive function. Individuals classified as non-amnestic MCI were significantly older and had more years of education than normal individuals. The MCI groups were not significantly different than cognitively normal individuals on health factors. Individuals classified as MCI performed significantly worse on global cognitive measures as well as across specific cognitive domains than cognitively normal individuals. CONCLUSION This study demonstrates that impairment in a non-memory domain may be an early indicator of cognitive impairment, particularly among African Americans. PMID:20069588

Cognitive impairment among prostate cancer patients: An overview of reviews.

PubMed

Treanor, C J; Li, J; Donnelly, M

2017-11-01

To identify and clarify definitions and methods of measuring cancer-related cognitive impairment among prostate cancer patients treated with androgen deprivation therapy (ADT) and to assess the incidence and prevalence of cognitive impairment. A systematic review of Medline, EMBASE, PubMed, PsycINFO and CINAHL up to December 2015 was undertaken to identify English-language reviews. A total of 28 reviews were identified describing 20 primary studies. There were no studies of incidence. Reported prevalence rates varied between 10% and 69%. Cognitive domains impaired by ADT included: verbal memory, visuospatial ability and executive functions. Cognitive impairment was infrequently defined and four definitions were reported. A variety of measures and methods were used to assess cognitive function including neuropsychological tests, self-report measures and clinical assessments. The finding that, often, one measure was used to assess more than one aspect of cognition is likely to have contributed to imprecise estimates. There is a need to agree a definition of cognitive impairment in the clinical epidemiology of cancer and to standardise the selection of measures in order to aid accurate assessment and fair comparisons across studies regarding the prevalence of cognitive impairment among prostate cancer patients. © 2017 John Wiley & Sons Ltd.

The joint association of depression and cognitive function with severe disability among community-dwelling older adults in Finland, Poland and Spain.

PubMed

Olaya, Beatriz; Moneta, Maria Victoria; Koyanagi, Ai; Lara, Elvira; Miret, Marta; Ayuso-Mateos, José Luis; Chatterji, Somnath; Leonardi, Matilde; Koskinen, Seppo; Tobiasz-Adamczyk, Beata; Lobo, Antonio; Haro, Josep Maria

2016-04-01

To explore the joint association of depression and cognitive function with severe disability in nationally-representative samples of community-dwelling adults aged 50 years and older from Finland, Poland and Spain. Cross-sectional. Community-based. Population-based sample of 7987 non-institutionalized adults aged 50 and older. The outcome was severe disability, defined as ≥ 90th percentile of the 12-item version of the World Health Organization Disability Assessment Schedule (WHODAS 2.0). Past 12-month DSM-IV major depressive disorder was assessed with the depression module of the WHO Composite International Diagnostic Interview (CIDI). A global cognitive function score was obtained through neuropsychological tests. Product terms between depression and cognition were introduced in multivariable logistic regression models to test for interaction. Lower cognitive function and depression were both significantly associated with severe disability in all countries. A significant interaction was only found in Finland where the ORs (95% CIs) of depression for severe disability at the 25th (worse), 50th, and 75th (better) percentiles of cognitive function were 7.26 (4.28-12.32), 11.1 (6.7-18.38), and 17.56 (9.29-33.2), respectively. People with depression and cognitive decline are likely to benefit from the usual evidence-based treatments to reduce the burden of disability. However, in Finland, those with better cognitive function may benefit from more aggressive depression treatment. Future research is warranted to assess whether our results may be replicated.

Validation of the Persian version of the Schizophrenia Cognition Rating Scale (SCoRS) in patients with schizophrenia.

PubMed

Mazhari, Shahrzad; Ghafaree-Nejad, Ali R; Soleymani-Zade, Somayeh; Keefe, Richard S E

2017-06-01

The Schizophrenia Cognition Rating Scale (SCoRS) is an interview-based assessment of cognition that involves interviews with patients and informants. The SCoRS has shown good reliability, validity, and sensitivity to cognitive impairment in schizophrenia, with the advantage of brief administration and scoring time. The present study aimed to test the concurrent validity of the Persian version of the SCoRS. A group of 35 patients with schizophrenia and a group of 35 healthy controls received the Persian-SCoRS in the first session, and a standardized performance-based cognitive battery, the Brief Assessment of Cognition in Schizophrenia (BACS), in the second session.Our results indicated that the Persian version of the SCoRS was sensitive to cognitive impairment in the patients. The Persian SCoRS global rating was significantly associated with the composite score generated from the Persian version of the BACS and predicted functional outcomes as measured by Global Assessment of Functioning (GAF) and World Health Organization Quality of Life (WHO QOL). A Persian version of the SCoRS, an interview based measure of cognition that included informants, is related to cognitive performance and global functioning. Copyright © 2017 Elsevier B.V. All rights reserved.

Criteria for validation and selection of cognitive tests for investigating the effects of foods and nutrients.

PubMed

de Jager, Celeste A; Dye, Louise; de Bruin, Eveline A; Butler, Laurie; Fletcher, John; Lamport, Daniel J; Latulippe, Marie E; Spencer, Jeremy P E; Wesnes, Keith

2014-03-01

This review is an output of the International Life Sciences Institute (ILSI) Europe Marker Initiative, which aims to identify evidence-based criteria for selecting adequate measures of nutrient effects on health through comprehensive literature review. Experts in cognitive and nutrition sciences examined the applicability of these proposed criteria to the field of cognition with respect to the various cognitive domains usually assessed to reflect brain or neurological function. This review covers cognitive domains important in the assessment of neuronal integrity and function, commonly used tests and their state of validation, and the application of the measures to studies of nutrition and nutritional intervention trials. The aim is to identify domain-specific cognitive tests that are sensitive to nutrient interventions and from which guidance can be provided to aid the application of selection criteria for choosing the most suitable tests for proposed nutritional intervention studies using cognitive outcomes. The material in this review serves as a background and guidance document for nutritionists, neuropsychologists, psychiatrists, and neurologists interested in assessing mental health in terms of cognitive test performance and for scientists intending to test the effects of food or food components on cognitive function.

Metabolic Syndrome and 16-year Cognitive Decline in Community-Dwelling Older Adults

PubMed Central

McEvoy, Linda K.; Laughlin, Gail A.; Barrett-Connor, Elizabeth; Bergstrom, Jaclyn; Kritz-Silverstein, Donna; Der-Martirosian, Claudia; von Mühlen, Denise

2012-01-01

PURPOSE To determine whether metabolic syndrome is associated with accelerated cognitive decline in community-dwelling older adults. METHODS Longitudinal study of 993 adults (mean 66.8 ± 8.7 years) from the Rancho Bernardo Study. Metabolic syndrome components, defined by 2001 NCEP-ATP III criteria, were measured in 1984–87. Cognitive function was first assessed in 1988–92. Cognitive assessments were repeated approximately every four years, for a maximum 16-year follow-up. Mixed-effects models examined longitudinal rate of cognitive decline by metabolic syndrome status, controlling for factors plausibly associated with cognitive function (diabetes, inflammation). RESULTS Metabolic syndrome was more common in men than women (14% vs. 9%, p=0.01). In women, metabolic syndrome was associated with greater executive function and long term memory decline. These associations did not differ by inflammatory biomarker levels. Diabetes did not alter the association of metabolic syndrome with long-term recall but modified the association with executive function: metabolic syndrome was associated with accelerated executive function decline in diabetic women only. Metabolic syndrome was not related to rate of decline on any cognitive measure in men. CONCLUSIONS Metabolic syndrome was a risk factor for accelerated cognitive decline, but only in women. Prevention of metabolic syndrome may aid in maintenance of cognitive function with age. PMID:22285865

Spiritual activity is associated with better cognitive function in old age.

PubMed

Fung, A W T; Lam, L C W

2013-09-01

This cross-sectional study aimed to explore the association between late-life spiritual activity participation and cognitive function in older Chinese adults in Hong Kong. Participants aged 60 years or older without clinical dementia or major psychiatric disorders were recruited. Dementia severity and global cognitive function were assessed using the Clinical Dementia Rating and Cantonese version of the Mini-Mental State Examination, respectively. Cognitive performance was measured using 10-minute delayed recall, the Category Verbal Fluency Test, Visual Aural Digit Span Test, and Modified Card Sorting Test. Psychological status was assessed using the Chinese version of the Purpose in Life scale. Activities participated in were categorised into 6 domains of physical, cognitive, social, prosocial, spiritual, and recreational activities. A total of 380 participants were enrolled. Bivariate correlation showed that the composite score of cognitive function was positively correlated with aerobic exercise (r = 0.14; p = 0.01), cognitive activity (r = 0.30; p < 0.001), and spiritual activity (r = 0.16; p = 0.002). Multiple linear regression suggested that frequent participation in cognitive activity (B = 0.87, beta = 0.22; 95% confidence interval [CI] = 0.52-1.25 and p < 0.001) and spiritual activity (B = 0.45, beta = 0.11; 95% CI = 0.13-0.76 and p = 0.01) were associated with better cognitive function after controlling for age and years of education. Engagement in spiritual activity may benefit cognitive function in old age. Longitudinal studies are recommended to further examine the causal relationship of spiritual activity and cognitive function.

Emotional and cognitive social processes are impaired in Parkinson's disease and are related to behavioral disorders.

PubMed

Narme, Pauline; Mouras, Harold; Roussel, Martine; Duru, Cécile; Krystkowiak, Pierre; Godefroy, Olivier

2013-03-01

Parkinson's disease (PD) is associated with behavioral disorders that can affect social functioning but are poorly understood. Since emotional and cognitive social processes are known to be crucial in social relationships, impairment of these processes may account for the emergence of behavioral disorders. We used a systematic battery of tests to assess emotional processes and social cognition in PD patients and relate our findings to conventional neuropsychological data (especially behavioral disorders). Twenty-three PD patients and 46 controls (matched for age and educational level) were included in the study and underwent neuropsychological testing, including an assessment of the behavioral and cognitive components of executive function. Emotional and cognitive social processes were assessed with the Interpersonal Reactivity Index caregiver-administered questionnaire (as a measure of empathy), a facial emotion recognition task and two theory of mind (ToM) tasks. When compared with controls, PD patients showed low levels of empathy (p = .006), impaired facial emotion recognition (which persisted after correction for perceptual abilities) (p = .001), poor performance in a second-order ToM task (p = .008) that assessed both cognitive (p = .004) and affective (p = .03) inferences and, lastly, frequent dysexecutive behavioral disorders (in over 40% of the patients). Overall, impaired emotional and cognitive social functioning was observed in 17% of patients and was related to certain cognitive dysexecutive disorders. In terms of behavioral dysexecutive disorders, social behavior disorders were related to impaired emotional and cognitive social functioning (p = .04) but were independent of cognitive impairments. Emotional and cognitive social processes were found to be impaired in Parkinson's disease. This impairment may account for the emergence of social behavioral disorders. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Determination of the relationship between cognitive function and hand dexterity in patients with chronic obstructive pulmonary disease (COPD): a cross-sectional study.

PubMed

Soysal Tomruk, Melda; Ozalevli, Sevgi; Dizdar, Gorkem; Narin, Selnur; Kilinc, Oguz

2015-07-01

Hand dexterity is important for daily living activities and can be related to cognitive functions in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to investigate the relationship between cognitive dysfunction and hand dexterity in patients with COPD. 35 COPD patients and 36 healthy individuals were assessed. The Minnesota Hand Dexterity Test and Mini Mental State Examination (MMSE) were used for assessment of cognitive function and hand dexterity. Hand dexterity test scores and cognitive function of COPD patients' were significantly lower than the healthy group (p < 0.01). The MMSE scores were negatively correlated with hand dexterity scores in the COPD group (p < 0.05). There was a relationship between cognitive function and hand dexterity in the patients with COPD; however, hand dexterity did not alter according to hypoxemia severity. Hand dexterity which is important in daily living activities should be evaluated in greater detail with further studies in COPD patients.

Social isolation and cognitive function in Appalachian older adults.

PubMed

DiNapoli, Elizabeth A; Wu, Bei; Scogin, Forrest

2014-03-01

Investigating the relation between social isolation and cognitive function will allow us to identify components to incorporate into cognitive interventions. Data were collected from 267 Appalachian older adults (M = 78.5, range 70-94 years). Overall cognitive functioning and specific cognitive domains were assessed from data of a self-assembled neuropsychological battery of frequently used tasks. Social isolation, social disconnectedness, and perceived isolation were measured from the Lubben Social Network scale-6. Results indicated a significant positive association between all predictor variables (e.g., social isolation, social disconnectedness, and perceived isolation) and outcome variables (e.g., overall cognitive function, memory, executive functioning, attention, and language abilities). Perceived isolation accounted for nearly double the amount of variance in overall cognitive functioning than social disconnectedness (10.2% vs. 5.7%). Findings suggest that social isolation is associated with poorer overall cognitive functioning and this remains true across varied cognitive domains. © The Author(s) 2012.

Clinical assessment of social cognitive function in neurological disorders.

PubMed

Henry, Julie D; von Hippel, William; Molenberghs, Pascal; Lee, Teresa; Sachdev, Perminder S

2016-01-01

Social cognition broadly refers to the processing of social information in the brain that underlies abilities such as the detection of others' emotions and responding appropriately to these emotions. Social cognitive skills are critical for successful communication and, consequently, mental health and wellbeing. Disturbances of social cognition are early and salient features of many neuropsychiatric, neurodevelopmental and neurodegenerative disorders, and often occur after acute brain injury. Its assessment in the clinic is, therefore, of paramount importance. Indeed, the most recent edition of the American Psychiatric Association's Diagnostic and Statistical Manual for Mental Disorders (DSM-5) introduced social cognition as one of six core components of neurocognitive function, alongside memory and executive control. Failures of social cognition most often present as poor theory of mind, reduced affective empathy, impaired social perception or abnormal social behaviour. Standard neuropsychological assessments lack the precision and sensitivity needed to adequately inform treatment of these failures. In this Review, we present appropriate methods of assessment for each of the four domains, using an example disorder to illustrate the value of these approaches. We discuss the clinical applications of testing for social cognitive function, and finally suggest a five-step algorithm for the evaluation and treatment of impairments, providing quantitative evidence to guide the selection of social cognitive measures in clinical practice.

Cognitive Impairment after Severe Traumatic Brain Injury, Clinical Course and Impact on Outcome: A Swedish-Icelandic Study

PubMed Central

Stenberg, Maud; Godbolt, Alison K.; Nygren De Boussard, Catharina; Levi, Richard; Stålnacke, Britt-Marie

2015-01-01

Objective. To assess the clinical course of cognitive and emotional impairments in patients with severe TBI (sTBI) from 3 weeks to 1 year after trauma and to study associations with outcomes at 1 year. Methods. Prospective, multicenter, observational study of sTBI in Sweden and Iceland. Patients aged 18–65 years with acute Glasgow Coma Scale 3–8 were assessed with the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) and the Hospital Anxiety and Depression Scale (HADS). Outcome measures were Glasgow Outcome Scale Extended (GOSE) and Rancho Los Amigos Cognitive Scale-Revised (RLAS-R). Results. Cognition was assessed with the BNIS assessed for 42 patients out of 100 at 3 weeks, 75 patients at 3 months, and 78 patients at 1 year. Cognition improved over time, especially from 3 weeks to 3 months. The BNIS subscales “orientation” and “visuospatial and visual problem solving” were associated with the GOSE and RLAS-R at 1 year. Conclusion. Cognition seemed to improve over time after sTBI and appeared to be rather stable from 3 months to 1 year. Since cognitive function was associated with outcomes, these results indicate that early screening of cognitive function could be of importance for rehabilitation planning in a clinical setting. PMID:26783381

Significantly improved neurocognitive function in major depressive disorders 6 weeks after ECT.

PubMed

Mohn, Christine; Rund, Bjørn Rishovd

2016-09-15

Cognitive side effects may occur after electroconvulsive treatment (ECT) in depressive disorder patients. Previous studies have been limited by small numbers of cognitive functions assessed. The present study reports the first results from a prospective project monitoring cognitive effects of ECT using a comprehensive neuropsychological test battery and subjective report of everyday cognitive function. Thirty-one patients with major depressive disorder were assessed with the MATRICS Consensus Cognitive Battery (MCCB). Subjective cognitive complaints were described with the Everyday Memory Questionnaire (EMQ). Severity of depression symptoms were assessed with the Montgomery-Åsberg Depression Rating Scale (MADRS). These assessments were performed prior to and 6 weeks after non-standardized ECT. Compared to baseline, the mean depression severity level was nearly halved and there were significant improvements in mean levels of Speed of Processing, Attention/Vigilance, and Visual Learning 6 weeks after ECT. The other cognitive domains were not altered from baseline. There was no significant change in subjective cognitive complaints. At baseline, there were several significant correlations between the MADRS and MCCB scores. There was no strong association between the EMQ and MCCB scores at either assessment point, but the post-ECT EMQ score was significantly correlated with depression severity. Major limitations were low N and lack of uniform ECT procedure. There was significant improvement in Speed of Processing, Attention/Vigilance, and Visual Learning 6 weeks after ECT. Cognitive tests scores were related to severity of depression, but not to subjective memory complaints. Copyright © 2016 Elsevier B.V. All rights reserved.

Cognitive functioning over 2 years after intracerebral hemorrhage in school-aged children.

PubMed

Murphy, Lexa K; Compas, Bruce E; Gindville, Melissa C; Reeslund, Kristen L; Jordan, Lori C

2017-11-01

Previous research investigating outcomes after pediatric intracerebral hemorrhage (ICH) has generally been limited to global and sensorimotor outcomes. This study examined cognitive outcomes after spontaneous ICH in school-aged children with serial assessments over 2 years after stroke. Seven children (age range 6-16y, median 13; six males, one female; 57% white, 43% black) presenting with spontaneous ICH (six arteriovenous malformations) were assessed at 3 months, 12 months, and 24 months after stroke. The Pediatric Stroke Outcome Measure (PSOM) quantified neurological outcome and Wechsler Intelligence Scales measured cognitive outcomes: verbal comprehension, perceptual reasoning, working memory, and processing speed. PSOM scales showed improved neurological function over the first 12 months, with mild to no sensorimotor deficits and moderate overall deficits at 1- and 2-year follow-ups (median 2-year sensorimotor PSOM=0.5, total PSOM=1.5). Changes in cognitive function indicated a different trajectory; verbal comprehension and perceptual reasoning improved over 24 months; low performance was sustained in processing speed and working memory. Age-normed centile scores decreased between 1- and 2-year follow-ups for working memory, suggesting emerging deficits compared with peers. Early and serial cognitive testing in children with ICH is needed to assess cognitive functioning and support children in school as they age and cognitive deficits become more apparent and important for function. In children with intracerebral hemorrhage (ICH), motor function improved between 3 months and 24 months. Improvements in cognitive function were variable between 3 months and 24 months. Working memory centiles declined, suggesting emerging deficits compared with peers. Processing speed improved but remained significantly below the 50th centile. Cognitive impact of ICH may increase with age in children. © 2017 Mac Keith Press.

Predictors of Optimal Cognitive Aging in 80+ Women: The Women's Health Initiative Memory Study.

PubMed

Goveas, Joseph S; Rapp, Stephen R; Hogan, Patricia E; Driscoll, Ira; Tindle, Hilary A; Smith, J Carson; Kesler, Shelli R; Zaslavsky, Oleg; Rossom, Rebecca C; Ockene, Judith K; Yaffe, Kristine; Manson, JoAnn E; Resnick, Susan M; Espeland, Mark A

2016-03-01

Independent predictors of preserved cognitive functioning and factors associated with maintaining high preserved cognitive function in women ≥ 80 years remain elusive. Two thousand two hundred twenty-eight women with a mean age of 85 years who participated in the Women's Health Initiative Memory Study were classified as cognitively normal (n = 1,905, 85.5%), mild cognitive impairment (n = 88, 3.9%), dementia (n = 121, 5.4%) or other cognitive impairment (n = 114, n = 5.1%) by central adjudication. Global cognitive functioning was assessed using telephone interview for cognitive status-modified in those women who did not meet cognitive impairment criteria. Differences between women grouped by cognitive status with respect to each potential risk factor were assessed using chi-squared tests and t-tests. Backward stepwise logistic regression was used to select factors that were independently associated with cognitive status. Factors associated with preserved cognitive functioning were younger age, higher education, and family incomes, being non-Hispanic white, better emotional wellbeing, fewer depressive symptoms, more insomnia complaints, being free of diabetes, and not carrying the apolipoprotein E-epsilon 4 allele. Cognitively normal women who demonstrated sustained high preserved cognition were younger, more educated, and endorsed better self-reported general health, emotional wellbeing, and higher physical functioning. Addressing sociodemographic disparities such as income inequality, and targeting interventions to improve depressive symptoms and vascular risk factors, including diabetes, may play an important role in preserving cognition among women who survive to 80 years of age. Person-centered approaches that combine interventions to improve physical, cognitive, and psychosocial functioning may promote maintenance of high preserved cognitive health in the oldest-old. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Predictors of Optimal Cognitive Aging in 80+ Women: The Women’s Health Initiative Memory Study

PubMed Central

Rapp, Stephen R.; Hogan, Patricia E.; Driscoll, Ira; Tindle, Hilary A.; Smith, J. Carson; Kesler, Shelli R.; Zaslavsky, Oleg; Rossom, Rebecca C.; Ockene, Judith K.; Yaffe, Kristine; Manson, JoAnn E.; Resnick, Susan M.; Espeland, Mark A.

2016-01-01

Background. Independent predictors of preserved cognitive functioning and factors associated with maintaining high preserved cognitive function in women ≥80 years remain elusive. Methods. Two thousand two hundred twenty-eight women with a mean age of 85 years who participated in the Women’s Health Initiative Memory Study were classified as cognitively normal (n = 1,905, 85.5%), mild cognitive impairment (n = 88, 3.9%), dementia (n = 121, 5.4%) or other cognitive impairment (n = 114, n = 5.1%) by central adjudication. Global cognitive functioning was assessed using telephone interview for cognitive status-modified in those women who did not meet cognitive impairment criteria. Differences between women grouped by cognitive status with respect to each potential risk factor were assessed using chi-squared tests and t-tests. Backward stepwise logistic regression was used to select factors that were independently associated with cognitive status. Results. Factors associated with preserved cognitive functioning were younger age, higher education, and family incomes, being non-Hispanic white, better emotional wellbeing, fewer depressive symptoms, more insomnia complaints, being free of diabetes, and not carrying the apolipoprotein E-epsilon 4 allele. Cognitively normal women who demonstrated sustained high preserved cognition were younger, more educated, and endorsed better self-reported general health, emotional wellbeing, and higher physical functioning. Conclusions. Addressing sociodemographic disparities such as income inequality, and targeting interventions to improve depressive symptoms and vascular risk factors, including diabetes, may play an important role in preserving cognition among women who survive to 80 years of age. Person-centered approaches that combine interventions to improve physical, cognitive, and psychosocial functioning may promote maintenance of high preserved cognitive health in the oldest-old. PMID:26858326

[Effectiveness of a cognitive-motorphysiotherapeutical therapy intervention in institutionalized older adults with mild cognitive impairment and mild dementia].

PubMed

Menezes, Alessandra Vieira; Aguiar, Alessandra da Silva de; Alves, Elysama Fernandes; Quadros, Layse Biz de; Bezerra, Poliana Penasso

2016-11-01

The aim of this study was to investigate the effectiveness of four months of cognitive-motor physiotherapy intervention, with a single weekly visit, on cognitive function, mobility and functional independence of institutionalized elderly individuals with mild cognitive impairment and mild dementia. In a controlled clinical trial, 15 subjects were allocated to experimental and control groups. Regarding the assessment of the subjects the following instruments were applied: Mini-Mental State Examination, Clinical Dementia Rating Scale, Verbal Fluency Test and Frontal Assessment Battery for analyzing cognitive functions; Berg Balance Scale and Timed Up and Go Test to verify mobility, and; Barthel Scale and Pfeffer Index for measurement of functional independence. The statistical procedures involved the application of Student's t-test with a 5% significance threshold. With respect to the results, the experimental group performed better only in mobility-related tests at the end of the intervention (p < 0.05). The proposed intervention showed efficacy on mobility, but not on cognition and functional independence. The short period of time and low weekly basis may be related to the results obtained.

Different Cognitive Profiles of Patients with Severe Aphasia.

PubMed

Marinelli, Chiara Valeria; Spaccavento, Simona; Craca, Angela; Marangolo, Paola; Angelelli, Paola

2017-01-01

Cognitive dysfunction frequently occurs in aphasic patients and primarily compromises linguistic skills. However, patients suffering from severe aphasia show heterogeneous performance in basic cognition. Our aim was to characterize the cognitive profiles of patients with severe aphasia and to determine whether they also differ as to residual linguistic abilities. We examined 189 patients with severe aphasia with standard language tests and with the CoBaGA (Cognitive Test Battery for Global Aphasia), a battery of nonverbal tests that assesses a wide range of cognitive domains such as attention, executive functions, intelligence, memory, visual-auditory recognition, and visual-spatial abilities. Twenty patients were also followed longitudinally in order to assess their improvement in cognitive skills after speech therapy. Three different subgroups of patients with different types and severity of cognitive impairment were evidenced. Subgroups differed as to residual linguistic skills, in particular comprehension and reading-writing abilities. Attention, reasoning, and executive functions improved after language rehabilitation. This study highlights the importance of an extensive evaluation of cognitive functions in patients with severe aphasia.

Cognitive function in patients with stable coronary heart disease: Related cerebrovascular and cardiovascular responses.

PubMed

Gayda, Mathieu; Gremeaux, Vincent; Bherer, Louis; Juneau, Martin; Drigny, Joffrey; Dupuy, Olivier; Lapierre, Gabriel; Labelle, Véronique; Fortier, Annik; Nigam, Anil

2017-01-01

Chronic exercise has been shown to prevent or slow age-related decline in cognitive functions in otherwise healthy, asymptomatic individuals. We sought to assess cognitive function in a stable coronary heart disease (CHD) sample and its relationship to cerebral oxygenation-perfusion, cardiac hemodynamic responses, and [Formula: see text] peak compared to age-matched and young healthy control subjects. Twenty-two young healthy controls (YHC), 20 age-matched old healthy controls (OHC) and 25 patients with stable CHD were recruited. Cognitive function assessment included short term-working memory, perceptual abilities, processing speed, cognitive inhibition and flexibility and long-term verbal memory. Maximal cardiopulmonary function (gas exchange analysis), cardiac hemodynamic (impedance cardiography) and left frontal cerebral oxygenation-perfusion (near-infra red spectroscopy) were measured during and after a maximal incremental ergocycle test. Compared to OHC and CHD, YHC had higher [Formula: see text] peak, maximal cardiac index (CI max), cerebral oxygenation-perfusion (ΔO2 Hb, ΔtHb: exercise and recovery) and cognitive function (for all items) (P<0.05). Compared to OHC, CHD patients had lower [Formula: see text] peak, CI max, cerebral oxygenation-perfusion (during recovery) and short term-working memory, processing speed, cognitive inhibition and flexibility and long-term verbal memory (P<0.05). [Formula: see text] peak and CI max were related to exercise cerebral oxygenation-perfusion and cognitive function (P<0.005). Cerebral oxygenation-perfusion (exercise) was related to cognitive function (P<0.005). Stable CHD patients have a worse cognitive function, a similar cerebral oxygenation/perfusion during exercise but reduced one during recovery vs. their aged-matched healthy counterparts. In the all sample, cognitive functions correlated with [Formula: see text] peak, CI max and cerebral oxygenation-perfusion.

Development of functional oral health literacy assessment instruments: application of literacy and cognitive theories.

PubMed

Bridges, Susan M; Parthasarathy, Divya S; Au, Terry K F; Wong, Hai Ming; Yiu, Cynthia K Y; McGrath, Colman P

2014-01-01

This paper describes the development of a new literacy assessment instrument, the Hong Kong Oral Health Literacy Assessment Task for Paediatric Dentistry (HKOHLAT-P). Its relationship to literacy theory is analyzed to establish content and face validity. Implications for construct validity are examined by analyzing cognitive demand to determine how "comprehension" is measured. Key influences from literacy assessment were identified to analyze item development. Cognitive demand was analyzed using an established taxonomy. The HKOHLAT-P focuses on the functional domain of health literacy assessment. Items had strong content and face validity reflecting established principles from modern literacy theory. Inclusion of new text types signified relevant developments in the area of new literacies. Analysis of cognitive demand indicated that this instrument assesses the "comprehension" domain, specifically the areas of factual and procedural knowledge, with some assessment of conceptual knowledge. Metacognitive knowledge was not assessed. Comprehension tasks assessing patient health literacy predominantly examine functional health literacy at the lower levels of comprehension. Item development is influenced by the fields of situated and authentic literacy. Inclusion of content regarding multiliteracies is suggested for further research. Development of functional health literacy assessment instruments requires careful consideration of the clinical context in determining construct validity. © 2013 American Association of Public Health Dentistry.

Gait and Cognition: A Complementary Approach to Understanding Brain Function and the Risk of Falling

PubMed Central

Montero-Odasso, Manuel; Verghese, Joe; Beauchet, Olivier; Hausdorff, Jeffrey M.

2012-01-01

Until recently, clinicians and researchers have performed gait assessments and cognitive assessments separately when evaluating older adults. Increasing evidence from clinical practice, epidemiological studies, and clinical trials shows that gait and cognition are inter-related in older adults. Quantifiable alterations in gait among older adults are associated with falls, dementia, and disability. At the same time, emerging evidence indicates that early disturbances in cognitive processes such as attention, executive function, and working memory are associated with slower gait and gait instability during single and dual-task testing, and that these cognitive disturbances assist in the prediction of future mobility loss, falls, and progression to dementia. This paper reviews the importance of the gait-cognition inter-relationship in aging and presents evidence that gait assessments can provide a window into the understanding of cognitive function and dysfunctions, and fall risk in older people in clinical practice. To this end, the benefits of dual-task gait assessments (e.g., walking while performing an attention-demanding task) as a marker of fall risk are summarized. Further, we also present a potential complementary approach for reducing the risk of falls by improving certain aspects of cognition through both non-pharmacological and pharmacological treatments. Untangling the relationship between early gait disturbances and early cognitive changes may be helpful for identifying older adults at higher risk of experiencing mobility decline, falls and the progression to dementia. PMID:23110433

Cognitive decline in prostate cancer patients undergoing ADT: a potential role for exercise training.

PubMed

Mundell, Niamh L; Daly, Robin M; Macpherson, Helen; Fraser, Steve F

2017-04-01

Androgen deprivation therapy (ADT) is an effective and widely prescribed treatment for prostate cancer (PCa), but it is associated with multiple treatment-induced adverse effects that impact on various musculoskeletal and cardiometabolic health outcomes. Emerging research has shown that ADT is also associated with cognitive impairment, which has been linked to a loss of independence, increased falls and fracture risk and greater use of medical services. The aim of this review is to outline the evidence related to the effect of ADT use on cognitive function, and propose a role for exercise training as part of usual care to prevent and/or manage cognitive impairments for PCa survivors on ADT. The following results have been obtained from this study. ADT has been shown to adversely affect specific cognitive domains, particularly verbal memory, visuomotor function, attention and executive function. However, current clinical guidelines do not recommend routine assessment of cognitive function in these men. No studies have examined whether exercise training can preserve or improve cognitive function in these men, but in healthy adults', multimodal exercise training incorporating aerobic training, progressive resistance training (PRT) and challenging motor control exercises have the potential to attenuate cognitive decline. In conclusion, as treatment with ADT for men with PCa has been associated with a decline in cognition, it is recommended that cognitive function be routinely monitored in these men and that regular exercise training be prescribed to preserve (or improve) cognitive function. Assessment of cognition and individualised exercise training should be considered in the usual treatment plan of PCa patients receiving ADT. © 2017 Society for Endocrinology.

Assessment of Differential Item Functioning under Cognitive Diagnosis Models: The DINA Model Example

ERIC Educational Resources Information Center

Li, Xiaomin; Wang, Wen-Chung

2015-01-01

The assessment of differential item functioning (DIF) is routinely conducted to ensure test fairness and validity. Although many DIF assessment methods have been developed in the context of classical test theory and item response theory, they are not applicable for cognitive diagnosis models (CDMs), as the underlying latent attributes of CDMs are…

Gene by Neuroticism Interaction and Cognitive Function among Older Adults

PubMed Central

Dar-Nimrod, Ilan; Chapman, Benjamin P.; Robbins, John A.; Porsteinsson, Anton; Mapstone, Mark; Duberstein, Paul R.

2012-01-01

Objectives Both ApoE (apolipoprotein E) ε-4 allele(s) and elevated trait neuroticism, the tendency to experience distress, are associated with cognitive function among older adults. We predicted that neuroticism moderates the association between ApoE and cognitive function and also explored whether other personality dimensions (openness to experience, agreeableness, extraversion, and conscientiousness) affect the association between ApoE status and cognitive function. Method Five-hundred and ninety-seven older adults (mean age of 78) enrolled in the Ginkgo Evaluation of Memory (GEM) study completed the NEO-Five Factor Inventory of personality. Cognitive function was assessed via the cognitive portion of the Alzheimer’s Disease Assessment Scale (ADAS-cog), and a blood sample for ApoE genotyping was drawn. Results As hypothesized, regression analysis indicated that neuroticism moderated the relationship between the presence of ApoE ε-4 and cognitive function. Individuals with high neuroticism scores had significantly lower ADAS-cog scores compared with individual with low neuroticism scores, but this was true only among carriers of ApoE ε-4 (interaction effect β = .124, p = .028). There was scant evidence that other personality dimensions moderate the association between ApoE ε-4 and cognitive function. Conclusions Cognitive function may be affected by ApoE and neuroticism acting in tandem. Research on the underlying physiological mechanisms by which neuroticism amplifies the effect of ApoE ε-4 is warranted. The study of genotype by phenotype interactions provides an important and useful direction for the study of cognitive function among older adults and for the development of novel prevention programs. PMID:23042108

Comparison of the abbreviated minimal assessment of cognitive function in multiple sclerosis (aMACFIMS) and the brief international cognitive assessment for multiple sclerosis (BICAMS).

PubMed

Gromisch, Elizabeth S; Portnoy, Jeffrey G; Foley, Frederick W

2018-05-15

Cognitive impairment is a prevalent and often intrusive problem among persons with multiple sclerosis (PwMS). Valid and reliable assessments, including quick screening measures, are crucial. The Brief International Cognitive Assessment for MS (BICAMS) was developed for this reason. While it lends itself to use in locations where formal neuropsychological resources might be limited, it does not include measures of verbal fluency or executive functioning, domains assessed as part of the Minimal Assessment of Cognitive Function in MS (MACFIMS). Given previous evidence that shortened MACFIMS measures have strong criterion validity, this study aimed to determine which of these should be included in the abbreviated MACFIMS (aMACFIMS), and how the aMACFIMS compares to the BICAMS. One hundred forty-seven PwMS were included in the analyses. A stepwise logistic regression was used to determine the measures in the aMACFIMS. Receiver-operating-characteristic (ROC) curves assessed the classification accuracy, sensitivity, and specificity. The batteries' sensitivity, specificity, and predictive values were then compared. Compared to the BICAMS, the final aMACFIMS had higher specificity (87% versus 72%) and positive predictive value (86% versus 77%), but lower sensitivity (71% versus 81%). The aMACFIMS has several benefits, including reduced administration time and the addition of a verbal fluency/executive functioning measure. Copyright © 2018 Elsevier B.V. All rights reserved.

Loneliness and Cognitive Function in Older Adults: Findings From the Chinese Longitudinal Healthy Longevity Survey

PubMed Central

Chen, Shu-Lin; Tu, Xin; Conwell, Yeates

2017-01-01

Objectives: To examine the relationship between loneliness and cognitive function and to explore the mediating role of physical health on the loneliness–cognition relationship in Chinese older adults (OAs). Method: Data came from a nationally representative sample of 14,199 Chinese OAs (aged 65+) from 2002, 2005, 2008, and 2011 waves of the Chinese Longitudinal Healthy Longevity Survey. A latent variable cross-lagged panel model combined with mediation analysis was used to determine the relationship between loneliness and cognitive function and the mediating effect of increase in the number of chronic conditions (ΔNCCs) on the ascertained loneliness–cognition relationship. Results: Severe loneliness at prior assessment points was significantly associated with poorer cognitive function at subsequent assessments, and vice versa. The ΔNCCs partially mediated this prospective reciprocal relationships, accounting for 2.58% of the total effect of loneliness on cognition and 4.44% of the total effect of cognition on loneliness, respectively. Discussion: Loneliness may predict subsequent cognitive decline, and vice versa. This loneliness–cognition relationship is partially explained by their impact on physical health. Multidisciplinary interventions aimed at reducing loneliness and cognitive decline per se and their associated risk factors as well as improving chronic illness management would be beneficial for emotional well-being and cognitive health in OAs. PMID:27013536

Combination antiretroviral therapy improves cognitive performance and functional connectivity in treatment-naïve HIV-infected individuals.

PubMed

Zhuang, Yuchuan; Qiu, Xing; Wang, Lu; Ma, Qing; Mapstone, Mark; Luque, Amneris; Weber, Miriam; Tivarus, Madalina; Miller, Eric; Arduino, Roberto C; Zhong, Jianhui; Schifitto, Giovanni

2017-10-01

Our study aimed to investigate the short-term effect of combination antiretroviral therapy (cART) on cognitive performance and functional and structural connectivity and their relationship to plasma levels of antiretroviral (ARV) drugs. Seventeen ARV treatment-naïve HIV-infected individuals (baseline mean CD4 cell count, 479 ± 48 cells/mm 3 ) were age matched with 17 HIV-uninfected individuals. All subjects underwent a detailed neurocognitive and functional assessment and magnetic resonance imaging. HIV-infected subjects were scanned before starting cART and 12 weeks after initiation of treatment. Uninfected subjects were assessed once at baseline. Functional connectivity (FC) was assessed within the default mode network while structural connectivity was assessed by voxel-wise analysis using tract-based spatial statistics (TBSS) and probabilistic tractography within the DMN. Tenofovir and emtricitabine blood concentration were measured at week 12 of cART. Prior to cART, HIV-infected individuals had significantly lower cognitive performance than control subjects as measured by the total Z-score from the neuropsychological tests assessing six cognitive domains (p = 0.020). After 12 weeks of cART treatment, there remained only a weak cognitive difference between HIV-infected and HIV-uninfected subjects (p = 0.057). Mean FC was lower in HIV-infected individuals compared with those uninfected (p = 0.008), but FC differences became non-significant after treatment (p = 0.197). There were no differences in DTI metrics between HIV-infected and HIV-uninfected individuals using the TBSS approach and limited evidence of decreased structural connectivity within the DMN in HIV-infected individuals. Tenofovir and emtricitabine plasma concentrations did not correlate with either cognitive performance or imaging metrics. Twelve weeks of cART improves cognitive performance and functional connectivity in ARV treatment-naïve HIV-infected individuals with relatively preserved immune function. Longer periods of observation are necessary to assess whether this effect is maintained.

Children with chronic lung diseases have cognitive dysfunction as assessed by event-related potential (auditory P300) and Stanford-Binet IQ (SB-IV) test.

PubMed

Kamel, Terez Boshra; Abd Elmonaem, Mahmoud Tarek; Khalil, Lobna Hamed; Goda, Mona Hamdy; Sanyelbhaa, Hossam; Ramzy, Mourad Alfy

2016-10-01

Chronic lung disease (CLD) in children represents a heterogeneous group of many clinico-pathological entities with risk of adverse impact of chronic or intermittent hypoxia. So far, few researchers have investigated the cognitive function in these children, and the role of auditory P300 in the assessment of their cognitive function has not been investigated yet. This study was designed to assess the cognitive functions among schoolchildren with different chronic pulmonary diseases using both auditory P300 and Stanford-Binet test. This cross-sectional study included 40 school-aged children who were suffering from chronic chest troubles other than asthma and 30 healthy children of similar age, gender and socioeconomic state as a control group. All subjects were evaluated through clinical examination, radiological evaluation and spirometry. Audiological evaluation included (basic otological examination, pure-tone, speech audiometry and immittancemetry). Cognitive function was assessed by auditory P300 and psychological evaluation using Stanford-Binet test (4th edition). Children with chronic lung diseases had significantly lower anthropometric measures compared to healthy controls. They had statistically significant lower IQ scores and delayed P300 latencies denoting lower cognitive abilities. Cognitive dysfunction correlated to severity of disease. P300 latencies were prolonged among hypoxic patients. Cognitive deficits in children with different chronic lung diseases were best detected using both Stanford-Binet test and auditory P300. P300 is an easy objective tool. P300 is affected early with hypoxia and could alarm subtle cognitive dysfunction.

Older adult awareness of the influence of cardiovascular disease risk factors on cognitive function.

PubMed

Wright, Regina S; Ford, Cassandra; Sniscak, Courtney R

2017-03-01

The aims of the current study were to (i) assess older people's awareness of the association between CVD risk factors and cognitive function; and (ii) examine whether awareness varies as a function of demographic factors. Cardiovascular disease (CVD) risk factors have been linked to subtle deficits in cognitive function. CVD risk factors increase the risk of cognitive decline and dementia. The association between cardiovascular disease (CVD) risk factors and cognitive decrements has been well documented among older people; however, we are unaware of any studies that have measured older people's awareness of this relationship in an effort to assess educational needs. A descriptive, cross-sectional survey design was employed. Community-based older adults aged 60 and older completed a survey that assessed their knowledge of the association between CVD risk factors and cognitive function. One hundred fifty older adults, with a mean age of 72.88 years, completed the survey. Results showed that over 75% of the sample was aware that CVD risk factors affect cognitive function. White older adults and older adults with greater perceived financial well-being tended to be more aware of these relationships than non-White participants with less perceived financial well-being. Results suggest that many, but not all older people have awareness of this relationship. As such, there is a need for increased education about the cognitive effects of CVD risk factors, particularly among older people who are already at risk for developing CVD and those with lesser financial well-being. Appropriate educational strategies can expose older patients to the importance of healthy lifestyle and self-care to maintain cognitive function. Nurses can incorporate education into care by identifying patients that would benefit from tailored interventions and providing information to at-risk patients about how to maintain their cognitive function through management of specific CVD risk factors. © 2016 John Wiley & Sons Ltd.

Association between CSF biomarkers, hippocampal volume and cognitive function in patients with amnestic mild cognitive impairment (MCI).

PubMed

Nathan, Pradeep J; Lim, Yen Ying; Abbott, Rosemary; Galluzzi, Samantha; Marizzoni, Moira; Babiloni, Claudio; Albani, Diego; Bartres-Faz, David; Didic, Mira; Farotti, Lucia; Parnetti, Lucilla; Salvadori, Nicola; Müller, Bernhard W; Forloni, Gianluigi; Girtler, Nicola; Hensch, Tilman; Jovicich, Jorge; Leeuwis, Annebet; Marra, Camillo; Molinuevo, José Luis; Nobili, Flavio; Pariente, Jeremie; Payoux, Pierre; Ranjeva, Jean-Philippe; Rolandi, Elena; Rossini, Paolo Maria; Schönknecht, Peter; Soricelli, Andrea; Tsolaki, Magda; Visser, Pieter Jelle; Wiltfang, Jens; Richardson, Jill C; Bordet, Régis; Blin, Olivier; Frisoni, Giovanni B

2017-05-01

Few studies have examined the relationship between CSF and structural biomarkers, and cognitive function in MCI. We examined the relationship between cognitive function, hippocampal volume and cerebrospinal fluid (CSF) Aβ 42 and tau in 145 patients with MCI. Patients were assessed on cognitive tasks from the Cambridge Neuropsychological Test Automated Battery (CANTAB), the Geriatric Depression Scale and the Functional Activities Questionnaire. Hippocampal volume was measured using magnetic resonance imaging (MRI), and CSF markers of Aβ 42 , tau and p-tau 181 were also measured. Worse performance on a wide range of memory and sustained attention tasks were associated with reduced hippocampal volume, higher CSF tau and p-tau 181 and increased tau/Aβ 42 ratio. Memory tasks were also associated with lower ability to conduct functional activities of daily living, providing a link between AD biomarkers, memory performance and functional outcome. These results suggest that biomarkers of Aβ and tau are strongly related to cognitive performance as assessed by the CANTAB, and have implications for the early detection and characterization of incipient AD. Copyright © 2017 Elsevier Inc. All rights reserved.

Limbic and Basal Ganglia Neuroanatomical Correlates of Gait and Executive Function: Older Adults With Mild Cognitive Impairment and Intact Cognition.

PubMed

McGough, Ellen L; Kelly, Valerie E; Weaver, Kurt E; Logsdon, Rebecca G; McCurry, Susan M; Pike, Kenneth C; Grabowski, Thomas J; Teri, Linda

2018-04-01

This study aimed to examine differences in spatiotemporal gait parameters between older adults with amnestic mild cognitive impairment and normal cognition and to examine limbic and basal ganglia neural correlates of gait and executive function in older adults without dementia. This was a cross-sectional study of 46 community-dwelling older adults, ages 70-95 yrs, with amnestic mild cognitive impairment (n = 23) and normal cognition (n = 23). Structural magnetic resonance imaging was used to attain volumetric measures of limbic and basal ganglia structures. Quantitative motion analysis was used to measure spatiotemporal parameters of gait. The Trail Making Test was used to assess executive function. During fast-paced walking, older adults with amnestic mild cognitive impairment demonstrated significantly slower gait speed and shorter stride length compared with older adults with normal cognition. Stride length was positively correlated with hippocampal, anterior cingulate, and nucleus accumbens volumes (P < 0.05). Executive function was positively correlated with hippocampal, anterior cingulate, and posterior cingulate volumes (P < 0.05). Compared with older adults with normal cognition, those with amnestic mild cognitive impairment demonstrated slower gait speed and shorter stride length, during fast-paced walking, and lower executive function. Hippocampal and anterior cingulate volumes demonstrated moderate positive correlation with both gait and executive function, after adjusting for age. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) discuss gait performance and cognitive function in older adults with amnestic mild cognitive impairment versus normal cognition, (2) discuss neurocorrelates of gait and executive function in older adults without dementia, and (3) recognize the importance of assessing gait speed and cognitive function in the clinical management of older adults at risk for dementia. Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Cognitive function in early and later life is associated with blood glucose in older individuals: analysis of the Lothian Birth Cohort of 1936.

PubMed

Altschul, Drew M; Starr, John M; Deary, Ian J

2018-06-02

The aim of this study was to examine whether cognitive function in early and later life, and decline in cognitive function from age 70 to 79 years, are associated with high blood glucose, as measured by HbA 1c , at baseline (age 70), and changes in blood glucose from age 70 to 79. Participants (n = 1091) in the Lothian Birth Cohort of 1936 were examined. Fourteen tests were used to assess cognitive functions, grouped into four domains: visuospatial ability, processing speed, memory and crystallised ability. Test results, and measurements of HbA 1c and other health variables, were collected at each of four waves of assessment: at the mean age of 70, 73, 76 and 79 years. Data on cognitive function at age 11 was also available for this cohort. Latent growth curve modelling was performed and statistical controls for known risk factors were introduced. Higher age 11 cognitive function predicted lower HbA 1c level at age 70 (p < 0.001). Higher cognitive function at age 70 was related to a comparatively smaller increase in HbA 1c levels from age 70 to 79 (p < 0.001). HbA 1c from age 70 to 79 did not have any consistent association with change in cognitive function from age 70 to 79. These associations survived adjustments for age, sex, education, APOE*ε4, smoking history, cardiovascular disease history, hypertension history, BMI and corrections for multiple testing. Our results show that, among older individuals, high blood glucose is consistently predicted by lower cognitive function. Clinical care that examines and tracks cognitive function, while also taking the positive effects of maintaining cognitive function and emulating healthy behaviours associated with higher cognitive function into account, may be one approach for protecting at-risk individuals from elevated blood glucose and subsequent type 2 diabetes mellitus.

The Cognitive Assessment Interview (CAI): development and validation of an empirically derived, brief interview-based measure of cognition.

PubMed

Ventura, Joseph; Reise, Steven P; Keefe, Richard S E; Baade, Lyle E; Gold, James M; Green, Michael F; Kern, Robert S; Mesholam-Gately, Raquelle; Nuechterlein, Keith H; Seidman, Larry J; Bilder, Robert M

2010-08-01

Practical, reliable "real world" measures of cognition are needed to supplement neurocognitive performance data to evaluate possible efficacy of new drugs targeting cognitive deficits associated with schizophrenia. Because interview-based measures of cognition offer one possible approach, data from the MATRICS initiative (n=176) were used to examine the psychometric properties of the Schizophrenia Cognition Rating Scale (SCoRS) and the Clinical Global Impression of Cognition in Schizophrenia (CGI-CogS). We used classical test theory methods and item response theory to derive the 10-item Cognitive Assessment Interview (CAI) from the SCoRS and CGI-CogS ("parent instruments"). Sources of information for CAI ratings included the patient and an informant. Validity analyses examined the relationship between the CAI and objective measures of cognitive functioning, intermediate measures of cognition, and functional outcome. The rater's score from the newly derived CAI (10 items) correlate highly (r=.87) with those from the combined set of the SCoRS and CGI-CogS (41 items). Both the patient (r=.82) and the informant (r=.95) data were highly correlated with the rater's score. The CAI was modestly correlated with objectively measured neurocognition (r=-.32), functional capacity (r=-.44), and functional outcome (r=-.32), which was comparable to the parent instruments. The CAI allows for expert judgment in evaluating a patient's cognitive functioning and was modestly correlated with neurocognitive functioning, functional capacity, and functional outcome. The CAI is a brief, repeatable, and potentially valuable tool for rating cognition in schizophrenia patients who are participating in clinical trials. Copyright 2010 Elsevier B.V. All rights reserved.

The Cognitive Assessment Interview (CAI): Development and Validation of an Empirically Derived, Brief Interview-Based Measure of Cognition

PubMed Central

Ventura, Joseph; Reise, Steven P.; Keefe, Richard S. E.; Baade, Lyle E.; Gold, James M.; Green, Michael F.; Kern, Robert S.; Mesholam-Gately, Raquelle; Nuechterlein, Keith H.; Seidman, Larry J.; Bilder, Robert M.

2011-01-01

Background Practical, reliable “real world” measures of cognition are needed to supplement neurocognitive performance data to evaluate possible efficacy of new drugs targeting cognitive deficits associated with schizophrenia. Because interview-based measures of cognition offer one possible approach, data from the MATRICS initiative (n=176) were used to examine the psychometric properties of the Schizophrenia Cognition Rating Scale (SCoRS) and the Clinical Global Impression of Cognition in Schizophrenia (CGI-CogS). Method We used classical test theory methods and item response theory to derive the 10 item Cognitive Assessment Interview (CAI) from the SCoRS and CGI-Cogs (“parent instruments”). Sources of information for CAI ratings included the patient and an informant. Validity analyses examined the relationship between the CAI and objective measures of cognitive functioning, intermediate measures of cognition, and functional outcome. Results The rater’s score from the newly derived CAI (10-items) correlate highly (r = .87) with those from the combined set of the SCoRS and CGI-CogS (41 items). Both the patient (r= .82) and the informant (r= .95) data were highly correlated with the rater’s score. The CAI was modestly correlated with objectively measured neurocognition (r = −.32), functional capacity (r = −.44), and functional outcome (r = −.32), which was comparable to the parent instruments. Conclusions The CAI allows for expert judgment in evaluating a patient’s cognitive functioning and was modestly correlated with neurocognitive functioning, functional capacity, and functional outcome. The CAI is a brief, repeatable, and potentially valuable tool for rating cognition in schizophrenia patients who are participating in clinical trials. PMID:20542412

The effect of days since last concussion and number of concussions on cognitive functioning in Division I athletes.

PubMed

Thoma, Robert J; Cook, Julia A; McGrew, Christopher; King, John H; Mayer, Andrew R; Lewine, Jeffrey D; Yeo, Ronald A; Campbell, Richard

2015-01-01

Cognitive recovery from sports concussion may be incomplete after resolution of other symptoms. It was hypothesized that independent effects of the number of days since last concussion (Days) and total number of concussions (Number) would predict poorer cognitive functioning. Cognition was assessed in an NCAA Division I student-athlete population (n = 87) using the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) battery. In a MANOVA, the five ImPACT Composite scores were dependent variables, with Group (Concussion, Unaffected) as the independent variable and prior number of concussions (Number) and days since last concussion (Days; 68-2495 days) entered as covariates. The hypothesis that Days and Number would each independently affect cognitive functioning (as assessed by ImPACT Composite scores) was only partly supported. A significant, multivariate, main effect of Days (p = 0.01) indicated that more Days predicted better cognitive functioning overall (p = 0.01). Univariate effects emerged such that more Days specifically predicted better visual memory (p = 0.004) and faster reaction times (p = 0.02). A trend toward a Group*Days*Number three-way interaction for reaction time emerged (p = 0.06), such that smaller Number and more Days each predicted slower reaction time. Cognitive recovery following sports concussion may take far longer than was previously thought, the aetiology of cognitive reductions may be very complex and the ImPACT appears to be sensitive to subtle changes in cognition across time.

Masked Hypertension is Associated With Cognitive Decline in Geriatric Age-Geriatric MASked Hypertension and Cognition (G-MASH-cog) Study.

PubMed

Esme, Mert; Yavuz, Burcu Balam; Yavuz, Bunyamin; Asil, Serkan; Tuna Dogrul, Rana; Sumer, Fatih; Kilic, Mustafa Kemal; Kizilarslanoglu, Muhammet Cemal; Varan, Hacer Dogan; Sagir, Aykut; Balci, Cafer; Halil, Meltem; Cankurtaran, Mustafa

2018-01-16

Masked hypertension is described as high ambulatory blood pressure measurements (ABPM) where office blood pressure measurements are normal. Effect of hypertension on cognitive functions is well known. However, the effect of masked hypertension on cognitive functions is unclear. The aim of this study is to examine the relationship between masked hypertension and cognitive functions. One hundred-two normotensive patients admitted to the Geriatric Medicine outpatient clinic were included. Exclusion criteria were hypertension, dementia, major depression, and usage of antihypertensive medication. All patients underwent ABPM procedures and average daytime blood pressure, mean blood pressure at night and the 24-hour average blood pressure measurements were recorded. Comprehensive geriatric assessment tests and neuropsychological tests were administered. The diagnosis of masked hypertension was based on the definitions in the 2013 guideline of the European Society of Cardiology. Forty-four patients (43%) were diagnosed with masked hypertension. Patients with masked hypertension had significantly lower scores on Mini-Mental State Examination (MMSE) test, Quick Mild Cognitive Impairment Test (QMCI), and Categorical Fluency Test than the normotensive patients (p = .011; p = .046; and p = .004; respectively). Montreal Cognitive Assessment Scale test score was lower in masked hypertension, although this was not statistically significant. This study may indicate that geriatric patients with masked hypertension, compared to normotensive patients have decreased cognitive functions. Masked hypertension should be kept in mind while assessing older adults. When masked hypertension is detected, cognitive assessment is essential to diagnose possible cognitive dysfunction at early stage. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Residential Mobility and Cognitive Function Among Middle-Aged and Older Adults in China.

PubMed

Xu, Hanzhang; Dupre, Matthew E; Østbye, Truls; Vorderstrasse, Allison A; Wu, Bei

2018-01-01

To assess the association between rural and urban residential mobility and cognitive function among middle-aged and older adults in China. We used data from the World Health Organization Study on global AGEing and adult health that included adults age 50+ from China ( N = 12,410). We used multivariate linear regressions to examine how residential mobility and age at migration were associated with cognitive function. Urban and urban-to-urban residents had the highest level of cognitive function, whereas rural and rural-to-rural residents had the poorest cognitive function. Persons who migrated to/within rural areas before age 20 had poorer cognitive function than those who migrated during later adulthood. Socioeconomic factors played a major role in accounting for the disparities in cognition; however, the association remained significant after inclusion of all covariates. Residential mobility and age at migration have significant implications for cognitive function among middle-aged and older adults in China.

Posterior Teeth Occlusion Associated with Cognitive Function in Nursing Home Older Residents: A Cross-Sectional Observational Study

PubMed Central

Takeuchi, Kenji; Izumi, Maya; Furuta, Michiko; Takeshita, Toru; Shibata, Yukie; Kageyama, Shinya; Ganaha, Seijun; Yamashita, Yoshihisa

2015-01-01

Early detection and subsequent reduction of modifiable risk factors for cognitive decline is important for extending healthy life expectancy in the currently aging society. Although a recent increase in studies on the state or number of the teeth and cognitive function, few studies have focused on the association between posterior teeth occlusion necessary to maintain chewing function and cognitive function among older adults. This study examined the association between posterior teeth occlusion and cognitive function in nursing home older residents. In this cross-sectional study, 279 residents aged ≥60 years from eight nursing homes in Aso City, Japan participated in cognitive function and dental status assessments and completed a comprehensive questionnaire survey in 2014. Cognitive function was measured using a Mini-Mental State Examination (MMSE). Posterior teeth occlusion was assessed using a total number of functional tooth units (total-FTUs), depending on the number and location of the remaining natural and artificial teeth on implant-supported, fixed, and removable prostheses. Linear regression models were used to assess univariate and multivariate associations between total-FTUs and MMSE scores. Models were sequentially adjusted for demographic characteristics, number of natural teeth, socioeconomic status, health behaviors, comorbidities, physical function, and nutritional status. Among the 200 residents included in our analysis, mean MMSE scores and total-FTUs were 11.0 ± 8.6 and 9.3 ± 4.6, respectively. Higher total-FTUs were significantly associated with higher MMSE scores after adjustment for demographics and teeth number (B = 0.48, 95% confidence interval [CI] = 0.22–0.74). The association remained significant even after adjustment for all covariates (B = 0.25, 95% CI = 0.01–0.49). The current findings demonstrated that loss of posterior teeth occlusion was independently associated with cognitive decline in nursing home older residents in Japan. Maintenance and restoration of posterior teeth occlusion may be a preventive factor against cognitive decline in aged populations. PMID:26512900

Cognitive Function | Science Inventory | US EPA

EPA Pesticide Factsheets

Because chemicals can adversely affect cognitive function in humans, considerable effort has been made to characterize their effects using animal models. Information from such models will be necessary to: evaluate whether chemicals identified as potentially neurotoxic by screening methods actually do affect cognitive function; identify and characterize the mechanisms or pathways by which effects at these targets lead to cognitive dysfunction; address issues of susceptibility and variability, which require understanding the compensations and interactions that only a whole organism can engage; and improve our understanding of the neurobiological underpinnings of cognitive function.This chapter has several purposes. First, it provides working definitions of cognitive functions, such as learning, memory and attention, in terms frequently used by behavioral toxicologists. It is important to have a common vocabulary to assess methods used in this area of research. Second, it presents an overview of some of the procedures commonly used in behavioral toxicology to assess the effects of chemicals on cognitive function in animals. It should be noted that this overview is not intended to be comprehensive or complete, but is intended to illustrate specific points by discussing examples. Finally, this chapter discusses some critical experimental and conceptual variables that are important for studies on chemical-induced cognitive dysfunction, and touches on the potential p

Assessing cognition following petrol sniffing for Indigenous Australians.

PubMed

Dingwall, Kylie M; Lewis, Matthew S; Maruff, Paul; Cairney, Sheree

2010-07-01

Chronic petrol inhalation can be associated with significant cognitive impairment. While rehabilitation programs can rely on such skills to educate clients and achieve treatment outcomes, cognitive function is rarely assessed on admission. This is particularly true for Indigenous populations where standard assessments are not appropriate. This paper describes a process for assessing cognition in Indigenous Australians. Two studies investigate firstly the demographic factors impacting on cognition for healthy Indigenous Australians and secondly the utility of the assessment process for detecting petrol sniffing related cognitive impairments. Study One assessed a naturalistic sample of healthy Indigenous Australians from the Northern Territory (N = 206; mean age = 28.03) on computerised tests of psychomotor speed, visual attention, memory, learning, spatial awareness and executive functions. Multiple regression analyses determined the unique contributions of six factors (age, education, gender, familiarity with computers, regular long term cannabis use and locality) to the variance in performance for this group. Study Two examined group differences in cognitive performance on the same tests between healthy Indigenous Australians (N = 96) and Indigenous petrol sniffers (N = 50; both age restricted to < 26 years) while controlling those factors found to impact on performance from Study One. Age, computer familiarity, and education significantly contributed to the variance in performance measures. While controlling these factors, petrol abuse was associated with poorer performance on complex tasks of psychomotor, visual attention, memory, learning, spatial awareness and executive function. This assessment process is useful for detecting substance abuse related impairments in Indigenous Australians and when using this assessment process, age and computer familiarity in particular should be controlled for.

Sex differences in obesity and cognitive function in a cognitively normal aging Chinese Han population.

PubMed

Li, Wei; Qiu, Qi; Sun, Lin; Yue, Ling; Wang, Tao; Li, Xia; Xiao, Shifu

2017-01-01

Sex differences in Alzheimer's disease and mild cognitive impairment have been well recognized. However, sex differences in cognitive function and obesity in cognitively normal aging Chinese Han population have not attracted much attention. The aim of this study was to investigate the relationship between sex, obesity, and cognitive function in an elderly Chinese population with normal cognitive function. A total of 228 cognitively normal aging participants (males/females =93/135) entered this study. Their general demographic information (sex, age, and education) was collected by standardized questionnaire. Apolipoprotein E (APOE) genotype and serum lipid levels were measured. The Montreal Cognitive Assessment (MoCA) was used to assess participants' cognitive function. The prevalence of obesity in elderly women (18/133, 13.5%) was significantly higher than that in men (5/92, 5.4%, P =0.009). Regression analyses showed that obesity was associated with drinking alcohol (OR =13.695, P =0.045) and triglyceride (OR =1.436, P =0.048) in women and limited to low-density lipoprotein (OR =11.829, P =0.023) in men. Women performed worse on the naming score for MoCA than men ( P <0.01). Stepwise linear regression analysis showed that education ( t =3.689, P <0.001) and smoking ( t =2.031, P =0.045) were related to the score of naming in female, while high-density lipoprotein ( t =-2.077, P =0.041) was related to the score of naming in male; however, no correlation was found between body mass index and cognitive function in both male and female ( P >0.05). Our finding suggests that there are significant sex differences in obesity and specific cognitive domains in aging Chinese Han population with normal cognitive function.

Examination of Variables That May Affect the Relationship Between Cognition and Functional Status in Individuals with Mild Cognitive Impairment: A Meta-Analysis

PubMed Central

Mcalister, Courtney; Schmitter-Edgecombe, Maureen; Lamb, Richard

2016-01-01

The objective of this meta-analysis was to improve understanding of the heterogeneity in the relationship between cognition and functional status in individuals with mild cognitive impairment (MCI). Demographic, clinical, and methodological moderators were examined. Cognition explained an average of 23% of the variance in functional outcomes. Executive function measures explained the largest amount of variance (37%), whereas global cognitive status and processing speed measures explained the least (20%). Short- and long-delayed memory measures accounted for more variance (35% and 31%) than immediate memory measures (18%), and the relationship between cognition and functional outcomes was stronger when assessed with informant-report (28%) compared with self-report (21%). Demographics, sample characteristics, and type of everyday functioning measures (i.e., questionnaire, performance-based) explained relatively little variance compared with cognition. Executive functioning, particularly measured by Trails B, was a strong predictor of everyday functioning in individuals with MCI. A large proportion of variance remained unexplained by cognition. PMID:26743326

Cognitive function in chronic obstructive pulmonary disease: relationship to global initiative for chronic obstructive lung disease 2011 categories.

PubMed

Tulek, Baykal; Atalay, Nart Bedin; Yildirim, Gulfem; Kanat, Fikret; Süerdem, Mecit

2014-08-01

Recently, comorbidities such as impaired cognitive function have been attracting more focus when considering the management of chronic obstructive pulmonary disease (COPD). Here we investigated the relationship between cognitive function and the categories given in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines in 2011. Specifically, after controlling for non-COPD covariates, we assessed the clinical features that may be predictive of cognitive impairment in patients with COPD. We recruited 119 stable patients with mild to very severe COPD. We administered a broad array of standardized neuropsychological tests that assessed cognitive functions in the domains of attention, memory, psychomotor coordination and language. Cognitive scores were significantly different between patients falling within GOLD 2011 categories. Scores were lower in patients with high future risk compared with low future risk. In parallel, there were significant differences in cognitive function between COPD patient subgroups when patients were grouped according to the forced expiratory volume in 1 s, exacerbation history and C-reactive protein levels. After controlling for non-COPD predictors, only exacerbation history remained a significant predictor of cognitive scores. The number of exacerbation events in a year may be used as a predictor of cognitive impairment in patients with COPD. © 2014 Asian Pacific Society of Respirology.

Patients undergoing subacute physical rehabilitation following an acute hospital admission demonstrated improvement in cognitive functional task independence.

PubMed

McPhail, Steven M; Varghese, Paul N; Kuys, Suzanne S

2014-01-01

This study investigated cognitive functioning among older adults with physical debility not attributable to an acute injury or neurological condition who were receiving subacute inpatient physical rehabilitation. A cohort investigation with assessments at admission and discharge. Three geriatric rehabilitation hospital wards. Consecutive rehabilitation admissions (n = 814) following acute hospitalization (study criteria excluded orthopaedic, neurological, or amputation admissions). Usual rehabilitation care. The Functional Independence Measure (FIM) Cognitive and Motor items. A total of 704 (86.5%) participants (mean age = 76.5 years) completed both assessments. Significant improvement in FIM Cognitive items (Z-score range 3.93-8.74, all P < 0.001) and FIM Cognitive total score (Z-score = 9.12, P < 0.001) occurred, in addition to improvement in FIM Motor performance. A moderate positive correlation existed between change in Motor and Cognitive scores (Spearman's rho = 0.41). Generalized linear modelling indicated that better cognition at admission (coefficient = 0.398, P < 0.001) and younger age (coefficient = -0.280, P < 0.001) were predictive of improvement in Motor performance. Younger age (coefficient = -0.049, P < 0.001) was predictive of improvement in FIM Cognitive score. Improvement in cognitive functioning was observed in addition to motor function improvement among this population. Causal links cannot be drawn without further research.

The role of premorbid adjustment in schizophrenia: Focus on cognitive remediation outcome.

PubMed

Buonocore, Mariachiara; Bosinelli, Francesca; Bechi, Margherita; Spangaro, Marco; Piantanida, Marco; Cocchi, Federica; Bianchi, Laura; Guglielmino, Carmelo; Mastromatteo, Antonella Rita; Cavallaro, Roberto; Bosia, Marta

2018-02-19

Premorbid adjustment has been associated with several outcomes in schizophrenia and has been proposed as an index of cognitive reserve. This study aims to comprehensively analyse the relation between premorbid adjustment and clinical, neurocognitive, socio-cognitive and functional assessments, as well as to investigate the effect of premorbid adjustment on cognitive improvements after a cognitive remediation therapy protocol. Seventy-nine clinically stabilised outpatients with schizophrenia underwent a combined intervention consisting of cognitive remediation therapy added to standard rehabilitation therapy. All patients were assessed at baseline for psychopathology, premorbid adjustment, intellectual level, cognition and functioning. Cognitive evaluations were also repeated after the intervention. At baseline, significant correlations were observed between premorbid adjustment and working memory. The global cognitive improvement after treatment was significantly predicted by age and premorbid adjustment. This study confirms the association between premorbid adjustment and cognitive impairment and is the first to highlight the possible role of premorbid adjustment on the capacity to recover from cognitive deficits through a cognitive remediation therapy protocol. The data suggest that cognitive remediation may be particularly effective for people in the early course and that the assessment of premorbid adjustment could be of value to design individualised interventions.

The relationship between change in cognition and change in functional ability in schizophrenia during cognitive and psychosocial rehabilitation.

PubMed

Rispaud, Samuel G; Rose, Jennifer; Kurtz, Matthew M

2016-10-30

While a wealth of studies have evaluated cross-sectional links between cognition and functioning in schizophrenia, few have investigated the relationship between change in cognition and change in functioning in the context of treatment trials targeted at cognition. Identifying cognitive skills that, when improved, predict improvement in functioning will guide the development of more targeted rehabilitation for this population. The present study identifies the relationship between change in specific cognitive skills and change in functional ability during one year of cognitive rehabilitation. Ninety-six individuals with schizophrenia were assessed with a battery of cognitive measures and a measure of performance-based functioning before and after cognitive training consisting of either drill-and-practice cognitive remediation or computer skills training. Results revealed that while working and episodic memory, problem-solving, and processing speed skills all improved during the trial, only improved working memory and processing speed skills predicted improvement in functional ability. Secondary analyses revealed these relationships were driven by individuals who showed a moderate level (SD≥0.5) of cognitive improvement during the trial. These findings suggest that while a variety of cognitive skills may improve during training targeted at cognition, only improvements in a subset of cognitive functions may translate into functional gains. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Assessing cognitive function in clinical trials: latest developments and future directions.

PubMed

Wesnes, Keith

2002-01-01

Properly developed automated test systems are of value for assessing changes in cognitive function in clinical trials. Besides the other advantages that automation brings to trials, such as increased reliability and utility, it is shown that such systems are also more sensitive to change in cognitive function than traditional nonautomated procedures. Data from a variety of topical areas in drug development are presented to illustrate the added value such techniques have brought. The latest developments in automation include remote testing via the Internet and telephone.

The impact of illiteracy on the assessment of cognition and dementia: a critical issue in the developing countries.

PubMed

Noroozian, Maryam; Shakiba, Alia; Iran-nejad, Shahrzad

2014-12-01

Dementia and Alzheimer's disease (AD) is considered a major public health challenge in this decade and in the future. Early detection of AD through appropriate screening tools would be valuable approach in facing the burden of disease specifically in developing societies with insufficient resources. Selecting a screening tool which is non-expensive, non-invasive and implementable by trained primary healthcare providers is the first and probably the most important step in detecting high risk individuals. The goal of this review is to address the key issues in assessment tools in developing countries with a high level of illiteracy. We set about a review on literature on the subject of cognitive function assessment among minorities, people with low or no education, and people who live in underdeveloped societies. We also reviewed the studies on validation of such tests in a new society. The most popular assessment tools are more or less biased by the level of education; not all of them are useful for any type of dementia as they assess only some domains of cognitive function. Even though people with lower level of education have a higher rate of developing dementia, cognitive function cannot be accurately assessed because of limitations of current available tools. It is strongly suggested that special attention be paid to assess them by functional scales and activity daily living scales. For a more efficient assessment, cognitive tests can also benefit from illustrative questions, proverbs, metaphors, traditions, religious rituals and historical events.

Mild cognitive impairment is associated with poor physical function but not bone structure or density in late adulthood: findings from the Hertfordshire cohort study.

PubMed

Patel, A; Jameson, K A; Edwards, M H; Ward, K; Gale, C R; Cooper, C; Dennison, Elaine M

2018-04-24

This study investigated the association between mild cognitive impairment (MCI) and physical function and bone health in older adults. MCI was associated with poor physical performance but not bone mineral density or bone microarchitecture. Cross-sectional study to investigate the association between mild cognitive impairment (MCI) and physical performance, and bone health, in a community-dwelling cohort of older adults. Cognitive function of 222 men and 221 women (mean age 75.5 and 75.8 years in men and women, respectively) was assessed by the Strawbridge questionnaire and Mini Mental State Exam (MMSE). Participants underwent dual-energy X-ray absorptiometry (DXA), peripheral-quantitative computed tomography (pQCT) and high-resolution peripheral-quantitative computed tomography (HR-pQCT) scans to assess their bone density, strength and microarchitecture. Their physical function was assessed and a physical performance (PP) score was recorded. In the study, 11.8% of women and 8.1% of men were cognitively impaired on the MMSE (score < 24). On the Strawbridge questionnaire, 24% of women were deemed cognitively impaired compared to 22.3% of men. Cognitive impairment on the Strawbridge questionnaire was associated with poorer physical performance score in men but not in women in the unadjusted analysis. MMSE < 24 was strongly associated with the risk of low physical performance in men (OR 12.9, 95% CI 1.67, 99.8, p = 0.01). Higher MMSE score was associated with better physical performance in both sexes. Poorer cognitive function, whether assessed by the Strawbridge questionnaire, or by MMSE score, was not associated with bone density, shape or microarchitecture, in either sex. MCI in older adults was associated with poor physical performance, but not bone density, shape or microarchitecture.

Physical activity and cognitive trajectories in cognitively normal adults: the adult children study.

PubMed

Pizzie, Rachel; Hindman, Halley; Roe, Catherine M; Head, Denise; Grant, Elizabeth; Morris, John C; Hassenstab, Jason J

2014-01-01

Increased physical activity may protect against cognitive decline, the primary symptom of Alzheimer disease. In this study, we examined the relationship between physical activity and trajectories of cognitive functioning over serial assessments. Cognitively normal (Clinical Dementia Rating 0) middle-aged and older adults (N=173; mean age, 60.7 ± 7.8 y) completed a self-report measure of physical activity and a battery of standard neuropsychological tests assessing processing speed, attention, executive functioning, and verbal memory. At baseline, individuals with higher physical activity levels performed better on tests of episodic memory and visuospatial functioning. Over subsequent follow-up visits, higher physical activity was associated with small performance gains on executive functioning and working memory tasks in participants with one or more copies of the apolipoprotein ε4 allele (APOE4). In APOE4 noncarriers, slopes of cognitive performance over time were not related to baseline physical activity. Our results suggest that cognitively normal older adults who report higher levels of physical activity may have slightly better cognitive performance, but the potential cognitive benefits of higher levels of physical activity over time may be most evident in individuals at genetic risk for Alzheimer disease.

The relationship between motor function, cognition, independence and quality of life in myelomeningocele patients.

PubMed

Luz, Carolina Lundberg; Moura, Maria Clara Drummond Soares de; Becker, Karine Kyomi; Teixeira, Rosani Aparecida Antunes; Voos, Mariana Callil; Hasue, Renata Hydee

2017-08-01

Motor function, cognition, functional independence and quality of life have been described in myelomeningocele patients, but no study has investigated their relationships. We aimed to investigate the relationships between motor function, cognition, functional independence, quality of life, age, and lesion level in myelomeningocele patients, and investigate the influence of hydrocephalus on these variables. We assessed 47 patients with the Gross Motor Function Measure (motor function), Raven's Colored Progressive Matrices (cognition), Pediatric Evaluation of Disability Inventory (functional independence) and the Autoquestionnaire Qualité de vie Enfant Imagé (quality of life). Spearman's correlation tests determined relationships between the variables. The Friedman ANOVAs determined the influence of hydrocephalus. Motor function was strongly related to mobility and lesion level, and moderately related to cognition, self-care and social function. Cognition and quality of life were moderately related to functional independence. Age correlated moderately with functional independence and quality of life. Hydrocephalus resulted in poorer motor/cognitive outcomes and lower functional independence.

[Poststroke cognitive, emotional impairment and sleep quality: efficience of treatment with melaxen].

PubMed

Kulesh, A A; Shestakov, V V

2014-01-01

To study melatonin secretion and its correlations with poststroke cognitive, emotional impairment and sleep quality in the acute period of stroke and to assess treatment efficacy of melaxen. We studied 96 patients with acute stroke. A battery of tests and scales for assessment of neurological deficit, neuropsychological status and emotional impairment was used. The night urinary level of 6-sulfatoxymelatonin was assessed. The relationship between 6-sulfatoxymelatonin and cognitive, emotional status and sleep parameters was analyzed. The level of 6-sulfatoxymelatonin was decreased in the night urine. Patients with dysexecutive poststroke cognitive impairment had higher level of 6-sulfatoxymelatonin and patients with dysmnestic and mixed cognitive impairment had lower level of 6-sulfatoxymelatonin in comparison with patients with normal cognitive functions. Melaxen improved cognitive function and sleep parameters, reduced the level of anxiety in the early recovery period of stroke. A role of chronobiological processes in the development of clinical signs of stroke in the aspect of cognitive impairment is discussed.

Experimental Effects of Acute Exercise and Meditation on Parameters of Cognitive Function.

PubMed

Edwards, Meghan K; Loprinzi, Paul D

2018-05-29

Single bouts of aerobic exercise and meditation have been shown to improve cognitive function. Yet to be examined in the literature, we sought to examine the effects of a combination of acute bouts of aerobic exercise and meditation on cognitive function among young adults. Participants ( n = 66, mean (SD) age = 21 (2)) were randomly assigned to walk then meditate, meditate then walk, or to sit (inactive control). All walking and meditation bouts were 10 min in duration. Participants' cognition was monitored before and after the intervention using Identification, Set Shifting, Stroop, and Trail Making tasks. Additionally, a subjective assessment of cognitive function was implemented before and after the intervention. Significant group by time interaction effects were observed when examining the Stroop congruent trials ( P = 0.05). Post hoc paired t -tests revealed that reaction time significantly decreased from baseline to post-intervention in both combination groups ( P < 0.001 for both), but not in the control group ( P = 0.09). Regarding all other cognitive assessments, there were no significant group by time interaction effects ( P > 0.05). Cognitive function was not substantially affected by a combination of brief meditation and exercise, though there is evidence to suggest that this combination may have beneficial effects on certain aspects of cognition. Future work should be conducted to evaluate the influences of different doses of exercise and meditation on cognitive functioning.

Cognitive function and advanced kidney disease: longitudinal trends and impact on decision-making.

PubMed

Iyasere, Osasuyi; Okai, David; Brown, Edwina

2017-02-01

Background: Cognitive impairment commonly affects renal patients. But little is known about the influence of dialysis modality on cognitive trends or the influence of cognitive impairment on decision-making in renal patients. This study evaluated cognitive trends amongst chronic kidney disease (CKD), haemodialysis (HD) and peritoneal dialysis (PD) patients. The relationship between cognitive impairment and decision-making capacity (DMC) was also assessed. Methods: Patients were recruited from three outpatient clinics. Cognitive function was assessed 4-monthly for up to 2 years, using the Montreal Cognitive Assessment (MoCA) tool. Cognitive trends were assessed using mixed model analysis. DMC was assessed using the Macarthur Competency Assessment tool (MacCAT-T). MacCAT-T scores were compared between patients with cognitive impairment (MoCA <26) and those without. Results: In total, 102 (41 HD, 25 PD and 36 CKD) patients were recruited into the prospective study. After multivariate analysis, the total MoCA scores declined faster in dialysis compared with CKD patients [coefficient = -0.03, 95% confidence interval (95% CI) = -0.056 to - 0.004; P = 0.025]. The MoCA executive scores declined faster in the HD compared with PD patients (coefficient = -0.12, 95% CI = -0.233 to - 0.007; P = 0.037). DMC was assessed in 10 patients. Those with cognitive impairment had lower MacCAT-T compared with those without [median (interquartile range) 19 (17.9-19.6) versus 17.4 (16.3-18.4); P = 0.049]. Conclusions: Cognition declines faster in dialysis patients compared with CKD patients and in HD patients compared with PD patients. Cognitive impairment affects DMC in patients with advanced kidney disease.

Social cognition and prefrontal hemodynamic responses during a working memory task in schizophrenia.

PubMed

Pu, Shenghong; Nakagome, Kazuyuki; Yamada, Takeshi; Itakura, Masashi; Yamanashi, Takehiko; Yamada, Sayaka; Masai, Mieko; Miura, Akihiko; Yamauchi, Takahira; Satake, Takahiro; Iwata, Masaaki; Nagata, Izumi; Roberts, David L; Kaneko, Koichi

2016-03-01

Social cognition is an important determinant of functional impairment in schizophrenia, but its relationship with the prefrontal functional abnormalities associated with the condition is still unclear. The present study aimed to explore the relationship between social cognition and prefrontal function in patients with schizophrenia using 52-channel near-infrared spectroscopy (NIRS). Twenty-six patients with schizophrenia and 26 age-, gender-, and intelligence quotient-matched healthy controls (HCs) participated in the study. Hemodynamic responses in the prefrontal and superior temporal cortical regions were assessed during a working memory task using NIRS. Social cognition was assessed using the Social Cognition Screening Questionnaire (SCSQ). The observed hemodynamic responses were significantly reduced in the lateral prefrontal cortex (PFC), the frontopolar cortex, and temporal regions in subjects with schizophrenia compared to HCs. Additionally, lateral PFC hemodynamic responses assessed during the working memory task demonstrated a strong positive correlation with the SCSQ theory of mind (ToM) subscale score even after controlling for working memory performance. These results suggest that ToM integrity is closely related to lateral PFC functional abnormalities found in patients with schizophrenia. In addition, this study provides evidence to suggest that NIRS could be used to identify biomarkers of social cognition function in subjects with schizophrenia.

The aging physician and surgeon.

PubMed

Sataloff, Robert T; Hawkshaw, Mary; Kutinsky, Joshua; Maitz, Edward A

2016-01-01

As the population of aging physicians increases, methods of assessing physicians' cognitive function and predicting clinically significant changes in clinical performance become increasingly important. Although several approaches have been suggested, no evaluation system is accepted or utilized widely. This article reviews literature using MEDLINE, PubMed, and other sources. Articles discussing the problems of geriatric physicians are summarized, stressing publications that proposed methods of evaluation. Selected literature on evaluating aging pilots also was reviewed, and potential applications for physician evaluation are proposed. Neuropsychological cognitive test protocols were summarized, and a reduced evaluation protocol is proposed for interdisciplinary longitudinal research. Although there are several articles evaluating cognitive function in aging physicians and aging pilots, and although a few institutions have instituted cognitive evaluation, there are no longitudinal data assessing cognitive function in physicians over time or correlating them with performance. Valid, reliable testing of cognitive function of physicians is needed. In order to understand its predictive value, physicians should be tested over time starting when they are young, and results should be correlated with physician performance. Early testing is needed to determine whether cognitive deficits are age-related or long-standing. A multi-institutional study over many years is proposed. Additional assessments of other factors such as manual dexterity (perhaps using simulators) and physician frailty are recommended.

Frontal Gamma-Aminobutyric Acid Concentrations Are Associated With Cognitive Performance in Older Adults.

PubMed

Porges, Eric C; Woods, Adam J; Edden, Richard A E; Puts, Nicolaas A J; Harris, Ashley D; Chen, Huaihou; Garcia, Amanda M; Seider, Talia R; Lamb, Damon G; Williamson, John B; Cohen, Ronald A

2017-01-01

Gamma-aminobutyric acid (GABA), the brain's principal inhibitory neurotransmitter, has been associated with perceptual and attentional functioning. Recent application of magnetic resonance spectroscopy (MRS) provides in vivo evidence for decreasing GABA concentrations during adulthood. It is unclear, however, how age-related decrements in cerebral GABA concentrations contribute to cognitive decline, or whether previously reported declines in cerebral GABA concentrations persist during healthy aging. We hypothesized that participants with higher GABA concentrations in the frontal cortex would exhibit superior cognitive function and that previously reported age-related decreases in cortical GABA concentrations continue into old age. We measured GABA concentrations in frontal and posterior midline cerebral regions using a Mescher-Garwood point-resolved spectroscopy (MEGA-PRESS) 1 H-MRS approach in 94 older adults without history or clinical evidence of mild cognitive impairment or dementia (mean age, 73 years). We administered the Montreal Cognitive Assessment to assess cognitive functioning. Greater frontal GABA concentrations were associated with superior cognitive performance. This relation remained significant after controlling for age, years of education, and brain atrophy. GABA concentrations in both frontal and posterior regions decreased as a function of age. These novel findings from a large, healthy, older population indicate that cognitive function is sensitive to cerebral GABA concentrations in the frontal cortex, and GABA concentration in frontal and posterior regions continue to decline in later age. These effects suggest that proton MRS may provide a clinically useful method for the assessment of normal and abnormal age-related cognitive changes and the associated physiological contributors.

Frontal Gamma-Aminobutyric Acid Concentrations Are Associated With Cognitive Performance in Older Adults

PubMed Central

Porges, Eric C.; Woods, Adam J.; Edden, Richard A.E.; Puts, Nicolaas A.J.; Harris, Ashley D.; Chen, Huaihou; Garcia, Amanda M.; Seider, Talia R.; Lamb, Damon G.; Williamson, John B.; Cohen, Ronald A.

2017-01-01

BACKGROUND Gamma-aminobutyric acid (GABA), the brain’s principal inhibitory neurotransmitter, has been associated with perceptual and attentional functioning. Recent application of magnetic resonance spectroscopy (MRS) provides in vivo evidence for decreasing GABA concentrations during adulthood. It is unclear, however, how age-related decrements in cerebral GABA concentrations contribute to cognitive decline, or whether previously reported declines in cerebral GABA concentrations persist during healthy aging. We hypothesized that participants with higher GABA concentrations in the frontal cortex would exhibit superior cognitive function and that previously reported age-related decreases in cortical GABA concentrations continue into old age. METHODS We measured GABA concentrations in frontal and posterior midline cerebral regions using a Mescher-Garwood point-resolved spectroscopy (MEGA-PRESS) 1H-MRS approach in 94 older adults without history or clinical evidence of mild cognitive impairment or dementia (mean age, 73 years). We administered the Montreal Cognitive Assessment to assess cognitive functioning. RESULTS Greater frontal GABA concentrations were associated with superior cognitive performance. This relation remained significant after controlling for age, years of education, and brain atrophy. GABA concentrations in both frontal and posterior regions decreased as a function of age. CONCLUSIONS These novel findings from a large, healthy, older population indicate that cognitive function is sensitive to cerebral GABA concentrations in the frontal cortex, and GABA concentration in frontal and posterior regions continue to decline in later age. These effects suggest that proton MRS may provide a clinically useful method for the assessment of normal and abnormal age-related cognitive changes and the associated physiological contributors. PMID:28217759

Demonstration of cognitive decline in Parkinson's disease using the Cambridge Cognitive Assessment (Revised) (CAMCOG-R).

PubMed

Athey, Richard J; Walker, Richard W

2006-10-01

Cognitive impairment is well recognised in Parkinson's Disease (PD) but few studies have examined cognitive decline over time in such subjects. Standard clinical assessments of cognitive function, such as the MMSE, do not measure all cognitive domains and often have a ceiling effect. CAMCOG-R provides a more comprehensive cognitive assessment allowing several different domains of cognition to be compared. It also features the ability to test 'executive function'. CAMCOG-R has only been reported on one previous occasion in PD subjects and this is the first study to report a follow-up CAMCOG-R to assess cognitive decline. In a previously published study CAMCOG-R was administered to a prevalent community-based population of 94 subjects with PD with a MMSE of 25 or above. In this subsequent study 85 of the subjects (two declined and seven were deceased) underwent a follow-up CAMCOG-R after a mean delay of 13.1 months. The initial, and follow-up mean total CAMCOG-R scores were 88.65/104 and 84.75/104 respectively, demonstrating a significant decline (p < 0.05). Significant cognitive decline (p < 0.05) was also seen across every CAMCOG-R cognitive domain and in the executive function scores. A wide range of cognitive ability was again demonstrated using CAMCOG-R in this PD population. The decline of 3.9 CAMCOG-R points over the 13-month period compares to other previous studies showing an annual decline of 1.6 CAMCOG points in normal elderly individuals and 12 CAMCOG points annually in those with established dementia. This study suggests that CAMCOG-R is a useful and appropriate tool for use in follow-up cognitive screening in PD subjects. Copyright (c) 2006 John Wiley & Sons, Ltd.

Performance of a computer-based assessment of cognitive function measures in two cohorts of seniors

USDA-ARS?s Scientific Manuscript database

Computer-administered assessment of cognitive function is being increasingly incorporated in clinical trials, however its performance in these settings has not been systematically evaluated. The Seniors Health and Activity Research Program (SHARP) pilot trial (N=73) developed a computer-based tool f...

A Randomized, Placebo-Controlled, Active-Reference, Double-Blind, Flexible-Dose Study of the Efficacy of Vortioxetine on Cognitive Function in Major Depressive Disorder

PubMed Central

Mahableshwarkar, Atul R; Zajecka, John; Jacobson, William; Chen, Yinzhong; Keefe, Richard SE

2015-01-01

This multicenter, randomized, double-blind, placebo-controlled, active-referenced (duloxetine 60 mg), parallel-group study evaluated the short-term efficacy and safety of vortioxetine (10–20 mg) on cognitive function in adults (aged 18–65 years) diagnosed with major depressive disorder (MDD) who self-reported cognitive dysfunction. Efficacy was evaluated using ANCOVA for the change from baseline to week 8 in the digit symbol substitution test (DSST)–number of correct symbols as the prespecified primary end point. The patient-reported perceived deficits questionnaire (PDQ) and physician-assessed clinical global impression (CGI) were analyzed in a prespecified hierarchical testing sequence as key secondary end points. Additional predefined end points included the objective performance-based University of San Diego performance-based skills assessment (UPSA) (ANCOVA) to measure functionality, MADRS (MMRM) to assess efficacy in depression, and a prespecified multiple regression analysis (path analysis) to calculate direct vs indirect effects of vortioxetine on cognitive function. Safety and tolerability were assessed at all visits. Vortioxetine was statistically superior to placebo on the DSST (P<0.05), PDQ (P<0.01), CGI-I (P<0.001), MADRS (P<0.05), and UPSA (P<0.001). Path analysis indicated that vortioxetine's cognitive benefit was primarily a direct treatment effect rather than due to alleviation of depressive symptoms. Duloxetine was not significantly different from placebo on the DSST or UPSA, but was superior to placebo on the PDQ, CGI-I, and MADRS. Common adverse events (incidence ⩾5%) for vortioxetine were nausea, headache, and diarrhea. In this study of MDD adults who self-reported cognitive dysfunction, vortioxetine significantly improved cognitive function, depression, and functionality and was generally well tolerated. PMID:25687662

Clinical Trials of Blood Pressure Lowering and Antihypertensive Medication: Is Cognitive Measurement State-of-the-Art?

PubMed

Elias, Merrill F; Torres, Rachael V; Davey, Adam

2018-05-07

Randomized controlled trials of blood pressure (BP) lowering and antihypertensive medication use on cognitive outcomes have often been disappointing, reporting mixed findings and small effect sizes. We evaluate the extent to which cognitive assessment protocols used in these trials approach state-of-the-art. Overall, we find that a primary focus on cognition and the systematic selection of cognitive outcomes across trials take a backseat to other trial goals. Twelve trials investigating change in cognitive functioning were examined and none met criteria for state-of-the-art assessment, including use of at least 4 tests indexing 2 cognitive domains. Four trials investigating incident dementia were also examined. Each trial used state-of-the-art diagnostic criteria to assess dementia, although follow-up periods were relatively short, with only 2 trials lasting for at least 3 years. Weaknesses in each trial may act to obscure or weaken the positive effects of BP lowering on cognitive functioning. Improving trial designs in terms of cognitive outcomes selected and length of follow-up periods employed could lead to more promising findings. We offer logical steps to achieve state-of-the-art assessment protocols, with examples, in hopes of improving future trials.

Predicting cognitive function of the Malaysian elderly: a structural equation modelling approach.

PubMed

Foong, Hui Foh; Hamid, Tengku Aizan; Ibrahim, Rahimah; Haron, Sharifah Azizah; Shahar, Suzana

2018-01-01

The aim of this study was to identify the predictors of elderly's cognitive function based on biopsychosocial and cognitive reserve perspectives. The study included 2322 community-dwelling elderly in Malaysia, randomly selected through a multi-stage proportional cluster random sampling from Peninsular Malaysia. The elderly were surveyed on socio-demographic information, biomarkers, psychosocial status, disability, and cognitive function. A biopsychosocial model of cognitive function was developed to test variables' predictive power on cognitive function. Statistical analyses were performed using SPSS (version 15.0) in conjunction with Analysis of Moment Structures Graphics (AMOS 7.0). The estimated theoretical model fitted the data well. Psychosocial stress and metabolic syndrome (MetS) negatively predicted cognitive function and psychosocial stress appeared as a main predictor. Socio-demographic characteristics, except gender, also had significant effects on cognitive function. However, disability failed to predict cognitive function. Several factors together may predict cognitive function in the Malaysian elderly population, and the variance accounted for it is large enough to be considered substantial. Key factor associated with the elderly's cognitive function seems to be psychosocial well-being. Thus, psychosocial well-being should be included in the elderly assessment, apart from medical conditions, both in clinical and community setting.

Clinical progression and outcome of dysphagia following paediatric traumatic brain injury: a prospective study.

PubMed

Morgan, Angela; Ward, Elizabeth; Murdoch, Bruce

2004-04-01

To provide a preliminary clinical profile of the resolution and outcomes of oral-motor impairment and swallowing function in a group of paediatric dysphagia patients post-traumatic brain injury (TBI). To document the level of cognitive impairment parallel to the return to oral intake, and to investigate the correlation between the resolution of impaired swallow function versus the resolution of oral-motor impairment and cognitive impairment. Thirteen children admitted to an acute care setting for TBI. A series of oral-motor (Verbal Motor Production Assessment for Children, Frenchay Dysarthria Assessment, Schedule for Oral Motor Assessment) and swallowing (Paramatta Hospital's Assessment for Dysphagia) assessments, an outcome measure for swallowing (Royal Brisbane Hospital's Outcome Measure for Swallowing), and a cognitive rating scale (Rancho Level of Cognitive Functioning Scale). Across the patient group, oral-motor deficits resolved to normal status between 3 and 11 weeks post-referral (and at an average of 12 weeks post-injury) and swallowing function and resolution to normal diet status were achieved by 3-11 weeks post-referral (and at an average of 12 weeks post-injury). The resolution of dysphagia and the resolution of oral-motor impairment and cognitive impairment were all highly correlated. The provision of a preliminary profile of oral-motor functioning and dysphagia resolution, and data on the linear relationship between swallowing impairment and cognition, will provide baseline information on the course of rehabilitation of dysphagia in the paediatric population post-TBI. Such data will contribute to more informed service provision and rehabilitation planning for paediatric patients post-TBI.

The Study of Cognitive Function and Related Factors in Patients With Heart Failure

PubMed Central

Ghanbari, Atefeh; Moaddab, Fatemeh; Salari, Arsalan; Kazemnezhad Leyli, Ehsan; Sedghi Sabet, Mitra; Paryad, Ezzat

2013-01-01

Background: Cognitive impairment is increasingly recognized as a common adverse consequence of heart failure. Both Heart failure and cognitive impairment are associated with frequent hospitalization and increased mortality, particularly when they occur simultaneously. Objectives: To determine cognitive function and related factors in patients with heart failure. Materials and Methods: In this descriptive cross-sectional study, we assessed 239 patients with heart failure. Data were collected by Mini Mental status Examination, Charlson comorbidity index and NYHA classification system. Data were analyzed using descriptive statistics, Kolmogorov-Smirnov test, chi-square test, t-test and logistic regression analysis. Results: The mean score of cognitive function was 21.68 ± 4.51. In total, 155 patients (64.9%) had cognitive impairment. Significant associations were found between the status of cognitive impairment and gender (P < 0.002), education level (P < 0.000), living location (P < 0.000), marital status (P < 0.03), living arrangement (P < 0.001 ), employment status (P < 0.000), income (P < 0.02), being the head of family (P < 0.03), the family size (P < 0.02), having a supplemental insurance (P < 0.003) and the patient’s comorbidities (P < 0.02). However, in logistic regression analysis, only education and supplementary insurance could predict cognitive status which indicates that patients with supplementary insurance and higher education levels were more likely to maintain optimal cognitive function. Conclusions: More than a half of the subjects had cognitive impairment. As the level of patients cognitive functioning affects their behaviors and daily living activities, it is recommended that patients with heart failure should be assessed for their cognitive functioning. PMID:25414874

Physical Activity Throughout the Adult Life Span and Domain-Specific Cognitive Function in Old Age: A Systematic Review of Cross-Sectional and Longitudinal Data.

PubMed

Engeroff, Tobias; Ingmann, Tobias; Banzer, Winfried

2018-06-01

A growing body of literature suggests that physical activity might alleviate the age-related neurodegeneration and decline of cognitive function. However, most of this evidence is based on data investigating the association of exercise interventions or current physical activity behavior with cognitive function in elderly subjects. We performed a systematic review and hypothesize that physical activity during the adult life span is connected with maintained domain-specific cognitive functions during late adulthood defined as age 60+ years. We performed a systematic literature search up to November 2017 in PubMed, Web of Science, and Google Scholar without language limitations for studies analyzing the association of leisure physical activity during the adult life span (age 18+ years) and domain-specific cognitive functions in older adults (age 60+ years). The literature review yielded 14,294 articles and after applying inclusion and exclusion criteria, nine cross-sectional and 14 longitudinal studies were included. Moderate- and vigorous-intensity leisure physical activity was associated with global cognitive function and specific cognitive domains including executive functions and memory but not attention or working memory. Most studies assessed mid- to late-adulthood physical activity, thus information concerning the influence of young adult life-span physical activity is currently lacking. Observational evidence that moderate- and vigorous-intensity leisure physical activity is beneficially associated with maintained cognitive functions during old age is accumulating. Further studies are necessary to confirm a causal link by assessing objective physical activity data and the decline of cognitive functions at multiple time points during old age.

Cognitive training plus a comprehensive psychosocial programme (OPUS) versus the comprehensive psychosocial programme alone for patients with first-episode schizophrenia (the NEUROCOM trial): a study protocol for a centrally randomised, observer-blinded multi-centre clinical trial.

PubMed

Vesterager, Lone; Christensen, Torben Ø; Olsen, Birthe B; Krarup, Gertrud; Forchhammer, Hysse B; Melau, Marianne; Gluud, Christian; Nordentoft, Merete

2011-02-09

Up to 85% of patients with schizophrenia demonstrate cognitive dysfunction in at least one domain. Cognitive dysfunction plays a major role in functional outcome. It is hypothesized that addition of cognitive training to a comprehensive psychosocial programme (OPUS) enhances both cognitive and everyday functional capacity of patients more than the comprehensive psychosocial programme alone. The NEUROCOM trial examines the effect on cognitive functioning and everyday functional capacity of patients with schizophrenia of a 16-week manualised programme of individual cognitive training integrated in a comprehensive psychosocial programme versus the comprehensive psychosocial programme alone. The cognitive training consists of four modules focusing on attention, executive functioning, learning, and memory. Cognitive training involves computer-assisted training tasks as well as practical everyday tasks and calendar training. It takes place twice a week, and every other week the patient and trainer engage in a dialogue on the patient's cognitive difficulties, motivational goals, and progress in competence level. Cognitive training relies on errorless learning principles, scaffolding, and verbalisation in its effort to improve cognitive abilities and teach patients how to apply compensation strategies as well as structured problem solving techniques. At 16-week post-training and at ten-months follow-up, assessments are conducted to investigate immediate outcome and possible long-term effects of cognitive training. We conduct blinded assessments of cognition, everyday functional capacity and associations with the labour market, symptom severity, and self-esteem. Results from four-month and ten-month follow-ups have the potential of reliably providing documentation of the long-term effect of CT for patients with schizophrenia. Clinicaltrials.gov NCT00472862.

Association between age associated cognitive decline and health related quality of life among Iranian older individuals.

PubMed

Kazazi, Leila; Foroughan, Mahshid; Nejati, Vahid; Shati, Mohsen

2018-04-01

Age associated cognitive decline or normal cognitive aging is related with lower levels of functioning in real life, and may interfere with maintaining independence and health related quality of life (HRQL). In this study, health related quality of life and cognitive function in community-dwelling older adults were evaluated with the aim of exploring the association between them by adjusting for potential confounders. This cross-sectional study, was implemented on 425 community-dwelling older adults aged 60 and over, between August 2016 and October 2016 in health centers of the municipality of Tehran, Iran, using Mini Mental State Examination (MMSE) to assess cognitive function and Short Form-36 scales (SF-36) to assess HRQL. The relation between HRQL and cognitive function was evaluated by Pearson's correlation coefficient, and the impact of cognitive function on HRQL adjusted for potential confounders was estimated by linear regression model. All analyses were done using SPSS, version 22.0. A positive significant correlation between cognitive function and quality of life (r=0.434; p<0.001) and its dimensions was observed. Two variables of educational level (B=2.704; 95% CI: 2.09 to 3.30; p<0.001) and depression (B=2.554; 95% CI: 2.00 to 3.10; p<0.001) were assumed as potential confounder by changing effect measure after entering the model. After adjusting for potential confounders in regression model, the association between MMSE scores and quality of life persisted (B=2.417; 95% CI: 1.86 to 2.96; p<0.001). The results indicate that cognitive function was associated with HRQL in older adults with age associated cognitive function. Two variables of educational level and depression can affect the relation between cognitive decline and HRQL.

Connections between Vision, Hearing, and Cognitive Function in Old Age.

ERIC Educational Resources Information Center

Wahl, Hans-Werner; Heyl, Vera

2003-01-01

Discusses findings of studies that examined the relationship between vision, hearing, and cognitive function in normally aging adults. Indicates that most found at least modest significant relationships between sensory and cognitive measures based on diverse assessment and design methods. (Contains 42 references.) (JOW)

Cognitive Functioning in Long Duration Head-down Bed Rest

NASA Technical Reports Server (NTRS)

Seaton, Kimberly A.; Slack, Kelley J.; Sipes, Walter A.; Bowie, Kendra

2008-01-01

The Space Flight Cognitive Assessment Tool for Windows (WinSCAT) is a self-administered battery of tests used on the International Space Station for evaluating cognitive functioning. Here, WinSCAT was used to assess cognitive functioning during extended head-down bed rest. Thirteen subjects who participated in 60 or 90 days of 6 deg head-down bed rest took WinSCAT during the pre-bed rest phase, the in-bed rest phase, and the post-bed rest (reconditioning) phase of study participation. After adjusting for individual baseline performance, 12 off-nominal scores were observed out of 351 total observations during bed rest and 7 of 180 during reconditioning. No evidence was found for systematic changes in off-nominal incidence as time in bed rest progressed, or during the reconditioning period. Cognitive functioning does not appear to be adversely affected by long duration head-down bed rest. Individual differences in underlying cognitive ability and motivation level are likely explanations for the current findings.

Relationship between financial competence and cognitive function in patients with schizophrenia.

PubMed

Niekawa, Nobuyuki; Sakuraba, Yukie; Uto, Hanae; Kumazawa, Yoshiko; Matsuda, Osamu

2007-10-01

The present study examined financial competence in patients with schizophrenia and the relationship between their financial competence and cognitive function. The subjects consisted of 25 patients with schizophrenia (10 inpatients and 15 outpatients) and 22 normal controls who were community-dwelling people with no psychiatric disorders or cognitive deficit. To assess the subjects' cognitive function and financial competence, they completed the Japanese version of the Neurobehavioral Cognitive Status Examination (COGNISTAT), which has 10 subtests, and the Financial Competency Assessment Tool (FCAT), which has six subordinate domains of financial competence. Patients with schizophrenia performed significantly worse than the controls in all scores on the FCAT. The financial scores that were significantly different between the patients and the normal controls were significantly positively correlated with the scores on several COGNISTAT subtests (e.g. comprehension). These results suggest that patients with schizophrenia have problems with financial competence and that these problems may be accounted for by deficits in several cognitive functions.

[Noopept in the treatment of mild cognitive impairment in patients with stroke].

PubMed

Amelin, A V; Iliukhina, A Iu; Shmonin, A A

2011-01-01

Noopept is a neuroprotector and nootropics. Literature data revealed the treatment effect of noopept on mild cognitive impairment in patients with discirculatory encephalopathy. The present open prospective study included 60 patients with stroke treated with noopept during 12 months. Cognitive functions were assessed before and after treatment using neuropsychological tests. An analysis of MMSE scores and lateral and categorical associations revealed the significant improvement of cognitive functions after 2 months in patients of the main group compared to the controls. The global assessment of efficacy revealed the mild improvement in the main group while no changes were found in the control group. The results have demonstrated that noopept, used in dose 20 mg daily during 2 months, improves cognitive functions in stroke patients and has a high level of safety.

[Effects of Square-Stepping Exercise inducing activation of the brain's cognitive function in community-dwelling older Japanese females--Focus on the baseline cognitive function level and age].

PubMed

Abe, Takumi; Tsuji, Taishi; Kitano, Naruki; Muraki, Toshiaki; Hotta, Kazushi; Okura, Tomohiro

2015-01-01

The purpose of this study was to investigate whether the degree of improvement in cognitive function achieved with an exercise intervention in community-dwelling older Japanese women is affected by the participant's baseline cognitive function and age. Eighty-eight women (mean age: 70.5±4.2 years) participated in a prevention program for long-term care. They completed the Square-Stepping Exercise (SSE) program once a week, 120 minutes/session, for 11 weeks. We assessed participants' cognitive function using 5 cognitive tests (5-Cog) before and after the intervention. We defined cognitive function as the 5-Cog total score and defined the change in cognitive function as the 5-cog post-score minus the pre-score. We divided participants into four groups based on age (≤69 years or ≥70 years) and baseline cognitive function level (above vs. below the median cognitive function level). We conducted two-way analysis of variance. All 4 groups improved significantly in cognitive function after the intervention. There were no baseline cognitive function level×age interactions and no significant main effects of age, although significant main effects of baseline cognitive function level (P=0.004, η(2)=0.09) were observed. Square-Stepping Exercise is an effective exercise for improving cognitive function. These results suggest that older adults with cognitive decline are more likely to improve their cognitive function with exercise than if they start the intervention with high cognitive function. Furthermore, during an exercise intervention, baseline cognitive function level may have more of an effect than a participant's age on the degree of cognitive improvement.

Cultural Factors Affecting the Differential Performance of Israeli and Palestinian Children on the Loewenstein Occupational Therapy Cognitive Assessment

ERIC Educational Resources Information Center

Josman, Naomi; Abdallah, Taisir M.; Engel-Yeger, Batya

2010-01-01

Cognitive performance is essential for children's functioning and may also predict school readiness. The suitability of Western standardized assessments for cognitive performance among children from different cultures needs to be elaborated. This study referred to the existence of differences in cognitive performance between and within children…

Cognitive impairment as measured by the THINC-integrated tool (THINC-it): Association with psychosocial function in major depressive disorder.

PubMed

Cha, Danielle S; Carmona, Nicole E; Subramaniapillai, Mehala; Mansur, Rodrigo B; Lee, Yena; Hon Lee, Jae; Lee, JungGoo; Rosenblat, Joshua D; Shekotikhina, Margarita; Park, Caroline; Rong, Carola; Greer, Tracy L; Lam, Raymond; Baune, Bernhard T; Harrison, John; McIntyre, Roger S

2017-11-01

Psychosocial impairment represents an important treatment target in major depressive disorder (MDD). The majority of patients with MDD do not regain premorbid levels of psychosocial functioning despite the resolution of core depressive symptoms. This study aimed to investigate the respective effects of cognitive function and depression severity on impaired psychosocial function in MDD. Adults aged 18-65 with moderate-to-severe MDD (n = 100) and age-, sex-, and education-matched healthy controls participated in a cross-sectional study validating the THINC-integrated tool (THINC-it), a cognitive screening tool comprised of objective and subjective measures of cognitive function. Depression severity was assessed using the Montgomery-Åsberg Depression Rating Scale and psychosocial function was assessed using the Sheehan Disability Scale (SDS). Subjects with MDD reported greater impairment in psychosocial function than healthy controls, with significant differences in SDS total and domain scores (ps < .01) after controlling for age, sex, and education. Generalized linear models indicated that subjective cognitive function was most strongly associated with SDS total score (RR = .14, p = .01) and SDS domains of work/school (RR = .15, p = .03), family and home responsibilities (RR = .15, p = .02), and economic days lost (RR = .18, p =.03). Depression severity was most strongly associated with SDS social life (RR = .08, p < .01) and economic days underproductive (RR = .07, p < .01). Objective cognitive function was not significantly associated with any SDS outcomes. The cross-sectional, observational study design limits temporal inferences. The self-report nature of measures included may have influenced associations observed. Potential medication effects are not noted. Cognitive deficits, as measured by the THINC-it, are associated with significant psychosocial impairment in MDD. These results provide empirical support for the assessment of both subjective and objective measures of cognition, as they are not associated with each other and have differential effects on functional trajectory. Copyright © 2017 Elsevier B.V. All rights reserved.

Volunteering in the Community: Potential Benefits for Cognitive Aging.

PubMed

Guiney, Hayley; Machado, Liana

2018-03-02

This review aims to advance understanding of the potential benefits of volunteering in the community for older adults' cognitive functioning by taking an in-depth look at the relevant evidence to date. This review describes the main pathways through which volunteering could plausibly benefit cognitive functioning and critically examines research that has specifically investigated links between volunteering and cognition. Fifteen articles that assessed in adults aged ≥ 55 years the relationship between volunteering (predictor) and cognitive functioning (outcome) were identified via literature database searches. On balance, evidence from the small number of relevant studies to date supports the idea that volunteering can protect against cognitive aging with respect to global functioning and at least some specific cognitive domains. Studies that used robust designs and assessed domain-specific cognitive functioning produced the largest effect sizes. To help advance the field, this review puts forward recommendations for future research, with an emphasis on the need for robust study designs and specific investigations into the nature and extent of the cognitive benefits of volunteering. Through that work, researchers can determine how a simple and accessible activity like volunteering can best be used to help reduce the burden of age-related cognitive decline. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Cognitive function and living situation in COPD: is there a relationship with self-management and quality of life?

PubMed

Dulohery, Megan M; Schroeder, Darrell R; Benzo, Roberto P

2015-01-01

Cognitive impairment is increasingly being found to be a common comorbidity in chronic obstructive pulmonary disease (COPD). This study sought to understand the relationship of comprehensively measured cognitive function with COPD severity, quality of life, living situation, health care utilization, and self-management abilities. Subjects with COPD were recruited from the outpatient pulmonary clinic. Cognitive function was assessed using the Montreal Cognitive Assessment (MOCA). Self-management abilities were measured using the Self Management Ability Score 30. Quality of life was measured using the Chronic Respiratory Disease Questionnaire. Pearson correlation was used to assess the bivariate association of the MOCA with other study measures. Multivariate analysis was completed to understand the interaction of the MOCA and living situation on COPD outcomes of hospitalization, quality of life, and self-management ability. This study included 100 participants of mean age 70±9.4 years (63% male, 37% female) with COPD (mean FEV1 [forced expiratory volume in 1 second] percentage predicted 40.4±16.7). Mean MOCA score was 23.8±3.9 with 63% of patients having mild cognitive impairment. The MOCA was negatively correlated with age (r=-0.28, P=0.005) and positively correlated with education (r=+0.24, P=0.012). There was no significant correlation between cognitive function and exacerbations, emergency room (ER) visits, or hospitalizations. There was no association between the MOCA score and self-management abilities or quality of life. We tested the interaction of living situation and the MOCA with self-management abilities and found statistical significance (P=0.017), indicating that individuals living alone with higher cognitive function report lower self-management abilities. Cognitive impairment in COPD does not appear to be meaningfully associated with COPD severity, health outcomes, or self-management abilities. The routine screening for cognitive impairment due to a diagnosis of COPD may not be indicated. Living alone significantly affects the interaction between self-management abilities and cognitive function.

Longitudinal cognitive biomarkers predicting symptom onset in presymptomatic frontotemporal dementia.

PubMed

Jiskoot, Lize C; Panman, Jessica L; van Asseldonk, Lauren; Franzen, Sanne; Meeter, Lieke H H; Donker Kaat, Laura; van der Ende, Emma L; Dopper, Elise G P; Timman, Reinier; van Minkelen, Rick; van Swieten, John C; van den Berg, Esther; Papma, Janne M

2018-06-01

We performed 4-year follow-up neuropsychological assessment to investigate cognitive decline and the prognostic abilities from presymptomatic to symptomatic familial frontotemporal dementia (FTD). Presymptomatic MAPT (n = 15) and GRN mutation carriers (n = 31), and healthy controls (n = 39) underwent neuropsychological assessment every 2 years. Eight mutation carriers (5 MAPT, 3 GRN) became symptomatic. We investigated cognitive decline with multilevel regression modeling; the prognostic performance was assessed with ROC analyses and stepwise logistic regression. MAPT converters declined on language, attention, executive function, social cognition, and memory, and GRN converters declined on attention and executive function (p < 0.05). Cognitive decline in ScreeLing phonology (p = 0.046) and letter fluency (p = 0.046) were predictive for conversion to non-fluent variant PPA, and decline on categorical fluency (p = 0.025) for an underlying MAPT mutation. Using longitudinal neuropsychological assessment, we detected a mutation-specific pattern of cognitive decline, potentially suggesting prognostic value of neuropsychological trajectories in conversion to symptomatic FTD.

Comparison of cognitive functions between male and female medical students: a pilot study.

PubMed

Upadhayay, Namrata; Guragain, Sanjeev

2014-06-01

There are gender differences in cognitive abilities. The major enigma is whether males or females perform better in various cognitive tasks. The reports were found to be contradictory. Studies have shown that oestrogen and testosterone accentuate cognitive functions. But the effects of progesterone on cognitive functions are still contradictory. To assess and compare the cognitive functions between male and female students. This study was conducted on healthy male (n=21) and female (n=21) volunteers who were aged between 19-37 years. Cognitive functions which were assessed in males (one time) and females (two times: during preovulatory and postovulatory phases of the menstrual cycle) were attentional: visual reaction time (VRT) and Go/No-Go VRT; perceptual: fast counting (FC), executive: Erisken Flanker Test (EFT) and Stroop Test (ST), and working memory. Data were compared by using Mann-Whitney U-test. Cognitive functions in female preovulatory phase were comparable to male cognitive functions. In addition, the female postovulatory phase cognitive functions were also similar to those of males in all the tasks, except those seen in VRT and ST. Male performed better than females in VRT (M: 331.66 ms, IQR: 286.99-375.33 vs. M: 367.8 ms, IQR: 340.66-435.66; p=0.05). However, in ST, females showed higher accuracies in reading colour interferences than males (M: 100%, IQR: 95.12-100 vs. M: 95.24%, IQR: 86.36-100; p=0.04). In addition, males showed trend of a poorer performance than females in Go/No-Go VRT, ST colour reading normal time and interference time and in working-memory time. Male cognitive functions were comparable to female preovulatory phase cognitive functions. However, females, during postovulatory phase of their cycle, may have advantages in executive tasks (Stroop test) and disadvantages in attentional tasks (VRT), as compared to males.

How self-reflection and self-certainty are related to neurocognitive functioning: an examination of cognitive insight in bipolar disorder.

PubMed

Van Camp, L S C; Oldenburg, J F E; Sabbe, B G C

2016-01-01

The pattern of associations between clinical insight, cognitive insight, and neurocognitive functioning was assessed in bipolar disorder patients. Data from 42 bipolar disorder patients were examined. Cognitive insight was measured using the Beck Cognitive Insight Scale (BCIS). The BCIS is a 15-item self-report instrument consisting of two subscales, self-reflectiveness and self-certainty. Clinical insight was measured by the use of the item G12 of the Positive and Negative Syndrome Scale. Neurocognitive functioning was assessed using the International Society for Bipolar Disorders-Battery for Assessment of Neurocognition. Correlation analyses revealed significant positive associations between self-reflectiveness and speed of processing, attention, working memory, visual learning, and reasoning and problem solving. The subscale self-certainty was negatively correlated to working memory, however, this correlation disappeared when we controlled for confounding variables. No correlations between clinical insight and neurocognition were found. In addition, there was no association between cognitive insight and clinical insight. Better neurocognitive functioning was more related to higher levels of self-reflectiveness than to diminished self-certainty.

Association of Cognitive and Noncognitive Symptoms of Delirium: A Study from Consultation-liaison Psychiatry Set-up.

PubMed

Grover, Sandeep; Mehra, Aseem; Chakrabarti, Subho; Avasthi, Ajit

2016-12-01

This study aims to evaluate the cognitive functions of patients with delirium using Hindi Mental Status Examination (HMSE), to study the correlation of cognitive functions assessed by HMSE with noncognitive symptoms as assessed using Delirium Rating Scale-Revised 1998 (DRS-R-98) and to study the association of cognitive functions assessed using HMSE and DRS-R98. A total of 76 consecutive patients fulfilling the diagnosis of delirium were evaluated on DRS-R-98, HMSE, and Short Informant Questionnaire on Cognitive Decline in the Elderly (retrospective IQCODE). The mean DRS-R-98 score 33.9 (standard deviation [SD] - 7.2) and the mean DRS-R-98 severity score was 25.9 (SD - 7.2). The mean score on HMSE was 19.3 (7.98). There were significant correlations of all the domains of HMSE with DRS-R-98 total score, DRS-R-98 severity score, DRS-R-98 cognitive subscale score, DRS-R-98 noncognitive domain subscale score, and DRS severity score without attention score. When the association of each item of DRS-R-98 and HMSE was evaluated, except for the items of delusions, lability of affect and motor retardation, there were significant negative association between all the items of DRS-R-98 and HMSE, indicating that higher severity of cognitive symptoms as assessed on HMSE is associated with higher severity of all the cognitive symptoms and most of the noncognitive symptoms as assessed by DRS-R-98. The present study suggests that attention deficits in patients with delirium influence the severity of cognitive and noncognitive symptoms of delirium. Further, the present study suggests an increase in the severity of cognitive symptoms in other domains is also associated with an increase in the severity of noncognitive symptoms of delirium.

The role of physical exercise in cognitive recovery after traumatic brain injury: A systematic review.

PubMed

Morris, Timothy; Gomes Osman, Joyce; Tormos Muñoz, Jose Maria; Costa Miserachs, David; Pascual Leone, Alvaro

2016-11-22

There is a growing body of evidence revealing exercise-induced effects on brain structure and cognitive function across the lifespan. Animal models of traumatic brain injury also suggest exercise is capable of modulating not only the pathophysiological changes following trauma but also the associated cognitive deficits. To evaluate the effect of physical exercise on cognitive impairment following traumatic brain injury in humans. A systematic search of the PubMed database was performed using the search terms "cognition" and "executive function, memory or attention", "traumatic brain injury" and "physical exercise". Adult human traumatic brain injury studies that assessed cognitive function as an outcome measure (primary or secondary) and used physical exercise as a treatment (single or combined) were assessed by two independent reviewers. Data was extracted under the guidance of the population intervention comparison outcome framework wherein, characteristics of included studies (exercise duration, intensity, combined or single intervention, control groups and cognitive measures) were collected, after which, methodological quality (Cochrane criteria) was assessed. A total of 240 citations were identified, but only 6 met our inclusion criteria (3 from search records, 3 from reference lists. Only a small number of studies have evaluated the effect of exercise on cognition following traumatic brain injury in humans, and of those, assessment of efficacy is difficult due to low methodological strength and a high risk of different types of bias. Evidence of an effect of physical exercise on cognitive recovery suggests further studies should explore this treatment option with greater methodological approaches. Recommendations to reduce risk of bias and methodological shortfalls are discussed and include stricter inclusion criteria to create homogenous groups and larger patient pools, more rigorous cognitive assessments and the study and reporting of additional and combined rehabilitation techniques.

The Minimum Data Set 3.0 Cognitive Function Scale.

PubMed

Thomas, Kali S; Dosa, David; Wysocki, Andrea; Mor, Vincent

2017-09-01

The Minimum Data Set (MDS) 3.0 introduced the Brief Interview for Mental Status (BIMS), a short performance-based cognitive screener for nursing home (NH) residents. Not all residents are able to complete the BIMS and are consequently assessed by staff. We designed a Cognitive Function Scale (CFS) integrating self-report and staff-report data and present evidence of the scale's construct validity. A retrospective cohort study. The subjects consisted of 3 cohorts: (1) long-stay NH residents (N=941,077) and (2) new admissions (N=2,066,580) during 2011-2012, and (3) residents with the older MDS 2.0 assessment in 2010 and the newer MDS 3.0 assessment (n=688,511). MDS 3.0 items were used to create a single, integrated 4-category hierarchical CFS that was compared with residents' prior MDS 2.0 Cognitive Performance Scale scores and other concurrent MDS 3.0 measures of construct validity. The new CFS suggests that 28% of the long-stay cohort in 2011-2012 were cognitively intact, 22% were mildly impaired, 33% were moderately impaired, and 17% were severely impaired. For the admission cohort, the CFS noted 56% as cognitively intact, 23% as mildly impaired, 17% as moderately impaired, and 4% as severely impaired. The CFS corresponded closely with residents' prior MDS 2.0 Cognitive Performance Scale scores and with performance of Activities of Daily Living, and nurses' judgments of function and behavior in both the admission and long-stay cohorts. The new CFS is valuable to researchers as it provides a single, integrated measure of NH residents' cognitive function, regardless of the mode of assessment.

The cognitive impact of antiepileptic drugs

PubMed Central

Eddy, Clare M.; Rickards, Hugh E.

2011-01-01

Effective treatment of epilepsy depends on medication compliance across a lifetime, and studies indicate that drug tolerability is a significant limiting factor in medication maintenance. Available antiepileptic drugs (AEDs) have the potential to exert detrimental effects on cognitive function and therefore compromise patient wellbeing. On the other hand, some agents may serve to enhance cognitive function. In this review paper, we highlight the range of effects on cognition linked to a variety of newer and older AEDs, encompassing key alterations in both specific executive abilities and broader neuropsychological functions. Importantly, the data reviewed suggest that the effects exerted by an AED could vary depending on both patient characteristics and drug-related variables. However, there are considerable difficulties in evaluating the available evidence. Many studies have failed to investigate the influence of patient and treatment variables on cognitive functioning. Other difficulties include variation across studies in relation to design, treatment group and assessment tools, poor reporting of methodology and poor specification of the cognitive abilities assessed. Focused and rigorous experimental designs including a range of cognitive measures assessing more precisely defined abilities are needed to fill the gaps in our knowledge and follow up reported patterns in the literature. Longitudinal studies are needed to improve our understanding of the influence of factors such as age, tolerance and the stability of cognitive effects. Future trials comparing the effects of commonly prescribed agents across patient subgroups will offer critical insight into the role of patient characteristics in determining the cognitive impact of particular AEDs. PMID:22164192

Higher plasma CD4 lymphocyte count correlates with better cognitive function in human immunodeficiency virus-acquired immunodeficiency syndrome (HIV-AIDS) patients

NASA Astrophysics Data System (ADS)

Fitri, F. I.; Rambe, A. S.; Fitri, A.

2018-03-01

Neurocognitive disorders in HIV-AIDS are still prevalent despite the use of antiretroviral therapy and seem to be under-recognized. Plasma lymphocyte CD4 count is a marker for general immunology status, but its association with cognitive function remains unclear. The aim of this study was to determine the correlation between plasma CD4 lymphocyte and cognitive function in HIV-AIDS patients.This was a cross-sectional study involving 48 HIV-AIDS patients. All subjects underwent physical, neurologic examination and Montreal Cognitive Assessment-Indonesian Version (MoCA-INA) to assess cognitive function and measurement of lymphocyte CD4 counts.This study included 48 subjects consisted of 29 males (60.4%) and 19 females (39.6%). The mean age was 39.17±11.21 years old. There was a significant correlation between CD4 lymphocyte counts and MoCA-INA score (r=0.347, p=0.016).Higher plasma CD4 lymphocyte count is correlated with better cognitive function in HIV-AIDS patients.

Exercise improves cognitive function in aging patients

PubMed Central

Hu, Jian-Ping; Guo, Yan-Hua; Wang, Feng; Zhao, Xin-Ping; Zhang, Quan-Hai; Song, Qing-Hua

2014-01-01

A decline in cognitive ability commonly occurs among older individuals. This study sought to explore the restorative effects of exercise in older patients with existing cognitive disabilities. Ninety-six patients with mild cognitive impairment were placed in an exercise program for six months. Following completion of the program, participants were assessed via the Chinese Mini Mental Status Examination (MMSE), Activity of Daily Living (ADL) assessment, and body movement testing and compared to a control group of patients with mild cognitive impairment who did not participate in the exercise program (N = 102). Statistical analyses were performed using the Student’s t-test and chi-square test to compare results between groups. Compared with control group, patients who exercised showed improved cognitive function in immediate memory (p < 0.001) and delayed recall (p = 0.004) function. In addition, activities associated with daily living showed improvement (p < 0.001), as did body movement (p < 0.05), arm stability (p < 0.001), and the appearance of rotation (p < 0.05). Based on these results, we conclude that participation in an exercise program can improve patients’ cognitive function, physical abilities, and body movement capacity. PMID:25419345

Gait speed in older people: an easy test for detecting cognitive impairment, functional independence, and health state.

PubMed

Garcia-Pinillos, Felipe; Cozar-Barba, Manuela; Munoz-Jimenez, Marcos; Soto-Hermoso, Victor; Latorre-Roman, Pedro

2016-05-01

With ageing, physical and cognitive functions become impaired. Analyzing and determining the association between both functions can facilitate the prevention and diagnosis of associated problems. Some previous works have proposed batteries of physical performance tests to determine both physical and cognitive functions. However, only a few studies have used the gait speed (GS) test as a tool to evaluate parameters representative of health in the elderly such as functionality, mobility, independence, autonomy, and comorbidity. Therefore, the aim of this study was to determine the association between physical and cognitive functions in older people (over 65 years old) and to detect the most appropriate physical test to assess cognitive impairment, functional independence, comorbidity, and perceived health in this population. One hundred six older adults (38 men, 68 women) participated voluntarily in this cross-sectional study. To assess the physical function handgrip strength, GS, 30-s chair stand tests, and body composition analysis were performed. To evaluate cognitive function, the Mini-Mental State Examination, Barthel index, and Charlson index were employed. No significant differences (P ≥ 0.05) between sexes were found. Multiple regression analysis of the Mini-Mental State Examination and physical fitness variables, adjusted for age and sex, indicates that GS is a predictor of Mini-Mental State Examination score (R(2) = 0.138). The results showed that GS is an important predictor of functional capacity (physical and cognitive function) in adults over 65 years old. © 2015 The Authors. Psychogeriatrics © 2015 Japanese Psychogeriatric Society.

Cognitive function in ecstasy naive abstinent drug dependants and MDMA users.

PubMed

Potter, Adam; Downey, Luke; Stough, Con

2013-03-01

'Hidden' symptoms, or subtle cognitive deficits and long-term changes in mood, have been linked to the recreational use of 3, 4-methylenedioxymethamphetamine/MDMA, and are notionally present in non-heavy polydrug users. This study assessed the cognitive functioning and mood profiles of clinically diagnosed drug dependents who had never consumed MDMA, recreational drug users that had previously consumed MDMA, with both groups having not consumed illicit drugs for 6-months, and a control group with limited illicit drug use and no MDMA usage in their past. Cognitive functioning was assessed using the Cognitive Drug Research computerised cognitive assessment system and participants completed the Profile of Mood States and Beck Depression Inventory to assess their current mood and depression. Participants in the clinically diagnosed drug dependent group scored significantly worse on the 'Quality of Working Memory' cognitive factor score than both the MDMA and control group (F (2, 33) = 5.75, p = 0.007). The control and clinical groups also differed on depression scores (U [16] = 13.00, p = 0.016) and Tension/Anxiety scores (U [16] = 16.00, p = 0.034), with the clinical group scoring significantly higher in both cases. The MDMA group did not differ from the control group on the measures of cognition or mood. These results suggest that despite a 6-month prolonged abstinence the cognitive deficits ostensibly caused by 'heavy' usage or the dependence on or abuse of illicit drugs are not reversed by abstinence.

The Association Between Physical Activity and Cognitive Function With Considerations by Social Risk Status.

PubMed

Frith, Emily; Loprinzi, Paul D

2017-11-01

We evaluated the association between physical activity and cognitive function among a national sample of the broader U.S. adult population, with consideration by social risk. Data from the 1999-2002 National Health and Nutrition Examination Survey (NHANES) were used to identify 2031 older adults, ages 60-85. Social risk was classified by measuring four NHANES variables, namely poverty level, education, minority status, and social living status, which were graded on a scale of 0-4, with higher scores corresponding with higher social risk. The Digit Symbol Substitution Test (DSST) was used to assess cognitive function. Physical activity was assessed via a validated self-report questionnaire. After adjustments, meeting physical activity guidelines (vs not) was associated with greater cognitive function (β = 3.0, 95% CI [1.5, 4.4], p < 0.001). In this same model, social risk status was also independently associated with cognitive function. Meeting physical activity guidelines (vs. not) was not associated with higher cognitive function among those with a social risk score of of 3 (β = -0.01; 95% CI [-6.3, 6.4], p = 0.99) or a social risk score of 4 (β = -6.8, 95% CI [-15.7, 2.0], p = 0.12). In this national sample of older adults, meeting physical activity guidelines, and degree of social risk were independently associated with cognitive function. However, physical activity was not associated with cognitive function among older adults with the highest degree of social risk.

Web-Based Programs Assess Cognitive Fitness

NASA Technical Reports Server (NTRS)

2009-01-01

The National Space Biomedical Research Institute, based in Houston and funded by NASA, began funding research for Harvard University researchers to design Palm software to help astronauts monitor and assess their cognitive functioning. The MiniCog Rapid Assessment Battery (MRAB) was licensed by the Criteria Corporation in Los Angeles and adapted for Web-based employment testing. The test battery assesses nine different cognitive functions and can gauge the effect of stress-related deficits, such as fatigue, on various tasks. The MRAB can be used not only for pre-employment testing but also for repeat administrations to measure day-to-day job readiness in professions where alertness is critical.

Further Evaluation of the Criterion Validity of the Severe Impairment Battery for the Assessment of Cognitive Functioning in Adults with Down Syndrome

ERIC Educational Resources Information Center

Hutchinson, Nick; Oakes, Peter

2011-01-01

Background: People with Down Syndrome are at significant risk of developing Alzheimer's disease as they get older and early assessment, diagnosis and intervention is essential. Neuro-psychological measures of cognitive functioning play an important part in the assessment process. The aim of the present study was to examine the concurrent criterion…

Subjective physical and cognitive age among community-dwelling older people aged 75 years and older: differences with chronological age and its associated factors.

PubMed

Ihira, Hikaru; Furuna, Taketo; Mizumoto, Atsushi; Makino, Keitaro; Saitoh, Shigeyuki; Ohnishi, Hirofumi; Shimada, Hiroyuki; Makizako, Hyuma

2015-01-01

The aim of this cross-sectional study was to determine the associations between self-reported subjective physical and cognitive age, and actual physical and cognitive functions among community-dwelling older people aged 75 years and older. The sample comprised 275 older adults aged 75-91 years. Two questions were asked regarding subjective age: 'How old do you feel physically?' and 'How old do you feel cognitively?' To assess physical functions, we measured handgrip strength, knee extension strength, standing balance and walking speed. Tests of attention, executive function, processing speed and memory were performed to assess actual cognitive function. Subjective physical and cognitive age was associated with performance on all of the physical and cognitive tests, respectively (p < 0.01). We also found that older adults who reported themselves as feeling older than their chronological age had a slower walking speed and lower scores for word-list memory recall than those who did not report themselves as feeling older than their actual age. These findings suggest that promoting a fast walking speed and good memory function may help to maintain a younger subjective physical and cognitive age in older adults aged 75 years and older.

Subjective Cognitive Complaints and Objective Cognitive Function in Aging: A Systematic Review and Meta-Analysis of Recent Cross-Sectional Findings.

PubMed

Burmester, Bridget; Leathem, Janet; Merrick, Paul

2016-12-01

Research investigating how subjective cognitive complaints (SCCs) might reliably indicate impairments in objective cognitive functioning has produced highly varied findings, and despite attempts to synthesise this literature (e.g., Jonker et al. International Journal of Geriatric Psychiatry, 15, 983-991, 2000; Reid and MacLullich Dementia and Geriatric Cognitive Disorders, 22(5-6), 471-485, 2006; Crumley et al. Psychology and Aging, 29(2), 250-263, 2014), recent work continues to offer little resolution. This review provides both quantitative and qualitative synthesis of research conducted since the last comprehensive review in 2006, with the aim of identifying reasons for these discrepancies that might provide fruitful avenues for future exploration. Meta-analysis found a small but significant association between SCCs and objective cognitive function, although it was limited by large heterogeneity between studies and evidence of potential publication bias. Often, assessments of SCCs and objective cognitive function were brief or not formally validated. However, studies that employed more comprehensive SCC measures tended to find that SCCs were associated independently with both objective cognitive function and depressive symptoms. Further explicit investigation of how assessment measures relate to reports of SCCs, and the validity of the proposed 'compensation theory' of SCC aetiology, is recommended.

The Art Gallery Test: A Preliminary Comparison between Traditional Neuropsychological and Ecological VR-Based Tests.

PubMed

Gamito, Pedro; Oliveira, Jorge; Alghazzawi, Daniyal; Fardoun, Habib; Rosa, Pedro; Sousa, Tatiana; Maia, Ines; Morais, Diogo; Lopes, Paulo; Brito, Rodrigo

2017-01-01

Ecological validity should be the cornerstone of any assessment of cognitive functioning. For this purpose, we have developed a preliminary study to test the Art Gallery Test (AGT) as an alternative to traditional neuropsychological testing. The AGT involves three visual search subtests displayed in a virtual reality (VR) art gallery, designed to assess visual attention within an ecologically valid setting. To evaluate the relation between AGT and standard neuropsychological assessment scales, data were collected on a normative sample of healthy adults ( n = 30). The measures consisted of concurrent paper-and-pencil neuropsychological measures [Montreal Cognitive Assessment (MoCA), Frontal Assessment Battery (FAB), and Color Trails Test (CTT)] along with the outcomes from the three subtests of the AGT. The results showed significant correlations between the AGT subtests describing different visual search exercises strategies with global and specific cognitive measures. Comparative visual search was associated with attention and cognitive flexibility (CTT); whereas visual searches involving pictograms correlated with global cognitive function (MoCA).

Behavioral toxicology of cognition: extrapolation from experimental animal models to humans: behavioral toxicology symposium overview.

PubMed

Paule, Merle G; Green, Leonard; Myerson, Joel; Alvarado, Maria; Bachevalier, Jocelyne; Schneider, Jay S; Schantz, Susan L

2012-03-01

A variety of behavioral instruments are available for assessing important aspects of cognition in both animals and humans and, in many cases, the same instruments can be used in both. While nonhuman primates are phylogenetically closest to humans, rodents, pigeons and other animals also offer behaviors worthy of note. Delay Discounting procedures are as useful as any in studies of impulsivity and may have utility in shedding light on processes associated with drug abuse. Specific memory tests such as Visual Paired Comparisons tasks (similar to the Fagan test of infant intelligence) can be modified to allow for assessment of different aspects of memory such as spatial memory. Use of these and other specific memory tasks can be used to directly monitor aspects of cognitive development in infant animals, particularly in nonhuman primates such as monkeys, and children and to draw inferences with respect to possible neuroanatomical substrates sub-serving their functions. Tasks for assessing working memory such as Variable Delayed Response (VDR), modified VDR and Spatial Working Memory tasks are now known to be affected in Parkinson's disease (PD). These and other cognitive function tasks are being used in a monkey model of PD to assess the ability of anti-Parkinson's disease therapies to ameliorate these cognitive deficits without diminishing their therapeutic effects on motor dysfunction. Similarly, in a rat model of the cognitive deficits associated with perinatal exposure to polychlorinated biphenyls (PCBs), clear parallels with children can be seen in at least two areas of executive function: cognitive flexibility and response inhibition. In the rat model, discrimination reversal tasks were utilized to assess cognitive flexibility, a function often assessed in humans using the Wisconsin Card Sorting Task. Response inhibition was assessed using performance in a Differential Reinforcement of Low Response Rates (DRL) task. As the data continue to accumulate, it becomes more clear that our attempts to adapt animal-appropriate tasks for the study of important aspects of human cognition have proven to be very fruitful. Published by Elsevier Inc.

Is There a Link Between Cognitive Reserve and Cognitive Function in the Oldest-Old?

PubMed

Lavrencic, Louise M; Richardson, Connor; Harrison, Stephanie L; Muniz-Terrera, Graciela; Keage, Hannah A D; Brittain, Katie; Kirkwood, Thomas B L; Jagger, Carol; Robinson, Louise; Stephan, Blossom C M

2018-03-14

The oldest-old (aged ≥85 years) are the fastest growing age group, with the highest risk of cognitive impairment and dementia. This study investigated whether cognitive reserve applies to the oldest-old. This has implications for cognitive interventions in this age group. Baseline and 5-year follow-up data from the Newcastle 85+ Study were used (N = 845, mean age = 85.5, 38% male). A Cognitive Reserve Index (CRI) was created, including: education, social class, marital status, engagement in mental activities, social participation, and physical activity. Global (Mini-Mental State Examination) and domain specific (Cognitive Drug Research Battery subtests assessing memory, attention, and speed) cognitive functions were assessed. Dementia diagnosis was determined by health records. Logistic regression analysis examined the association between CRI scores and incident dementia. Mixed effects models investigated baseline and longitudinal associations between the CRI scores and cognitive function. Analyses controlled for sex, age, depression, and cardiovascular disease history. Higher reserve associated with better cognitive performance on all baseline measures, but not 5-year rate of change. The CRI associated with prevalent, but not incident dementia. In the oldest-old, higher reserve associated with better baseline global and domain-specific cognitive function and reduced risk of prevalent dementia; but not cognitive decline or incident dementia. Increasing reserve could promote cognitive function in the oldest-old. The results suggest there would be little impact on trajectories, but replication is needed. Development of preventative strategies would benefit from identifying the role of each factor in building reserve and why rate of change is not affected.

The Mind Bending Quest for Cognitive Enhancers

PubMed Central

Arce, E

2016-01-01

Adequate cognitive functioning is essential for daily activities. When there is an insult to the brain, cognitive abilities can suffer, which, in turn, produce substantial medical and functional impairment. Advances in neurobiology, circuit neuroscience, and clinical assessment technology are converging in a manner that holds promise for the development of new pharmacological agents for cognitive enhancement in neuropsychiatric disease. PMID:27706806

Compliance and Cognitive Function: A Methodological Approach to Measuring Unintentional Errors in Medication Compliance in the Elderly.

ERIC Educational Resources Information Center

Isaac, Lisa M.; And Others

1993-01-01

Assessed multiple aspects of cognitive performance, medication planning ability, and medication compliance in 20 elderly outpatients. Findings suggest that aspects of attention/concentration, visual and verbal memory, and motor function which are untapped by simple mental status assessment are related to medication access, planning, and compliance…

A Physical Activity Program Improves Behavior and Cognitive Functions in Children with ADHD: An Exploratory Study

ERIC Educational Resources Information Center

Verret, Claudia; Guay, Marie-Claude; Berthiaume, Claude; Gardiner, Phillip; Beliveau, Louise

2012-01-01

Objective: The objective of this study is to explore the effects of a moderate- to high-intensity physical activity program on fitness, cognitive functions, and ADHD-related behavior in children with ADHD. Method: Fitness level, motor skills, behaviors, and cognitive functions are assessed by standardized tests before and after a 10-week training…

Epidemiological investigation of muscle-strengthening activities and cognitive function among older adults.

PubMed

Loprinzi, Paul D

2016-06-01

Limited research has examined the association of muscle-strengthening activities and executive cognitive function among older adults, which was this study's purpose. Data from the 1999-2002 NHANES were employed (N = 2157; 60-85 years). Muscle-strengthening activities were assessed via self-report, with cognitive function assessed using the digit symbol substitution test. After adjusting for age, age-squared, gender, race-ethnicity, poverty level, body mass index, C-reactive protein, smoking, comorbid illness and physical activity, muscle-strengthening activities were significantly associated with cognitive function (βadjusted = 3.4; 95% CI: 1.7-5.1; P < 0.001). Compared to those not engaging in aerobic exercise and not meeting muscle-strengthening activity guidelines, those doing 1 (βadjusted = 3.7; 95% CI: 1.9-5.4; P < 0.001) and both (βadjusted = 6.6; 95% CI: 4.8-8.3; P < 0.001) of these behaviors had a significantly higher executive cognitive function score. In conclusion, muscle-strengthening activities are associated with executive cognitive function among older U.S. adults, underscoring the importance of promoting both aerobic exercise and muscle-strengthening activities to older adults. © The Author(s) 2016.

Cardiovascular disease biomarkers on cognitive function in older adults: Joint effects of cardiovascular disease biomarkers and cognitive function on mortality risk.

PubMed

Loprinzi, Paul D; Crush, Elizabeth; Joyner, Chelsea

2017-01-01

Previous research demonstrates an inverse association between age and cardiovascular disease (CVD) biomarkers with cognitive function; however, little is known about the combined associations of CVD risk factors and cognitive function with all-cause mortality in an older adult population, which was the purpose of this study. Data from the 1999-2002 NHANES were used (N=2,097; 60+yrs), with mortality follow-up through 2011. Evaluated individual biomarkers included mean arterial pressure (MAP), high-sensitivity C-reactive protein (CRP), HDL-C, total cholesterol (TC), A1C, and measured body mass index (BMI). Cognitive function was assessed using the Digit Symbol Substitution Test (DSST). Further, 4 groups were created based on CVD risk and cognitive function. Group 1: high cognitive function and low CVD risk; Group 2: high cognitive function and high CVD risk; Group 3: low cognitive function and low CVD risk; Group 4: low cognitive function and high CVD risk. An inverse relationship was observed where those with more CVD risk factors had a lower (worse) cognitive function score. Compared to those in Group 1, only those in Group 3 and 4 had an increase mortality risk. Copyright © 2016 Elsevier Inc. All rights reserved.

Assessment of the effects of glutamic acid decarboxylase antibodies and trace elements on cognitive performance in older adults.

PubMed

Alghadir, Ahmad H; Gabr, Sami A; Al-Eisa, Einas S

2015-01-01

Homeostatic imbalance of trace elements such as iron (Fe), copper (Cu), and zinc (Zn) demonstrated adverse effects on brain function among older adults. The present study aimed to investigate the effects of trace elements and the presence of anti-glutamic acid decarboxylase antibodies (GADAs) in human cognitive abilities among healthy older adults. A total of 100 healthy subjects (65 males, 35 females; age range; 64-96 years) were recruited for this study. Based on Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) score, the participants were classified according to cognitive performance into normal (n=45), moderate (n=30), and severe (n=25). Cognitive functioning, leisure-time physical activity (LTPA), serum trace elements - Fe, Cu, Zn, Zn/Cu, and GADAs were assessed using LOTCA battery, pre-validated physical activity (PA) questionnaire, atomic absorption, and immunoassay techniques, respectively. Approximately 45% of the study population (n=45) had normal distribution of cognitive function and 55% of the study population (n=55) had abnormal cognitive function; they were classified into moderate (score 62-92) and severe (score 31-62). There was a significant reduction in the level of Zn and Zn/Cu ratio along with an increase in the level of Fe, Cu, and anti-GADAs in subjects of severe (P=0.01) and moderate (P=0.01) cognitive performance. LOTCA-cognitive scores correlated positively with sex, HbA(1c), Fe, Cu, Zn, and Zn/Cu ratio, and negatively with age, PA, body mass index, and anti-GADAs. Significant inter-correlation was reported between serum trace element concentrations and anti-GADAs which suggest producing a cognitive decline via oxidative and neural damage mechanism. This study found significant associations among trace elements, anti-GADAs, and cognitive function in older adults. The homeostatic balance of trace elements should be recommended among older adults for better cognitive performance.

Effects of Noise Level and Cognitive Function on Speech Perception in Normal Elderly and Elderly with Amnestic Mild Cognitive Impairment.

PubMed

Lee, Soo Jung; Park, Kyung Won; Kim, Lee-Suk; Kim, HyangHee

2016-06-01

Along with auditory function, cognitive function contributes to speech perception in the presence of background noise. Older adults with cognitive impairment might, therefore, have more difficulty perceiving speech-in-noise than their peers who have normal cognitive function. We compared the effects of noise level and cognitive function on speech perception in patients with amnestic mild cognitive impairment (aMCI), cognitively normal older adults, and cognitively normal younger adults. We studied 14 patients with aMCI and 14 age-, education-, and hearing threshold-matched cognitively intact older adults as experimental groups, and 14 younger adults as a control group. We assessed speech perception with monosyllabic word and sentence recognition tests at four noise levels: quiet condition and signal-to-noise ratio +5 dB, 0 dB, and -5 dB. We also evaluated the aMCI group with a neuropsychological assessment. Controlling for hearing thresholds, we found that the aMCI group scored significantly lower than both the older adults and the younger adults only when the noise level was high (signal-to-noise ratio -5 dB). At signal-to-noise ratio -5 dB, both older groups had significantly lower scores than the younger adults on the sentence recognition test. The aMCI group's sentence recognition performance was related to their executive function scores. Our findings suggest that patients with aMCI have more problems communicating in noisy situations in daily life than do their cognitively healthy peers and that older listeners with more difficulties understanding speech in noise should be considered for testing of neuropsychological function as well as hearing.

Effect of yoga on cognitive abilities in schoolchildren from a socioeconomically disadvantaged background: a randomized controlled study.

PubMed

Chaya, Mayasandra S; Nagendra, Hongasandra; Selvam, Sumithra; Kurpad, Anura; Srinivasan, Krishnamachari

2012-12-01

The objective of this study was to assess the effect of yoga, compared to physical activity on the cognitive performance in 7-9 year-old schoolchildren from a socioeconomic disadvantaged background. Two hundred (200) schoolchildren from Bangalore, India, after baseline assessment of cognitive functioning were randomly allocated to either a yoga or a physical-activity group. Cognitive functions (attention and concentration, visuo-spatial abilities, verbal ability, and abstract thinking) were assessed using an Indian adaptation of the Wechsler Intelligence Scale for Children at baseline, after 3 months of intervention, and later at a 3-month follow-up. Of the 200 subjects, 193 were assessed at 3 months after the study, and then 180 were assessed at the 3-month follow-up. There were no significant differences in cognitive performance between the two study groups (yoga versus physical activity) at postintervention, after controlling for grade levels. Improvement in the mean scores of cognitive tests following intervention varied from 0.5 (Arithmetic) to 1.4 (Coding) for the yoga group and 0.7 (Arithmetic) to 1.6 (Vocabulary) in the physical-activity group. Yoga was as effective as physical activity in improving cognitive performance in 7-9 year old schoolchildren. Further studies are needed to examine the dose-response relationship between yoga and cognitive performance.

Do economic recessions during early and mid-adulthood influence cognitive function in older age?

PubMed

Leist, Anja K; Hessel, Philipp; Avendano, Mauricio

2014-02-01

Fluctuations in the national economy shape labour market opportunities and outcomes, which in turn may influence the accumulation of cognitive reserve. This study examines whether economic recessions experienced in early and mid-adulthood are associated with later-life cognitive function. Data came from 12,020 respondents in 11 countries participating in the Survey of Health, Ageing and Retirement in Europe (SHARE). Cognitive assessments in 2004/2005 and 2006/2007 were linked to complete work histories retrospectively collected in 2008/2009 and to historical annual data on fluctuations in Gross Domestic Product per capita for each country. Controlling for confounders, we assessed whether recessions experienced at ages 25-34, 35-44 and 45-49 were associated with cognitive function at ages 50-74. Among men, each additional recession at ages 45-49 was associated with worse cognitive function at ages 50-74 (b=-0.06, CI -0.11 to -0.01). Among women, each additional recession at ages 25-44 was associated with worse cognitive function at ages 50-74 (b25-34=-0.03, CI -0.04 to -0.01; b35-44=-0.02, CI -0.04 to -0.00). Among men, recessions at ages 45-49 influenced risk of being laid-off, whereas among women, recessions at ages 25-44 led to working part-time and higher likelihood of downward occupational mobility, which were all predictors of worse later-life cognitive function. Recessions at ages 45-49 among men and 25-44 among women are associated with later-life cognitive function, possibly through more unfavourable labour market trajectories. If replicated in future studies, findings indicate that policies that ameliorate the impact of recessions on labour market outcomes may promote later-life cognitive function.

Do Economic Recessions During Early and Mid-Adulthood Influence Cognitive Function in Older Age?

PubMed Central

Leist, Anja K.; Hessel, Philipp; Avendano, Mauricio

2014-01-01

Background Fluctuations in the national economy shape labour market opportunities and outcomes, which in turn may influence the accumulation of cognitive reserve. This study examines whether economic recessions experienced in early and mid-adulthood are associated with later-life cognitive function. Method Data came from 12,020 respondents in 11 countries participating in the Survey of Health, Ageing and Retirement in Europe (SHARE). Cognitive assessments in 2004/5 and 2006/7 were linked to complete work histories retrospectively collected in 2008/9, and to historical annual data on fluctuations in Gross Domestic Product (GDP) per capita for each country. Controlling for confounders, we assessed whether recessions experienced at ages 25-34, 35-44 and 45-49 were associated with cognitive function at ages 50-74. Results Among men, each additional recession at ages 45-49 was associated with worse cognitive function at ages 50-74 (b = -0.06, Confidence Interval [CI] -0.11, -0.01). Among women, each additional recession at ages 25-44 was associated with worse cognitive function at ages 50-74 (b25-34 = -0.03, CI -0.04, -0.01; b35-44= -0.02, CI -0.04, -0.00). Among men, recessions at ages 45-49 influenced risk of being laid-off, whereas among women, recessions at ages 25-44 led to working part-time and higher likelihood of downward occupational mobility, which were all predictors of worse later-life cognitive function. Conclusions Recessions at ages 45-49 among men and 25-44 among women are associated with later-life cognitive function, possibly via more unfavourable labour market trajectories. If replicated in future studies, findings may indicate that policies that ameliorate the impact of recessions on labour market outcomes may promote later-life cognitive function. PMID:24258197

Relations between cognitive functioning and alcohol use, craving, and posttraumatic stress: An examination among trauma exposed military Veterans with alcohol use disorder

PubMed Central

Heinz, Adrienne J.; Pennington, David L.; Cohen, Nicole; Schmeling, Brandi; Lasher, Brooke A.; Schrodek, Emily; Batki, Steven L.

2015-01-01

Cognitive dysfunction is commonly observed among individuals with Alcohol Use Disorder (AUD) and trauma exposure and is, in turn, associated with worse clinical outcomes. Accordingly, disruptions in cognitive functioning may be conceptualized as a trans-disease phenomenon representing a potential high-yield target for intervention. Less is known though about how different cognitive functions co-vary with alcohol use, craving, and posttraumatic stress symptom severity among trauma exposed individuals with AUD. Sixty-eight male and female trauma exposed military Veterans with AUD, entering treatment trials to reduce alcohol use, completed measures assessing alcohol use and craving, posttraumatic stress symptom severity, and cognitive functioning. In multivariate models, after controlling for posttraumatic stress symptom severity, poorer learning and memory was associated with higher alcohol consumption and higher risk-taking/impulsivity was associated with stronger pre-occupations with alcohol and compulsions to drink. Alcohol consumption and craving, but not performance on cognitive tests, were positively associated with posttraumatic stress symptom severity. Findings suggest that interventions to strengthen cognitive functioning might be used as a preparatory step to augment treatments for AUD. Clinicians are encouraged to consider a standard assessment of cognitive functioning, in addition to posttraumatic stress symptom severity, in treatment planning and delivery for this vulnerable and high-risk population. PMID:27391620

Assessment of Cognitive Outcome Measures in Teenagers with 15q13.3 Microdeletion Syndrome

ERIC Educational Resources Information Center

Crutcher, Emeline; Ali, May; Harrison, John; Sovago, Judit; Gomez-Mancilla, Baltazar; Schaaf, Christian P.

2016-01-01

15q13.3 microdeletion syndrome causes a spectrum of cognitive disorders, including intellectual disability and autism. We aimed to determine if any or all of three cognitive testing systems (the KiTAP, CogState, and Stanford-Binet) are suitable for assessment of cognitive function in affected individuals. These three tests were administered to ten…

Gait Rather Than Cognition Predicts Decline in Specific Cognitive Domains in Early Parkinson's Disease.

PubMed

Morris, Rosie; Lord, Sue; Lawson, Rachael A; Coleman, Shirley; Galna, Brook; Duncan, Gordon W; Khoo, Tien K; Yarnall, Alison J; Burn, David J; Rochester, Lynn

2017-11-09

Dementia is significant in Parkinson's disease (PD) with personal and socioeconomic impact. Early identification of risk is of upmost importance to optimize management. Gait precedes and predicts cognitive decline and dementia in older adults. We aimed to evaluate gait characteristics as predictors of cognitive decline in newly diagnosed PD. One hundred and nineteen participants recruited at diagnosis were assessed at baseline, 18 and 36 months. Baseline gait was characterized by variables that mapped to five domains: pace, rhythm, variability, asymmetry, and postural control. Cognitive assessment included attention, fluctuating attention, executive function, visual memory, and visuospatial function. Mixed-effects models tested independent gait predictors of cognitive decline. Gait characteristics of pace, variability, and postural control predicted decline in fluctuating attention and visual memory, whereas baseline neuropsychological assessment performance did not predict decline. This provides novel evidence for gait as a clinical biomarker for PD cognitive decline in early disease. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America.

Assessing cognitive functioning in ALS: A focus on frontal lobe processes.

PubMed

Gillingham, S M; Yunusova, Y; Ganda, A; Rogaeva, E; Black, S E; Stuss, D T; Zinman, L

2017-05-01

It is generally acknowledged that at least 50% of individuals with amyotrophic lateral sclerosis (ALS) will exhibit cognitive deficits outside of the characteristic motor neuron involvement. However, a specific cognitive profile has been difficult to ascertain due to disease-related testing barriers and limitations in the sensitivity and specificity of available assessment methods. This study assessed the level of functioning of extramotor frontal cognitive processes in ALS, and the amount of change in the functioning in these processes over time as disease progresses. Empirical tests validated for a model of frontal lobe functioning were modified into an assessment battery appropriate for individuals with ALS in a clinical setting (the ALS-CFB, Computerised Frontal Battery). Twenty ALS participants and 36 age- and education-matched neurologically healthy controls were tested, and a sub-sample of each group (11 ALS and 20 controls) re-tested after approximately nine months. Compared to standard neuropsychological screening tests that did not show a difference between ALS participants and healthy controls, the ALS-CFB illustrated a profile of extramotor frontal dysfunction involving energisation (preparing the neural system to respond) and executive functions, a profile that may be indicative of the nature of neurodegeneration in ALS.

Improvement in cognitive and psychosocial functioning and self image among adolescent inpatient suicide attempters.

PubMed

Hintikka, Ulla; Marttunen, Mauri; Pelkonen, Mirjami; Laukkanen, Eila; Viinamäki, Heimo; Lehtonen, Johannes

2006-12-29

Psychiatric treatment of suicidal youths is often difficult and non-compliance in treatment is a significant problem. This prospective study compared characteristics and changes in cognitive functioning, self image and psychosocial functioning among 13 to 18 year-old adolescent psychiatric inpatients with suicide attempts (n = 16) and with no suicidality (n = 39) The two-group pre-post test prospective study design included assessments by a psychiatrist, a psychologist and medical staff members as well as self-rated measures. DSM-III-R diagnoses were assigned using the SCID and thereafter transformed to DSM-IV diagnoses. Staff members assessed psychosocial functioning using the Global Assessment Scale (GAS). Cognitive performance was assessed using the Wechsler Adult Intelligence Scale, while the Offer Self-Image Questionnaire (OSIQ) was used to assess the subjects' self-image. ANCOVA with repeated measures was used to test changes from entry to discharge among the suicide attempters and non suicidal patients. Logistic regression modeling was used to assess variables associated with an improvement of 10 points or more in the GAS score. Among suicide attempter patients, psychosocial functioning, cognitive performance and both the psychological self and body-image improved during treatment and their treatment compliance and outcome were as good as that of the non-suicidal patients. Suicidal ideation and hopelessness declined, and psychosocial functioning improved. Changes in verbal cognitive performance were more pronounced among the suicide attempters. Having an improved body-image associated with a higher probability of improvement in psychosocial functioning while higher GAS score at entry was associated with lower probability of functional improvement in both patient groups. These findings illustrate that a multimodal treatment program seems to improve psychosocial functioning and self-image among severely disordered suicidal adolescent inpatients. There were no changes in familial relationships, possibly indicating a need for more intensive family interventions when treating suicidal youths. Multimodal inpatient treatment including an individual therapeutic relationship seems recommendable for severely impaired psychiatric inpatients tailored to the suicidal adolescent's needs.

Physical Exercise Helped to Maintain and Restore Functioning in Chinese Older Adults With Mild Cognitive Impairment: A 5-Year Prospective Study of the Hong Kong Memory and Ageing Prospective Study (HK-MAPS).

PubMed

Ma, Duan Yang; Wong, Candy H Y; Leung, Grace T Y; Fung, Ada W T; Chan, Wai Chi; Lam, Linda C W

2017-04-01

This study investigated the potential of physical exercise habit as a lifestyle modification against cognitive and functional decline at the community level. A total of 454 community-dwelling Chinese older adults without dementia participated in the Hong Kong Memory and Ageing Prospective Study at baseline and follow-up at 5 years. Their cognitive and functional performances were assessed by the Cantonese version of the Mini-Mental State Examination (CMMSE) and the Chinese version of Disability Assessment in Dementia (DAD). Hierarchical multiple regression analyses were performed to examine whether physical exercise was a significant predictor of the follow-up CMMSE and DAD scores after controlling for the covariates. Subgroup analyses were performed with a group of 127 participants with mild cognitive impairment at baseline. Physical exercise habit was a significant predictor for both the follow-up CMMSE scores and DAD scores. Participants with exercise habits of 5 years or more showed better cognitive and functional performances at follow-up. Participants who picked up exercise habits only after the baseline assessment also demonstrated better functioning at follow-up. The same patterns were observed in the subgroup analyses with the mild cognitive impairment group. Results suggested that prolonged exercise habit is required for positive effects on cognition to emerge, but benefits on functioning can be observed when individuals take up an exercise habit later in life or even after the beginning of cognitive decline. These findings are encouraging in promoting an exercise habit among older adults living in the community. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Indoor air pollution and cognitive function among older Mexican adults.

PubMed

Saenz, Joseph L; Wong, Rebeca; Ailshire, Jennifer A

2018-01-01

A growing body of research suggests exposure to high levels of outdoor air pollution may negatively affect cognitive functioning in older adults, but less is known about the link between indoor sources of air pollution and cognitive functioning. We examine the association between exposure to indoor air pollution and cognitive function among older adults in Mexico, a developing country where combustion of biomass for domestic energy remains common. Data come from the 2012 Wave of the Mexican Health and Aging Study. The analytic sample consists of 13 023 Mexican adults over age 50. Indoor air pollution is assessed by the reported use of wood or coal as the household's primary cooking fuel. Cognitive function is measured with assessments of verbal learning, verbal recall, attention, orientation and verbal fluency. Ordinary least squares regression is used to examine cross-sectional differences in cognitive function according to indoor air pollution exposure while accounting for demographic, household, health and economic characteristics. Approximately 16% of the sample reported using wood or coal as their primary cooking fuel, but this was far more common among those residing in the most rural areas (53%). Exposure to indoor air pollution was associated with poorer cognitive performance across all assessments, with the exception of verbal recall, even in fully adjusted models. Indoor air pollution may be an important factor for the cognitive health of older Mexican adults. Public health efforts should continue to develop interventions to reduce exposure to indoor air pollution in rural Mexico. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The association between adherence to a Mediterranean style diet and cognition in older people: The impact of medication.

PubMed

Hardman, Roy J; Meyer, Denny; Kennedy, Greg; Macpherson, Helen; Scholey, Andrew B; Pipingas, Andrew

2017-10-31

Recent reviews indicate that adherence to a Mediterranean diet may be associated with better cognitive functioning. In assessing these relationships in older individuals, previous studies have not taken into account medication usage that may support or compromise cognitive functioning. To investigate the association between adherence to a Mediterranean style diet, cognition and medication usage in cognitively healthy older individuals. Data were assessed from individuals aged 60-90 years (mean = 77.8 years, SD = 6.7) from 15 independent living aged care villages around Melbourne, Australia. Participants' diets were assessed using a food frequency questionnaire (FFQ). Cognition was assessed using reaction times from the Swinburne University Computerised Cognitive Assessment Battery (SUCCAB). Prescribed medications were recorded and analysed using binary measures. Cluster analyses were used to group participants in terms of cognitive measures and medications taken. Analyses controlled for age, gender, average daily kilojoule (kJ) intake and medication cluster. The relationship between cognitive speed clusters and medication clusters was significant (Chi-squared = 10.63, df = 3, p = 0.014). The odds ratio of 1.533 for average daily food intake suggested that for each additional kilojoule of average daily intake, the odds of belonging to the slower reaction time cluster increased by 53% and odds ratio of 0.573 for Mediterranean diet score suggested that for every additional unit, the odds of belonging to the slower reaction time cluster declined by 43%. The relationship between Mediterranean diet score and cognition was only significant when medication use was taken into account. These data demonstrate that when medications are considered, a higher Mediterranean diet score is associated with a faster response on cognitive function tests. The present findings also indicate that it is pertinent to take into account medication use when investigating relationships between dietary status and cognitive performance. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Dietary patterns are associated with cognitive function in the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort.

PubMed

Pearson, Keith E; Wadley, Virginia G; McClure, Leslie A; Shikany, James M; Unverzagt, Fred W; Judd, Suzanne E

2016-01-01

Identifying factors that contribute to the preservation of cognitive function is imperative to maintaining quality of life in advanced years. Of modifiable risk factors, diet quality has emerged as a promising candidate to make an impact on cognition. The objective of this study was to evaluate associations between empirically derived dietary patterns and cognitive function. This study included 18 080 black and white participants aged 45 years and older from the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort. Principal component analysis on data from the Block98 FFQ yielded five dietary patterns: convenience, plant-based, sweets/fats, Southern, and alcohol/salads. Incident cognitive impairment was defined as shifting from intact cognitive status (score >4) at first assessment to impaired cognitive status (score ≤4) at latest assessment, measured by the Six-Item Screener. Learning, memory and executive function were evaluated with the Word List Learning, Word List Delayed Recall, and animal fluency assessments. In fully adjusted models, greater consumption of the alcohol/salads pattern was associated with lower odds of incident cognitive impairment (highest quintile (Q5) v . lowest quintile (Q1): OR 0·68; 95 % CI 0·56, 0·84; P for trend 0·0005). Greater consumption of the alcohol/salads pattern was associated with higher scores on all domain-specific assessments and greater consumption of the plant-based pattern was associated with higher scores in learning and memory. Greater consumption of the Southern pattern was associated with lower scores on each domain-specific assessment (all P  < 0·05). In conclusion, dietary patterns including plant-based foods and alcohol intake were associated with higher cognitive scores, and a pattern including fried food and processed meat typical of a Southern diet was associated with lower scores.

The functional implications of motor, cognitive, psychiatric, and social problem-solving states in Huntington's disease.

PubMed

Van Liew, Charles; Gluhm, Shea; Goldstein, Jody; Cronan, Terry A; Corey-Bloom, Jody

2013-01-01

Huntington's disease (HD) is a genetic, neurodegenerative disorder characterized by motor, cognitive, and psychiatric dysfunction. In HD, the inability to solve problems successfully affects not only disease coping, but also interpersonal relationships, judgment, and independent living. The aim of the present study was to examine social problem-solving (SPS) in well-characterized HD and at-risk (AR) individuals and to examine its unique and conjoint effects with motor, cognitive, and psychiatric states on functional ratings. Sixty-three participants, 31 HD and 32 gene-positive AR, were included in the study. Participants completed the Social Problem-Solving Inventory-Revised: Long (SPSI-R:L), a 52-item, reliable, standardized measure of SPS. Items are aggregated under five scales (Positive, Negative, and Rational Problem-Solving; Impulsivity/Carelessness and Avoidance Styles). Participants also completed the Unified Huntington's Disease Rating Scale functional, behavioral, and cognitive assessments, as well as additional neuropsychological examinations and the Symptom Checklist-90-Revised (SCL-90R). A structural equation model was used to examine the effects of motor, cognitive, psychiatric, and SPS states on functionality. The multifactor structural model fit well descriptively. Cognitive and motor states uniquely and significantly predicted function in HD; however, neither psychiatric nor SPS states did. SPS was, however, significantly related to motor, cognitive, and psychiatric states, suggesting that it may bridge the correlative gap between psychiatric and cognitive states in HD. SPS may be worth assessing in conjunction with the standard gamut of clinical assessments in HD. Suggestions for future research and implications for patients, families, caregivers, and clinicians are discussed.

Relationship of depression with cognitive insight and socio-occupational outcome in patients with schizophrenia.

PubMed

Grover, Sandeep; Sahoo, Swapnajeet; Nehra, Ritu; Chakrabarti, Subho; Avasthi, Ajit

2017-05-01

To evaluate the prevalence of depression using different measures in patients with schizophrenia and to study the relationship of depression in schizophrenia with cognitive insight and clinical insight, disability and socio-occupational functioning. A total of 136 patients with schizophrenia were evaluated for depression, cognitive insight and socio-occupational functioning. Of the 136 patients included in the study, one-fourth ( N = 34; 25%) were found to have depression as per the Mini International Neuropsychiatric Interview (MINI). The prevalence of depression as assessed by Calgary Depression Scale for Schizophrenia (CDSS), Hamilton depression rating scale (HDRS) and Depressive Subscale of Positive and Negative Syndrome Scale (PANSS-D) was 23.5%, 19.9% and 91.9%, respectively. Among the different scales, CDSS has highest concordance with clinician's diagnosis. Sensitivity, specificity, positive predictive value and negative predictive value for CDSS was also higher than that noted for HDRS and PANSS-D. When those with and without depression as per clinician's diagnosis were compared, those with depression were found to have significantly higher scores on Positive and Negative Syndrome Scale (PANSS) positive and general psychopathology subscales, PANSS total score, participation restriction as assessed by P-scale and had lower level of functioning as assessed by Global Assessment of Functioning (GAF). No significant difference was noted on negative symptom subscale of PANSS, clinical insight as assessed on G-12 item of PANSS, disability as assessed by Indian Disability Evaluation and Assessment Scale (IDEAS) and socio-occupational functioning as assessed by Social and Occupational Functioning Assessment Scale (SOFS). In terms of cognitive insight, those with depression had significantly higher score for both the subscales, that is, self-reflective and self-certainty subscales as well as the mean composite index score. Our results suggest that one-fourth of patients with schizophrenia have depression, compared to HDRS and PANSS-D, CDSS has highest concordance with clinician's diagnosis of depression and presence of depression is related to cognitive insight.

Examination of Variables That May Affect the Relationship Between Cognition and Functional Status in Individuals with Mild Cognitive Impairment: A Meta-Analysis.

PubMed

Mcalister, Courtney; Schmitter-Edgecombe, Maureen; Lamb, Richard

2016-03-01

The objective of this meta-analysis was to improve understanding of the heterogeneity in the relationship between cognition and functional status in individuals with mild cognitive impairment (MCI). Demographic, clinical, and methodological moderators were examined. Cognition explained an average of 23% of the variance in functional outcomes. Executive function measures explained the largest amount of variance (37%), whereas global cognitive status and processing speed measures explained the least (20%). Short- and long-delayed memory measures accounted for more variance (35% and 31%) than immediate memory measures (18%), and the relationship between cognition and functional outcomes was stronger when assessed with informant-report (28%) compared with self-report (21%). Demographics, sample characteristics, and type of everyday functioning measures (i.e., questionnaire, performance-based) explained relatively little variance compared with cognition. Executive functioning, particularly measured by Trails B, was a strong predictor of everyday functioning in individuals with MCI. A large proportion of variance remained unexplained by cognition. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The value of assessing cognitive function in drug development

PubMed Central

Wesnes, Keith A.

2000-01-01

This paper reviews the value and utility of measuring cognitive function in the development of new medicines by reference to the most widely used automated system in clinical research. Evidence is presented from phase 1 to 3 of the nature and quality of the information that can be obtained by applying the Cognitive Drug Research computerized assessment system to ongoing clinical trials. Valuable evidence can be obtained even in the first trial in which a novel compound is administered to man. One application of such testing is to ensure that novel compounds are relatively free from cognition-impairing properties, particularly in relation to competitor products. Another is to ensure that unwanted interactions with alcohol and other medications do not occur, or, if they do, to put them in context. In many patient populations, cognitive dysfunction occurs as a result of the disease process, and newer medicines which can treat the symptoms of the disease without further impairing function can often reveal benefits as the disease-induced cognitive dysfunction is reduced. Another major application is to identify benefits for compounds designed to enhance cognitive function. Such effects can be sought in typical phase 1 trials, or a scopolamine model of the core deficits of Alzheimer's disease can be used to screen potential antidernentia drugs. Ultimately, of course, such effects can be demonstrated using properly validated and highly sensitive automated procedures in the target populations. The data presented demonstrate that the concept of independently assessing a variety of cognitive functions is crucial in helping differentiate drugs, types of dementia, and different illnesses. Such information offers a unique insight into how the alterations to various cognitive functions will manifest themselves in everyday behavior. This reveals a major limitation of scales that yield a single score, because such limited information does not permit anything but a quantitative interpretation; and the concept of “more” cognitive function or “less” is manifestly inappropriate for something as complex and diverse as the interplay between cognitive function and human behavior. Finally, the next generations of cognitive testing are described. Testing via the telephone has just been introduced and will have dramatic effects on the logistics of conducting cognitive testing in large patient trials. Testing via the Internet is not far off either, and will come fully into play as the proportion of homes connected to the Internet increases in Europe and North America. There are no sound reasons for not wishing to include cognitive function testing in the development protocol of any novel medicine. PMID:22033754

An evaluation of the cognitive and mood effects of an energy shot over a 6h period in volunteers: a randomized, double-blind, placebo controlled, cross-over study.

PubMed

Wesnes, Keith A; Barrett, Marilyn L; Udani, Jay K

2013-08-01

Energy drinks are widely available mostly containing glucose, and several have been demonstrated to improve alertness and cognitive function; these effects generally being identified 30-60min after administration. The present study assessed whether an energy shot without carbohydrates would affect major aspects of cognitive function and also mood in volunteers over a 6h time period. This randomized, double-blind, placebo-controlled,crossover study compared the acute effects of the energy shot with a matching placebo in 94 healthy volunteers. Cognitive function was assessed with a widely used set of automated tests of attention and memory. Mood was assessed with the Bond-Lader, Beck Anxiety Index, Beck Depression Index, Chalder Fatigue Scales (CFS), and the POMS. The volunteers were requested to limit their sleep to between 3 and 6h the night before each testing day. Compared to the placebo, the energy shot significantly improved 6 validated composite cognitive function measures from the CDR System as well as self-rated alertness; the benefits on 4 of the cognitive measures still remaining at 6h. The overall effect sizes of the performance improvements were in the small to medium range and thus notable in this field. In conclusion, an energy shot can significantly improve important aspects of cognitive function for up to 6h compared to placebo in partially sleep-deprived healthy volunteers. Copyright © 2013 Elsevier Ltd. All rights reserved.

Association of Dynapenia, Sarcopenia, and Cognitive Impairment Among Community-Dwelling Older Taiwanese.

PubMed

Huang, Chung-Yu; Hwang, An-Chun; Liu, Li-Kuo; Lee, Wei-Ju; Chen, Liang-Yu; Peng, Li-Ning; Lin, Ming-Hsien; Chen, Liang-Kung

2016-02-01

A decline in physical and/or cognitive function is a common feature of aging, and frailty has been shown to be associated with cognitive impairment and dementia. This study aimed to evaluate the association between dynapenia, sarcopenia, and cognitive impairment among community-dwelling older people in Taiwan. Data from the I-Lan Longitudinal Aging Study (ILAS) were retrieved for study. Global cognitive function was assessed by Mini-Mental State Examination (MMSE), whereas the Chinese Version Verbal Learning Test, Boston Naming Test, Verbal Fluency Test, Taylor Complex Figure Test, Digits Backward Test, and Clock Drawing Test were used to assess different domains of cognitive function. Association between sarcopenia and global cognitive function as well as all different dimensions of cognitive function were evaluated. Data from 731 elderly participants (mean age 73.4 ± 5.4 years, 53.8% males) were used for study analysis. The overall prevalence of sarcopenia was 6.8%, which was significantly higher in men (9.3% versus 4.1%, p < 0.05). The mean MMSE score was 23.4 ± 4.4 for all participants, and 10.3% of the study participants were cognitively impaired. Sarcopenia was not significantly associated with global cognitive function (odds ratio [OR] = 1.55, p = 0.317), but global cognitive impairment was significantly associated with low physical performance (OR = 2.31, p = 0.003) and low muscle strength (OR = 2.59, p = 0.011). Nonetheless, sarcopenia was significantly associated with impairment in the verbal fluency test (OR = 3.96, p = 0.006) after adjustment for potential confounders. Dynapenia was significantly associated with cognitive impairment in multiple dimensions and global cognitive function, but sarcopenia was only associated with an impaired verbal fluency test. Reduced muscle strength and/or physical performance related to non-muscle etiology were strongly associated with cognitive impairment. More longitudinal studies are needed.

The Mediterranean diet and age-related cognitive functioning: A systematic review of study findings and neuropsychological assessment methodology.

PubMed

Knight, Alissa; Bryan, Janet; Murphy, Karen

2017-10-01

The primary aims of this review were to identify studies investigating the association between the MedDiet pattern and age-related cognitive function, to determine the current status of knowledge, and to ascertain whether a lack of standardization with the operationalization of age-related cognitive function and differences in the chosen neuropsychological assessment methodology impacted on the results and findings. The systematic review protocol for this paper was carried out following the statement and general principles of PRISMA and the UK Centre for Reviews and Dissemination (CRD). A systematic search of electronic databases yielded two cross-sectional studies, two cross-sectional/prospective studies, and 11 prospective studies for inclusion. Among this group of studies, conflicting results and conclusions regarding the efficacy of the MedDiet as a therapeutic approach for age-related cognitive function were found. Of importance, clear differences among studies in relation to neuropsychological assessment methodology were identified. Such disparity appeared to be one plausible factor contributing to the lack of consensus among study findings. One of the important challenges for future research will be to aim toward some kind of standardized neuropsychological assessment criteria. This type of endeavor will enable the ability to validate with greater confidence, whether or not adherence to a MedDiet does promote benefit for age-related cognitive function.

An automated system for assessing cognitive function in any environment

NASA Astrophysics Data System (ADS)

Wesnes, Keith A.

2005-05-01

The Cognitive Drug Research (CDR) computerized assessment system has been in use in worldwide clinical trials for over 20 years. It is a computer based system which assesses core aspects of human cognitive function including attention, information, working memory and long-term memory. It has been extensively validated and can be performed by a wide range of clinical populations including patients with various types of dementia. It is currently in worldwide use in clinical trials to evaluate new medicines, as well as a variety of programs involving the effects of age, stressors illnesses and trauma upon human cognitive function. Besides being highly sensitive to drugs which will impair or improve function, its utility has been maintained over the last two decades by constantly increasing the number of platforms upon which it can operate. Besides notebook versions, the system can be used on a wrist worn device, PDA, via tht telephone and over the internet. It is the most widely used automated cognitive function assessment system in worldwide clinical research. It has dozens of parallel forms and requires little training to use or administer. The basic development of the system wil be identified, and the huge databases (normative, patient population, drug effects) which have been built up from hundreds of clinical trials will be described. The system is available for use in virtually any environment or type of trial.

Workplace Exposures and Cognitive Function During Adulthood: Evidence From National Survey of Midlife Development and the O*NET.

PubMed

Grzywacz, Joseph G; Segel-Karpas, Dikla; Lachman, Margie E

2016-06-01

Expand understanding of the role of selected workplace exposures (ie, occupational complexity, conflict in the workplace, pace of work, and physical hazards) in adults' cognitive function. Cross-sectional data (n = 1991) from the second wave of the Midlife in the United States (MIDUS) study; restricted to participants who completed telephone-based cognitive assessments of episodic memory, executive functioning, and self-perceived memory. Occupational exposure data were harvested from the ONET Release 6.0. Greater complexity was associated with better self-perceived memory among women and men, and better episodic memory and executive functioning among women. Greater physical hazards were independently associated with poorer episodic memory and executive functioning. Objective assessments of physical and psychosocial exposures in the workplace are independently associated with cognitive outcomes in adulthood, with psychosocial exposures being particularly pronounced among women.

Investigating human cognitive performance during spaceflight

NASA Astrophysics Data System (ADS)

Pattyn, Nathalie; Migeotte, Pierre-Francois; Demaeseleer, Wim; Kolinsky, Regine; Morais, Jose; Zizi, Martin

2005-08-01

Although astronauts' subjective self-evaluation of cognitive functioning often reports impairments, to date most studies of human higher cognitive functions in space never yielded univocal results. Since no golden standard exists to evaluate the higher cognitive functions, we proposed to assess astronaut's cognitive performance through a novel series of tests combined with the simultaneous recording of physiological parameters. We report here the validation of our methodology and the cognitive results of this testing on the cosmonauts from the 11 days odISSsea mission to the ISS (2002) and on a control group of pilots, carefully matched to the characteristics of the subjects. For the first time, we show a performance decrement in higher cognitive functions during space flight. Our results show a significant performance decrement for inflight measurement, as well as measurable variations in executive control of cognitive functions. Taken together, our data establish the validity of our methodology and the presence of a different information processing in operational conditions.

The effects of lifelong cognitive lifestyle on executive function in older people with Parkinson's disease.

PubMed

Hindle, John V; Martin-Forbes, Pamela A; Martyr, Anthony; Bastable, Alexandra J M; Pye, Kirstie L; Mueller Gathercole, Virginia C; Thomas, Enlli M; Clare, Linda

2017-12-01

Active lifelong cognitive lifestyles increase cognitive reserve and have beneficial effects on global cognition, cognitive decline and dementia risk in Parkinson's disease (PD). Executive function is particularly impaired even in early PD, and this impacts on quality of life. The effects of lifelong cognitive lifestyle on executive function in PD have not been studied previously. This study examined the association between lifelong cognitive lifestyle, as a proxy measure of cognitive reserve, and executive function in people with PD. Sixty-nine people diagnosed with early PD without dementia were recruited as part of the Bilingualism as a protective factor in Age-related Neurodegenerative Conditions study. Participants completed a battery of tests of executive function. The Lifetime of Experiences Questionnaire was completed as a comprehensive assessment of lifelong cognitive lifestyle. Non-parametric correlations compared clinical measures with executive function scores. Cross-sectional analyses of covariance were performed comparing the performance of low and high cognitive reserve groups on executive function tests. Correlational analyses showed that better executive function scores were associated with younger age, higher levodopa dose and higher Lifetime of Experiences Questionnaire scores. Higher cognitive reserve was associated with better motor function, but high and low cognitive reserve groups did not differ in executive function. Cognitive reserve, although associated with global cognition, does not appear to be associated with executive function. This differential effect may reflect the specific cognitive profile of PD. The long-term effects of cognitive reserve on executive function in PD require further exploration. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Cognitive change in patients with Huntington disease on the Repeatable Battery for the Assessment of Neuropsychological Status.

PubMed

Beglinger, Leigh J; Duff, Kevin; Allison, Jessica; Theriault, Danielle; O'Rourke, Justin J F; Leserman, Anne; Paulsen, Jane S

2010-07-01

Huntington disease (HD) is a neurodegenerative disease associated with cognitive, motor, and psychiatric deterioration over time. Although there is currently no cure for HD, there has been a surge of clinical trials available to patients with HD over the past 5 years. However, cognitive measures have generally been lacking from these trials. A brief, repeatable neuropsychological battery is needed to assess cognitive endpoints. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) may be useful for assessing change in interventional studies or for clinical monitoring. A total of 38 patients with HD were assessed using the RBANS, other cognitive tests, and the standardized HD battery (Unified Huntington's Disease Rating Scale, UHDRS) at two clinic visits approximately 16 months apart. The RBANS Attention Index, as well as individual subtest scores on Coding, Digit Span, List Recognition, Figure Copy, and Figure Recall all declined significantly over this interval. Performance on the UHDRS cognitive tests (Symbol Digit Modalities; Stroop Color, and Stroop Word) also declined, as did functional capacity. Results suggest that cognitive changes were detected both on established cognitive tasks used in HD research and on the RBANS in patients with measurable functional decline. The RBANS provided additional information about other cognitive domains affected (e.g., memory) and may be a useful measure for tracking longitudinal change.

Does Naming Therapy Make Ordering in a Restaurant Easier? Dynamics of Co-Occurring Change in Cognitive-Linguistic and Functional Communication Skills in Aphasia

PubMed Central

Johnson, Jeffrey P.; Villard, Sarah; Kiran, Swathi

2017-01-01

Purpose This study was conducted to investigate the static and dynamic relationships between impairment-level cognitive-linguistic abilities and activity-level functional communication skills in persons with aphasia (PWA). Method In Experiment 1, a battery of standardized assessments was administered to a group of PWA (N = 72) to examine associations between cognitive-linguistic ability and functional communication at a single time point. In Experiment 2, impairment-based treatment was administered to a subset of PWA from Experiment 1 (n = 39) in order to examine associations between change in cognitive-linguistic ability and change in function and associations at a single time point. Results In both experiments, numerous significant associations were found between scores on tests of cognitive-linguistic ability and a test of functional communication at a single time point. In Experiment 2, significant treatment-induced gains were seen on both types of measures in participants with more severe aphasia, yet cognitive-linguistic change scores were not significantly correlated with functional communication change scores. Conclusions At a single time point, cognitive-linguistic and functional communication abilities are associated in PWA. However, although changes on standardized assessments reflecting improvements in both types of skills can occur following an impairment-based therapy, these changes may not be significantly associated with each other. PMID:28196373

Development of a virtual reality assessment of everyday living skills.

PubMed

Ruse, Stacy A; Davis, Vicki G; Atkins, Alexandra S; Krishnan, K Ranga R; Fox, Kolleen H; Harvey, Philip D; Keefe, Richard S E

2014-04-23

Cognitive impairments affect the majority of patients with schizophrenia and these impairments predict poor long term psychosocial outcomes.  Treatment studies aimed at cognitive impairment in patients with schizophrenia not only require demonstration of improvements on cognitive tests, but also evidence that any cognitive changes lead to clinically meaningful improvements.  Measures of "functional capacity" index the extent to which individuals have the potential to perform skills required for real world functioning.  Current data do not support the recommendation of any single instrument for measurement of functional capacity.  The Virtual Reality Functional Capacity Assessment Tool (VRFCAT) is a novel, interactive gaming based measure of functional capacity that uses a realistic simulated environment to recreate routine activities of daily living. Studies are currently underway to evaluate and establish the VRFCAT's sensitivity, reliability, validity, and practicality. This new measure of functional capacity is practical, relevant, easy to use, and has several features that improve validity and sensitivity of measurement of function in clinical trials of patients with CNS disorders.

The effects of cognitive rehabilitation on Alzheimer's dementia patients' cognitive assessment reference diagnosis system performance based on level of cognitive functioning.

PubMed

Hwang, Jung-Ha; Cha, Hyun-Gyu; Cho, Hyuk-Shin

2015-09-01

[Purpose] The purpose of this study is to apply cognitive rehabilitation according to Alzheimer's disease (AD) patients' level of cognitive functioning to compare changes in Cognitive Assessment Reference Diagnosis System performance and present standards for effective intervention. [Subjects] Subjects were 30 inpatients diagnosed with AD. Subjects were grouped by Clinical Dementia Rating (CDR) class (CDR-0.5, CDR-1, or CDR-2, n = 10 per group), which is based on level of cognitive functioning, and cognitive rehabilitation was applied for 50 minutes per day, five days per week, for four weeks. [Methods] After cognitive rehabilitation intervention, CARDS tests were conducted to evaluate memory. [Results] Bonferroni tests comparing the three groups revealed that the CDR-0.5 and CDR-1 groups showed significant increases in Delayed 10 word-list, Delayed 10 object-list, Recognition 10 object, and Recent memory performance compared to the CDR-2 group. In addition, the CDR-0.5 group showed significant decreases in Recognition 10 word performance compared to the CDR-1 group. [Conclusion] Cognitive rehabilitation, CDR-0.5 or CDR-1 subjects showed significantly greater memory improvements than CDR-2 subjects. Moreover, was not effective for CDR-2 subjects.

Long sleep duration is associated with lower cognitive function among middle-age adults - the Doetinchem Cohort Study.

PubMed

van Oostrom, Sandra H; Nooyens, Astrid C J; van Boxtel, Martin P J; Verschuren, W M Monique

2018-01-01

In older adults, both short and long sleep duration are associated with lower cognitive function, suggesting an inverted U-shaped association between sleep duration and cognitive outcomes. This study examined whether sleep duration is associated with (changes in) cognitive function in a middle-aged population. In the Doetinchem Cohort Study, the cognitive function of 2970 men and women aged 41-75 years at baseline (1995-2007) was examined 2-3 times, with 5-year time intervals. Global cognitive function and the domains memory, information processing speed, and cognitive flexibility were assessed. In multivariable linear regression models, (change in) self-reported sleep duration was studied in association with the level and change in cognitive function. In a subsample of the population (n = 2587), the association of sleep duration and feeling rested with cognitive function was studied. Sleep duration of 9 h and more was statistically significantly associated with lower global cognitive function (p < 0.01), memory (p = 0.02), and flexibility (p = 0.03), compared to a sleep duration of 7 or 8 h. Among adults feeling frequently not well rested, both short and long sleep duration were associated with a lower speed of cognitive function. An inverted U-shaped association between sleep duration and cognitive function was observed for speed, flexibility, and global cognitive function. Sleep duration was not associated with change in cognitive function. Middle-age adults with long sleep duration had a lower cognitive function. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Combined associations of sedentary behavior and cardiorespiratory fitness on cognitive function among older adults.

PubMed

Edwards, Meghan K; Loprinzi, Paul D

2017-02-15

Sedentary behavior, cardiorespiratory fitness, cognition and age are interrelated and associated with cardiovascular function. No study, however, has specifically evaluated the independent and combined associations of cardiorespiratory fitness and sedentary behavior on cognition, which was this study's purpose. Data from the 1999-2002 NHANES were used (N=2451; 60-85yrs). Sedentary behavior was assessed via self-report; cardiorespiratory fitness was assessed from a medical-related algorithm; and cognition function was assessed from the Digit Symbol Substitution Test (DSST). Being in the bottom quartile for sedentary behavior (β=2.13; 95% CI: 0.49-3.77; P=0.01) and the top quartile for cardiorespiratory fitness (β=7.48; 95% CI: 5.4-9.5; P<0.001) were independently associated with higher cognitive function. In the additive model, those with an index score of 1 (vs. 0) and 2 (vs. 0), respectively, had a 3.87 (β=3.87; 95% CI: 1.76-5.98; P=0.001) and 10.40 (β=10.4; 95% CI: 7.31-13.5; P<0.001) higher DSST score. High cardiorespiratory fitness and low sedentary behavior were jointly associated with the highest cognitive function. This has important cardiovascular implications as a progression of neurocognitive impairment is associated with increasingly severe manifestations of cardiovascular disease. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Predictors of response to cognitive remediation in service recipients with severe mental illness.

PubMed

Lindenmayer, Jean-Pierre; Ozog, Veronica Anna; Khan, Anzalee; Ljuri, Isidora; Fregenti, Samantha; McGurk, Susan R

2017-03-01

Cognitive challenges are prominent features of individuals diagnosed with schizophrenia, impairing occupational, social, and economic functioning. These challenges are predictive of social and work outcomes. Cognitive remediation has been shown to be effective in improving both cognitive and social functions. However, cognitive remediation does not produce improvement in all participants. We investigated demographic, neurocognitive, and psychopathological predictors associated with improvement following cognitive remediation interventions in service recipients with severe mental illnesses. One hundred thirty-seven adult participants with a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.) were enrolled in 12-week cognitive remediation programs. Assessments of demographic and illness variables, together with baseline and end point assessment of psychopathology (Positive and Negative Syndrome Scale [PANSS]), neurocognition (Measurement and Treatment Research to Improve Cognition in Schizophrenia [MATRICS] Consensus Cognitive Battery [MCBB]), and social functions (Personal and Social Performance Scale [PSP]) were conducted. Change in cognitive domains was calculated using the reliable change index. Logistic regression analysis was used to assess predictors of cognitive improvement after the intervention. Sixty-two percent of participants improved on at least 1 of the MCCB domains. Higher baseline speed of processing, attention or vigilance, and working memory predicted a positive response to cognitive remediation. Younger age, higher education level, shorter length of stay, and lower PANSS Negative and Disorganized factors were additional predictors. Our results indicate the clinical usefulness of cognitive remediation and identified a pattern of clinical and cognitive predictors of good response to the intervention. Identification of these predictive factors by clinicians may enhance the outcome and aid in the development of individualized rehabilitative cognitive remediation treatment plans. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Moderators of noise-induced cognitive change in healthy adults.

PubMed

Wright, Bernice Al; Peters, Emmanuelle R; Ettinger, Ulrich; Kuipers, Elizabeth; Kumari, Veena

2016-01-01

Environmental noise causes cognitive impairment, particularly in executive function and episodic memory domains, in healthy populations. However, the possible moderating influences on this relationship are less clear. This study assessed 54 healthy participants (24 men) on a cognitive battery (measuring psychomotor speed, attention, executive function, working memory, and verbal learning and memory) under three (quiet, urban, and social) noise conditions. IQ, subjective noise sensitivity, sleep, personality, paranoia, depression, anxiety, stress, and schizotypy were assessed on a single occasion. We found significantly slower psychomotor speed (urban), reduced working memory and episodic memory (urban and social), and more cautious decision-making (executive function, urban) under noise conditions. There was no effect of sex. Variance in urban noise-induced changes in psychomotor speed, attention, Trail Making B-A (executive function), and immediate recall and social noise-induced changes in verbal fluency (executive function) and immediate recall were explained by a combination of baseline cognition and paranoia, noise sensitivity, sleep, or cognitive disorganization. Higher baseline cognition (but not IQ) predicted greater impairment under urban and social noise for most cognitive variables. Paranoia predicted psychomotor speed, attention, and executive function impairment. Subjective noise sensitivity predicted executive function and memory impairment. Poor sleep quality predicted less memory impairment. Finally, lower levels of cognitive disorganization predicted slower psychomotor speed and greater memory impairment. The identified moderators should be considered in studies aiming to reduce the detrimental effects of occupational and residential noise. These results highlight the importance of studying noise effects in clinical populations characterized by high levels of the paranoia, sleep disturbances, noise sensitivity, and cognitive disorganization.

Impact of cognitive function on oral perception in independently living older people.

PubMed

Fukutake, Motoyoshi; Ogawa, Taiji; Ikebe, Kazunori; Mihara, Yusuke; Inomata, Chisato; Takeshita, Hajime; Matsuda, Kenichi; Hatta, Kodai; Gondo, Yasuyuki; Masui, Yukie; Inagaki, Hiroki; Arai, Yasumichi; Kamide, Kei; Ishizaki, Tatsuro; Maeda, Yoshinobu

2018-04-10

Oral tactile perception is important for better mastication, appetite, and enjoyment of food. However, previous investigations have not utilized comprehensible variables thought to have negative effect on oral perception, including aging, denture wearing, and cognitive function. The aim of this study was to elucidate the impact of cognitive function on oral perception in independently living older individuals. The study sample was comprised of 987 participants (466 males, 521 females; age 69-71 years). Oral examinations, assessments of cognitive function in preclinical level by Montreal Cognitive Assessment (MoCA)-J, and determination of oral stereognostic ability as an indicator of oral perception were performed. Related variables were selected by univariate analyses; then, multivariate logistic regression model analysis was conducted. Univariate analyses revealed that number of teeth, removable dentures usage, and cognitive function respectively had a significant relationship with stereognostic score. Next, the subjects were classified into good and poor perception groups (lowest 17.4%) according to oral stereognostic ability. Logistic regression analysis revealed that lower cognitive function was significantly associated with poor oral perception (OR = 0.934, p = 0.017) after controlling for other variables. Cognitive decline even in preclinical stage was associated with reduced oral perception after controlling for gender, tooth number and denture use in independent living older people. This study suggested that preclinical level of change in cognitive function affected oral perception. Dental practitioners and caregivers may need to pay attention to reduced oral perception among older people even if they do not have trouble in daily life.

Moderators of noise-induced cognitive change in healthy adults

PubMed Central

Wright, Bernice AL; Peters, Emmanuelle R; Ettinger, Ulrich; Kuipers, Elizabeth; Kumari, Veena

2016-01-01

Environmental noise causes cognitive impairment, particularly in executive function and episodic memory domains, in healthy populations. However, the possible moderating influences on this relationship are less clear. This study assessed 54 healthy participants (24 men) on a cognitive battery (measuring psychomotor speed, attention, executive function, working memory, and verbal learning and memory) under three (quiet, urban, and social) noise conditions. IQ, subjective noise sensitivity, sleep, personality, paranoia, depression, anxiety, stress, and schizotypy were assessed on a single occasion. We found significantly slower psychomotor speed (urban), reduced working memory and episodic memory (urban and social), and more cautious decision-making (executive function, urban) under noise conditions. There was no effect of sex. Variance in urban noise-induced changes in psychomotor speed, attention, Trail Making B-A (executive function), and immediate recall and social noise-induced changes in verbal fluency (executive function) and immediate recall were explained by a combination of baseline cognition and paranoia, noise sensitivity, sleep, or cognitive disorganization. Higher baseline cognition (but not IQ) predicted greater impairment under urban and social noise for most cognitive variables. Paranoia predicted psychomotor speed, attention, and executive function impairment. Subjective noise sensitivity predicted executive function and memory impairment. Poor sleep quality predicted less memory impairment. Finally, lower levels of cognitive disorganization predicted slower psychomotor speed and greater memory impairment. The identified moderators should be considered in studies aiming to reduce the detrimental effects of occupational and residential noise. These results highlight the importance of studying noise effects in clinical populations characterized by high levels of the paranoia, sleep disturbances, noise sensitivity, and cognitive disorganization. PMID:27157685

Cognitive functioning in the first-episode of major depressive disorder: A systematic review and meta-analysis.

PubMed

Ahern, Elayne; Semkovska, Maria

2017-01-01

Cognitive deficits are frequently observed in major depression. Yet, when these deficits emerge and how they relate to the depressed state is unclear. The aim of this 2-part systematic review and meta-analysis is to determine the pattern and extent of cognitive deficits during a first-episode of depression (FED) and their persistence following FED remission. Published, peer-reviewed articles on cognitive function in FED patients through October 2015 were searched. Meta-analyses with random-effects modeling were conducted. Part 1 assessed weighted, mean effect sizes of cognitive function in FED patients relative to healthy controls. Moderator analyses of clinical and demographical variables effects were conducted. Part 2 assessed weighted, mean effect sizes of change in cognitive function at remission compared with acute FED performance in longitudinal studies. Thirty-one studies including 994 FED patients were retained in Part 1. Relative to healthy controls, small to large impairments were observed across most cognitive domains. Remission was associated with a normalization of function in processing speed, learning and memory, autobiographical memory, shifting, and IQ. Lower FED age was associated with higher IQ, but more impairment in word-list delayed memory. Four studies including 92 FED patients were retained in Part 2. Following remission, FED patients showed small improvements in processing speed and shifting but persistent impairment in inhibition and verbal fluency. Significant cognitive deficits are already identifiable during a FED, with some functions showing persistent impairment upon remission. Clinicians must consider cognitive impairment alongside mood symptoms to ensure functional recovery from the FED. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Cognitive self-regulation and social functioning among French children: A longitudinal study from kindergarten to first grade.

PubMed

Hubert, Blandine; Guimard, Philippe; Florin, Agnès

2017-03-01

This study adds to the body of research examining the links between two components of cognitive self-regulation (inhibitory control and verbal working memory) and social functioning (social integration, social problem solving, and prosocial skills) and focuses on children's sex as a moderator of the association between cognitive self-regulation and social functioning. The participants (N = 131) were French schoolchildren followed from kindergarten (Mage = 68.36 months, SD = 3.33 months) through Grade 1. Using hierarchical regression analyses, three major findings were revealed: (1) inhibitory control was a better predictor than verbal working memory of prosocial skills assessed by peers using the sociometric technique as well as by teachers using questionnaires, after controlling for sex, mother's education, and verbal and non-verbal IQ; (2) the prosocial skills assessed by teachers in kindergarten contributed more to explaining the prosocial skills and peer acceptance assessed in Grade 1 than cognitive self-regulation; and (3) sex did not moderate the relationship between cognitive self-regulation and social functioning. These results suggest that developing strong cognitive self-regulation, especially inhibitory control and prosocial skills, in young children schooled in France could be beneficial for their social development. © 2017 The Institute of Psychology, Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.

Comparing Individual Differences in Inconsistency and Plasticity as Predictors of Cognitive Function in Older Adults

PubMed Central

Grand, Jacob H.G.; Stawski, Robert S.; MacDonald, Stuart W.S.

2016-01-01

Introduction Recent theorizing differentiates key constraints on cognition, including one’s current range of processing efficiency (i.e., flexibility or inconsistency) as well as the capacity to expand flexibility over time (i.e., plasticity). The present study uses intensive assessment of response time data to examine the interplay between markers of intraindividual variability (inconsistency) and gains across biweekly retest sessions (plasticity) in relation to age-related cognitive function. Method Participants included 304 adults (aged 64 to 92 years: M=74.02, SD=5.95) from Project MIND, a longitudinal burst design study assessing performance across micro and macro intervals (response latency trials, weekly bursts, annual retests). For two reaction time measures (choice RT and one-back choice RT), baseline measures of response time (RT) inconsistency (intraindividual standard deviation (ISD) across-trials at the first testing session) and plasticity (within-person performance gains in average RT across the 5 biweekly burst sessions) were computed, and then employed in linear mixed models as predictors of individual differences in cognitive function and longitudinal (6 year) rates of cognitive change. Results Independent of chronological age and years of education, higher RT inconsistency was associated uniformly with poorer cognitive function at baseline and with increased cognitive decline for measures of episodic memory and crystallized verbal ability. In contrast, predictive associations for plasticity were more modest for baseline cognitive function and were absent for 6-year cognitive change. Conclusions These findings underscore the potential utility of response times for articulating inconsistency and plasticity as dynamic predictors of cognitive function in older adults. PMID:26898536

Comparing individual differences in inconsistency and plasticity as predictors of cognitive function in older adults.

PubMed

Grand, Jacob H G; Stawski, Robert S; MacDonald, Stuart W S

2016-01-01

Recent theorizing differentiates key constraints on cognition, including one's current range of processing efficiency (i.e., flexibility or inconsistency) as well as the capacity to expand flexibility over time (i.e., plasticity). The present study uses intensive assessment of response time data to examine the interplay between markers of intraindividual variability (inconsistency) and gains across biweekly retest sessions (plasticity) in relation to age-related cognitive function. Participants included 304 adults (aged 64 to 92 years: M = 74.02, SD = 5.95) from Project MIND, a longitudinal burst design study assessing performance across micro and macro intervals (response latency trials, weekly bursts, annual retests). For two reaction time (RT) measures (choice RT and one-back choice RT), baseline measures of RT inconsistency (intraindividual standard deviation, ISD, across trials at the first testing session) and plasticity (within-person performance gains in average RT across the 5 biweekly burst sessions) were computed and were then employed in linear mixed models as predictors of individual differences in cognitive function and longitudinal (6-year) rates of cognitive change. Independent of chronological age and years of education, higher RT inconsistency was associated uniformly with poorer cognitive function at baseline and with increased cognitive decline for measures of episodic memory and crystallized verbal ability. In contrast, predictive associations for plasticity were more modest for baseline cognitive function and were absent for 6-year cognitive change. These findings underscore the potential utility of response times for articulating inconsistency and plasticity as dynamic predictors of cognitive function in older adults.

Impact of Short- and Long-term Tai Chi Mind-Body Exercise Training on Cognitive Function in Healthy Adults: Results From a Hybrid Observational Study and Randomized Trial.

PubMed

Walsh, Jacquelyn N; Manor, Brad; Hausdorff, Jeffrey; Novak, Vera; Lipsitz, Lewis; Gow, Brian; Macklin, Eric A; Peng, Chung-Kang; Wayne, Peter M

2015-07-01

Cognitive decline amongst older adults is a significant public health concern. There is growing interest in behavioral interventions, including exercise, for improving cognition. Studies to date suggest tai chi (TC) may be a safe and potentially effective exercise for preserving cognitive function with aging; however, its short-term and potential long-term impact on physically active, healthy adults is unclear. To compare differences in cognitive function among long-term TC expert practitioners and age-matched and gender-matched TC-naïve adults and to determine the effects of short-term TC training on measures of cognitive function in healthy, nonsedentary adults. A hybrid design including an observational comparison and a 2-arm randomized clinical trial (RCT). Healthy, nonsedentary, TC-naive adults (50 y-79 y) and age-matched and gender-matched long-term TC experts. A cross-sectional comparison of cognitive function in healthy TC-naïve (n=60) and TC expert (24.5 y ÷ 12 y experience; n=27) adults: TC-naïve adults then completed a 6-month, 2-arm, wait-list randomized clinical trial of TC training. Six measures of cognitive function were assessed for both cross-sectional and longitudinal comparisons. TC experts exhibited trends towards better scores on all cognitive measures, significantly so for category fluency (P=.01), as well as a composite z score summarizing all 6 cognitive assessments (P=.03). In contrast, random assignment to 6 months of TC training in TC-naïve adults did not significantly improve any measures of cognitive function. In healthy nonsedentary adults, long-term TC training may help preserve cognitive function; however, the effect of short-term TC training in healthy adults remains unclear. ClinicalTrials.gov NCT01340365.

Perceived stress and change in cognitive function among adults 65 years and older.

PubMed

Aggarwal, Neelum T; Wilson, Robert S; Beck, Todd L; Rajan, Kumar B; Mendes de Leon, Carlos F; Evans, Denis A; Everson-Rose, Susan A

2014-01-01

Exposure to acute and chronic stress can affect learning and memory, but most evidence comes from animal studies or clinical observations. Almost no population-based studies have investigated the relation of stress to cognition or changes in cognition over time. We examined whether higher levels of perceived stress were associated with accelerated decline in cognitive function in older blacks and whites from a community-based population sample. Participants included 6207 black and white adults (65.7% black, 63.3% women) from the Chicago Health and Aging Project. Two to five in-home assessments were completed over an average of 6.8 years of follow-up and included sociodemographics, health behaviors, psychosocial measures, cognitive function tests, and health history. Perceived stress was measured by a six-item scale, and a composite measure of four tests of cognition was used to determine cognitive function at each assessment. Mixed-effects regression models showed that increasing levels of perceived stress were related to lower initial cognitive scores (B = -0.0379, standard error = 0.0025, p < .001) and a faster rate of cognitive decline (stress × time interaction: B = -0.0015, standard error = 0.0004, p < .001). Results were similar after adjusting for demographic variables, smoking, systolic blood pressure, body mass index, chronic medical conditions, and psychosocial factors and did not vary by race, sex, age, or education. Increasing levels of stress are independently associated with accelerated declines in cognitive function in black and white adults 65 years and older.

On-road assessment of fitness-to-drive in persons with MS with cognitive impairment: A prospective study.

PubMed

Morrow, Sarah A; Classen, Sherrilene; Monahan, Miriam; Danter, Tim; Taylor, Robert; Krasniuk, Sarah; Rosehart, Heather; He, Wenqing

2017-08-01

Cognitive impairment is common in multiple sclerosis (MS). In other populations, cognitive impairment is known to affect fitness-to-drive. Few studies have focused on fitness-to-drive in MS and no studies have solely focused on the influence of cognitive impairment. To assess fitness-to-drive in persons with MS with cognitive impairment and low physical disability. Persons with MS, aged 18-59 years with EDSS ⩽ 4.0, impaired processing speed, and impairment on at least one measure of memory or executive function, were recruited. Cognition was assessed using the Minimal Assessment of Cognitive Function battery. A formal on-road driving assessment was conducted. Chi-square analysis examined the association between the fitness-to-drive (pass/fail) and the neuropsychological test results (normal/impaired). Bayesian statistics predicting failure of the on-road assessment were calculated. Of 36 subjects, eight (22.2%) were unfit to drive. Only the BVMTR-IR, measuring visual-spatial memory, predicted on-road driving assessment failure ( X 2 ( df = 1, N = 36) = 3.956; p = 0.047) with a sensitivity of 100%, but low specificity (35.7%) due to false positives (18/25). In persons with MS and impaired processing speed, impairment on the BVMTR-IR should lead clinicians to address fitness-to-drive.

An eye-tracking controlled neuropsychological battery for cognitive assessment in neurological diseases.

PubMed

Poletti, Barbara; Carelli, Laura; Solca, Federica; Lafronza, Annalisa; Pedroli, Elisa; Faini, Andrea; Zago, Stefano; Ticozzi, Nicola; Ciammola, Andrea; Morelli, Claudia; Meriggi, Paolo; Cipresso, Pietro; Lulé, Dorothée; Ludolph, Albert C; Riva, Giuseppe; Silani, Vincenzo

2017-04-01

Traditional cognitive assessment in neurological conditions involving physical disability is often prevented by the presence of verbal-motor impairment; to date, an extensive motor-verbal-free neuropsychological battery is not available for such purposes. We adapted a set of neuropsychological tests, assessing language, attentional abilities, executive functions and social cognition, for eye-tracking (ET) control, and explored its feasibility in a sample of healthy participants. Thirty healthy subjects performed a neuropsychological assessment, using an ET-based neuropsychological battery, together with standard "paper and pencil" cognitive measures for frontal (Frontal Assessment Battery-FAB) and working memory abilities (Digit Sequencing Task) and for global cognitive efficiency (Montreal Cognitive Assessment-MoCA). Psychological measures of anxiety (State-Trait Anxiety Inventory-Y-STAI-Y) and depression (Beck Depression Inventory-BDI) were also collected, and a usability questionnaire was administered. Significant correlations were observed between the "paper and pencil" screening of working memory abilities and the ET-based neuropsychological measures. The ET-based battery also correlated with the MoCA, while poor correlations were observed with the FAB. Usability aspects were found to be influenced by both working memory abilities and psychological components. The ET-based neuropsychological battery developed could provide an extensive assessment of cognitive functions, allowing participants to perform tasks independently from the integrity of motor or verbal channels. Further studies will be aimed at investigating validity and usability components in neurological populations with motor-verbal impairments.

Mindfulness-Based Cognitive Therapy for Bipolar Disorder: Effects on Cognitive Functioning

PubMed Central

Stange, Jonathan P.; Eisner, Lori R.; Hölzel, Britta K.; Peckham, Andrew D.; Dougherty, Darin D.; Rauch, Scott L.; Nierenberg, Andrew A.; Lazar, Sara; Deckersbach, Thilo

2012-01-01

Bipolar disorder is associated with impairments in cognition, including difficulties in executive functioning, even when patients are euthymic (neither depressed nor manic). The purpose of this study was to assess changes in self-reported cognitive functioning in patients with bipolar disorder who participated in an open pilot trial of mindfulness-based cognitive therapy (MBCT). Following MBCT, patients reported significant improvements in executive functioning, memory, and ability to initiate and complete tasks, as measured by the Behavior Rating Inventory of Executive Function (BRIEF) and the Frontal Systems Behavior Scale (FrSBe). Changes in cognitive functioning were correlated with increases in mindful, nonjudgmental observance and awareness of thoughts, feelings, and sensations, and were not associated with decreases in depression. Improvements tended to diminish after termination of treatment, but some improvements, particularly those in executive functioning, persisted after 3 months. These results provide preliminary evidence that MBCT may be a treatment option that can be used as an adjunct to medication to improve cognitive functioning in bipolar disorder. PMID:22108398

Cognitive evaluation by tasks in a virtual reality environment in multiple sclerosis.

PubMed

Lamargue-Hamel, Delphine; Deloire, Mathilde; Saubusse, Aurore; Ruet, Aurélie; Taillard, Jacques; Philip, Pierre; Brochet, Bruno

2015-12-15

The assessment of cognitive impairment in multiple sclerosis (MS) requires large neuropsychological batteries that assess numerous domains. The relevance of these assessments to daily cognitive functioning is not well established. Cognitive ecological evaluation has not been frequently studied in MS. The aim of this study was to determine the interest of cognitive evaluation in a virtual reality environment in a sample of persons with MS with cognitive deficits. Thirty persons with MS with at least moderate cognitive impairment were assessed with two ecological evaluations, an in-house developed task in a virtual reality environment (Urban DailyCog®) and a divided attention task in a driving simulator. Classical neuropsychological testing was also used. Fifty-two percent of the persons with MS failed the driving simulator task and 80% failed the Urban DailyCog®. Virtual reality assessments are promising in identifying cognitive impairment in MS. Copyright © 2015 Elsevier B.V. All rights reserved.

Passive Assessment of Routine Driving with Unobtrusive Sensors: A New Approach for Identifying and Monitoring Functional Level in Normal Aging and Mild Cognitive Impairment

PubMed Central

Seelye, Adriana; Mattek, Nora; Sharma, Nicole; Witter, Phelps; Brenner, Ariella; Wild, Katherine; Dodge, Hiroko; Kaye, Jeffrey

2017-01-01

Background Driving is a key functional activity for many older adults, and changes in routine driving may be associated with emerging cognitive decline due to early neurodegenerative disease. Current methods for assessing driving such as self-report are inadequate for identifying and monitoring subtle changes in driving patterns that may be the earliest signals of functional change in developing mild cognitive impairment (MCI). Objective This proof of concept study aimed to establish the feasibility of continuous driving monitoring in a sample of cognitively normal and MCI older adults for an average of 206 days using an unobtrusive driving sensor and demonstrate that derived sensor-based driving metrics could effectively discriminate between MCI and cognitively intact groups. Methods Novel objective driving measures derived from 6 months of routine driving monitoring were examined in older adults with intact cognition (n = 21) and MCI (n = 7) who were enrolled in the Oregon Center for Aging and Technology (ORCATECH) longitudinal assessment program. Results Unobtrusive continuous monitoring of older adults’ routine driving using a driving sensor was feasible and well accepted. MCI participants drove fewer miles and spent less time on the highway per day than cognitively intact participants. MCI drivers showed less day-to-day fluctuations in their driving habits than cognitively intact drivers. Conclusion Sensor-based driving measures are objective, unobtrusive, and can be assessed every time a person drives his or her vehicle to identify clinically meaningful changes in daily driving. This novel methodology has the potential to be useful for the early detection and monitoring of changes in daily functioning within individuals. PMID:28731434

Patient Reported Cognitive Limitations in Brain Tumor Survivors

DTIC Science & Technology

2006-01-01

seizures may also have a negative impact on cognitive function. Common side effects can include sedation , language dysfunction, psychomotor slowing...treatment exposure [40]. Also, when compared to collateral data collected from nursing staff regarding patient symptoms and functioning (e.g...Moen J, Fougner B, Borchgrevink PC, and Kaasa S. 2002. Self-reports are not related to objective assessments of cognitive function and sedation in

Effect of virtual reality on cognition in stroke patients.

PubMed

Kim, Bo Ryun; Chun, Min Ho; Kim, Lee Suk; Park, Ji Young

2011-08-01

To investigate the effect of virtual reality on the recovery of cognitive impairment in stroke patients. Twenty-eight patients (11 males and 17 females, mean age 64.2) with cognitive impairment following stroke were recruited for this study. All patients were randomly assigned to one of two groups, the virtual reality (VR) group (n=15) or the control group (n=13). The VR group received both virtual reality training and computer-based cognitive rehabilitation, whereas the control group received only computer-based cognitive rehabilitation. To measure, activity of daily living cognitive and motor functions, the following assessment tools were used: computerized neuropsychological test and the Tower of London (TOL) test for cognitive function assessment, Korean-Modified Barthel index (K-MBI) for functional status evaluation, and the motricity index (MI) for motor function assessment. All recruited patients underwent these evaluations before rehabilitation and four weeks after rehabilitation. The VR group showed significant improvement in the K-MMSE, visual and auditory continuous performance tests (CPT), forward digit span test (DST), forward and backward visual span tests (VST), visual and verbal learning tests, TOL, K-MBI, and MI scores, while the control group showed significant improvement in the K-MMSE, forward DST, visual and verbal learning tests, trail-making test-type A, TOL, K-MBI, and MI scores after rehabilitation. The changes in the visual CPT and backward VST in the VR group after rehabilitation were significantly higher than those in the control group. Our findings suggest that virtual reality training combined with computer-based cognitive rehabilitation may be of additional benefit for treating cognitive impairment in stroke patients.

[Assessing Motor-Cognition Interaction of Patients with Cognitive Disorders: Clinical Aspects].

PubMed

Schniepp, R; Wuehr, M; Schöberl, F; Zwergal, A

2016-08-01

Difficulties of walking and deficits of cognitive functions appear to be associated in the elderly. Thus, clinical assessment in geriatry and neurology should focus on: (1) diagnostic approaches covering both domains of everyday functioning; (2) therapeutic interventions that take into account possible interactions and synergies of both domains. In order to assess the capability for motor-cognitive interactions in the elderly it is recommended to investigate walking patterns during dual-tasks (e.g. walking and counting backwards, walking and naming words) and to examine clinical tests of everyday mobility tasks, such as the Timed-up-and-go-Test and spatial navigation tasks. Patients with cognitive disorders often perform inferior with a reduction of walking speed and an increase of stepping variability. Dual-task performance appears to be a reliable parameter for long-term observations of the course of the disease. Moreover, it might improve the quality of the gait examination during diagnostic or therapeutic interventions (e.g. the spinal tap test in patients with NPH). Several studies further highlight gait deficits during dual-task walking as a marker for the everyday functioning and the quality of life in elderly persons and patients with cognitive disorders.Therapeutic approaches in this context comprise complex motor-cognitive interventions, such as Thai Chi and Dalcroze rhythmic exercises. These interventions appear to act synergistically in motor and cognitive domains. First evidence for the efficacy for improving executive functions and reducing the fall risk of patients with cognitive impairments is given, thought randomized, controlled trials are rare. © Georg Thieme Verlag KG Stuttgart · New York.

Parental Family Stress during Pregnancy and Cognitive Functioning in Early Childhood: The Generation R Study

ERIC Educational Resources Information Center

Henrichs, Jens; Schenk, Jacqueline J.; Kok, Rianne; Ftitache, Bouchra; Schmidt, Henk G.; Hofman, Albert; Jaddoe, Vincent W. V.; Verhulst, Frank C.; Tiemeier, Henning

2011-01-01

We investigated whether parental family stress during pregnancy is associated with cognitive functioning in early childhood in a population-based cohort (n = 3139). Family stress was assessed using the Family Assessment Device at the 20th week of pregnancy and was reported by mothers and fathers. Mothers completed the MacArthur Communicative…

Successful evaluation of cognitive function and the nature of cognitive deficits among people with schizophrenia in clinical rehabilitation settings.

PubMed

John, Alexander Panickacheril; Yeak, Kim; Ayres, Helen; Sevastos, Marie; Moore, Elizabeth

2016-08-01

Despite possessing considerable relevance for planning and delivery of effective rehabilitation interventions, systematic evaluation of cognitive function is often ignored in clinical practice. This paper describes a successful method for measuring cognitive function and the nature of cognitive deficits (CD) in people with schizophrenia admitted to psychiatric rehabilitation services. Data on the cognitive functioning of consecutive patients with schizophrenia / schizoaffective disorder admitted during a 5-year period to a public in-patient rehabilitation facility was collated retrospectively and analysed. The Brief Assessment of Cognition in Schizophrenia (BACS) was used to evaluate cognitive function. It was possible to administer the BACS to 122 of 135 consecutive admissions. The mean composite score on the BACS was 1.8 standard deviations below the norm, and 43% had moderate or severe CD. The BACS sub-tests of list learning and symbol coding revealed more severe deficits. The study indicates that evaluation of cognitive function using brief instruments is feasible in psychiatric rehabilitation settings. Global and domain-specific CD were prevalent among people with schizophrenia. In view of the strong association of cognitive functioning with community functioning and rehabilitation outcomes, further studies exploring the feasibility and utility of routinely evaluating cognitive function are warranted. © The Royal Australian and New Zealand College of Psychiatrists 2016.

Validation of the Movie for the Assessment of Social Cognition in Adolescents with ASD: Fixation Duration and Pupil Dilation as Predictors of Performance

ERIC Educational Resources Information Center

Müller, Nico; Baumeister, Sarah; Dziobek, Isabel; Banaschewski, Tobias; Poustka, Luise

2016-01-01

Impaired social cognition is one of the core characteristics of autism spectrum disorders (ASD). Appropriate measures of social cognition for high-functioning adolescents with ASD are, however, lacking. The Movie for the Assessment of Social Cognition (MASC) uses dynamic social stimuli, ensuring ecological validity, and has proven to be a…

French version of the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) version 3.

PubMed

Joly, F; Lange, M; Rigal, O; Correia, H; Giffard, B; Beaumont, J L; Clisant, S; Wagner, L

2012-12-01

Impairment of cognitive function, a common complaint in patients receiving chemotherapy, is usually measured through neuropsychological tests. Patient self-evaluation of cognitive difficulties is an important complement to those tests. The Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) is a self-report questionnaire with potential to be used in standard clinical practice as a tool for evaluating patient's cognitive function before, during, and after chemotherapy. The purpose of our study was to conduct linguistic validation of the French version of the FACT-Cog. Both qualitative and quantitative methods were used in this study. After undergoing a rigorous translation methodology, the French FACT-Cog version was pretested in France with 35 cancer patients undergoing chemotherapy treatment. Interviews were conducted with all patients to ascertain their understanding of each item. The validation of the final version was conducted among 63 cancer patients, and sociodemographic information was collected as well as brief measure of cognitive function and depression score. Patient comments obtained through the cognitive debriefing interviews indicated that patients understand the French FACT-Cog items as they are intended and that the measure is culturally appropriate. Internal consistency reliability of the subscales, evaluated using Cronbach's coefficient alpha, was high for all four subscales: Perceived Cognitive Impairments = 0.93, Impact On QOL = 0.85, Comments From Others = 0.70, and Perceived Cognitive Abilities = 0.89. All item-total correlations for each subscale were greater than 0.20, and most were greater than 0.50. Results from this study effectively demonstrate that the French FACT-Cog is a reliable instrument for the self-reporting of cognitive abilities in patients undergoing chemotherapy.

Developmental Change and Intraindividual Variability: Relating Cognitive Aging to Cognitive Plasticity, Cardiovascular Lability, and Emotional Diversity

PubMed Central

Ram, Nilam; Gerstorf, Denis; Lindenberger, Ulman; Smith, Jacqui

2010-01-01

Repeated assessments obtained over years can be used to measure individuals’ developmental change, whereas repeated assessments obtained over a few weeks can be used to measure individuals’ dynamic characteristics. Using data from a burst of measurement embedded in the Berlin Aging Study (BASE: Baltes & Mayer, 1999), we illustrate and examine how long-term changes in cognitive ability are related to short-term changes in cognitive performance, cardiovascular function, and emotional experience. Our findings suggest that “better” cognitive aging over approximately13 years was associated with greater cognitive plasticity, less cardiovascular lability, and less emotional diversity over approximately 2 weeks at age 90 years. The study highlights the potential benefits of multi-time scale longitudinal designs for the study of individual function and development. PMID:21443355

The Feldenkrais Method(®) can enhance cognitive function in independent living older adults: A case-series.

PubMed

Ullmann, Gerhild; Williams, Harriet G

2016-07-01

Poor cognitive health a major concern of aging individuals, can compromise independent living. More than 16 million people in the United States are affected by cognitive impairment. We have studied the effects of the Feldenkrais Method(®) on cognitive function. In this case series with three participants cognitive function was assessed with the Trail Making Test A and B at baseline and after the Feldenkrais intervention. All participants improved performance on Trail Making Test A and B after completing the Feldenkrais intervention indicating that Feldenkrais lessons may offset age-related decline in cognitive function. The results of this case series warrant larger scale studies on cognitive outcomes of Feldenkrais interventions in clinical and non-clinical populations. Copyright © 2015 Elsevier Ltd. All rights reserved.

Daily Physical Activity and Cognitive Function Variability in Older Adults.

PubMed

Phillips, Christine B; Edwards, Jerri D; Andel, Ross; Kilpatrick, Marcus

2016-04-01

Physical activity (PA) is believed to preserve cognitive function in older adulthood, though little is known about these relationships within the context of daily life. The present microlongitudinal pilot study explored within- and between-person relationships between daily PA and cognitive function and also examined within-person effect sizes in a sample of community-dwelling older adults. Fifty-one healthy participants (mean age = 70.1 years) wore an accelerometer and completed a cognitive assessment battery for five days. There were no significant associations between cognitive task performance and participants' daily or average PA over the study period. Effect size estimates indicated that PA explained 0-24% of within-person variability in cognitive function, depending on cognitive task and PA dose. Results indicate that PA may have near-term cognitive effects and should be explored as a possible strategy to enhance older adults' ability to perform cognitively complex activities within the context of daily living.

Loneliness and Cognitive Function in Older Adults: Findings From the Chinese Longitudinal Healthy Longevity Survey.

PubMed

Zhong, Bao-Liang; Chen, Shu-Lin; Tu, Xin; Conwell, Yeates

2017-01-01

To examine the relationship between loneliness and cognitive function and to explore the mediating role of physical health on the loneliness-cognition relationship in Chinese older adults (OAs). Data came from a nationally representative sample of 14,199 Chinese OAs (aged 65+) from 2002, 2005, 2008, and 2011 waves of the Chinese Longitudinal Healthy Longevity Survey. A latent variable cross-lagged panel model combined with mediation analysis was used to determine the relationship between loneliness and cognitive function and the mediating effect of increase in the number of chronic conditions (ΔNCCs) on the ascertained loneliness-cognition relationship. Severe loneliness at prior assessment points was significantly associated with poorer cognitive function at subsequent assessments, and vice versa. The ΔNCCs partially mediated this prospective reciprocal relationships, accounting for 2.58% of the total effect of loneliness on cognition and 4.44% of the total effect of cognition on loneliness, respectively. Loneliness may predict subsequent cognitive decline, and vice versa. This loneliness-cognition relationship is partially explained by their impact on physical health. Multidisciplinary interventions aimed at reducing loneliness and cognitive decline per se and their associated risk factors as well as improving chronic illness management would be beneficial for emotional well-being and cognitive health in OAs. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Cognitive Function, Coping, and Depressive Symptoms in Children and Adolescents with Sickle Cell Disease.

PubMed

Prussien, Kemar V; DeBaun, Michael R; Yarboi, Janet; Bemis, Heather; McNally, Colleen; Williams, Ellen; Compas, Bruce E

2018-06-01

The objective of this study was to investigate the association between cognitive functioning, coping, and depressive symptoms in children and adolescents with sickle cell disease (SCD). Forty-four children (M age = 9.30, SD = 3.08; 56.8% male) with SCD completed cognitive assessments measuring working memory (Wechsler Intelligence Scale for Children-Fourth Edition) and verbal comprehension (Wechsler Abbreviated Scale of Intelligence-Second Edition). Participants' primary caregivers completed questionnaires assessing their child's coping and depressive symptoms. Verbal comprehension was significantly positively associated with secondary control coping (cognitive reappraisal, acceptance, distraction), and both working memory and secondary control coping were negatively associated with depressive symptoms. In partial support of the primary study hypothesis, verbal comprehension had an indirect association with depressive symptoms through secondary control coping, whereas working memory had a direct association with depressive symptoms. The results provide new evidence for the associations between cognitive function and coping, and the association of both of these processes with depressive symptoms in children with SCD. Findings provide potential implications for clinical practice, including interventions to improve children's cognitive functioning to attenuate depressive symptoms.

An examination of relationship between neurological soft signs and neurocognition.

PubMed

Solanki, Ram Kumar; Swami, Mukesh Kumar; Singh, Paramjeet

2012-03-01

Neurological soft signs (NSS) and cognitive function had been examined in schizophrenia, but their relationship has remained elusive for several years. We examined the relationship between NSS and cognitive functions in the present study. A cross sectional study was carried out. Subjects were drawn from first degree relatives of schizophrenia patients, admitted as inpatient or attending as an outpatient. Controls were recruited by word of mouth from hospital staff and visitors of hospitalized patients. Those subjects who satisfied the screening process were subjected to Cambridge Neurological Inventory for soft sign assessment and digit span test, paired associate learning test (PALT) and visuo-spatial working memory matrix (VSWMM) for cognitive function assessment. Correlation analysis and structural equation modeling (SEM) was used for analysis. Significant negative correlation of primitive reflexes with PALT; of motor coordination with VSWMM, working memory (WM) and cognitive index; of total NSS with WM and cognitive index among first degree relatives. SEM showed that motor soft signs have important negative influence over WM. The current findings indicate that NSS have significant negative effect on cognitive functioning. Copyright © 2011 Elsevier B.V. All rights reserved.

The role of social cognition and prosocial behaviour in relation to the socio-emotional functioning of primary aged children with specific language impairment.

PubMed

Bakopoulou, Ioanna; Dockrell, Julie E

2016-01-01

Children with language impairments often experience difficulties with their socio-emotional functioning and poorly developed prosocial behaviour. However, the nature of the association between language impairment and difficulties with socio-emotional functioning remains unclear. The social cognition skills of a group of primary-aged children (6-11 years old) with Specific Language Impairment (SLI) were examined in relation to their teachers' ratings of socio-emotional functioning. Forty-two children with SLI were individually matched with 42 children for chronological age and non-verbal cognitive ability, and 42 children for receptive language ability. The children all attended mainstream primary schools or one Language Unit. Four aspects of social cognition were directly assessed: emotion identification, emotion labelling, inferring the causes of emotions, and knowledge of conflict resolution strategies. The children's socio-emotional functioning was assessed using the Strengths and Difficulties questionnaire (SDQ), a standardised measure, completed by their teachers. Associations between children's performance on tasks of social cognition and children's socio-emotional functioning were explored. Significant group differences were found for all social cognition tasks. The SLI group was rated to experience significantly more problems with socio-emotional functioning by their teachers than both control groups, indicating problems with all aspects of socio-emotional functioning. Social cognition and prosocial behaviour, but not language ability, predicted teacher-rated behavioural, emotional and social difficulties for the SLI group. The results challenge current understanding of socio-emotional functioning in children with SLI by pointing to the crucial role of social cognition and prosocial behaviour. Factors other than expressive and receptive language play a role in the socio-emotional functioning of children with SLI. Copyright © 2015 Elsevier Ltd. All rights reserved.

Cognitive and Physical Function in Relation to the Risk of Injurious Falls in Older Adults: A Population-Based Study.

PubMed

Welmer, Anna-Karin; Rizzuto, Debora; Laukka, Erika J; Johnell, Kristina; Fratiglioni, Laura

2017-05-01

We aimed to quantify the independent effect of cognitive and physical deficits on the risk of injurious falls, to verify whether this risk is modified by global cognitive impairment, and to explore whether risk varies by follow-up time. Data on 2,495 participants (≥60 years) from the population-based Swedish National Study on Aging and Care in Kungsholmen (SNAC-K) study were analyzed using flexible parametric survival models. Two cognitive domains (processing speed and executive function) were assessed with standard tests. Physical function tests included balance (one-leg-stands), walking speed, chair stands, and grip strength. Global cognition was assessed using the Mini-Mental State Examination. A total of 167 people experienced an injurious fall over 3 years of follow-up, 310 over 5 years, and 571 over 10 years. Each standard deviation worse balance, slower walking speed, and longer chair stand time increased the risk of injurious falls over 3 years by 43%, 38%, and 23%, respectively (p < .05). Each standard deviation worse processing speed and executive function was significantly associated with 10% increased risk of injurious falls over 10 years (p < .05). In stratified analyses, deficits in physical functioning were associated with injurious falls only in people with cognitive impairment, whereas deficits in processing speed and executive function were associated with injurious falls only in people without cognitive impairment. Deficits in specific cognitive domains, such as processing speed and executive function, appear to predict injurious falls in the long term. Deficits in physical function predict falls in the short term, especially in people with global cognitive impairment. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The perception of sexuality in older adults and its relationship with cognitive functioning.

PubMed

Hartmans, Carien; Comijs, Hannie; Jonker, Cees

2015-03-01

Investigating whether cognitive functioning is associated with the perception of one's sexuality in old age. Cross-sectional analysis, using observation cycle 2005/2006 of the population-based prospective cohort of the Longitudinal Aging Study Amsterdam. Municipal registries in three Dutch regions. 1,908 older adults (mean [standard deviation] age: 71 [8.87] years; 54% women). Sexuality and intimacy were assessed using four questions. Four cognitive domains were assessed: general cognitive functioning (Mini-Mental State Examination), memory performance (Auditory Verbal Learning Test), processing speed (Coding Task), and fluid intelligence (Raven's Coloured Progressive Matrices). Multinomial regression analysis was used, with sexuality as outcome. The interaction effect between gender and sexuality was also tested. Lower fluid intelligence was associated with perceiving sexuality as unimportant; lower general cognitive functioning was associated with perceiving sexuality as unimportant; and lower immediate memory recall was associated with evaluating sexual life as unpleasant. Associations were also found between lower fluid intelligence, processing speed, and general cognitive functioning, and agreeing with sexuality no longer being important. Lower processing speed, general cognitive functioning, and delayed memory recall were associated with disagreeing with a remaining need for intimacy when getting older. Finally, the association between fluid intelligence and perceiving sexuality as important, and the association between immediate memory recall score and evaluating sexual life as pleasant, was only significant in women. The association between lower general cognitive functioning and perceiving sexuality as unimportant seemed stronger in women compared with men. Higher cognitive functioning was associated with the way in which older people perceive their current sexuality. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Ankle-brachial index and inter-artery blood pressure differences as predictors of cognitive function in overweight and obese older adults with diabetes: results from the Action for Health in Diabetes movement and memory study.

PubMed

Espeland, Mark A; Beavers, Kristen M; Gibbs, Bethany Barone; Johnson, Karen C; Hughes, Timothy M; Baker, Laura D; Jakicic, John; Korytkowski, Mary; Miller, Marsha; Bray, George A

2015-10-01

Ankle-brachial index (ABI) and interartery systolic blood pressure differences, as markers of vascular disease, are plausible risk factors for deficits in cognitive function among overweight and obese adults with type 2 diabetes. The ABI and maximum interartery differences (MIAD) in systolic blood pressures were assessed annually for five years among 479 participants assigned to the control condition in a randomized clinical trial of a behavioral weight loss intervention. A battery of standardized cognitive function tests was administered 4 to 5 years later. Analyses of covariance were used to assess relationships that ABI, MIAD, and progression of ABI and MIAD had with cognitive function. There was a curvilinear relationship between ABI and a composite index of cognitive function (p = 0.03), with lower ABI being associated with poorer function. In graded fashions, both greater MIAD and increases in MIAD over time also had modest relationships with poorer verbal memory (both p ≤ 0.05), processing speed (both p ≤ 0.05), and composite cognitive function (both p < 0.04). These relationships were independent of each other and remained evident after extensive covariate adjustment. In overweight and obese adults with type 2 diabetes, lower ABI and larger interartery systolic blood pressure differences have modest, independent, graded relationships with poorer cognitive function 4-5 years later. Copyright © 2014 John Wiley & Sons, Ltd.

Frontal lobe connectivity and cognitive impairment in pediatric frontal lobe epilepsy.

PubMed

Braakman, Hilde M H; Vaessen, Maarten J; Jansen, Jacobus F A; Debeij-van Hall, Mariette H J A; de Louw, Anton; Hofman, Paul A M; Vles, Johan S H; Aldenkamp, Albert P; Backes, Walter H

2013-03-01

Cognitive impairment is frequent in children with frontal lobe epilepsy (FLE), but its etiology is unknown. With functional magnetic resonance imaging (fMRI), we have explored the relationship between brain activation, functional connectivity, and cognitive functioning in a cohort of pediatric patients with FLE and healthy controls. Thirty-two children aged 8-13 years with FLE of unknown cause and 41 healthy age-matched controls underwent neuropsychological assessment and structural and functional brain MRI. We investigated to which extent brain regions activated in response to a working memory task and assessed functional connectivity between distant brain regions. Data of patients were compared to controls, and patients were grouped as cognitively impaired or unimpaired. Children with FLE showed a global decrease in functional brain connectivity compared to healthy controls, whereas brain activation patterns in children with FLE remained relatively intact. Children with FLE complicated by cognitive impairment typically showed a decrease in frontal lobe connectivity. This decreased frontal lobe connectivity comprised both connections within the frontal lobe as well as connections from the frontal lobe to the parietal lobe, temporal lobe, cerebellum, and basal ganglia. Decreased functional frontal lobe connectivity is associated with cognitive impairment in pediatric FLE. The importance of impairment of functional integrity within the frontal lobe network, as well as its connections to distant areas, provides new insights in the etiology of the broad-range cognitive impairments in children with FLE. Wiley Periodicals, Inc. © 2012 International League Against Epilepsy.

Is there a relationship between accelerometer-assessed physical activity and sedentary time and cognitive function in U.S. Hispanic/Latino adults? The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

PubMed Central

Vásquez, Elizabeth; Strizich, Garrett; Isasi, Carmen R; Echeverria, Sandra E; Sotres-Alvarez, Daniela; Evenson, Kelly R.; Gellman, Marc D; Palta, Priya; Qi, Qibin; Lamar, Melissa; Tarraf, Wassim; González, Hector M; Kaplan, Robert

2018-01-01

Normative changes in cognitive function are expected with increasing age. Research on the relationship between normative cognitive decline and moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SED) needs further investigation in Hispanic/Latinos adults. We assessed the cross-sectional association between accelerometer assessed MVPA and SED with cognitive function in 7,478 adults aged 45–74 years from the Hispanic Community Health Study/Study of Latinos. At baseline, cognitive tests included two executive function tests (Digit Symbol Substitution Test (DSST), a test of language (Word Fluency), and a test of memory (Spanish English Verbal Learning Test). Multiple regression models were used to examine associations of time spent in MVPA and SED with cognitive function by age groups, adjusted for age, education, sex, acculturation, and field center. Mean time spent in sedentary behaviors was 12.3 hours/day in females and 11.9 hours/day in males (75% and 77% of accelerometer wear time, respectively). Higher SED, but not MVPA, was associated with lower DSST raw scores (β −0.03 with each 10-min increment in SED; P < 0.05), indicating lower performance in executive function in all age groups. No associations were observed for MVPA and SED with tests of language or memory tests. Our findings suggest a distinct association of SED but not MVPA on executive functioning in middle-aged and older Latino adults. Longitudinal studies are needed to more conclusively determine causal links. PMID:28765082

Body Mass Index, Height and Socioeconomic Position in Adolescence, Their Trajectories into Adulthood, and Cognitive Function in Midlife.

PubMed

Cohen-Manheim, Irit; Doniger, Glen M; Sinnreich, Ronit; Simon, Ely S; Murad, Havi; Pinchas-Mizrachi, Ronit; Kark, Jeremy D

2017-01-01

Whether life course anthropometric indices relate to cognitive function in midlife remains insufficiently explored. Rarely was socioeconomic position (SEP) adequately accounted for. To examine the association of the cumulative life course burden of high-ranked body mass index (BMI), its trajectory, and stature with cognitive function in midlife. Weight and height were measured from age 17 across a 33-year follow-up. 507 individuals completed a NeuroTrax computerized cognitive assessment at ages 48-52. Life course SEP was assessed by multiple methods. Using mixed models we calculated the area under the curve (AUC), representing both the life-course burden of BMI (total AUC) and trends in BMI (incremental AUC) from age 17 to midlife. The associations of BMI and height with global cognition and its five component domains were assessed by multiple regression. Higher BMI in late adolescence and total AUC over the life course were associated with poorer global cognition (Standardized beta (Beta) = -0.111, p = 0.005 and Beta = -0.105, p = 0.018, respectively), adjusted for childhood and adulthood SEP, and demographic characteristics. The associations with higher adolescent and midlife BMI were both restricted to those with low childhood SEP (p < 0.05 for interaction). Short adolescent stature was related to poorer cognition (Beta = 0.115, p = 0.040), whereas late final growth in women was associated with better cognition (Beta = 0.213, p = 0.007). An adverse association of higher BMI with cognitive function began in adolescence and was restricted to low childhood SEP. Taller stature in both sexes and late growth in women were associated with better midlife cognitive performance.

Cognitive stimulation therapy in the Italian context: its efficacy in cognitive and non-cognitive measures in older adults with dementia.

PubMed

Capotosto, Emanuela; Belacchi, Carmen; Gardini, Simona; Faggian, Silvia; Piras, Federica; Mantoan, Vanessa; Salvalaio, Elisa; Pradelli, Samantha; Borella, Erika

2017-03-01

Cognitive stimulation therapy (CST) has been shown to have significant benefits in enhancing cognitive functioning and improving the quality of life of people with mild to moderate dementia. The present study examines the efficacy of the Italian version of the therapy (CST-IT). Older adults with mild to moderate dementia (n = 39) were randomly assigned to two programs: one group participated in the CST-IT, consisting of 14 sessions (twice a week for 7 weeks) and the active control group took part in alternative general activities. The outcome measures were cognitive functioning (measured by the Mini-Mental State Examination-MMSE-, the Alzheimer's Disease Assessment scale-cognitive subscale, the backward digit span test, and a narrative language test); quality of life (Quality of life--Alzheimer's Disease scale); mood (Cornell scale for depression in dementia and the social and emotional loneliness scale); functional activities in daily living (Disability Assessment for Dementia); and behavior (neuropsychiatric inventory). After the intervention, only the CST-IT group maintained its MMSE score, while the control group displayed deterioration. The CST-IT group also performed better in some of the cognitive measures (Alzheimer's Disease Assessment Scale-Cognitive subscale and narrative language), mood measures (Cornell scale, social and emotional loneliness scale with a decrease in reported loneliness), and the Quality of life--Alzheimer's Disease scale. No other treatment effect was observed. The findings confirm the efficacy, at least in the short term, of the CST in sustaining cognitive functions and perceived quality of life in older adults with dementia in the Italian care setting as well. Copyright © 2016 John Wiley & Sons, Ltd.

Is longer treatment better? A comparison study of 3 versus 6 months cognitive remediation in schizophrenia.

PubMed

Buonocore, Mariachiara; Bosia, Marta; Bechi, Margherita; Spangaro, Marco; Cavedoni, Silvia; Cocchi, Federica; Guglielmino, Carmelo; Bianchi, Laura; Mastromatteo, Antonella Rita; Cavallaro, Roberto

2017-05-01

Despite its extensive use for treating cognitive deficits in schizophrenia, computer-assisted cognitive remediation (CACR) currently lacks a standardized protocol. Duration is an important feature to be defined, as it may contribute to heterogeneous outcome. This study compares 2 treatment durations, 3 versus 6 months, to analyze their effects on both cognition and daily functioning. Fifty-seven outpatients with schizophrenia received 3 months of CACR and 41 received 6 months of CACR. All patients were assessed at baseline and after 3 and 6 months with the Brief Assessment for Cognition in Schizophrenia and with the Quality of Life Scale (QLS). Repeated measures ANOVA showed significant improvements in all cognitive domains after 3 months. A significant effect of treatment duration was observed only for executive functions, with significantly higher scores among patients treated for 6 months. Significant improvements in QLS were also observed after 6 months in both groups, with a significant time by treatment interaction for QLS Total Score. Results confirm the efficacy of 3-months CACR in terms of both cognitive and functional improvements, suggesting that an extended intervention may lead to further benefits in executive functions and daily functioning. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Social cognition and functional capacity in bipolar disorder and schizophrenia.

PubMed

Thaler, Nicholas S; Sutton, Griffin P; Allen, Daniel N

2014-12-15

Social cognition is a functionally relevant predictor of capacity in schizophrenia (SZ), though research concerning its value for bipolar disorder (BD) is limited. The current investigation examined the relationship between two social cognitive factors and functional capacity in bipolar disorder. This study included 48 individuals with bipolar disorder (24 with psychotic features) and 30 patients with schizophrenia. Multiple regression controlling for estimated IQ scores was used to assess the predictive value of social cognitive factors on the UCSD Performance-Based Functional Skills Assessment (UPSA). Results found that for the bipolar with psychosis and schizophrenia groups, the social/emotion processing factor predicted the UPSA. The theory of mind factor only predicted the UPSA for the schizophrenia group.. Findings support the clinical utility of evaluating emotion processing in individuals with a history of psychosis. For BD, theory of mind may be better explained by a generalized cognitive deficit. In contrast, social/emotion processing may be linked to distinct neurobiological processes associated with psychosis. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

BDNF (brain-derived neurotrophic factor) serum levels in schizophrenic patients with cognitive deficits

NASA Astrophysics Data System (ADS)

Utami, N.; Effendy, E.; Amin, M. M.

2018-03-01

Schizophrenia is a complex neurodevelopmental disorder with cognitive impairment as the main part. BDNF regulates aspects of developmental plasticity in the brain and is involved in cognitive function. Cognitive functions include capabilities such as attention, executive functioning, assessing, monitoring and evaluating. The aim of the study was to know the BDNF levels in schizophrenic patients with cognitive deficits. The study was held in October 2016 - March 2017, and was the first in Indonesia, especially in North Sumatra. The study was approved by the medical ethics committee of the University of North Sumatera. The study is descriptive based on a retrospective method with cross-sectional approach. The subject is 40 male schizophrenia. Cognitive deficits were assessed by MoCA-Ina. BDNF serum levels were analyzed using the quantitative sandwich enzyme immunoassay. The average MoCA-Ina score is 21.03±5.21. This suggests that there is a cognitive function deficit in schizophrenic patients. The mean serum BDNF level was 26629±6762. MoCA-Ina scores in schizophrenic patients <26 who experienced a deficit of 77.5% and serum BDNF levels with normal values ranging from 6.186 to 42.580pg/ml.

Cognitive and psychosocial effects of oxcarbazepine monotherapy in newly diagnosed partial epilepsy.

PubMed

Kim, Daeyoung; Seo, Ji-Hye; Joo, Eun Yeon; Lee, Hyang Woon; Shin, Won Chul; Hong, Seung Bong

2014-01-01

The aim of this study was to assess the effects of oxcarbazepine (OXC) on cognition and psychosocial difficulties in patients with new-onset partial epilepsy. Cognitive and psychosocial assessments were performed before and after 6 to 12 months of OXC monotherapy in 52 drug-naive patients (25 women; mean age, 31.1 years; SD, 12.1 years). Cognitive functions were evaluated with well-structured and validated tools. Mood, psychological distress, subjective handicap, and quality of life were also evaluated. Differences between baseline and after-treatment evaluation were compared and adjusted for possible confounders such as age, sex, seizure control, duration of epilepsy, assessment interval, and epileptogenic region. Mean assessment interval was 231.8 (range, 182-348) days, and mean (SD) OXC dose at retest was 693.8 (208.9) mg. The OXC was found to have no significant adverse effect on cognition. Furthermore, OXC monotherapy was not found to affect psychosocial difficulties, including psychological distress and subjective handicap. The results suggest that OXC monotherapy could be used to treat newly diagnosed partial epilepsy without adversely affecting cognitive and psychosocial functions.

Relationship between fruit and vegetable intake and interference control in breast cancer survivors.

PubMed

Zuniga, Krystle E; Mackenzie, Michael J; Roberts, Sarah A; Raine, Lauren B; Hillman, Charles H; Kramer, Arthur F; McAuley, Edward

2016-06-01

Nutrition plays an important role in brain structure and function, and the effects of diet may even be greater in those at greater risk of cognitive decline, such as individuals with cancer-related cognitive impairment. However, the relation of dietary components to cognitive function in cancer survivors is unknown. The objective of this study was to determine whether breast cancer survivors (BCS) evidenced impairments in interference control, a component of cognitive control, compared to age-matched women with no prior history of cancer, and to examine the moderating role of diet on cognitive function. In this cross-sectional study, a modified flanker task was used to assess interference control in BCS (n = 31) and age-matched women with no prior history of cancer (n = 30). Diet was assessed with 3-day food records. Differences between BCS and age-matched controls were assessed using linear mixed models, and multilevel regression analyses were conducted to assess the moderating role of diet on cognitive performance. Cognitive performance was not different between groups. Fruit intake and vegetable intake were significantly associated with better performance on the incompatible condition of the flanker task (i.e., shorter reaction time and increased accuracy), independent of disease status. The association between dietary components and cognition was stronger for the incompatible incongruent condition, suggesting that fruit and vegetables may be important for the up-regulation of cognitive control when faced with higher cognitive demands. There was no difference in performance on an interference control task between BCS and age-matched controls. The data suggest that greater fruit intake and vegetable intake were positively associated with interference control in both BCS and age-matched controls.

Physical Fitness Measures as Potential Markers of Low Cognitive Function in Japanese Community-Dwelling Older Adults without Apparent Cognitive Problems.

PubMed

Narazaki, Kenji; Matsuo, Eri; Honda, Takanori; Nofuji, Yu; Yonemoto, Koji; Kumagai, Shuzo

2014-09-01

Detecting signs of cognitive impairment as early as possible is one of the most urgent challenges in preventive care of dementia. It has still been unclear whether physical fitness measures can serve as markers of low cognitive function, a sign of cognitive impairment, in older people free from dementia. The aim of the present study was to examine an association between each of five physical fitness measures and global cognition in Japanese community-dwelling older adults without apparent cognitive problems. The baseline research of the Sasaguri Genkimon Study was conducted from May to August 2011 in Sasaguri town, Fukuoka, Japan. Of the 2,629 baseline subjects who were aged 65 years or older and not certified as individuals requiring nursing care by the town, 1,552 participants without apparent cognitive problems (Mini-Mental State Examination score ≥24) were involved in the present study (59.0% of the baseline subjects, median age: 72 years, men: 40.1%). Global cognitive function was measured by the Japanese version of the Montreal Cognitive Assessment. Handgrip strength, leg strength, sit-to-stand rate, gait speed, and one-leg stand time were examined as physical fitness measures. In multiple linear regression analyses, each of the five physical fitness measures was positively associated with the Montreal Cognitive Assessment score after adjusting for age and sex (p < 0.001). These associations were preserved after additional adjustment for years of formal education, body mass index, and other confounding factors (p < 0.001). The present study first demonstrated the associations between multiple aspects of physical fitness and global cognitive function in Japanese community-dwelling older people without apparent cognitive problems. These results suggest that each of the physical fitness measures has a potential as a single marker of low cognitive function in older populations free from dementia and thereby can be useful in community-based preventive care of dementia. Key pointsThere is a great need for identifying lifestyle-related markers which help detect subtle cognitive impairment in the preclinical or earlier phase of dementia.In the present study, each of the five physical fitness measures employed was linearly and positively associated with the Montreal Cognitive Assessment score in the present older adults without apparent cognitive problems, after adjusting for age, sex, education, body mass index, and other confounding factors.The results suggest the potential of each physical fitness measure as a single lifestyle-related marker of low cognitive function in the population, which can be useful in community-based preventive care of dementia.

Ghrelin is a possible new predictor associated with executive function in patients with type 2 diabetes mellitus.

PubMed

Chen, Siting; Zuo, Xuyang; Li, Yuan; Jiang, Tian; Zhang, Nan; Dai, Fang; Chen, Qiaoer; Zhang, Qiu

2017-05-01

The aim of the present research was to study the ghrelin level, executive function and their possible association in patients with type 2 diabetes mellitus. A total of 370 people were recruited between March 2015 and March 2016 in this study. Among them, 212 participants were patients with type 2 diabetes mellitus and 158 participants were included as the control group. Their blood sample was analyzed for the level of ghrelin and other clinical indexes. Cognitive function was measured by the Montreal Cognitive Assessment, and executive function was evaluated by the Wisconsin Card Sorting Test. In the type 2 diabetes mellitus group, age, years of education, duration of diabetes, fasting blood glucose, glycated hemoglobin, hypertension and waist-to-hip ratio were correlated with total Montreal Cognitive Assessment scores. No association was found between ghrelin level and total Montreal Cognitive Assessment score in patients with type 2 diabetes mellitus. However, ghrelin was found to be a significant predictor for executive function impairment measured by the Wisconsin Card Sorting Test in patients with type 2 diabetes mellitus. The level of serum ghrelin might be a biomarker of executive function and become a strong predictor of executive function impairment in patients with type 2 diabetes mellitus. Ghrelin might have a potential protective effect against cognitive function impairment in type 2 diabetes patients. © 2016 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

Issues and developments related to assessing function in serious mental illness.

PubMed

Brown, Matt A; Velligan, Dawn I

2016-06-01

Serious mental illness (SMI) results in functional disability that imposes a significant burden on individuals, caregivers, and society. Development of novel treatments is under way in an effort to improve the illness domains of cognitive impairment and negative symptoms and subsequently to improve functional outcomes. The assessment of functional outcomes in SMI faces a number of challenges, including the proliferation of assessment instruments and the differential prioritization of functional goals among stakeholder groups. Functional assessments relying on self- and informant report present a number of limitations. Identifying alternative strategies to assess functioning that are reliable, valid, and sensitive to change is necessary for use in clinical trials. Measures of functional capacity have been proposed for clinical trials investigating compounds to treat cognitive impairment in schizophrenia. Alternative approaches employing effort-based decision making or daily activity recording using instruments such as the Daily Activity Report may be more appropriate for studies focused on improving negative symptoms.

Antipsychotic treatment in schizophrenia: the role of computerized neuropsychological assessment.

PubMed

Kertzman, Semion; Reznik, Ilya; Grinspan, Haim; Weizman, Abraham; Kotler, Moshe

2008-01-01

The present study analyzes the role of neurocognitive assessment instruments in the detection of the contribution of antipsychotic treatment to cognitive functioning. Recently, a panel of experts suggested six main domains (working memory; attention/vigilance; verbal/visual learning and memory; reasoning and problem solving; speed of processing) implicated in schizophrenia-related cognitive deficits, which serve as a theoretical base for creation of real-time computerized neurocognitive batteries. The high sensitivity of computerized neuropsychological testing is based on their ability to adopt the reaction time (RT) paradigm for the assessment of brain function in a real-time regime. This testing is highly relevant for the monitoring of the cognitive effects of antipsychotics. Computerized assessment assists in the identification of state- and trait-related cognitive impairments. The optimal real-time computerized neurocognitive battery should composite balance between broad and narrow coverage of cognitive domains relevant to the beneficial effects of antipsychotics and will enable better planning of treatment and rehabilitation programs.

More than Memory Impairment in Voltage-Gated Potassium Channel Complex Encephalopathy

PubMed Central

Bettcher, Brianne M.; Gelfand, Jeffrey M.; Irani, Sarosh R.; Neuhaus, John; Forner, Sven; Hess, Christopher P.; Geschwind, Michael D.

2014-01-01

Objective Autoimmune encephalopathies (AE) are a heterogeneous group of neurological disorders that affect cognition. Although memory difficulties are commonly endorsed, few reports of AE inclusively assess all cognitive domains in detail. Our aim was to perform an unbiased cognitive evaluation of AE patients with voltage-gated potassium channel complex antibodies (VGKCC-Abs) in order to delineate cognitive strengths and weaknesses. Methods We assessed serial VGKCC-Abs AE subjects (n=12) with a comprehensive evaluation of memory, executive functions, visuospatial skills, and language. Clinical MRI (n=10/12) was evaluated. Five subjects had serial cognitive testing available, permitting descriptive analysis of change. Results Subjects demonstrated mild to moderate impairment in memory (mean Z=−1.9) and executive functions (mean Z=−1.5), with variable impairments in language and sparing of visuospatial skills. MRI findings showed T2 hyperintensities in medial temporal lobe (10/10) and basal ganglia (2/10). Serial cognitive examination revealed heterogeneity in cognitive function; whereas most patients improved in one or more domains, residual impairments were observed in some patients. Conclusions This study augments prior neuropsychological analyses in VGKCC-Ab AE by identifying not only memory and executive function deficits, but also language impairments, with preservation of visuospatial functioning. This study further highlights the importance of domain-specific testing to parse out the complex cognitive phenotypes of VGKCC-Ab AE. PMID:24981998

Cognitive insight in psychosis: the relationship between self-certainty and self-reflection dimensions and neuropsychological measures.

PubMed

Cooke, Michael A; Peters, Emmanuelle R; Fannon, Dominic; Aasen, Ingrid; Kuipers, Elizabeth; Kumari, Veena

2010-07-30

Cognitive insight in schizophrenia encompasses the evaluation and reinterpretation of distorted beliefs and appraisals. We investigated the neuropsychological basis of cognitive insight in psychosis. It was predicted that, like clinical insight, cognitive insight would be associated with a wide range of neuropsychological functions, but would be most strongly associated with measures of executive function. Sixty-five outpatients with schizophrenia or schizoaffective disorder were assessed on tests of intelligence quotient (IQ), executive function, verbal fluency, attention and memory, and completed the Beck Cognitive Insight Scale, which includes two subscales, self-certainty and self-reflection. Higher self-certainty scores reflect greater certainty about being right and more resistant to correction (poor insight), while higher self-reflection scores indicate the expression of introspection and the willingness to acknowledge fallibility (good insight). The self-certainty dimension of poor cognitive insight was significantly associated with lower scores on the Behavioural Assessment of Dysexecutive Syndrome; this relationship was not mediated by IQ. There were no relationships between self-reflection and any neuropsychological measures. We conclude that greater self-certainty (poor cognitive insight) is modestly associated with poorer executive function in psychotic individuals; self-reflection has no association with executive function. The self-certainty and self-reflection dimensions of cognitive insight have differential correlates, and probably different mechanisms, in psychosis. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

The impact of sepsis, delirium, and psychological distress on self-rated cognitive function in ICU survivors-a prospective cohort study.

PubMed

Brück, Emily; Schandl, Anna; Bottai, Matteo; Sackey, Peter

2018-01-01

Many intensive care unit (ICU) survivors develop psychological problems and cognitive impairment. The relation between sepsis, delirium, and later cognitive problems is not fully elucidated, and the impact of psychological symptoms on cognitive function is poorly studied in ICU survivors. The primary aim of this study was to examine the relationship between sepsis, ICU delirium, and later self-rated cognitive function. A second aim was to investigate the association between psychological problems and self-rated cognitive function 3 months after the ICU stay. Patients staying more than 24 h at the general ICU at the Karolinska University Hospital Solna, Stockholm, Sweden, were screened for delirium with the Confusion Assessment Method-ICU (CAM-ICU) during their ICU stay. Sepsis incidence and severity were recorded. Three months later, 216 patients received the Cognitive Failures Questionnaire (CFQ), Hospital Anxiety and Depression Scale (HADS), and Post-Traumatic Stress Symptoms-10 (PTSS-10) questionnaires via postal mail. One hundred twenty-five patients (60%) responded to all questionnaires. Among respondents, the incidence of severe sepsis or septic shock was 42%. The overall incidence of delirium was 34%. Patients with severe sepsis/septic shock had a higher incidence of delirium, with an odds ratio (OR) of 3.7 (95% confidence interval (CI), 1.7-8.1). Self-rated cognitive problems 3 months post-ICU were found in 58% of the patients. We did not find any association between sepsis or delirium and late self-rated cognitive function. However, there was a correlation between psychological symptoms and self-rated cognitive function, with the strongest correlation between PTSS-10 scores and CFQ scores ( r  = 0.53; p  < 0.001). ICU delirium is more common in severely septic/septic shock patients. In our cohort, neither severe sepsis nor ICU delirium was associated with self-rated cognitive function 3 months after the ICU stay. Ongoing psychological symptoms, particularly post-traumatic stress was associated with worse self-rated cognitive function. Psychological symptoms need to be taken into account when assessing cognitive function in ICU survivors.

Cognitive Dysfunction in Asian Patients with Depression (CogDAD): A Cross-Sectional Study

PubMed Central

Manit, Srisurapanont; Yee Ming, Mok; Yen Kuang, Yang; Herng-Nieng, Chan; Constantine D, Della; Zuraida, Zainal, Nor; Stephen, Jambunathan; Nurmiati, Amir; Pranabi, Kalita

2017-01-01

Background: Cognitive dysfunction is a predominant symptom of Major Depressive Disorder (MDD), contributing to functional impairment. Objective: The primary objective of this study was to assess and describe perceived cognitive dysfunction amongst Asian patients diagnosed with MDD. The secondary objective was to explore the associations between depression severity, perceived cognitive dysfunction and functional disability. Methods: This was a multi-country, multi-centre, cross-sectional study. Adults with a current episode of MDD were recruited from 9 university/general hospital clinics in Asia. During a single study visit, psychiatrists assessed depression severity (Clinical Global Impression-Severity, CGI-S); patients completed questionnaires assessing depression severity (Patient Health Questionnaire-9 items, PHQ-9), perceived cognitive dysfunction (Perceived Deficit Questionnaire-Depression, PDQ-D) and functional disability (Sheehan Disability Scale, SDS). Results: Patients (n=664), predominantly women (66.3%), were aged 46.5±12.5 years, lived in urban areas (81.3%) and were employed (84.6%). 51.5% of patients were having their first depressive episode; 86.7% were receiving treatment; 82.2% had a current episode duration >8 weeks. Patients had mild-to-moderate depression (CGI-S=3.3±1.0; PHQ-9=11.3±6.9). Patients reported perceived cognitive dysfunction (PDQ-D=22.6±16.2) and functional disability (SDS=11.3±7.9). PHQ-9, PDQ-D and SDS were moderately-to-highly correlated (PHQ-9 and SDS: r=0.72; PHQ-9 and PDQ-D: r=0.69; PDQ-D and SDS, r=0.63). ANCOVA showed that after controlling for patient-reported depression severity (PHQ-9), perceived cognitive dysfunction (PDQ-D) was significantly associated with functional disability (SDS) (p<0.001). Conclusions: Asian patients with MDD reported perceived cognitive dysfunction. There is a need for physicians to evaluate cognitive dysfunction in the clinical setting in order to reach treatment goals, including functional recovery beyond remission of mood symptoms. PMID:29238395

Assessing and addressing cognitive impairment in bipolar disorder: the International Society for Bipolar Disorders Targeting Cognition Task Force recommendations for clinicians.

PubMed

Miskowiak, K W; Burdick, K E; Martinez-Aran, A; Bonnin, C M; Bowie, C R; Carvalho, A F; Gallagher, P; Lafer, B; López-Jaramillo, C; Sumiyoshi, T; McIntyre, R S; Schaffer, A; Porter, R J; Purdon, S; Torres, I J; Yatham, L N; Young, A H; Kessing, L V; Vieta, E

2018-05-01

Cognition is a new treatment target to aid functional recovery and enhance quality of life for patients with bipolar disorder. The International Society for Bipolar Disorders (ISBD) Targeting Cognition Task Force aimed to develop consensus-based clinical recommendations on whether, when and how to assess and address cognitive impairment. The task force, consisting of 19 international experts from nine countries, discussed the challenges and recommendations in a face-to-face meeting, telephone conference call and email exchanges. Consensus-based recommendations were achieved through these exchanges with no need for formal consensus methods. The identified questions were: (I) Should cognitive screening assessments be routinely conducted in clinical settings? (II) What are the most feasible screening tools? (III) What are the implications if cognitive impairment is detected? (IV) What are the treatment perspectives? Key recommendations are that clinicians: (I) formally screen cognition in partially or fully remitted patients whenever possible, (II) use brief, easy-to-administer tools such as the Screen for Cognitive Impairment in Psychiatry and Cognitive Complaints in Bipolar Disorder Rating Assessment, and (III) evaluate the impact of medication and comorbidity, refer patients for comprehensive neuropsychological evaluation when clinically indicated, and encourage patients to build cognitive reserve. Regarding question (IV), there is limited evidence for current evidence-based treatments but intense research efforts are underway to identify new pharmacological and/or psychological cognition treatments. This task force paper provides the first consensus-based recommendations for clinicians on whether, when, and how to assess and address cognition, which may aid patients' functional recovery and improve their quality of life. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Trace element levels in drinking water and cognitive function among elderly Chinese.

PubMed

Emsley, C L; Gao, S; Li, Y; Liang, C; Ji, R; Hall, K S; Cao, J; Ma, F; Wu, Y; Ying, P; Zhang, Y; Sun, S; Unverzagt, F W; Slemenda, C W; Hendrie, H C

2000-05-01

The relation between trace element levels in drinking water and cognitive function was investigated in a population-based study of elderly residents (n = 1,016) in rural China in 1996-1997. Cognitive function was measured using a Chinese translation of the Community Screening Interview for Dementia. A mixed effects model was used to evaluate the effect of each of the elements on cognitive function while adjusting for age, sex, and educational level. Several of the elements examined had a significant effect on cognitive function when they were assessed in a univariate context. However, after adjustment for other elements, many of these results were not significant. There was a significant quadratic effect for calcium and a significant zinc-cadmium interaction. Cognitive function increased with calcium level up to a certain point and then decreased as calcium continued to increase. Zinc showed a positive relation with cognitive function at low cadmium levels but a negative relation at high levels.

Discriminating cognitive screening and cognitive testing from neuropsychological assessment: implications for professional practice.

PubMed

Block, Cady K; Johnson-Greene, Doug; Pliskin, Neil; Boake, Corwin

2017-04-01

To provide clarification on the distinction between cognitive screening, cognitive testing, and neuropsychological assessment and highlight practical implications. Non-systematic brief clinical review. There is a present lack of explicit distinction between the various levels of measurement of cognitive functioning with regard to goals, indications for use, levels of complexity, and outcome. There is also a lack of guidance regarding the identification of who should be responsible for the administration and interpretation at each level. There is a growing awareness of the importance of cognitive health and disability, and of the importance of measurement of cognitive functions across the lifespan. For example, cognitive screening has been mandated by the Patient Protection and Affordable Care Act of 2010, and language contained within new psychiatric diagnostic criteria and healthcare regulatory changes reflect increased consideration of the importance of measurement of cognition. Changes such as these necessitate greater clarity on this important issue as it bears implications for professional practice, which ranges from education and training competencies, practice standards, and the way that neuropsychologists clarify and advocate for the value of specialty referrals for comprehensive assessment in a competitive and ever-changing healthcare market.

A longitudinal study of computerized cognitive training in stroke patients - effects on cognitive function and white matter.

PubMed

Nyberg, Claudia Kim; Nordvik, Jan Egil; Becker, Frank; Rohani, Darius A; Sederevicius, Donatas; Fjell, Anders M; Walhovd, Kristine B

2018-05-01

Background Computerized cognitive training is suggested to enhance attention and working memory functioning following stroke, but effects on brain and behavior are not sufficiently studied and longitudinal studies assessing brain and behavior relationships are scarce. Objective The study objectives were to investigate relations between neuropsychological performance post-stroke and white matter microstructure measures derived from diffusion tensor imaging (DTI), including changes after 6 weeks of working memory training. Methods In this experimental training study, 26 stroke patients underwent DTI and neuropsychological tests at 3 time points - before and after a passive phase of 6 weeks, and again after 6 weeks of working memory training (Cogmed QM). Fractional anisotropy (FA) was extracted from stroke-free brain areas to assess the white matter microstructure. Twenty-two participants completed the majority of training (≥18/25 sessions) and were entered into longitudinal analyses. Results Significant correlations between FA and baseline cognitive functions were observed (r = 0.58, p = 0.004), however, no evidence was found of generally improved cognitive functions following training or of changes in white matter microstructure. Conclusions While white matter microstructure related to baseline cognitive function in stroke patients, the study revealed no effect on cognitive functions or microstructural changes in white matter in relation to computerized working memory training.

Linguistic ability in early life and cognitive function and Alzheimer's disease in late life. Findings from the Nun Study.

PubMed

Snowdon, D A; Kemper, S J; Mortimer, J A; Greiner, L H; Wekstein, D R; Markesbery, W R

1996-02-21

To determine if linguistic ability in early life is associated with cognitive function and Alzheimer's disease in late life. Two measures of linguistic ability in early life, idea density and grammatical complexity, were derived from autobiographies written at a mean age of 22 years. Approximately 58 years later, the women who wrote these autobiographies participated in an assessment of cognitive function, and those who subsequently died were evaluated neuropathologically. Convents in the United States participating in the Nun Study; primarily convents in the Milwaukee, Wis, area. Cognitive function was investigated in 93 participants who were aged 75 to 95 years at the time of their assessments, and Alzheimer's disease was investigated in the 14 participants who died at 79 to 96 years of age. Seven neuropsychological tests and neuropathologically confirmed Alzheimer's disease. Low idea density and low grammatical complexity in autobiographies written in early life were associated with low cognitive test scores in late life. Low idea density in early life had stronger and more consistent associations with poor cognitive function than did low grammatical complexity. Among the 14 sisters who died, neuropathologically confirmed Alzheimer's disease was present in all of those with low idea density in early life and in none of those with high idea density. Low linguistic ability in early life was a strong predictor of poor cognitive function and Alzheimer's disease in late life.

Concurrent Validity of the Cognitive Assessment of Minnesota in Older Adults with and without Depressive Symptoms

PubMed Central

Feliciano, Leilani; Baker, Jonathan C.; Anderson, Sarah L.; LeBlanc, Linda A.; Orchanian, David M.

2011-01-01

Cognitive impairment represents a common mental health problem in community-dwelling and institutionalized older adults, and the prevalence increases with age. Multidisciplinary teams are often asked to assess cognitive and functional impairment in this population. The Cognitive Assessment of Minnesota was created by occupational therapists for this purpose and is frequently used, but has not been extensively validated. This study examined the performance of the CAM and compared it to the MMSE with 113 outpatient clinic patients over the age of 60. Subgroups were established based on scores on a depression inventory to determine if the presence of depressed mood altered the relationship between the measures. Both measures demonstrated good internal consistency. The overall correlation between the two measures was high, statistically significant and remained high regardless of depression status. We offer recommendations about the utility of each measure in screening cognitive functioning for older adults. PMID:21584250

Subjective deficits of attention, cognition and depression in patients with narcolepsy.

PubMed

Zamarian, Laura; Högl, Birgit; Delazer, Margarete; Hingerl, Katharina; Gabelia, David; Mitterling, Thomas; Brandauer, Elisabeth; Frauscher, Birgit

2015-01-01

Patients with narcolepsy often complain about attention deficits in everyday situations. In comparison with these subjective complaints, deficits in objective testing are subtler. The present study assessed the relationships between subjective complaints, objectively measured cognitive performance, disease-related variables, and mood. A total of 51 patients with narcolepsy and 35 healthy controls responded to questionnaires regarding subjectively perceived attention deficits, sleepiness, anxiety and depression. Moreover, they performed an extensive neuropsychological assessment tapping into attention, executive functions, and memory. Patients rated their level of attention in everyday situations to be relatively poor. In an objective assessment of cognitive functioning, they showed only slight attention and executive function deficits. The subjective ratings of attention deficits significantly correlated with ratings of momentary sleepiness, anxiety, and depression, but not with objectively measured cognitive performance. Momentary sleepiness and depression predicted almost 39% of the variance in the ratings of subjectively perceived attention deficits. The present study showed that sleepiness and depression, more than objective cognitive deficits, might play a role in the subjectively perceived attention deficits of patients with narcolepsy. The results suggested that when counselling and treating patients with narcolepsy, clinicians should pay attention to potential depression because subjective cognitive complaints may not relate to objective cognitive impairments. Copyright © 2014 Elsevier B.V. All rights reserved.

Latest Developments in the Matrics Process

PubMed Central

Green, Michael Foster; Nuechterlein, Keith H

2010-01-01

The Measurement and Treatment Research to Improve Cognition in Schizophrenia Research process has led to several developments in the assessment of cognitive functioning for schizophrenia-treatment studies. The first development was the development of a consensus cognitive battery and a United States Food and Drug Administration-endorsed research design. Since the development of the cognitive battery, interest has been spurred in clinical trials in different countries and the development of co-primary functional outcomes measures for these. The MATRICS Consensus Cognitive Battery has been translated into 11 different languages and is being translated into even more. A study has been completed that compared the usefulness of multiple potential co-primary measures, suggesting that the University of California San Diego Performance-Based skills assessment, version II (UPSA-II) is the most suitable for studies conducted in English. These findings suggest that reliable performance-based measures that are easy to administer and highly correlated with cognitive functioning are now available for use in treatment studies. PMID:20622946

Cognitive functioning and family risk factors in relation to symptom behaviors of ADHD and ODD in adolescents.

PubMed

Forssman, Linda; Eninger, Lilianne; Tillman, Carin M; Rodriguez, Alina; Bohlin, Gunilla

2012-05-01

In this study, the authors investigated whether ADHD and oppositional defiant disorder (ODD) behaviors share associations with problems in cognitive functioning and/or family risk factors in adolescence. This was done by examining independent as well as specific associations of cognitive functioning and family risk factors with ADHD and ODD behaviors. A sample of 120 adolescents from the general population was assessed on various cognitive tasks. ADHD and ODD behaviors were measured through parental and teacher ratings based on Diagnostic and Statistical Manual of Mental Disorders (4th edition) criteria. Parents and adolescents provided information regarding measures of family risk factors. The results show that only cognitive functioning was associated with ADHD behaviors, and family risk factors were, independent of cognitive functioning, associated with ODD behaviors. These results suggest that cognitive performance bears a specific significance for ADHD behaviors, whereas family risk factors have specific importance for ODD behaviors.

Does the Cambridge Automated Neuropsychological Test Battery (CANTAB) Distinguish Between Cognitive Domains in Healthy Older Adults?

PubMed

Lenehan, Megan E; Summers, Mathew J; Saunders, Nichole L; Summers, Jeffery J; Vickers, James C

2016-04-01

The Cambridge Neuropsychological Test Automated Battery (CANTAB) is a semiautomated computer interface for assessing cognitive function. We examined whether CANTAB tests measured specific cognitive functions, using established neuropsychological tests as a reference point. A sample of 500 healthy older (M = 60.28 years, SD = 6.75) participants in the Tasmanian Healthy Brain Project completed battery of CANTAB subtests and standard paper-based neuropsychological tests. Confirmatory factor analysis identified four factors: processing speed, verbal ability, episodic memory, and working memory. However, CANTAB tests did not consistently load onto the cognitive domain factors derived from traditional measures of the same function. These results indicate that five of the six CANTAB subtests examined did not load onto single cognitive functions. These CANTAB tests may lack the sensitivity to measure discrete cognitive functions in healthy populations or may measure other cognitive domains not included in the traditional neuropsychological battery. © The Author(s) 2015.

Midlife Eriksonian Psychosocial Development: Setting the Stage for Cognitive and Emotional Health in Late Life

PubMed Central

Malone, Johanna C.; Liu, Sabrina R.; Vaillant, George E.; Rentz, Dorene M.; Waldinger, Robert J.

2017-01-01

Erikson’s (1950) model of adult psychosocial development outlines the significance of successful involvement within one’s relationships, work, and community for healthy aging. He theorized that the consequences of not meeting developmental challenges included stagnation and emotional despair. Drawing on this model, the present study uses prospective longitudinal data to examine how the quality of assessed Eriksonian psychosocial development in midlife relates to late-life cognitive and emotional functioning. In particular we were interested to see whether late-life depression mediated the relationship between Eriksonian development and specific domains of cognitive functioning (i.e., executive functioning and memory). Participants were 159 men from the over 75 year longitudinal Study of Adult Development. The sample was comprised of men from both higher and lower socio-economic strata. Eriksonian psychosocial development was coded from men’s narrative responses to interviews between the ages of 30–47 (Vaillant and Milofsky, 1980). In late life (ages 75–85) men completed a performance - based neuropsychological assessment measuring global cognitive status, executive functioning, and memory. In addition depressive symptomatology was assessed using the Geriatric Depression Scale. Our results indicated that higher midlife Eriksonian psychosocial development was associated with stronger global cognitive functioning and executive functioning, and lower levels of depression three to four decades later. There was no significant association between Eriksonian development and late-life memory. Late-life depression mediated the relationship between Eriksonian development and both global cognition and executive functioning. All of these results controlled for highest level of education and adolescent intelligence. Findings have important implications for understanding the lasting benefits of psychosocial engagement in mid-adulthood for late-life cognitive and emotional health. In addition, it may be that less successful psychosocial development increases levels of depression making individuals more vulnerable to specific areas of cognitive decline. PMID:26551530

The older people, omega-3, and cognitive health (EPOCH) trial design and methodology: A randomised, double-blind, controlled trial investigating the effect of long-chain omega-3 fatty acids on cognitive ageing and wellbeing in cognitively healthy older adults

PubMed Central

2011-01-01

Background Some studies have suggested an association between omega-3 long-chain polyunsaturated fatty acids (n-3 LC PUFAs) and better cognitive outcomes in older adults. To date, only two randomised, controlled trials have assessed the effect of n-3 LC PUFA supplementation on cognitive function in older cognitively healthy populations. Of these trials only one found a benefit, in the subgroup carrying the ApoE-ε4 allele. The benefits of n-3 LC PUFA supplementation on cognitive function in older normal populations thus still remain unclear. The main objective of the current study was to provide a comprehensive assessment of the potential of n-3 LC PUFAs to slow cognitive decline in normal elderly people, and included ApoE-ε4 allele carriage as a potential moderating factor. The detailed methodology of the trial is reported herein. Methods The study was a parallel, 18-month, randomised, double-blind, placebo-controlled intervention with assessment at baseline and repeated 6-monthly. Participants (N = 391, 53.7% female) aged 65-90 years, English-speaking and with normal cognitive function, were recruited from metropolitan Adelaide, South Australia. Participants in the intervention arm received capsules containing fish-oil at a daily dosage of 1720 mg of docosahexaenoic acid and 600 mg of eicosapentaenoic acid while the placebo arm received the equivalent amount of olive oil in their capsules. The primary outcome is rate of change in cognitive performance, as measured by latent variables for the cognitive constructs (encompassing Reasoning, Working Memory, Short-term Memory, Retrieval Fluency, Inhibition, Simple and Choice-Reaction Time, Perceptual Speed, Odd-man-out Reaction Time, Speed of Memory Scanning, and Psychomotor Speed) and assessed by latent growth curve modeling. Secondary outcomes are change in the Mini-mental State Examination, functional capacity and well-being (including health status, depression, mood, and self-report cognitive functioning), blood pressure, and biomarkers of n-3 LC PUFA status, glucose, lipid metabolism, inflammation, oxidative stress, and DNA damage. Trial registration Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12607000278437 PMID:22011460

Are a Healthy Diet and Physical Activity Synergistically Associated with Cognitive Functioning in Older Adults?

PubMed

Nijholt, W; Jager-Wittenaar, H; Visser, M; van der Schans, C P; Hobbelen, J S M

2016-01-01

Previous research has demonstrated that being both physically active and adhering a healthy diet is associated with improved cognitive functioning; however, it remains unclear whether these factors act synergistically. We investigated the synergistic association of a healthy diet and being physically active with cognitive functioning. Cross-sectional study. Data from the Longitudinal Aging Study Amsterdam (LASA) were used. We analyzed data from 2,165 community dwelling adults who were aged 55-85 years, 56% of whom were female. Cognitive functioning was assessed by the Mini-Mental State Examination (MMSE), an MMSE score of >26 indicates good cognitive functioning. Physical activity was assessed by the LASA Physical Activity Questionnaire and was considered sufficient if the person engaged in moderately intense physical activity ≥ 20 min/day. A healthy diet score was based on the intake of fruit, vegetables and fish. Each of the food groups was assigned a score that ranged from 1 (well below the Dutch guideline for a healthy diet) to 4 (well above the Dutch guideline for a healthy diet), and the scores were aggregated to determine a healthy diet (healthy ≥ 9 points). Multiple logistic and linear regression analyses were used to examine the (synergistic) association among physical activity, a healthy diet and cognitive functioning. All analyses were adjusted for potential chronic diseases and lifestyle confounders. Of all of the participants, 25% were diagnosed with a cognitive impairment (MMSE ≤26), 80% were physically active and 41% had a healthy diet. Sixty three percent of the participants both adhered to a healthy diet and were physically active. Sufficient daily physical activity (OR=2.545 p<.001) and adherence to a healthy diet (OR=1.766 p=.002) were associated with good cognitive functioning. After adjusting for confounding factors, sufficient physical activity was not significantly related to cognitive functioning (p=.163); however adherence to a healthy diet remained significantly associated with good cognitive functioning (p=.017). No interaction among sufficient physical activity, healthy diet adherence and good cognitive functioning was observed (crude: p=.401, adjusted: p=.216). The results of this cross-sectional study indicate that adherence to a healthy diet is inde-pendently related to cognitive functioning. Being physically active does not modify this association. Furthermore, these two lifestyle factors do not synergistically relate to cognitive functioning.

Cognitive function, social functioning and quality of life in first-episode psychosis: A 1-year longitudinal study.

PubMed

Popolo, Raffaele; Vinci, Giancarlo; Balbi, Andrea

2010-03-01

Abstract Objective. The majority of patients with schizophrenia have cognitive deficits early in the disease. We evaluated the relationship between cognitive function, social functioning and quality of life in patients with first-episode psychosis. Methods. This was a longitudinal study in 15 patients aged 18-30 years who had recently experienced a first psychotic episode and were treated with the atypical antipsychotic aripiprazole, cognitive-behavioural therapy, psycho-educational sessions, family supportive sessions and social interventions. Patients were evaluated at baseline and after 1 year. Cognitive assessment included attention, memory, language skills and problem solving. Social functioning, quality of life, and psychopathological evaluation were performed with validated tools. Results. At baseline, patients had a severe impairment of social functioning and a low quality of life, while a specific pattern of cognitive functions was not identified. After 1-year, we observed a significant improvement in social functioning and quality of life, without a significant decrease in cognitive function. Conclusion. Contrary to previous findings, we found that social functioning and quality of life are related, but independent of cognitive impairment. The use of antipsychotic agents that do not interefere with cognitive function plus psychological assistance is a valuable treatment approach in patients with first-episode schizophrenia.

The Association Between Sedentary Behavior and Cognitive Function Among Older Adults May Be Attenuated With Adequate Physical Activity.

PubMed

Edwards, Meghan K; Loprinzi, Paul D

2017-01-01

Examine the independent association of sedentary behavior and cognitive function in older adults, as well as whether physical activity attenuates this potential association. Data from the 1999-2002 National Health and Nutrition Examination Survey were used (N = 2472 adults 60 to 85 yrs). Sedentary behavior was subjectively assessed and the Digit Symbol Substitution Test (DSST) was employed to assess cognitive function. Among an unadjusted and an adjusted model not accounting for physical activity, only 5+ hrs/day (vs. < 1 hr) of sedentary time was independently associated with lower DSST scores (β = -3.1; 95% CI: -5.8 to -0.4; P= .02). However, a fully adjusted model (adding in moderate-to-vigorous physical activity as a covariate) did not yield a statistically significant association between 5+ hrs/day of sedentary time and DSST scores (β = -2.5; 95% CI: -5.1 to 0.2; P = .07). Accumulated daily sedentary behavior of 5+ hrs is associated with lower cognitive function in an older adult population when physical activity is not taken into account. However, physical activity may account for 19% of the total association between sedentary behavior and cognitive function, thus attenuating the sedentary-cognitive function association. Efforts should be made to promote physical activity in the aging population.

[Greater level of physical activity associated with better cognitive function in hemodialysis in end stage renal disease].

PubMed

Stringuetta-Belik, Fernanda; Shiraishi, Flávio Gobbis; Oliveira e Silva, Viviana Rugolo; Barretti, Pasqual; Caramori, Jacqueline Costa Teixeira; Bôas, Paulo José Fortes Villas; Martin, Luis Cuadrado; Franco, Roberto Jorge da Silva

2012-01-01

Patients with chronic kidney disease (CKD) have a lower exercise tolerance and poor functional capacity, carry on a sedentary lifestyle. Another important change found in patients with CKD is cognitive dysfunction. Physical inactivity has been associated with cognitive dysfunction in the general population, but few studies have evaluated this association in CKD. To assess the association between physical activity and cognitive function in patients with CKD on hemodialysis (HD). We evaluated 102 patients undergoing HD. The participants completed the International Physical Activity Questionnaire, which assesses the level of physical activity and the Mini Mental State Examination, used for cognitive screening. Patients were divided into three groups according to their level of physical activity (GI: active/GII: irregularly active/GIII: sedentary). It was applied logistic regression analysis and adopted as outcome variable the presence of cognitive impairment and preserving as independent variables those with a probability of statistical difference between groups of less than 0.1. It was considered statistically significant when p less than 0.05. The groups were similar in age, duration of HD, and smoking. Statistically significant difference regarding race, body mass index, diabetes mellitus, underlying disease and degree of cognitive impairment. Regarding laboratory data, the groups differed in terms of creatinine, glucose, hemoglobin and hematocrit. There was significant association with better physical activity and cognitive function, even adjusting for confounding variables. the highest level of physical activity was associated with better cognitive function in CKD patients undergoing HD.

Serum interleukin-6 is related to lower cognitive functioning in elderly patients with major depression.

PubMed

Ali, Nehad Samir; Hashem, Abdel Hamid Hashem; Hassan, Akmal Mostafa; Saleh, Alia Adel; El-Baz, Heba Nabil

2018-05-01

There is an increased evidence of an association between inflammatory mediators, particularly serum IL-6, depression and cognitive impairment in the elderly. This study aims at exploring the relation of peripheral IL-6 to cognitive functions in elderly patients with major depressive disorder (MDD). (1) Assessment of serum IL-6 levels and cognitive functions in elderly patients suffering from major depression and comparing them to healthy age-matched control subjects; (2) correlation between serum IL-6 levels and clinical characteristics of depression and cognitive functions in these patients. The study is an observational, case-control study. It consisted of 80 subjects, 40 with the diagnosis of MDD according to the Diagnostic and Statistical Manual of Mental Disorders (DSM IV-TR) with early onset (first episode before the age of 60) and 40 community-dwelling subjects. They were subjected to the Structured Clinical Interview according to DSM-IV, Montreal Cognitive Assessment, Montgomery Asberg Depression Rating Scale, and serum IL-6 assay using ELISA. In the depression group, subjects had lower scores in cognitive testing, than the control group (p = 0.001). Serum IL-6 was found to have a negative correlation with cognitive testing in these patients even after controlling for the severity of depressive status and Body Mass Index (BMI) (p = 0.025). MDD in elderly subjects is associated with decline in cognitive functions that may be related to peripheral IL-6 levels.

Sleep and Cognitive Function in Multiple Sclerosis.

PubMed

Braley, Tiffany J; Kratz, Anna L; Kaplish, Neeraj; Chervin, Ronald D

2016-08-01

To examine associations between cognitive performance and polysomnographic measures of obstructive sleep apnea in patients with multiple sclerosis (MS). Participants underwent a comprehensive MS-specific cognitive testing battery (the Minimal Assessment of Cognitive Function in MS, or MACFIMS) and in-laboratory overnight PSG. In adjusted linear regression models, the oxygen desaturation index (ODI) and minimum oxygen saturation (MinO2) were significantly associated with performance on multiple MACFIMS measures, including the Paced Auditory Serial Addition Test (PASAT; 2-sec and 3-sec versions), which assesses working memory, processing speed, and attention, and on the Brief Visuospatial Memory Test-Revised, a test of delayed visual memory. The respiratory disturbance index (RDI) was also significantly associated with PASAT-3 scores as well as the California Verbal Learning Test-II (CVLT-II) Discriminability Index, a test of verbal memory and response inhibition. Among these associations, apnea severity measures accounted for between 12% and 23% of the variance in cognitive test performance. Polysomnographic measures of sleep fragmentation (as reflected by the total arousal index) and total sleep time also showed significant associations with a component of the CVLT-II that assesses response inhibition, explaining 18% and 27% of the variance in performance. Among patients with MS, obstructive sleep apnea and sleep disturbance are significantly associated with diminished visual memory, verbal memory, executive function (as reflected by response inhibition), attention, processing speed, and working memory. If sleep disorders degrade these cognitive functions, effective treatment could offer new opportunities to improve cognitive functioning in patients with MS. A commentary on this article appears in this issue on page 1489. © 2016 Associated Professional Sleep Societies, LLC.

Metacognitive awareness of cognitive problems in schizophrenia: exploring the role of symptoms and self-esteem.

PubMed

Cella, M; Swan, S; Medin, E; Reeder, C; Wykes, T

2014-02-01

People with a diagnosis of schizophrenia have limited metacognitive awareness of their symptoms. This is also evident for cognitive difficulties when neuropsychological assessments and self-reports are compared. Unlike for delusions and hallucinations, little attention has been given to factors that may influence the mismatch between objective and subjectively reported cognitive problems. Symptom severity, and also self-esteem and social functioning, can have an impact on cognitive problem perception and help to explain the gap between objective and subjective cognitive assessments in psychosis. One-hundred participants with a diagnosis of schizophrenia were recruited and assessed with a comprehensive neuropsychological battery, a measure of awareness of cognitive problems and measures of psychotic symptoms, social and behavioural functioning and self-esteem. Regression was used to investigate the influence of symptoms, social functioning and self-esteem, and patients with different levels of cognitive problem awareness were contrasted. Simple correlation analysis replicated the lack of association between objective cognitive measures and metacognitive awareness of cognitive problems. However, the results of the regression analyses highlight that self-esteem and negative symptoms predict metacognitive awareness. When significant predictors were controlled, individuals with better awareness had more impaired working memory but higher IQ. Poor self-esteem and high negative symptoms are negatively associated with metacognitive awareness in people with schizophrenia. Interventions that aim to improve cognition should consider that cognitive problem reporting in people with schizophrenia correlates poorly with objective measures and is biased not only by symptoms but also by self-esteem. Future studies should explore the causal pathways using longitudinal designs.

Trajectories of Nutritional Status and Cognitive Impairment among Older Taiwanese with Hip Fracture.

PubMed

Wang, H P; Liang, J; Kuo, L M; Chen, C Y; Shyu, Y I L

2017-01-01

This paper describes the trajectories of nutritional status and cognitive impairment and their correlation among older Taiwanese over 1 year after hip-fracture surgery. Secondary analysis of data from a clinical trial evaluating the effects of three types of post-discharge care for 292 older hip-fracture patients (age >60 years). Nutritional status was assessed by the Mini Nutritional Assessment before and 1, 3, 6, 12 months after hospital discharge. Cognitive function was measured by the Mini-Mental State Examination before surgery, at hospital discharge, 6 and 12 months after discharge. Trajectories of nutritional status and cognitive impairment were depicted by latent class growth modeling, whereas linkages between nutritional-status and cognitive-impairment trajectories were assessed by multinomial logistic regression. Nutritional status in general improved significantly, particularly during the first 3 months after discharge. We identified three trajectories of nutritional status: malnourished (15.4%), at risk for malnutrition (38.9%), and well-nourished (45.7%). In contrast, cognitive changes followed four largely linear but distinct trajectories: moderately impaired (12.2%), mildly impaired (27.8%), borderline impaired (21.8%), and cognitively intact (38.2%). Trajectories of nutritional status were significantly associated with cognitive-function trajectories. For instance, relative to malnourished patients, well-nourished patients were 95% less likely (OR=0.05, CI =0.01-0.24) to be moderately cognitively impaired. A good nutritional-status trajectory after hip fracture was associated with better cognitive function. To treat and care for elderly hip-fractured patients, specific interventions need to target those who are malnourished or at risk of malnutrition to decrease their risk for cognitive impairment.

Cognitive function and brain structure in females with a history of adolescent-onset anorexia nervosa.

PubMed

Chui, Harold T; Christensen, Bruce K; Zipursky, Robert B; Richards, Blake A; Hanratty, M Katherine; Kabani, Noor J; Mikulis, David J; Katzman, Debra K

2008-08-01

Abnormalities in cognitive function and brain structure have been reported in acutely ill adolescents with anorexia nervosa, but whether these abnormalities persist or are reversible in the context of weight restoration remains unclear. Brain structure and cognitive function in female subjects with adolescent-onset anorexia nervosa assessed at long-term follow-up were studied in comparison with healthy female subjects, and associations with clinical outcome were investigated. Sixty-six female subjects (aged 21.3 +/- 2.3 years) who had a diagnosis of adolescent-onset anorexia nervosa and treated 6.5 +/- 1.7 years earlier in a tertiary care hospital and 42 healthy female control subjects (aged 20.7 +/- 2.5 years) were assessed. All participants underwent a clinical examination, magnetic resonance brain scan, and cognitive evaluation. Clinical data were analyzed first as a function of weight recovery (n = 14, <85% ideal body weight; n = 52, >or=85% ideal body weight) and as a function of menstrual status (n = 18, absent/irregular menses; n = 29, oral contraceptive pill; n = 19, regular menses). Group comparisons were made across structural brain volumes and cognitive scores. Compared with control subjects, participants with anorexia nervosa who remained at low weight had larger lateral ventricles. Twenty-four-hour urinary free-cortisol levels were positively correlated with volumes of the temporal horns of the lateral ventricles and negatively correlated with volumes of the hippocampi in clinical participants. Participants who were amenorrheic or had irregular menses showed significant cognitive deficits across a broad range of many domains. Female subjects with adolescent-onset anorexia nervosa showed abnormal cognitive function and brain structure compared with healthy individuals despite an extended period since diagnosis. To our knowledge, this is the first study to report a specific relationship between menstrual function and cognitive function in this patient population. Possible mechanisms underlying neural and cognitive deficits with anorexia nervosa are discussed. Additional examination of the effects of estrogen on cognitive function in female subjects with anorexia nervosa is necessary.

Neurocognitive function in obstructive sleep apnoea: a meta-review.

PubMed

Bucks, Romola S; Olaithe, Michelle; Eastwood, Peter

2013-01-01

Adult obstructive sleep apnoea (OSA) is associated with cognitive dysfunction. While many review articles have attempted to summarize the evidence for this association, it remains difficult to determine which domains of cognition are affected by OSA. This is because of marked differences in the nature of these reviews (e.g. many are unsystematic) and the many different tasks and domains assessed. This paper addresses this issue by comparing the results of only systematic reviews or meta-analyses assessing the effects of OSA on cognition, the relationship between OSA severity and cognition, and/or the effects of treatment on cognition in OSA. Electronic databases and hand-searching were undertaken to select reviews that reported on these areas. We found 33 reviews; five reviews met predetermined, stringent selection criteria. The majority of reviews supported deficits in attention/vigilance, delayed long-term visual and verbal memory, visuospatial/constructional abilities, and executive function in individuals with OSA. There is also general agreement that language ability and psychomotor function are unaffected by OSA. Data are equivocal for the effects of OSA on working memory, short-term memory and global cognitive functioning. Attention/vigilance dysfunction appears to be associated with sleep fragmentation and global cognitive function with hypoxaemia. Continuous positive airway pressure treatment of OSA appears to improve executive dysfunction, delayed long-term verbal and visual memory, attention/vigilance and global cognitive functioning. In order to improve our understanding of cognitive dysfunction in OSA, future research should pay particular attention to participant characteristics, measures of disease severity and choice of neuropsychological tests. © 2012 The Authors. Respirology © 2012 Asian Pacific Society of Respirology.

Subjective cognitive impairment of older adults: a comparison between the US and China.

PubMed

Wu, Qiong

2016-03-01

Subjective assessment may be incomparable across countries due to differences in reporting styles. Based on two nationally representative surveys from the US and China, this study used data from three anchoring vignettes to estimate to what extent the US and Chinese older adults aged 50 and above differed in their reporting styles of subjective cognitive impairment. Cross country differences of subjective cognitive impairment were then estimated, both before and after adjusting for reporting heterogeneity. Directly assessed word recall test scores were analyzed to evaluate whether findings based on subjective cognitive impairment was consistent with objective performance. The results revealed a discrepancy between self-reported subjective cognitive impairment and directly assessed memory function among older adults: while Chinese respondents reported lower severity levels of subjective cognitive impairment, the US respondents demonstrated better performance in immediate word recall tests. By accounting for differences in reporting styles using anchoring vignettes data, Chinese older adults showed higher levels of subjective cognitive impairment than the US older adults, which was consistent with results from direct assessment of memory function. Non-negligible differences are present in reporting styles of subjective cognitive impairment. Cross country comparison needs to take into account such reporting heterogeneity. Copyright © 2016 John Wiley & Sons, Ltd.

Is cognitive adaptation training (CAT) compensatory, restorative, or both?

PubMed

Fredrick, Megan M; Mintz, Jim; Roberts, David L; Maples, Natalie J; Sarkar, Sonali; Li, Xueying; Velligan, Dawn I

2015-08-01

Cognitive adaptation training (CAT) is a psychosocial treatment incorporating environmental supports including signs, checklists to bypass the cognitive deficits of schizophrenia. Our objective was to examine the association between CAT, functional outcomes, and cognitive test performance (cognition). The two research questions were as follows: 1) Does cognition mediate the effect of CAT intervention on functional outcome? 2) Does CAT impact cognitive test performance? A total of 120 participants with schizophrenia were randomized to one of three treatments: 1) CAT (weekly for 9months; monthly thereafter), 2) generic environmental supports (given to participants on clinic visits to promote adaptive behavior), or 3) treatment as usual (TAU). Assessments of cognition and functional outcome were conducted at baseline, 9 and 24months. Mediation analyses and mixed effects regression were conducted. Mediation analyses revealed that during the initial 9months, the direct path from treatment group to functional outcome on the primary measure was positive and highly significant. CAT significantly improved functional outcome compared to the other treatments. However, paths involving cognition were negligible. There was no evidence that cognition mediated improvement in functional outcomes. At 24months, cognition improved more in CAT compared to other treatment groups. The test for cognition mediating improvement in functional outcomes was not significant at this time point. However, improvement in functional outcome led to better performance on cognitive testing. We concluded that improvement in cognition is not a necessary condition for improvement in functional outcome and that greater engagement in functional behavior has a positive impact on cognition. Copyright © 2015 Elsevier B.V. All rights reserved.

Cognitive functioning is more closely related to real-life mobility than to laboratory-based mobility parameters.

PubMed

Giannouli, Eleftheria; Bock, Otmar; Zijlstra, Wiebren

2018-03-01

Increasing evidence indicates that mobility depends on cognitive resources, but the exact relationships between various cognitive functions and different mobility parameters still need to be investigated. This study examines the hypothesis that cognitive functioning is more closely related to real-life mobility performance than to mobility capacity as measured with standardized laboratory tests. The final sample used for analysis consisted of 66 older adults (72.3 ± 5.6 years). Cognition was assessed by measures of planning (HOTAP test), spatial working memory (Grid-Span test) and visuospatial attention (Attention Window test). Mobility capacity was assessed by an instrumented version of the Timed Up-and-Go test (iTUG). Mobility performance was assessed with smartphones which collected accelerometer and GPS data over one week to determine the spatial extent and temporal duration of real-life activities. Data analyses involved an exploratory factor analysis and correlation analyses. Mobility measures were reduced to four orthogonal factors: the factor 'real-life mobility' correlated significantly with most cognitive measures (between r   =  .229 and r   =  .396); factors representing 'sit-to-stand transition' and 'turn' correlated with fewer cognitive measures (between r   =  .271 and r   =  .315 and between r   =  .210 and r   =  .316, respectively), and the factor representing straight gait correlated with only one cognitive measure ( r   =  .237). Among the cognitive functions tested, visuospatial attention was associated with most mobility measures, executive functions with fewer and spatial working memory with only one mobility measure. Capacity and real-life performance represent different aspects of mobility. Real-life mobility is more closely associated with cognition than mobility capacity, and in our data this association is most pronounced for visuospatial attention. The close link between real-life mobility and visuospatial attention should be considered by interventions targeting mobility in old age.

[Cognitive functions, their development and modern diagnostic methods].

PubMed

Klasik, Adam; Janas-Kozik, Małgorzata; Krupka-Matuszczyk, Irena; Augustyniak, Ewa

2006-01-01

Cognitive psychology is an interdisciplinary field whose main aim is to study the thinking mechanisms of humans leading to cognizance. Therefore the concept of human cognitive processes envelopes the knowledge related to the mechanisms which determine the way humans acquire information from the environment and utilize their knowledge and experience. There are three basic processes which need to be distinguished when discussing human perception development: acquiring sensations, perceptiveness and attention. Acquiring sensations means the experience arising from the stimulation of a single sense organ, i.e. detection and differentiation of sensory information. Perceptiveness stands for the interpretation of sensations and may include recognition and identification of sensory information. The attention process relates to the selectivity of perception. Mental processes of the higher order used in cognition, thanks to which humans tend to try to understand the world and adapt to it, doubtlessly include the processes of memory, reasoning, learning and problem solving. There is a great difference in the human cognitive functioning at different stages of one's life (from infancy to adulthood). The difference is both quantitative and qualitative. There are three main approaches to the human cognitive functioning development: Jean Piaget's approach, information processing approach and psychometric approach. Piaget's ideas continue to form the groundwork of child cognitive psychology. Piaget identified four developmental stages of child cognition: 1. Sensorimotor stage (birth - 2 years old); 2. Preoperational stage (ages 2-7); 3. Concrete operations (ages 7-11; 4. Formal operations (11 and more). The supporters of the information processing approach use a computer metaphor to present the human cognitive processes functioning model. The three important mechanisms involved are: coding, automation and strategy designing and they all often co-operate together. This theory has provided a theory. The psychometric approach concentrates on studying the differences in intelligence. The aim of this approach is to test intelligence by means of standardized tests (e.g. WISC-R, WAIS-R) used to show the individual differences among humans. Human cognitive functions determine individuals' adaptation capabilities and disturbances in this area indicate a number of psychopathological changes and are a symptom enabling to differentiate or diagnose one with a disorder. That is why the psychological assessment of cognitive functions is an important part of patients' diagnosis. Contemporary neuropsychological studies are to a great extent based computer tests. The use of computer methods has a number of measurement-related advantages. It allows for standardized testing environment, increasing therefore its reliability and standardizes the patient assessment process. Special attention should be paid to the neuropsychological tests included in the Vienna Test System (Cognitron, SIGNAL, RT, VIGIL, DAUF), which are used to assess the operational memory span, learning processes, reaction time, attention selective function, attention continuity as well as attention interference resistance. It also seems justified to present the CPT id test (Continuous Performance Test) as well as Free Recall. CPT is a diagnostic tool used to assess the attention selective function, attention continuity of attention, attention interference resistance as well as attention alertness. The Free Recall test is used in the memory processes diagnostics to assess patients' operational memory as well as the information organization degree in operational memory. The above mentioned neuropsychological tests are tools used in clinical assessment of cognitive function disorders.

Episodic memory impairment in Addison's disease: results from a telephonic cognitive assessment.

PubMed

Henry, Michelle; Thomas, Kevin G F; Ross, Ian L

2014-06-01

Patients with Addison's disease frequently self-report memory and attention difficulties, even when on standard replacement therapy. However, few published studies examine, using objective measures and assessing across multiple domains, the cognitive functioning of Addison's disease patients relative to healthy controls. The primary aim of this study was to investigate whether the previously reported subjective cognitive deficits in Addison's disease are confirmed by objective measures. Conducting comprehensive neuropsychological assessments of patients with relatively rare clinical disorders, such as Addison's disease, is challenging because access to those patients is often limited, and because their medical condition might prevent extended testing sessions. Brief telephonic cognitive assessments are a useful tool in such circumstances. Hence, we administered the Brief Test of Adult Cognition by Telephone to 27 Addison's disease patients and 27 matched healthy controls. The instrument provides objective assessment of episodic memory, working memory, executive functioning, reasoning, and speed of processing. Statistical analyses confirmed that, as expected, patients performed significantly more poorly than controls on the episodic memory subtest. There were, however, no significant between-group differences on the attention, executive functioning, reasoning, and speed of processing subtests. Furthermore, patients with a longer duration of illness performed more poorly across all domains of cognition. We conclude that, for Addison's disease patients, previously reported subjective cognitive deficits are matched by objective impairment, but only in the domain of episodic memory. Future research might investigate (a) whether these memory deficits are material-specific (i.e., whether non-verbal memory is also affected), and (b) the neurobiological mechanisms underlying these deficits.

Comparison of the sensitivity to change of the Functional Independence Measure with the Assessment of Motor and Process Skills within different rehabilitation populations.

PubMed

Choo, Silvana X; Stratford, Paul; Richardson, Julie; Bosch, Jackie; Pettit, Susan M; Ansley, Barbara J; Harris, Jocelyn E

2017-09-10

To determine whether there was a difference in the sensitivity to change of the subscales of the Functional Independence Measure and the Assessment of Motor and Process Skills within three different post-acute inpatient rehabilitation populations. We conducted retrospective chart review of patients consecutively admitted to inpatient rehabilitation units, with both admission and discharge Functional Independence Measure and Assessment of Motor and Process Skills scores. A total of 276 participants were included and categorized into diagnostic groups (orthopedic, oncology, and geriatric). Within group, sensitivity to change was evaluated for the subscales of each measure by calculating the difference in standardized response means (SRM) and 95% confidence intervals (CI). The Functional Independence Measure motor subscale was more sensitive to change than the Assessment of Motor and Process Skills in the orthopedic and geriatric groups (SRM difference  = 1.53 [95% CI 0.93, 2.3] and 0.65 [95% CI 0.3, 1.02], respectively) but not in the oncology group (SRM difference  = 0.42 [95% CI -0.2, 1.04]). For the cognitive subscales, the Assessment of Motor and Process Skills was more sensitive to change than the Functional Independence Measure in all three groups (SRM difference  = 0.38 [95% CI 004, 0.74], 0.65 [95% CI 0.45, 0.90], and 1.15 [95% CI 0.77, 1.69] for orthopedic, geriatric, and oncology, respectively). The Functional Independence Measure is a mandated measure for all rehabilitation units in Canada. As the cognitive subscale of the Assessment of Motor and Process Skills is more sensitive to change than the Functional Independence Measure, we recommend also administering the Assessment of Motor and Process Skills to better detect changes in the cognitive aspect of function. Implications for rehabilitation When deciding between the Functional Independence Measure or the Assessment of Motor and Process Skills, it is important to consider whether patients' functional status is expected to change similarly or differently. The difference in sensitivity to change between the subscales of the two outcome measures varies with the characteristics of change (similar or different) in patients' functional status. We recommend using the Assessment of Motor and Process Skills, along with the Functional Independence Measure, for patients who are expected to make similar amounts of change in functional status, as the cognitive subscale of the Assessment of Motor and Process Skills is more sensitive to change and can better detect changes in the cognitive aspect of functioning. For patients whose functional status are expected to change differently (diverse diagnoses), the Functional Independence Measure may be more useful as the motor subscale was more sensitive to change when comparing between rehabilitation populations.

Lower cognitive performance in healthy G2019S LRRK2 mutation carriers

PubMed Central

Thaler, Avner; Mirelman, Anat; Gurevich, Tanya; Simon, Ely; Orr-Urtreger, Avi; Marder, Karen; Bressman, Susan

2012-01-01

Objective: To assess cognitive abilities of healthy first-degree relatives of Ashkenazi patients with Parkinson disease (PD), carriers of the G2019S mutation in the LRRK2 gene. Methods: In this observational study, 60 consecutive healthy first-degree relatives (aged 50.9 ± 6.2 years; 48% male; 30 G2019S carriers) were assessed using a computerized cognitive program, the Montreal Cognitive Assessment questionnaire, the Unified Parkinson's Disease Rating Scale Part III, and the Geriatric Depression Scale. Results: G2019S carriers scored significantly lower on the computerized executive function index (p = 0.04) and on specific executive function tasks (Stroop test, p = 0.007). Conclusion: Carrying the LRRK2 G2019S mutation was associated with lower executive performance in a population at risk for PD. PMID:22914834

Brain mapping in cognitive disorders: a multidisciplinary approach to learning the tools and applications of functional neuroimaging

PubMed Central

Kelley, Daniel J; Johnson, Sterling C

2007-01-01

Background With rapid advances in functional imaging methods, human studies that feature functional neuroimaging techniques are increasing exponentially and have opened a vast arena of new possibilities for understanding brain function and improving the care of patients with cognitive disorders in the clinical setting. There is a growing need for medical centers to offer clinically relevant functional neuroimaging courses that emphasize the multifaceted and multidisciplinary nature of this field. In this paper, we describe the implementation of a functional neuroimaging course focusing on cognitive disorders that might serve as a model for other medical centers. We identify key components of an active learning course design that impact student learning gains in methods and issues pertaining to functional neuroimaging that deserve consideration when optimizing the medical neuroimaging curriculum. Methods Learning gains associated with the course were assessed using polychoric correlation analysis of responses to the SALG (Student Assessment of Learning Gains) instrument. Results Student gains in the functional neuroimaging of cognition as assessed by the SALG instrument were strongly associated with several aspects of the course design. Conclusion Our implementation of a multidisciplinary and active learning functional neuroimaging course produced positive learning outcomes. Inquiry-based learning activities and an online learning environment contributed positively to reported gains. This functional neuroimaging course design may serve as a useful model for other medical centers. PMID:17953758

Health Literacy, Cognitive Ability, and Functional Health Status among Older Adults

PubMed Central

Serper, Marina; Patzer, Rachel E; Curtis, Laura M; Smith, Samuel G; O'Conor, Rachel; Baker, David W; Wolf, Michael S

2014-01-01

Objective To investigate whether previously noted associations between health literacy and functional health status might be explained by cognitive function. Data Sources/Study Setting Health Literacy and Cognition in Older Adults (“LitCog,” prospective study funded by National Institute on Aging). Data presented are from interviews conducted among 784 adults, ages 55–74 years receiving care at an academic general medicine clinic or one of four federally qualified health centers in Chicago from 2008 to 2010. Study Design Study participants completed structured, in-person interviews administered by trained research assistants. Data Collection Health literacy was measured using the Test of Functional Health Literacy in Adults, Rapid Estimate of Adult Literacy in Medicine, and Newest Vital Sign. Cognitive function was assessed using measures of long-term and working memory, processing speed, reasoning, and verbal ability. Functional health was assessed with SF-36 physical health summary scale and Patient Reported Outcomes Measurement Information System short form subscales for depression and anxiety. Principal Findings All health literacy measures were significantly correlated with all cognitive domains. In multivariable analyses, inadequate health literacy was associated with worse physical health and more depressive symptoms. After adjusting for cognitive abilities, associations between health literacy, physical health, and depressive symptoms were attenuated and no longer significant. Conclusions Cognitive function explains a significant proportion of the associations between health literacy, physical health, and depression among older adults. Interventions to reduce literacy disparities in health care should minimize the cognitive burden in behaviors patients must adopt to manage personal health. PMID:24476068

The relationship between IGF-I concentration, cognitive function and quality of life in adults with Prader-Willi syndrome.

PubMed

van Nieuwpoort, I C; Deijen, J B; Curfs, L M G; Drent, M L

2011-04-01

Mental retardation is one of the clinical characteristics of Prader-Willi syndrome (PWS) and in part of the patients growth hormone deficiency is demonstrable. Cognitive function seems to be influenced by insulin-like growth factor I (IGF-I); however, little is known about cognitive function in relation to IGF-I levels in PWS adults. The aim of the present study was to evaluate cognitive function in adult PWS patients in comparison to healthy siblings and to investigate whether there is a correlation between cognitive function and IGF-I levels. Anthropometric measurements, IGF-I levels, quality of life (QoL), Appetite Assessment Score, IQ (GIT and Raven) and cognitive function (by four subtests of the Cambridge Neuropsychological Automated Testing Battery, CANTAB) were evaluated in PWS patients and their healthy siblings served as control group. PWS patients had significantly lower IGF-I levels, IQ and QoL when compared to controls. Reaction times were longer and performance was worse on CANTAB subtests in PWS adults. IGF-I on one hand and IQ, Appetite Assessment Score and cognitive performance on the other hand seem to be correlated in PWS patients. In conclusion, IGF-I levels, IQ and QoL are significantly lower in PWS subjects when compared to healthy siblings. In PWS adults, temporal as well as prefrontal cognitive functions are impaired. Higher IGF-I levels appear to be related to better intellectual skills and faster temporal memory processing in PWS patients. Copyright © 2011 Elsevier Inc. All rights reserved.

A Network Meta-Analysis Comparing Effects of Various Antidepressant Classes on the Digit Symbol Substitution Test (DSST) as a Measure of Cognitive Dysfunction in Patients with Major Depressive Disorder.

PubMed

Baune, Bernhard T; Brignone, Mélanie; Larsen, Klaus Groes

2018-02-01

Major depressive disorder is a common condition that often includes cognitive dysfunction. A systematic literature review of studies and a network meta-analysis were carried out to assess the relative effect of antidepressants on cognitive dysfunction in major depressive disorder. MEDLINE, Embase, Cochrane, CDSR, and PsychINFO databases; clinical trial registries; and relevant conference abstracts were searched for randomized controlled trials assessing the effects of antidepressants/placebo on cognition. A network meta-analysis comparing antidepressants was conducted using a random effects model. The database search retrieved 11337 citations, of which 72 randomized controlled trials from 103 publications met the inclusion criteria. The review identified 86 cognitive tests assessing the effect of antidepressants on cognitive functioning. However, the Digit Symbol Substitution Test, which targets multiple domains of cognition and is recognized as being sensitive to change, was the only test that was used across 12 of the included randomized controlled trials and that allowed the construction of a stable network suitable for the network meta-analysis. The interventions assessed included selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and other non-selective serotonin reuptake inhibitors/serotonin-norepinephrine reuptake inhibitors. The network meta-analysis using the Digit Symbol Substitution Test showed that vortioxetine was the only antidepressant that improved cognitive dysfunction on the Digit Symbol Substitution Test vs placebo {standardized mean difference: 0.325 (95% CI = 0.120; 0.529, P=.009}. Compared with other antidepressants, vortioxetine was statistically more efficacious on the Digit Symbol Substitution Test vs escitalopram, nortriptyline, and the selective serotonin reuptake inhibitor and tricyclic antidepressant classes. This study highlighted the large variability in measures used to assess cognitive functioning. The findings on the Digit Symbol Substitution Test indicate differential effects of various antidepressants on improving cognitive function in patients with major depressive disorder. © The Author 2017. Published by Oxford University Press on behalf of CINP.

Effects of childhood trauma exposure and cortisol levels on cognitive functioning among breast cancer survivors.

PubMed

Kamen, Charles; Scheiber, Caroline; Janelsins, Michelle; Jo, Booil; Shen, Hanyang; Palesh, Oxana

2017-10-01

Cognitive functioning difficultiesin breast cancer patients receiving chemotherapy are common, but not all women experience these impairments. Exposure to childhood trauma may impair cognitive functioning following chemotherapy, and these impairments may be mediated by dysregulation of hypothalamic-pituitary-adrenal (HPA) axis function and cortisol slope. This study evaluated the association between childhood trauma exposure, cortisol, and cognition in a sample of breast cancer survivors. 56 women completed measures of trauma exposure (the Traumatic Events Survey), salivary cortisol, and self-reported cognitive functioning (the Functional Assessment of Cancer Therapy - Cognitive). We examined correlations between childhood trauma exposure and cognitive functioning, then used linear regression to control for factors associated with cognition (age, education, time since chemotherapy, depression, anxiety, and insomnia), and the MacArthur approach to test whether cortisol levels mediated the relationship between trauma and cognitive functioning. 57.1% of the sample had experienced at least one traumatic event in childhood, with 19.6% of the sample witnessing a serious injury, 17.9% experiencing physical abuse, and 14.3% experiencing sexual abuse. Childhood trauma exposure and cognitive functioning were moderately associated (r=-0.29). This association remained even when controlling for other factors associated with cognition; the final model explained 47% of the variance in cognitive functioning. The association between childhood trauma and cognitive functioning was mediated by steeper cortisol slope (partial r=0.35, p=0.02). Childhood trauma exposure is associated with self-reported cognitive functioning among breast cancer survivors and is mediated by cortisol dysregulation. Trauma should be considered, among other factors, in programs aiming to address cognition in this population. Copyright © 2017 Elsevier Ltd. All rights reserved.

Everyday Cognition in Prodromal Huntington Disease

PubMed Central

Williams, Janet K.; Kim, Ji-In; Downing, Nancy; Farias, Sarah; Harrington, Deborah L.; Long, Jeffrey D.; Mills, James A.; Paulsen, Jane S.

2014-01-01

Objective Assessment of daily functions affected by cognitive loss in prodromal Huntington disease (HD) is necessary in practice and clinical trials. We evaluated baseline and longitudinal sensitivity of the Everyday Cognition (ECog) scales in prodromal HD and compared self- and companion-ratings. Method Everyday cognition was self-assessed by 850 participants with prodromal HD and 768 companions. We examined internal structure using confirmatory factor analysis (CFA) on baseline data. For longitudinal analysis, we stratified participants into Low, Medium, and High disease progression groups. We examined ECog scores for group differences and participant-and-companion differences using linear mixed effects regression (LMER). Comparison with the Total Functional Capacity (TFC) scale was made. Results CFA revealed good fit of a 5-factor model having a global factor (total score), and sub factors (subscales) of memory, language, visuospatial perception, and executive function. At study entry, participants and companions in the Medium and High groups reported significantly worsened everyday cognition as well as significant functional decline over time. Losses became more pronounced and participant and companion ratings diverged as individuals progressed. TFC showed significant functional loss over time in the High group but not in the Medium group. Conclusions Disease progression is associated with reduced self- and companion-reported everyday cognition in prodromal HD participants who are less than 13 years to estimated motor onset. Our findings suggest companion ratings are more sensitive than participants’ for detecting longitudinal change in daily cognitive function. ECog appears more sensitive to specific functional changes in the prodrome of HD than the TFC. PMID:25000321

Associations of objective and subjective sleep disturbance with cognitive function in older men with comorbid depression and insomnia.

PubMed

Biddle, Daniel J; Naismith, Sharon L; Griffiths, Kathleen M; Christensen, Helen; Hickie, Ian B; Glozier, Nicholas S

2017-06-01

To examine whether poor objective and subjective sleep quality are differentially associated with cognitive function. Cross-sectional. Participants were recruited from primary and secondary care, and directly from the community, in Sydney, Australia. The sample consisted of 74 men 50years and older (mean [SD], 58.4 [6.2] years), with comorbid depression and above-threshold insomnia symptoms, participating in a trial of online cognitive behavioral therapy for insomnia. Insomnia severity and depression severity were assessed via self-report. Objective sleep efficiency and duration were measured using actigraphy. Objective cognitive function was measured using 3 subtests of a computerized neuropsychological battery. Poor objective sleep efficiency was associated with slower reaction time (r=-0.249, P=.033) and poorer executive functioning (odds ratio, 4.14; 95% confidence interval, 1.35-12.69), but not memory. These associations remained after adjusting for age, education, depression severity, cardiovascular risk, and medication. Subjective sleep quality was not related to cognitive function. Among older men with depression and insomnia, objectively measured poor sleep efficiency may be associated with worse cognitive function, independent of depression severity. Objective poor sleep may be underpinned by neurobiological correlates distinct from those underlying subjective poor sleep and depression, and represent a potentially effective modifiable mechanism in interventions to improve cognitive functioning in this population. This supports the use of objective measures of sleep in diagnostic assessments and care. Copyright © 2017 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

Examining the association between participation in late-life leisure activities and cognitive function in community-dwelling elderly Chinese in Hong Kong.

PubMed

Leung, Grace T Y; Fung, Ada W T; Tam, Cindy W C; Lui, Victor W C; Chiu, Helen F K; Chan, W M; Lam, Linda C W

2010-02-01

Growing evidence suggests that participation in late-life leisure activity may have beneficial effects on cognitive function. The objective of the study was to evaluate the association between leisure activity participation and cognitive function in an elderly population of community-dwelling Hong Kong Chinese. 512 participants were assessed in the follow-up study of a population-based community survey of the prevalence of cognitive impairment among Hong Kong Chinese aged 60 years and over. Leisure activities were classified into four categories (physical, intellectual, social and recreational). Information regarding leisure activity participation, cognitive function and other variables was collected. Multivariate linear regression analyses were performed to examine the association between leisure activity participation and cognitive function. A higher level of late-life leisure activity participation, particularly in intellectual activities, was significantly associated with better cognitive function in the elderly, as reflected by the results of the Cantonese Mini-mental State Examination (p = 0.007, 0.029 and 0.005), the Category Verbal Fluency Test (p = 0.027, 0.003 and 0.005) and digit backward span (p = 0.031, 0.002 and 0.009), as measured by the total frequency, total hours per week and total number of subtypes, respectively; the Chinese Alzheimer's Disease Assessment Scale-Cognitive Subscale (p = 0.045) and word list learning (p = 0.003), as measured by the total number of subtypes; and digit forward span (p = 0.007 and 0.015), as measured by the total hours per week and total number of subtypes, respectively. Late-life intellectual activity participation was associated with better cognitive function among community-dwelling Hong Kong elderly Chinese.

The Impact of Inattention and Emotional Problems on Cognitive Control in Primary School Children

ERIC Educational Resources Information Center

Sorensen, Lin; Plessen, Kerstin J.; Lundervold, Astri J.

2012-01-01

Objective: The present study investigated the predictive value of parent/teacher reports of inattention and emotional problems on cognitive control function in 241 children in primary school. Method: Cognitive control was measured by functions of set-shifting and working memory as assessed by the Behavior Rating Inventory of Executive Function…

The effect of donepezil on the cognitive ability early in the course of recovery from traumatic brain injury.

PubMed

Campbell, Kelsey A; Kennedy, Richard E; Brunner, Robert C; Hollis, Sean D; Lumsden, Ross A; Novack, Thomas A

2018-05-08

To investigate the effect of donepezil on cognitive ability in patients who have sustained a traumatic brain injury (TBI). We hypothesized that donepezil, an acetylcholinesterase inhibitor, would enhance cognitive recovery beyond that of usual care in an acute rehabilitation facility. This retrospective, longitudinal analysis included 55 patients who were non-randomly prescribed donepezil during acute care and compared them to 74 patients who received usual rehabilitation treatment. All 129 patients completed neuropsychological assessment at two time points. Donepezil was increased from 5 to 10 mg 7-10 days after initiation and maintained until follow-up cognitive assessment. Primary cognitive abilities of interest included processing speed, attention and memory. Cognitive and functional abilities were assessed by a standard neuropsychological battery for TBI. Propensity scores were used to adjust for differences between groups. Mixed effect model analysis showed no significant differences between treatment and control groups on all neuropsychological subtests over time. Acute administration of donepezil did not significantly improve measures of cognitive or functional ability beyond that of treatment as usual in patients with moderate-to-severe TBI.

Can performance of daily activities discriminate between older adults with normal cognitive function and those with Mild Cognitive Impairment?

PubMed Central

Rodakowski, Juleen; Skidmore, Elizabeth R.; Reynolds, Charles F.; Dew, Mary Amanda; Butters, Meryl A.; Holm, Margo B.; Lopez, Oscar L.; Rogers, Joan C.

2014-01-01

OBJECTIVES Our primary aim was to examine whether preclinical disability in performance of cognitively-focused instrumental activities of daily living (C-IADL) tasks can discriminate between older adults with normal cognitive function and those with Mild Cognitive Impairment (MCI). The secondary purpose was to determine the two tasks with the strongest psychometric properties and assess their discriminative ability. Our goal was to generate diagnosis-relevant information about cognitive changes associated with MCI and DSM-5 Mild Neurocognitive Disorder. DESIGN Secondary analyses of cross-sectional data from a cohort of individuals diagnosed with normal cognitive function or MCI. SETTING Private home locations in Pittsburgh, PA. PARTICIPANTS Older adults with remitted major depression (N=157). MEASUREMENTS Diagnosis of cognitive status was made by the Alzheimer’s Disease Research Center at the University of Pittsburgh. Performance of 8 C-IADL was measured using the criterion-referenced, observation-based Performance Assessment of Self-Care Skills (PASS). RESULTS A total of 96 older adults with normal cognitive function (mean age=72.5, SD=5.9) and 61 older adults with MCI (mean age=75.5, SD=6.3) participated. The 8 C-IADL demonstrated 81% accuracy in discriminating cognitive status (area under curve 0.81, p<0.001). Two tasks (shopping and checkbook balancing) were the most discriminating (area under curve 0.80, p<0.001); they demonstrated similar ability, as the 8 C-IADL, to discriminate cognitive status. Assessing performance on these two C-IADL takes 10–15 minutes. CONCLUSION This is the first demonstration of the discriminative ability of preclinical disability in distinguishing MCI from cognitively normal older adults. These findings highlight potential tasks, when measured with the observation-based PASS, which demonstrate increased effort for individuals with MCI. These tasks may be considered when attempting to diagnose MCI or Mild Neurocognitive Disorder in clinical practice and research. PMID:24890517

Post-treatment cognitive dysfunction in women treated with thyroidectomy for papillary thyroid carcinoma.

PubMed

Jung, Mi Sook; Visovatti, Moira

2017-03-01

The purpose of the study is to assess cognitive function in papillary thyroid cancer, one type of differentiated thyroid cancer, and to identify factors associated with cognitive dysfunction. Korean women treated with papillary thyroid cancer post thyroidectomy (n = 90) and healthy women similar in age and educational level (n = 90) performed attention and working memory tests and completed self-report questionnaires on cognitive complaints, psychological distress, symptom distress, and cultural characteristics. Comparative and multivariable regression analyses were performed to determine differences in cognitive function and possible predictors of neurocognitive performance and cognitive complaints. Thyroid cancer survivors performed and perceived their function to be significantly worse on tests of attention and working memory compared to individuals without thyroid cancer. Regression analyses found that having thyroid cancer, older age, and lower educational level were associated with worse neurocognitive performance, while greater fatigue, more sleep problems, and higher levels of childrearing burden but not having thyroid cancer were associated with lower perceived effectiveness in cognitive functioning. Findings suggest that women receiving thyroid hormone replacement therapy after thyroidectomy for papillary thyroid cancer are at risk for attention and working memory problems. Coexisting symptoms and culture-related women's burden affected perceived cognitive dysfunction. Health care providers should assess for cognitive problems in women with thyroid cancer and intervene to reduce distress and improve quality of life.

A comprehensive assessment of cognitive function in the common genetic generalized epilepsy syndromes.

PubMed

Loughman, A; Bowden, S C; D'Souza, W J

2017-03-01

Considered to be benign conditions, the common genetic generalized epilepsy (GGE) syndromes are now known to be frequently accompanied by cognitive dysfunction. However, unresolved issues impede clinical management of this common comorbidity, including which cognitive abilities are most affected, whether there are differences between syndromes and how seizure type and mood symptoms affect cognitive dysfunction. We provide a detailed description of cognitive ability and evaluate factors contributing to cognitive dysfunction. A total of 76 adults with GGE were assessed with the Woodcock Johnson III Tests of Cognitive Abilities. Scores on tests of overall cognitive ability, acquired knowledge, long-term retrieval and speed of information processing were significantly below the normative mean. Long-term retrieval was a pronounced weakness with a large reduction in scores (d = 0.84). GGE syndrome, seizure type and the presence of recent psychopathology symptoms were not significantly associated with cognitive function. This study confirms previous meta-analytic findings with a prospective study, offers new insights into the cognitive comorbidity of these common epilepsy syndromes and reinforces the need for cognitive interventions in people with GGE. © 2016 EAN.

[Use of "the Middlesex Elderly Assessment of Mental State" scale in the assessment of cognitive functioning in patients with aneurysmal subarachnoid haemorrhage].

PubMed

Chyza, Karolina Julia; Polityńska, Barbara; Kochanowicz, Jan; Lewko, Janusz

2007-03-01

It is now well established that cognitive deficits are a frequent consequence of aneurysmal subarachnoid haemorrhage (SAH). The cognitive status in the acute phase of the illness may provide valuable prognostic information in relation to the effects of the proposed treatment and long-term functioning of the patient. A prerequisite for this task is the identification of instruments that might prove useful in the diagnosis of neuropsychological deficits in patients with SAH. For these purposes we used The Middlesex Elderly Assessment of Mental State (MEAMS) in order to assess the cognitive deficits consequent upon SAH. To assess the cognitive functioning of patients undergoing treatment for SAH of aneurysmal origin in the acute stage of the illness, using a modified form of the MEAMS. 49 patients participated in the study, none of whom had a previous history of neurological or psychiatric illness. The age of the patients ranged between 23-70 years. 35 (71%) patients received surgical treatment (clipping of the aneurysm neck) and in 14 (29%) the aneurysm was embolised. The patients were assessed on two occasions: the first on admission to the Neurosurgery department following the SAH, and on the second, following treatment to secure the aneurysm. A modified version of the MEAMS in two parallel versions was used in the assessment. The results obtained were evaluated with reference to a control group. A range of cognitive impairments was identified with the aid of the MEAMS in patients undergoing treatment for aneurysmal SAH. These included deficits in visual and auditory memory, executive, perceptual and visuo-spatial functions together with the tendency to perseverate. In those patients who underwent surgery, deficits were observed in the following areas: disorientation in relation to self, time and place; perceptual, memory and visuo-spatial impairments. The results obtained indicate that the Middlesex Elderly Assessment of Mental State, in the form used in the present study appears to be a sensitive and useful instrument for the screening of cognitive impairments in patients following SAH, in the acute stages of the illness.

Kidney function and cognitive decline in frail elderly: two faces of the same coin?

PubMed

Coppolino, Giuseppe; Bolignano, Davide; Gareri, Pietro; Ruberto, Carmen; Andreucci, Michele; Ruotolo, Giovanni; Rocca, Maurizio; Castagna, Alberto

2018-06-04

Cognitive and renal impairment are pervasive among elderly frails, a high-risk, geriatric sub-population with peculiar clinical characteristics. In a series of frail individuals with non-advanced chronic kidney disease (CKD), we aimed at assessing the entity of functional, general health and cognitive impairment and the possible relationship between these types of dysfunction and the severity of renal impairment. 2229 geriatric subjects were screened for frailty and CKD. Severity of CKD was assessed by eGFR (CKD-EPI formula). Frailty was established by the Fried Index. Functional, general health and cognitive status were assessed by validated score measures. Final analysis included 271 frail CKD subjects (162 women, 109 men). Mean eGFR was 64.25 ± 25.04 mL/min/1.73 m 2 . Prevalence of mild-to-moderate CKD (stage 3-4) was 44%. Twenty-six percent of patients had severe cognitive impairment, while mild and moderate impairment was found in 7 and 67% of individuals, respectively. All subjects had poor functional and general health status. Cognitive capacities significantly decreased across CKD stages (p for trend < 0.0001). In fully adjusted multivariate analyses, cognitive status remained an independent predictor of eGFR (β = 0.465; p < 0.0001). Mild-to-moderate CKD is highly pervasive among frail elderly individuals and the severity of renal dysfunction is independently correlated with that of cognitive impairment. Future studies are advocated to clarify whether the combination of kidney and mental dysfunction may portend a higher risk of worsen outcomes in this high-risk population.

Anticholinergic load negatively correlates with recovery of cognitive activities of daily living for geriatric patients after stroke in the convalescent stage.

PubMed

Kose, E; Hirai, T; Seki, T; Hidaka, S; Hamamoto, T

2018-05-16

Anticholinergic drugs are associated with risks of falls, confusion and cognitive dysfunction. However, the effect of anticholinergic drug use on rehabilitation outcomes after a stroke is poorly documented. We therefore aimed to establish whether the anticholinergic load was associated with functional recovery among geriatric patients convalescing after stroke. Consecutive geriatric stroke patients admitted and discharged from a convalescence rehabilitation ward between 2010 and 2016 were included in this retrospective cohort study. Anticholinergic load was assessed by the Anticholinergic Risk Scale (ARS), and functional recovery was assessed by the Functional Independence Measure (FIM). The primary outcome was cognitive FIM (FIM-C) gain, but we also assessed the interaction of other putative factors identified from univariate analysis. Multivariate analyses were performed, adjusting for confounding factors. We included 418 participants (171 males, 247 females) with a median age of 78 years (interquartile range, 72-84 years). Multiple regression analysis revealed that ARS change, length of stay, and epilepsy were independently and negatively correlated with cognitive FIM gain. Multiple logistic regression analysis indicated that the "Comprehension" and "Memory" items of the cognitive FIM gain were independently and negatively associated with anticholinergic load. A causal relationship cannot be established, but increased ARS scores during hospitalization may predict limited cognitive functional improvement in geriatric patients after stroke. Alternatively, cognitive impairment may lead to increased use of anticholinergic drugs. © 2018 John Wiley & Sons Ltd.

Measurement of Functional Cognition and Complex Everyday Activities in Older Adults with Mild Cognitive Impairment and Mild Dementia: Validity of the Large Allen's Cognitive Level Screen.

PubMed

Wesson, Jacqueline; Clemson, Lindy; Crawford, John D; Kochan, Nicole A; Brodaty, Henry; Reppermund, Simone

2017-05-01

To explore the validity of the Large Allen's Cognitive Level Screen-5 (LACLS-5) as a performance-based measure of functional cognition, representing an ability to perform complex everyday activities in older adults with mild cognitive impairment (MCI) and mild dementia living in the community. Using cross-sectional data from the Sydney Memory and Ageing Study, 160 community-dwelling older adults with normal cognition (CN; N = 87), MCI (N = 43), or dementia (N = 30) were studied. Functional cognition (LACLS-5), complex everyday activities (Disability Assessment for Dementia [DAD]), Assessment of Motor and Process Skills [AMPS]), and neuropsychological measures were used. Participants with dementia performed worse than CN on all clinical measures, and MCI participants were intermediate. Correlational analyses showed that LACLS-5 was most strongly related to AMPS Process scores, DAD instrumental activities of daily living subscale, Mini-Mental State Exam, Block Design, Logical Memory, and Trail Making Test B. Multiple regression analysis indicated that both cognitive (Block Design) and functional measures (AMPS Process score) and sex predicted LACLS-5 performance. Finally, LACLS-5 was able to adequately discriminate between CN and dementia and between MCI and dementia but was unable to reliably distinguish between CN and MCI. Construct validity, including convergent and discriminative validity, was supported. LACLS-5 is a valid performance-based measure for evaluating functional cognition. Discriminativevalidity is acceptable for identifying mild dementia but requires further refinement for detecting MCI. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

The association between pulse wave velocity and cognitive function: the Sydney Memory and Ageing Study.

PubMed

Singer, Joel; Trollor, Julian N; Crawford, John; O'Rourke, Michael F; Baune, Bernhard T; Brodaty, Henry; Samaras, Katherine; Kochan, Nicole A; Campbell, Lesley; Sachdev, Perminder S; Smith, Evelyn

2013-01-01

Pulse wave velocity (PWV) is a measure of arterial stiffness and its increase with ageing has been associated with damage to cerebral microvessels and cognitive impairment. This study examined the relationship between carotid-femoral PWV and specific domains of cognitive function in a non-demented elderly sample. Data were drawn from the Sydney Memory and Ageing Study, a cohort study of non-demented community-dwelling individuals aged 70-90 years, assessed in successive waves two years apart. In Wave 2, PWV and cognitive function were measured in 319 participants. Linear regression was used to analyse the cross-sectional relationship between arterial stiffness and cognitive function in the whole sample, and separately for men and women. Analysis of covariance was used to assess potential differences in cognition between subjects with PWV measurements in the top and bottom tertiles of the cohort. Covariates were age, education, body mass index, pulse rate, systolic blood pressure, cholesterol, depression, alcohol, smoking, hormone replacement therapy, apolipoprotein E ε4 genotype, use of anti-hypertensive medications, history of stroke, transient ischemic attack, myocardial infarction, angina, diabetes, and also sex for the whole sample analyses. There was no association between PWV and cognition after Bonferroni correction for multiple testing. When examining this association for males and females separately, an association was found in males, with higher PWV being associated with lower global cognition and memory, however, a significant difference between PWV and cognition between males and females was not found. A higher level of PWV was not associated with lower cognitive function in the whole sample.

Assessment of learning, memory, and attention in developmental neurotoxicity regulatory studies: synthesis, commentary, and recommendations.

PubMed

Vorhees, Charles V; Makris, Susan L

2015-01-01

Cognitive tests of learning and memory (L&M) have been required by U.S. Environmental Protection Agency (EPA) developmental neurotoxicity test (DNT) guidelines for more than two decades. To evaluate the utility of these guidelines, the EPA reviewed 69 pesticide DNT studies. This review found that the DNT provided or could provide the point-of-departure for risk assessment by showing the Lowest Observable Adverse Effect Level (LOAEL) in 28 of these studies in relation to other reported end points. Among the behavioral tests, locomotor activity and auditory/acoustic startle provided the most LOAELs, and tests of cognitive function and the Functional Observational Battery (FOB) the fewest. Two issues arose from the review: (1) what is the relative utility of cognitive tests versus tests of unconditioned behavior, and (2) how might cognitive tests be improved? The EPA sponsored a symposium to address this. Bushnell reviewed studies in which both screening (locomotor activity, FOB, reflex ontogeny, etc.) and complex tests (those requiring training) were used within the same study; he found relatively little evidence that complex tests provided a LOAEL lower than screening tests (with exceptions). Levin reviewed reasons for including cognitive tests in regulatory studies and methods and evidence for the radial arm maze and its place in developmental neurotoxicity assessments. Driscoll and Strupp reviewed the value of serial reaction time operant methods for assessing executive function in developmental neurotoxicity studies. Vorhees and Williams reviewed the value of allocentric (spatial) and egocentric cognitive tests and presented methods for using the Morris water maze for spatial and the Cincinnati water maze for egocentric cognitive assessment. They also reviewed the possible use of water radial mazes. The relatively lower impact of cognitive tests in previous DNT studies in the face of the frequency of human complaints of chemical-induced cognitive dysfunction indicates that animal cognitive tests need improvement. The contributors to this symposium suggest that if the guidelines are updated, they be made more specific by recommending preferred tests and providing greater detail on key characteristics of such tests. Additionally, it is recommended that guidance be developed to address important issues with cognitive tests and to provide the information needed to improve the design, conduct, and interpretation of tests of higher function within a regulatory context. These steps will maximize the value of cognitive tests for use in hazard evaluation and risk assessment. Copyright © 2015 Elsevier Inc. All rights reserved.

Association of Fatigue Intensification with Cognitive Impairment during Radiation Therapy for Prostate Cancer.

PubMed

Feng, Li Rebekah; Espina, Alexandra; Saligan, Leorey N

2018-01-01

Cancer-related fatigue is a common complaint during cancer treatment and is often associated with cognitive impairment. This study examined cognitive deficits that were associated with fatigue symptoms during external-beam radiation therapy (EBRT) in men with localized prostate cancer. A total of 36 participants were enrolled and followed up at baseline, 24 h, 7 days, 14 days after EBRT initiation, at midpoint, and at completion of EBRT. Fatigue was measured by self-report using the Functional Assessment of Cancer Therapy - Fatigue (FACT-F), and cognitive impairment by the Computer Assessment of Mild Cognitive Impairment (CAMCI®). Subjects with increased fatigue during EBRT reported a significant decline in cognitive function and had difficulties with CAMCI®'s route finding and item recall tasks during EBRT. Increased fatigue during EBRT was associated with perceived cognitive difficulties in executive function and recognition memory, but not with attention or verbal memory. Our results suggest that there might be specific cognitive domains that are associated with increased fatigue during EBRT. These findings will provide important information for targeting specific cognitive domains using pharmacotherapy or behavioral interventions. CAMCI® is a valuable tool for psycho social providers to detect subtle cognitive impairment in fatigued cancer patients in a clinical setting. © 2018 S. Karger AG, Basel.

Assessment of Dentally-related Functional Competency for Older Adults with Cognitive Impairment – A Survey for Special-care Dental Professionals

PubMed Central

Chen, Xi; Clark, Jennifer JJ

2013-01-01

This survey was to study whether and how dental professional assess dental-related function in older adults with cognitive impairment (OACI). An invitation was sent to 525 special-care dental professionals, followed by a reminder in 2 weeks. Thirteen percent of the targeted participants completed the survey. Among them, 88% completed a hospital dentistry, geriatric dentistry or other post-graduate training program. Nearly 70% of the respondents considered somewhat to very difficult to assess dentally-related function; 45% did not ever or did not regularly assess dental-related function for OACI. Dental-related functional assessments were often based on a subjective, unstructured approach. Only 6% of the respondents routinely used standard instruments to assess the patients' function. These results indicate that an objective functional assessment based on a standardized instrument has not been routinely incorporated into dental care for OACI, raising concerns for quality of care in this vulnerable population. PMID:23451924

Assessment of dentally related functional competency for older adults with cognitive impairment--a survey for special-care dental professionals.

PubMed

Chen, Xi; Clark, Jennifer J J

2013-01-01

This survey was to study whether and how dental professional assess dental-related function in older adults with cognitive impairment (OACI). An invitation was sent to 525 special-care dental professionals, followed by a reminder in 2 weeks. Thirteen percent of the targeted participants completed the survey. Among them, 88% completed a hospital dentistry, geriatric dentistry, or other postgraduate training program. Nearly 70% of the respondents considered somewhat to very difficult to assess dentally related function; 45% did not ever or did not regularly assess dental-related function for OACI. Dental-related functional assessments were often based on a subjective, unstructured approach. Only 6% of the respondents routinely used standard instruments to assess the patients' function. These results indicate that an objective functional assessment based on a standardized instrument has not been routinely incorporated into dental care for OACI, raising concerns for quality of care in this vulnerable population. ©2012 Special Care Dentistry Association and Wiley Periodicals, Inc.

Relationship Between Cognitive Assessment and Balance Measures in Adolescents Referred for Vestibular Physical Therapy After Concussion

PubMed Central

Alsalaheen, Bara A.; Whitney, Susan L.; Marchetti, Gregory F.; Furman, Joseph M.; Kontos, Anthony P.; Collins, Michael W.; Sparto, Patrick J.

2016-01-01

Objective To examine the relationship between cognitive and balance performance in adolescents with concussion. Design Retrospective case series. Setting Tertiary. Patients Sixty patients. Interventions Correlation analyses were performed to describe the relationship between symptoms, cognitive measure, and balance measure at the time of initiation of vestibular physical therapy. Main Outcome Measures Cognitive performance was assessed using the Immediate Post-concussion Assessment and Cognitive Testing (ImPACT). The dizziness and balance function measures included dizziness severity rating, Activities-specific Balance Confidence scale (ABC), Dizziness Handicap Inventory (DHI), Functional Gait Assessment, gait speed, Timed “UP and GO,” Five Times Sit to Stand, and Sensory Organization Test (SOT). To account for multiple comparisons, the False Discovery Rate method was used. Results Performance measures of balance were significantly correlated with cognitive measures. Greater total symptom scores were related to greater impairment in the ABC and DHI (r = 0.35-0.39, P ≤ 0.008) and worse performance in condition 2 of the SOT (r = −0.48, P = 0.004). Among the ImPACT composite scores, lower memory scores were correlated with impaired balance performance measures (r = 0.37-0.59, P ≤ 0.012). Lower visual memory was also correlated with worse ABC scores. Conclusions The significant relationships reported between the cognitive performance scores and balance measures may reflect that similar levels of functioning exist across domains in individuals with protracted recovery who receive vestibular physical therapy. PMID:25706663

Physical Activity Is Positively Associated with Episodic Memory in Aging.

PubMed

Hayes, Scott M; Alosco, Michael L; Hayes, Jasmeet P; Cadden, Margaret; Peterson, Kristina M; Allsup, Kelly; Forman, Daniel E; Sperling, Reisa A; Verfaellie, Mieke

2015-11-01

Aging is associated with performance reductions in executive function and episodic memory, although there is substantial individual variability in cognition among older adults. One factor that may be positively associated with cognition in aging is physical activity. To date, few studies have objectively assessed physical activity in young and older adults, and examined whether physical activity is differentially associated with cognition in aging. Young (n=29, age 18-31 years) and older adults (n=31, ages 55-82 years) completed standardized neuropsychological testing to assess executive function and episodic memory capacities. An experimental face-name relational memory task was administered to augment assessment of episodic memory. Physical activity (total step count and step rate) was objectively assessed using an accelerometer, and hierarchical regressions were used to evaluate relationships between cognition and physical activity. Older adults performed more poorly on tasks of executive function and episodic memory. Physical activity was positively associated with a composite measure of visual episodic memory and face-name memory accuracy in older adults. Physical activity associations with cognition were independent of sedentary behavior, which was negatively correlated with memory performance. Physical activity was not associated with cognitive performance in younger adults. Physical activity is positively associated with episodic memory performance in aging. The relationship appears to be strongest for face-name relational memory and visual episodic memory, likely attributable to the fact that these tasks make strong demands on the hippocampus. The results suggest that physical activity relates to cognition in older, but not younger adults.

The relation of education and cognitive activity to mini-mental state in old age: the role of functional fitness status.

PubMed

Ihle, Andreas; Gouveia, Élvio R; Gouveia, Bruna R; Freitas, Duarte L; Jurema, Jefferson; Ornelas, Rui T; Antunes, António M; Muniz, Bárbara R; Kliegel, Matthias

2018-06-01

It remains unclear so far whether the role of cognitive reserve for cognitive functioning in old age may differ between individuals with low, compared to those with high functional fitness status. Therefore, the present study set out to investigate the relation of education and cognitive leisure activity as key markers of cognitive reserve to mini-mental state in old age (as an indicator of the extent of cognitive impairment) and its interplay with functional fitness status in a large sample of older adults. We assessed MMSE in 701 older adults ( M  = 70.4 years, SD = 6.9, range: 60-91). We measured functional fitness status using the Senior Fitness Test battery and interviewed individuals on their education and cognitive leisure activity. Results showed that better functional fitness status, longer education, and greater engagement in cognitive leisure activity were significantly related to higher MMSE scores. Moderation analyses showed that the relations of education and cognitive leisure activity to MMSE scores were significantly larger in individuals with low, compared to those with high functional fitness status. In conclusion, cognitive functioning in old age may more strongly depend on cognitive reserve accumulated during the life course in older adults with low, compared to those with high functional fitness status. These findings may be explained by cross-domain compensation effects in vulnerable individuals and may (at least partly) account for the large variability in cognitive reserve-cognition relations debated in the literature.

Influence of cognition, premorbid adjustment and psychotic symptoms on psycho-social functioning in first-episode psychosis.

PubMed

Grau, Norma; Rubio-Abadal, Elena; Usall, Judith; Barajas, Ana; Butjosa, Anna; Dolz, Montserrat; Baños, Iris; Sánchez, Bernardo; Rodríguez, Maria José; Peláez, Trinidad; Sammut, Stephanie; Carlson, Janina; Huerta-Ramos, Elena; Ochoa, Susana

2016-08-30

The aim of this study is to evaluate the relationship between psycho-social functioning and symptoms, cognitive function, and premorbid adjustment, in patients with a first-episode psychosis. Clinical data were obtained from 90 patients, who were assessed with the Disability Assessment Scale (DAS-sv), the Positive and Negative Syndrome Scale (PANSS), the Premorbid Adjustment Scale (PAS-S) and with a battery of cognitive tests including Trail Making Tests A and B (TMTA- B), Continous Performance Test (CPT), some subscales of the Wechler Adult Intelligence Scale (WAIS), and the Verbal Learning Test España-Complutense (TAVEC). The results of the study suggest that psycho-social functioning in first-episode psychosis is significantly related to: positive, negative, excitative, affective and disorganized symptoms, social premorbid adjustment, cognitive flexibility, working memory, short term and long term memory. Of these, those which best explained psycho-social functioning are the positive and excitative symptoms, premorbid adjustment, flexibility and memory. These findings highlight the importance early intervention on cognitive and clinical variables to help provide a better psycho-social functioning in people with a first-episode of psychosis. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

NIRS Study of the Effects of Computerized Brain Training Games for Cognitive Rehabilitation of Major Depressive Disorder Patients in Remission: A Pilot Study.

PubMed

Payzieva, Shaira; Maxmudova, D

2014-01-01

We used functional Near-Infrared Spectroscopy (fNIRS) to estimate brain activity in Major Depressive Disorder (MDD) patients (in remission), while they played a computerized brain training games for cognitive rehabilitation. MDD is characterized by marked deterioration in affect as well as significant impairment in cognitive function. It was found, that depressed patients showed long-lasting impaired cognitive performance on cognitive demanding tasks despite significant improvement in the depression symptoms. Previous studies have shown that video games can improve cognitive functions. But assessment was made only with cognitive tests. The main objective of this research was to study the effects of brain training games on cognitive functions of MDD patients in remission with objective instrumental NIRS method. Tissue oxygen saturation (StO2) and absolute concentrations of oxyhemoglobin ([O2Hb]), deoxyhemoglobin ([HHb]) and total hemoglobin ([tHb]) were measured by functional near-infrared spectroscopy (fNIRS) - Oxyprem (BORL, Zurich, Switzerland). Preliminary results are discussed.

Effect of Virtual Reality on Cognition in Stroke Patients

PubMed Central

Kim, Bo Ryun; Kim, Lee Suk; Park, Ji Young

2011-01-01

Objective To investigate the effect of virtual reality on the recovery of cognitive impairment in stroke patients. Method Twenty-eight patients (11 males and 17 females, mean age 64.2) with cognitive impairment following stroke were recruited for this study. All patients were randomly assigned to one of two groups, the virtual reality (VR) group (n=15) or the control group (n=13). The VR group received both virtual reality training and computer-based cognitive rehabilitation, whereas the control group received only computer-based cognitive rehabilitation. To measure, activity of daily living cognitive and motor functions, the following assessment tools were used: computerized neuropsychological test and the Tower of London (TOL) test for cognitive function assessment, Korean-Modified Barthel index (K-MBI) for functional status evaluation, and the motricity index (MI) for motor function assessment. All recruited patients underwent these evaluations before rehabilitation and four weeks after rehabilitation. Results The VR group showed significant improvement in the K-MMSE, visual and auditory continuous performance tests (CPT), forward digit span test (DST), forward and backward visual span tests (VST), visual and verbal learning tests, TOL, K-MBI, and MI scores, while the control group showed significant improvement in the K-MMSE, forward DST, visual and verbal learning tests, trail-making test-type A, TOL, K-MBI, and MI scores after rehabilitation. The changes in the visual CPT and backward VST in the VR group after rehabilitation were significantly higher than those in the control group. Conclusion Our findings suggest that virtual reality training combined with computer-based cognitive rehabilitation may be of additional benefit for treating cognitive impairment in stroke patients. PMID:22506159

Arthritis and Risk of Cognitive and Functional Impairment in Older Mexican Adults.

PubMed

Veeranki, Sreenivas P; Downer, Brian; Jupiter, Daniel; Wong, Rebeca

2017-04-01

This study investigated the risk of cognitive and functional impairment in older Mexicans diagnosed with arthritis. Participants included 2,681 Mexicans, aged ≥60 years, enrolled in the Mexican Health and Aging Study cohort. Participants were categorized into arthritis and no arthritis exposure groups. Primary outcome included participants categorized into "cognitively impaired" or "cognitively normal" groups. Secondary outcomes included participants categorized into Normal, Functionally Impaired only, Cognitively Impaired only, or Dementia (both cognitively and functionally impaired) groups. Multivariable logistic and multinomial regression models were used to assess the relationships. Overall, 16% or 7% were diagnosed with cognitive impairment or dementia. Compared with older Mexicans without arthritis, those who were diagnosed with arthritis had significantly increased risk of functional impairment (adjusted odds ratio [OR] 1.82, 95% confidence interval [CI] = [1.45, 2.29]), but not of dementia. Arthritis is associated with increased risk of functional impairment, but not with dementia after 11 years in older Mexicans.

Relationship between insulin sensitivity index and cognitive function in diet-induced insulin resistant rats.

PubMed

Chen, Sisi; Xie, Hao; Wu, Jing; Hong, Hao; Jin, Jianwen; Fang, Jinbo; Huang, Ji; Fu, Ying Zhou; Ji, Hui; Li, Yong Qi; Long, Yan; Xia, Yuan Zheng

2009-06-01

Clinical and animal studies have revealed significant cognitive impairment in type II diabetic subjects. However, whether there is a relationship between insulin resistance and cognitive function is poorly understood. In the present study, we used a high fat diet to induce insulin resistance (IR) in rats, insulin sensitivity index (ISI) (= FINS x FPG/22.5) to assess the extent of insulin resistance and the Morris Water Maze Task to judge cognitive function. The relationship between insulin sensitivity index and cognitive function was determined by analysing the correlation between ISI and the time rat spent in targeted quadrant, as well as between ISI and the times the rat swam across the very point where a platform was previously placed, using Pearson's method. Perfect negative correlation between ISI and cognitive function existed when ISI fell within a certain range, which indicates that insulin resistance is associated with cognitive function impairment in some cases where ISI might be an indicator.

Arthritis and Risk of Cognitive and Functional Impairment in Older Mexican Adults

PubMed Central

Veeranki, Sreenivas P.; Downer, Brian; Jupiter, Daniel; Wong, Rebeca

2016-01-01

Objective This study investigated the risk of cognitive and functional impairment in older Mexicans diagnosed with arthritis. Participants included 2,681 Mexicans, aged ≥60 years, enrolled in the Mexican Health and Aging Study cohort. Method Participants were categorized into arthritis and no arthritis exposure groups. Primary outcome included participants categorized into “cognitively impaired” or “cognitively normal” groups. Secondary outcomes included participants categorized into Normal, Functionally Impaired only, Cognitively Impaired only, or Dementia (both cognitively and functionally impaired) groups. Multivariable logistic and multinomial regression models were used to assess the relationships. Results Overall, 16% or 7% were diagnosed with cognitive impairment or dementia. Compared with older Mexicans without arthritis, those who were diagnosed with arthritis had significantly increased risk of functional impairment (adjusted odds ratio [OR] 1.82, 95% confidence interval [CI] = [1.45, 2.29]), but not of dementia. Conclusion Arthritis is associated with increased risk of functional impairment, but not with dementia after 11 years in older Mexicans. PMID:26965081

Virtual reality in the assessment of selected cognitive function after brain injury.

PubMed

Zhang, L; Abreu, B C; Masel, B; Scheibel, R S; Christiansen, C H; Huddleston, N; Ottenbacher, K J

2001-08-01

To assess selected cognitive functions of persons with traumatic brain injury using a computer-simulated virtual reality environment. A computer-simulated virtual kitchen was used to assess the ability of 30 patients with brain injury and 30 volunteers without brain injury to process and sequence information. The overall assessment score was based on the number of correct responses and the time needed to complete daily living tasks. Identical daily living tasks were tested and scored in participants with and without brain injury. Each subject was evaluated twice within 7 to 10 days. A total of 30 tasks were categorized as follows: information processing, problem solving, logical sequencing, and speed of responding. Persons with brain injuries consistently demonstrated a significant decrease in the ability to process information (P = 0.04-0.01), identify logical sequencing (P = 0.04-0.01), and complete the overall assessment (P < 0.01), compared with volunteers without brain injury. The time needed to process tasks, representing speed of cognitive responding, was also significantly different between the two groups (P < 0.01). A computer-generated virtual reality environment represents a reproducible tool to assess selected cognitive functions and can be used as a supplement to traditional rehabilitation assessment in persons with acquired brain injury.

Interleukin-6 and Depressive Mood Symptoms: Mediators of the Association Between Childhood Abuse and Cognitive Performance in Middle-Aged Adults.

PubMed

Davis, Mary C; Lemery-Chalfant, Kathryn; Yeung, Ellen WanHeung; Luecken, Linda J; Zautra, Alex J; Irwin, Michael R

2018-03-19

Childhood abuse is a risk factor for the development of cognitive deficits in adulthood, a relation that is likely mediated by stress-sensitive psychological and physiological indicators. To evaluate whether the link between exposure to childhood abuse and cognitive function in middle adulthood is mediated by interleukin-6 (IL-6), metabolic risk, and depressive mood symptoms. Participants were 770 adults aged 40-65 recruited from the community, who completed the following: (i) a questionnaire assessing exposure to abuse prior to age 18, (ii) a phone interview assessing current depressive mood symptoms, and (iii) a home visit that included blood sampling for evaluation of IL-6 and assessment of metabolic risk indices. A follow-up telephone assessment evaluating cognitive function was completed by 555 of the participants. Structural equation modeling was used to test study hypotheses. Childhood abuse predicted higher levels of IL-6, depressive mood symptoms, and metabolic risk scores (p < .05). The relation between childhood abuse and poorer cognitive performance was mediated by IL-6 (p = .046) and depressive mood symptoms (p = .023), but not metabolic risk. IL-6 and depressive mood symptoms significantly mediated the relation between childhood abuse and adult cognitive function. Exposure to early abuse conveys enduring physiological and psychological effects, which may contribute to cognitive deficits that are evident by middle adulthood. Increased vulnerability for cognitive decline among adults with a history of early trauma and the mediating roles of IL-6 and depressive mood symptoms point to the potential value of interventions that address inflammation or depression, singly or together, to prevent cognitive decline in this at-risk population.

A 10-minute measure of global cognition: Validation of the Brief Cognitive Assessment Tool for Schizophrenia (B-CATS).

PubMed

Hurford, Irene M; Ventura, Joseph; Marder, Stephen R; Reise, Steven P; Bilder, Robert M

2018-05-01

Schizophrenia is marked by a global cognitive impairment that contributes significantly to chronic disability and unemployment. As new treatments are developed for cognition in schizophrenia, clinicians require easily administered instruments to assess cognition. We previously developed a very brief cognitive battery (Bell et al., 2005). The Brief Cognitive Assessment Tool for Schizophrenia (B-CATS) was developed specifically to provide clinicians with a way to assess cognition in their patients with schizophrenia. Here, we report the results of a validity study comparing B-CATS to a larger neurocognitive battery, the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) battery. Outpatients with schizophrenia (N=91) were administered the B-CATS and the non-overlapping tests of the MATRICS battery at two time points separated by 1month. They were also administered the UCSD Performance-based Skills Assessment-Brief (UPSA-B), a measure of functional capacity. The B-CATS has an administration time of approximately 10min. It demonstrates good test-retest reliability and internal consistency. It correlates 0.76 (p<0.01) with the MATRICS battery. The shorter B-CATS and the MATRICS battery correlate with the UPSA-B at 0.50 and 0.58 respectively. A 10-minute version of the B-CATS correlates highly with the "gold standard" neurocognitive battery that has an administration time of over 60min. Both measures correlate moderately with a measure of functional capacity. This brief battery was designed to allow clinicians to monitor cognitive change and better inform treatment decisions. Copyright © 2017 Elsevier B.V. All rights reserved.

Development and Standardization of a New Cognitive Assessment Test Battery for Chinese Aphasic Patients: A Preliminary Study.

PubMed

Wu, Ji-Bao; Lyu, Zhi-Hong; Liu, Xiao-Jia; Li, Hai-Peng; Wang, Qi

2017-10-05

Nonlinguistic cognitive impairment has become an important issue for aphasic patients, but currently there are few neuropsychological cognitive assessment tests for it. To get more information on cognitive impairment of aphasic patients, this study aimed to develop a new cognitive assessment test battery for aphasic patients, the Non-language-based Cognitive Assessment (NLCA), and evaluate its utility in Chinese-speaking patients with aphasia. The NLCA consists of five nonverbal tests, which could assess five nonlinguistic cognitive domains such as visuospatial functions, attention test, memory, reasoning, and executive functions of aphasic patients. All tests are modified from the nonverbal items of the current existed tests with some changes to the characteristics of Chinese culture. The NLCA was tested in 157 participants (including 57 aphasic patients, 50 mild cognitive impairment (MCI) patients, and 50 normal controls), and was compared with other well-established relative neuropsychological tests on the reliability, validity, and utility. The NLCA was fully applicable in the MCI patients and the normal controls, almost working in the aphasic patients (57/62 patients, 91.9%). The NLCA scores were 66.70 ± 6.30, 48.67 ± 15.04, and 77.58 ± 2.56 for the MCI group, the aphasic group, and the control group, respectively , and a significant difference was found among three groups (F = 118.446, P < 0.001). The Cronbach's alpha of the NLCA as an index of internal consistency was 0.805, and the test-retest and interrater reliability was adequate (r=0.977 and r= 0.970, respectively). The correlations of the cognitive subtests and their validation instruments were between 0.540 and 0.670 (all P < 0.05). Spearman's correlation analysis indicated that the coefficient of internal consistency of each subtest itself was higher than other subtests. When choosing the Montreal Cognitive Assessment score of <26 as the diagnostic criteria of cognitive impairment, the area under the curve for all participants in the control and MCI groups was 0.942 (95% confidence interval: 0.895-0.989), and an optimal cutoff point of 75.00 seemed to provide the best balance between sensitivity and specificity. Age (r = -0.406, P < 0.001) was the main influence factor for the NLCA. The NLCA could efficiently differentiate the cognitive impairment patients from the normal controls and is a reliable and valid cognitive assessment test battery to specially find nonlinguistic cognitive function for aphasic patients.

Models of cognitive functions with respect to selected parameters of functional state of the thyroid gland in post-menopausal women.

PubMed

Gujski, Mariusz; Pinkas, Jarosław; Witczak, Mariusz; Owoc, Alfred; Bojar, Iwona

2017-01-01

The objective of the study was the development of models of cognitive functions in a group of post-menopausal women, according to the concentration of the selected laboratory parameters evaluating the functional state of the thyroid gland. The study was conducted during 2012-2014, and covered women aged 50-65 years, minimum two years after the last menstruation, without chronic diseases, cancerous diseases, mental disorders, addiction to drugs or alcohol, and who did not use hormone replacement therapy. At the stage of qualification, a brief MoCA test was performed; 383 women were qualified for the study. Blood was collected for the determination of such parameters as: TSH, TT4, fT4, anti-TPO, anti-Tg, and AB-TSHR. Assessment of cognitive functions was performed using the diagnostic instrument Central Nervous System - Vital Signs (CNS-VS) (Polish version). The results were statistically analysed. The mean age of the women in the study was 56.4 ± 3.4; the mean TSH was 1.91 ± 1.35 mU/L, fT4 14.76 ± 2.34 pmol/L, and TT4 99.12 ± 16.98 nmol/L. Mean values were: 64.74 IU/L for anti-TPO, 100.69 IU/L for anti-Tg, and 1.40 IU/L for AB-TSHR. The examined women obtained the neurocognitive index (NCI) on the level of 84.4 scores, on average. The lowest results were obtained in tests assessing cognitive flexibility (mean 78.64 scores), processing speed (mean 79.25 scores), and executive functions (mean 79.75 scores). In the tests evaluating complex attention, the mean values were 82.24 scores, psychomotor speed - mean 83.42 scores, and reaction time - mean 86.87 scores. The women examined obtained the best results in tests assessing memory (mean 90.15 scores), including verbal (mean 91.22 scores), and visual (mean 93.37 scores). The NCI and cognitive function models were assessed from the aspect of thyroid gland examinations in post-menopausal women. Based on the analyses performed, the following conclusions were drawn: The developed models of cognitive functions indicate a considerable effect of TSH, fT4, AB-TSHR, and anti-TPO, as well as TT4 and anti-Tg, on the level of cognitive functions after menopause in the group examined. The conducted study suggests the need for examination of the functional state of the thyroid gland in post-menopausal women who show cognitive function disorders.

Development of a Virtual Reality Assessment of Everyday Living Skills

PubMed Central

Ruse, Stacy A.; Davis, Vicki G.; Atkins, Alexandra S.; Krishnan, K. Ranga R.; Fox, Kolleen H.; Harvey, Philip D.; Keefe, Richard S.E.

2014-01-01

Cognitive impairments affect the majority of patients with schizophrenia and these impairments predict poor long term psychosocial outcomes.  Treatment studies aimed at cognitive impairment in patients with schizophrenia not only require demonstration of improvements on cognitive tests, but also evidence that any cognitive changes lead to clinically meaningful improvements.  Measures of “functional capacity” index the extent to which individuals have the potential to perform skills required for real world functioning.  Current data do not support the recommendation of any single instrument for measurement of functional capacity.  The Virtual Reality Functional Capacity Assessment Tool (VRFCAT) is a novel, interactive gaming based measure of functional capacity that uses a realistic simulated environment to recreate routine activities of daily living. Studies are currently underway to evaluate and establish the VRFCAT’s sensitivity, reliability, validity, and practicality. This new measure of functional capacity is practical, relevant, easy to use, and has several features that improve validity and sensitivity of measurement of function in clinical trials of patients with CNS disorders. PMID:24798174

Cognitive Training through mHealth for Individuals with Substance Use Disorder.

PubMed

Gamito, Pedro; Oliveira, Jorge; Lopes, Paulo; Brito, Rodrigo; Morais, Diogo; Caçoete, Cristina; Leandro, André; Almeida, Teresa; Oliveira, Hugo

2017-03-23

Heroin addiction has a negative impact on cognitive functions, and even recovering addicts suffer from cognitive impairment. Recent approaches to cognitive intervention have been taking advantage of what new technologies have to offer. We report a study testing the efficacy of a serious games approach using tablets to stimulate and rehabilitate cognitive functions in recovering addicts. A small-scale cognitive training program with serious games was run with a sample of 14 male heroin addicts undergoing a rehabilitation program. We found consistent improvements in cognitive functioning between baseline and follow-up assessments for frontal lobe functions, verbal memory and sustained attention, as well as in some aspects of cognitive flexibility, decision-making and in depression levels. More than two thirds of patients in cognitive training had positive outcomes related to indicators of verbal memory cognitive flexibility, which contrasts to patients not in training, in which only one patient improved between baseline and follow-up. The results are promising but still require randomized control trials to determine the efficiency of this approach to cognitive rehabilitation programs for the cognitive recovery of heroin addicts.

Negative Aspects of Close Relationships as Risk Factors for Cognitive Aging

PubMed Central

Liao, Jing; Head, Jenny; Kumari, Meena; Stansfeld, Stephen; Kivimaki, Mika; Singh-Manoux, Archana; Brunner, Eric J.

2014-01-01

The extent to which social relationships influence cognitive aging is unclear. In this study, we investigated the association of midlife quality of close relationships with subsequent cognitive decline. Participants in the Whitehall II Study (n = 5,873; ages 45–69 years at first cognitive assessment) underwent executive function and memory tests 3 times over a period of 10 years (1997–1999 to 2007–2009). Midlife negative and positive aspects of close relationships were assessed twice using the Close Persons Questionnaire during the 8 years preceding cognitive assessment. Negative aspects of close relationships, but not positive aspects, were associated with accelerated cognitive aging. Participants in the top third of reported negative aspects of close relationships experienced a faster 10-year change in executive function (−0.04 standard deviation, 95% confidence interval: −0.08, −0.01) than those in the bottom third, which was comparable with 1 extra year of cognitive decline for participants aged 60 years after adjustment for sociodemographic and health status. Longitudinal analysis found no evidence of reverse causality. This study highlights the importance of differentiating aspects of social relationships to evaluate their unique associations with cognitive aging. PMID:25342204

Is low cognitive functioning a predictor or consequence of major depressive disorder? A test in two longitudinal birth cohorts.

PubMed

Schaefer, Jonathan D; Scult, Matthew A; Caspi, Avshalom; Arseneault, Louise; Belsky, Daniel W; Hariri, Ahmad R; Harrington, Honalee; Houts, Renate; Ramrakha, Sandhya; Poulton, Richie; Moffitt, Terrie E

2017-11-16

Cognitive impairment has been identified as an important aspect of major depressive disorder (MDD). We tested two theories regarding the association between MDD and cognitive functioning using data from longitudinal cohort studies. One theory, the cognitive reserve hypothesis, suggests that higher cognitive ability in childhood decreases risk of later MDD. The second, the scarring hypothesis, instead suggests that MDD leads to persistent cognitive deficits following disorder onset. We tested both theories in the Dunedin Study, a population-representative cohort followed from birth to midlife and assessed repeatedly for both cognitive functioning and psychopathology. We also used data from the Environmental Risk Longitudinal Twin Study to test whether childhood cognitive functioning predicts future MDD risk independent of family-wide and genetic risk using a discordant twin design. Contrary to both hypotheses, we found that childhood cognitive functioning did not predict future risk of MDD, nor did study members with a past history of MDD show evidence of greater cognitive decline unless MDD was accompanied by other comorbid psychiatric conditions. Our results thus suggest that low cognitive functioning is related to comorbidity, but is neither an antecedent nor an enduring consequence of MDD. Future research may benefit from considering cognitive deficits that occur during depressive episodes from a transdiagnostic perspective.

Interrelationship of oral health status, swallowing function, nutritional status, and cognitive ability with activities of daily living in Japanese elderly people receiving home care services due to physical disabilities.

PubMed

Furuta, Michiko; Komiya-Nonaka, Manae; Akifusa, Sumio; Shimazaki, Yoshihiro; Adachi, Munehisa; Kinoshita, Toshinori; Kikutani, Takeshi; Yamashita, Yoshihisa

2013-04-01

Malnutrition and cognitive impairment lead to declines in activities of daily living (ADL). Nutritional status and cognitive ability have been shown to correlate with oral health status and swallowing function. However, the complex relationship among the factors that affect decline in ADL is not understood. We examined direct and indirect relationships among oral health status, swallowing function, nutritional status, cognitive ability, and ADL in Japanese elderly people living at home and receiving home care services because of physical disabilities. Participants were 286 subjects aged 60 years and older (mean age, 84.5±7.9 years) living at home and receiving home care services. Oral health status (the number of teeth and wearing dentures) was assessed, and swallowing function was examined using cervical auscultation. Additionally, ADL, cognitive ability, and nutritional status were assessed using the Barthel Index, the Clinical Dementia Rating Scale, and the Mini Nutritional Assessment-Short Form, respectively. Path analysis was used to test pathways from these factors to ADL. The mean number of teeth present in the participants was 8.6±9.9 (edentates, 40.6%). Dysphagia, malnutrition, and severe cognitive impairment were found in 31.1%, 14.0%, and 21.3% of the participants, respectively. Path analysis indicated that poor oral health status and cognitive impairment had a direct effect on denture wearing, and the consequent dysphagia, in addition to cognitive impairment, was positively associated with malnutrition. Malnutrition as well as dysphagia and cognitive impairment directly limited ADL. A lower number of teeth are positively related to swallowing dysfunction, whereas denture wearing contributes to recovery of swallowing function. Dysphagia, cognitive impairment, and malnutrition directly and indirectly decreased ADL in elderly people living at home and receiving home nursing care. The findings suggest that preventing tooth loss and encouraging denture wearing when teeth are lost may indirectly contribute to maintaining or improving ADL, mediated by recovery of swallowing function and nutritional status. © 2012 John Wiley & Sons A/S.

Decline in cognitive function and risk of elder self-neglect: finding from the Chicago Health Aging Project.

PubMed

Dong, XinQi; Simon, Melissa A; Wilson, Robert S; Mendes de Leon, Carlos F; Rajan, K Bharat; Evans, Denis A

2010-12-01

To examine the longitudinal association between decline in cognitive function and risk of elder self-neglect in a community-dwelling population. Prospective population-based study. Geographically defined community in Chicago. Community-dwelling subjects reported to the social services agency from 1993 to 2005 for self-neglect who also participated in the Chicago Health Aging Project (CHAP). Of the 5,519 participants in CHAP, 1,017 were reported to social services agency for suspected elder self-neglect from 1993 to 2005. Social services agency identified reported elder self-neglect. The primary predictor was decline in cognitive function assessed using the Mini-Mental State Examination (MMSE), the Symbol Digit Modalities Test (Executive Function), and immediate and delayed recall of the East Boston Memory Test (Episodic Memory). An index of global cognitive function scores was derived by averaging z-scores of all tests. Outcome of interest was elder self-neglect. Logistic and linear regression models were used to assess these longitudinal associations. After adjusting for potential confounding factors, decline in global cognitive function, MMSE score, and episodic memory were not independently associated with greater risk of reported and confirmed elder self-neglect. Decline in executive function was associated with greater risk of reported and confirmed elder self-neglect. Decline in global cognitive function was associated with greater risk of greater self-neglect severity (parameter estimate=0.76, standard error=0.31, P=.01). Decline in executive function was associated with risk of reported and confirmed elder self-neglect. Decline in global cognitive function was associated with risk of greater self-neglect severity. © 2010, Copyright the Authors. Journal compilation © 2010, The American Geriatrics Society.

Predictors of performance-based measures of instrumental activities of daily living in nondemented patients with Parkinson's disease.

PubMed

Pirogovsky, Eva; Martinez-Hannon, Mercedes; Schiehser, Dawn M; Lessig, Stephanie L; Song, David D; Litvan, Irene; Filoteo, J Vincent

2013-01-01

Few studies have examined instrumental activities of daily living (iADLs) in nondemented Parkinson's disease (PD), and the majority of these studies have used report-based measures, which can have limited validity. The present study had two main goals: (a) to examine the performance of nondemented PD patients on two performance-based measures of iADLs, which are considered more objective functional measures, and (b) to examine the cognitive, motor, and psychiatric correlates of iADL impairment in PD. Ninety-eight nondemented PD patients and 47 healthy older adults were administered performance-based measures that assess the ability to manage medications (Medication Management Ability Assessment) and finances (University of California, San Diego, UCSD, Performance-based Skills Assessment), the Mattis Dementia Rating Scale to assess global cognitive functioning, the Unified Parkinson's Disease Rating Scale Part III to assess motor symptom severity, and the Geriatric Depression Scale to assess depressive symptoms. Nondemented PD patients demonstrated significantly impaired scores relative to the healthy comparison group on the performance-based measure of financial management, but there were no significant group differences in medication management. Global cognitive functioning, motor severity, and depressive symptoms did not correlate with scores on either of the functional measures, except for a small correlation between depressive symptoms and financial management. The two performance-based measures of iADL functioning did not correlate with one another. These findings suggest that medication and financial management may not be predicted based on global cognitive functioning and that iADLs may not be represented by a single construct. Furthermore, these findings suggest the potential need for a multidimensional approach to assessing iADLs.

Cardiorespiratory Fitness and Cognitive Function in Midlife: Neuroprotection or Neuroselection?

PubMed Central

Belsky, Daniel W.; Caspi, Avshalom; Israel, Salomon; Blumenthal, James A.; Poulton, Richie; Moffitt, Terrie E.

2015-01-01

Objective To determine if better cognitive functioning at midlife among more physically fit individuals reflects “neuroprotection,” in which fitness protects against age-related cognitive decline, or “neuroselection,” in which children with higher cognitive functioning select into more active lifestyles. Methods Children in the Dunedin Longitudinal Study (N=1,037) completed the Wechsler Intelligence Scales and the Trail-Making, Rey-Delayed-Recall, and Grooved-Pegboard tasks as children and again at midlife (age-38). Adult cardiorespiratory fitness was assessed using a submaximal exercise test to estimate maximum-oxygen-consumption-adjusted-for-body-weight in milliliters/minute/kilogram (VO2max). We tested if more-fit individuals had better cognitive functioning than their less-fit counterparts (which could be consistent with neuroprotection), and if better childhood cognitive functioning predisposed to better adult cardiorespiratory fitness (neuroselection). Finally, we examined possible mechanisms of neuroselection. Results Participants with better cardiorespiratory fitness had higher cognitive test scores at midlife. However, fitness-associated advantages in cognitive functioning were present already in childhood. After accounting for childhood-baseline performance on the same cognitive tests, there was no association between cardiorespiratory fitness and midlife cognitive functioning. Socioeconomic and health advantages in childhood, and healthier lifestyles during young adulthood explained most of the association between childhood cognitive functioning and adult cardiorespiratory fitness. Interpretation We found no evidence for a neuroprotective effect of cardiorespiratory fitness as of midlife. Instead, children with better cognitive functioning are selecting into healthier lives. Fitness interventions may enhance cognitive functioning. But, observational and experimental studies testing neuroprotective effects of physical fitness should consider confounding by neuroselection. PMID:25601795

Fine particulate matter air pollution and cognitive function among U.S. older adults.

PubMed

Ailshire, Jennifer A; Clarke, Philippa

2015-03-01

There is growing interest in understanding how exposures in the residential environment relate to cognitive function in older adults. The goal of this study is to determine if neighborhood-level exposure to fine particulate matter air pollution (PM2.5) is associated with cognitive function in a diverse, national sample of older U.S. adults. We use cross-sectional data on non-Hispanic black and white men and women aged 55 and older from the 2001/2002 Americans' Changing Lives Study (N = 780). EPA air monitoring data were linked to respondents using census tract identifiers. Cognitive function was assessed with tests of working memory and orientation. Negative binomial regression models were used to examine the association between PM2.5 and the number of errors on the cognitive assessment. Older adults living in areas with high concentrations of PM2.5 had an error rate 1.5 times greater than those exposed to lower concentrations, net of individual and neighborhood-level demographic and socioeconomic characteristics. This study adds to a growing body of research demonstrating the importance of air pollution to cognitive function in older adults. Improvements to air quality may be an important mechanism for reducing age-related cognitive decline. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Comparison of Two Cognitive Training Programs With Effects on Functional Activities and Quality of Life.

PubMed

Hagovská, Magdaléna; Dzvoník, Oliver; Olekszyová, Zuzana

2017-07-01

The aim of the current study was to compare the effectiveness of two types of cognitive training in 60 older adults with mild cognitive impairment by assessing the impact on functional activities, quality of life (QOL), and various cognitive functions. The primary outcomes were functional activity level and QOL. The secondary outcome was cognitive examination. Group assignment was random. Group A (n = 30) underwent CogniPlus, a computer-based, cognitive training. Group B (n = 30) underwent classical group-based cognitive training. Both programs comprised two 30-minute sessions per week for 10 weeks. After training, group A had better QOL (p < 0.001, effect size [ES] = 0.69) and better attention (increased load score, p < 0.05, ES = -0.23; errors, p < 0.001, ES = -0.47); however, there were no group differences in functional activity level. Group A demonstrated larger improvements in QOL and attention than group B (i.e., classical cognitive training), but the transfer to functional activities was the same between groups. [Res Gerontol Nurs. 2017; 10(4):172-180.]. Copyright 2017, SLACK Incorporated.

Risk Factors and Cognitive Relevance of Cortical Cerebral Microinfarcts in Patients With Ischemic Stroke or Transient Ischemic Attack.

PubMed

Wang, Zhaolu; van Veluw, Susanne J; Wong, Adrian; Liu, Wenyan; Shi, Lin; Yang, Jie; Xiong, Yunyun; Lau, Alexander; Biessels, Geert Jan; Mok, Vincent C T

2016-10-01

It was recently demonstrated that cerebral microinfarcts (CMIs) can be detected in vivo using 3.0 tesla (T) magnetic resonance imaging. We investigated the prevalence, risk factors, and the longitudinal cognitive consequence of cortical CMIs on 3.0T magnetic resonance imaging, in patients with ischemic stroke or transient ischemic attack. A total of 231 patients undergoing 3.0T magnetic resonance imaging were included. Montreal Cognitive Assessment was used to evaluate global cognitive functions and cognitive domains (memory, language, and attention visuospatial and executive functions). Cognitive changes were represented by the difference in Montreal Cognitive Assessment score between baseline and 28-month after stroke/transient ischemic attack. The cross-sectional and longitudinal associations between cortical CMIs and cognitive functions were explored using ANCOVA and regression models. Cortical CMIs were observed in 34 patients (14.7%), including 13 patients with acute (hyperintense on diffusion-weighted imaging) and 21 with chronic CMIs (isointense on diffusion-weighted imaging). Atrial fibrillation was a risk factor for all cortical CMIs (odds ratio, 4.8; 95% confidence interval, 1.5-14.9; P=0.007). Confluent white matter hyperintensities was associated with chronic CMIs (odds ratio, 2.8; 95% confidence interval, 1.0-7.8; P=0.047). The presence of cortical CMIs at baseline was associated with worse visuospatial functions at baseline and decline over 28-month follow-up (β=0.5; 95% confidence interval, 0.1-1.0; P=0.008, adjusting for brain atrophy, white matter hyperintensities, lacunes, and microbleeds). Cortical CMIs are a common finding in patients with stroke/transient ischemic attack. Associations between CMI with atrial fibrillation and white matter hyperintensities suggest that these lesions have a heterogeneous cause, involving microembolism and cerebral small vessel disease. CMI seemed to preferentially impact visuospatial functions as assessed by a cognitive screening test. © 2016 American Heart Association, Inc.

The effectiveness of neurofeedback on cognitive functioning in patients with Alzheimer's disease: Preliminary results.

PubMed

Luijmes, Robin E; Pouwels, Sjaak; Boonman, Jacko

2016-06-01

Alzheimer's disease (AD) is the most common form of dementia. In quantified EEG (qEEG), the AD patients have a greater amount of theta activity compared with normal elderly individuals. Little is known about the effect of neurofeedback in patients with dementia. The objective of this study was to examine whether neurofeedback has a positive effect on cognitive performance in patients with AD. Ten patients with qEEG meeting criteria for AD received neurofeedback training. Participants were aged between 61 and 90 years. All patients underwent the CAMCOG test designed to assess cognitive functioning pre- and post-treatment. The individual results, analyzed with a reliable change index (RCI), showed that patients who received neurofeedback treatment had stable cognitive functions. These patients showed improvement in memory after neurofeedback and other cognitive functions were stable. In addition, an improvement was observed in recall of information and recognition. Patients with AD who received neurofeedback treatment had stable or improved cognitive performance. Future research should focus on the design of high quality randomized controlled trials to assess whether neurofeedback has a place in the treatment of AD. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Effect of dance exercise on cognitive function in elderly patients with metabolic syndrome: a pilot study.

PubMed

Kim, Se-Hong; Kim, Minjeong; Ahn, Yu-Bae; Lim, Hyun-Kook; Kang, Sung-Goo; Cho, Jung-Hyoun; Park, Seo-Jin; Song, Sang-Wook

2011-01-01

Metabolic syndrome is associated with an increased risk of cognitive impairment. The purpose of this prospective pilot study was to examine the effects of dance exercise on cognitive function in elderly patients with metabolic syndrome. The participants included 38 elderly metabolic syndrome patients with normal cognitive function (26 exercise group and 12 control group). The exercise group performed dance exercise twice a week for 6 months. Cognitive function was assessed in all participants using the Korean version of the Consortium to Establish a Registry for Alzheimer's disease (CERAD-K). Repeated-measures ANCOVA was used to assess the effect of dance exercise on cognitive function and cardiometabolic risk factors. Compared with the control group, the exercise group significantly improved in verbal fluency (p = 0.048), word list delayed recall (p = 0.038), word list recognition (p = 0.007), and total CERAD-K score (p = 0.037). However, no significance difference was found in body mass index, blood pressure, waist circumference, fasting plasma glucose, triglyceride, and HDL cholesterol between groups over the 6-month period. In the present study, six months of dance exercise improved cognitive function in older adults with metabolic syndrome. Thus, dance exercise may reduce the risk for cognitive disorders in elderly people with metabolic syndrome. Key pointsMetabolic syndrome (MS) is associated with an increased risk of cognitive impairment.Aerobic exercise improves cognitive function in elderly people and contributes to the prevention of degenerative neurological disease and brain damage. Dance sport is a form of aerobic exercise that has the additional benefits of stimulating the emotions, promoting social interaction, and exposing subjects to acoustic stimulation and music.In the present study, dance exercise for a 6-month period improved cognitive function in older adults with MS. In particular, positive effects were observed in verbal fluency, word list delayed recall, word list recognition, and the total CERAD-K score.Our data suggest that the implementation of dance exercise programs may be an effective means of prevention and treatment of cognitive disorders.

Sleep quality affects cognitive functioning in returning combat veterans beyond combat exposure, PTSD, and mild TBI history.

PubMed

Martindale, Sarah L; Morissette, Sandra B; Rowland, Jared A; Dolan, Sara L

2017-01-01

The purpose of this study was to determine how sleep quality affects cognitive functioning in returning combat veterans after accounting for effects of combat exposure, posttraumatic stress disorder (PTSD), and mild traumatic brain injury (mTBI) history. This was a cross-sectional assessment study evaluating combat exposure, PTSD, mTBI history, sleep quality, and neuropsychological functioning. One hundred and nine eligible male Iraq/Afghanistan combat veterans completed an assessment consisting of a structured clinical interview, neuropsychological battery, and self-report measures. Using partial least squares structural equation modeling, combat experiences and mTBI history were not directly associated with sleep quality. PTSD was directly associated with sleep quality, which contributed to deficits in neuropsychological functioning independently of and in addition to combat experiences, PTSD, and mTBI history. Combat experiences and PTSD were differentially associated with motor speed. Sleep affected cognitive function independently of combat experiences, PTSD, and mTBI history. Sleep quality also contributed to cognitive deficits beyond effects of PTSD. An evaluation of sleep quality may be a useful point of clinical intervention in combat veterans with cognitive complaints. Improving sleep quality could alleviate cognitive complaints, improving veterans' ability to engage in treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Neurofeedback training with a motor imagery-based BCI: neurocognitive improvements and EEG changes in the elderly.

PubMed

Gomez-Pilar, Javier; Corralejo, Rebeca; Nicolas-Alonso, Luis F; Álvarez, Daniel; Hornero, Roberto

2016-11-01

Neurofeedback training (NFT) has shown to be promising and useful to rehabilitate cognitive functions. Recently, brain-computer interfaces (BCIs) were used to restore brain plasticity by inducing brain activity with an NFT. In our study, we hypothesized that an NFT with a motor imagery-based BCI (MI-BCI) could enhance cognitive functions related to aging effects. To assess the effectiveness of our MI-BCI application, 63 subjects (older than 60 years) were recruited. This novel application was used by 31 subjects (NFT group). Their Luria neuropsychological test scores were compared with the remaining 32 subjects, who did not perform NFT (control group). Electroencephalogram changes measured by relative power (RP) endorsed cognitive potential findings under study: visuospatial, oral language, memory, intellectual and attention functions. Three frequency bands were selected to assess cognitive changes: 12, 18, and 21 Hz (bandwidth 3 Hz). Significant increases (p < 0.01) in the RP of these frequency bands were found. Moreover, results from cognitive tests showed significant improvements (p < 0.01) in four cognitive functions after performing five NFT sessions: visuospatial, oral language, memory, and intellectual. This established evidence in the association between NFT performed by a MI-BCI and enhanced cognitive performance. Therefore, it could be a novel approach to help elderly people.

A cross-sectional study of functional disabilities and perceived cognitive dysfunction in patients with major depressive disorder in South Korea: The PERFORM-K study.

PubMed

Kim, Jae Min; Chalem, Ylana; di Nicola, Sylvia; Hong, Jin Pyo; Won, Seung Hee; Milea, Dominique

2016-05-30

PERFORM-K was a cross-sectional observational study that investigated functional disability, productivity and quality of life in MDD outpatients in South Korea, and the associations of these with depressive symptoms, perceived cognitive dysfunction and other factors. A total of 312 outpatients who started antidepressant monotherapy underwent a single study interview. Physicians and patients assessed depression severity. Patients also assessed: perceived cognitive dysfunction, functional disability, impaired productivity and quality of life. Patients had moderate to severe depression (MADRS mean total score: 28.9±7.3), and reported marked functional disability (SDS mean total score: 16.7±8.6), impaired productivity (WPAI mean overall work productivity loss: 52.4±31.8%), perceived cognitive dysfunction (PDQ-D mean total score: 29.9±18.6) and impaired quality of life (EQ-5D mean utility index score of 0.726±0.192). Greater functional disability and impairment in daily activities were associated with more severe depression and greater perceived cognitive dysfunction. Irrespective of depression severity, patients with more severe perceived cognitive dysfunction reported worse work-related productivity outcomes (higher presenteeism and greater overall work productivity loss). PERFORM-K confirms the impact of MDD on functional status and well-being in South Korean patients, and highlights the importance of recognising cognitive dysfunction in clinical practice. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Group cognitive remediation therapy for chronic schizophrenia: A randomized controlled trial.

PubMed

Tan, Shuping; Zou, Yizhuang; Wykes, Til; Reeder, Clare; Zhu, Xiaolin; Yang, Fude; Zhao, Yanli; Tan, Yunlong; Fan, Fengmei; Zhou, Dongfeng

2016-07-28

Individual-level cognitive remediation therapy (CRT) has been shown to be effective for cognitive improvement and social function amelioration. Here, we aimed to test the efficacy of group-based CRT in Chinese subjects with schizophrenia. One-hundred and four inpatients were randomly assigned to either 40 sessions of small-group CRT therapy or therapeutic contact-matched Musical and Dancing Therapy (MDT). Cognitive and social functioning, as well as clinical symptoms, were evaluated over the course of treatment. Specifically, cognitive function was evaluated using a battery of cognitive measurements, clinical symptoms were evaluated using the Positive and Negative Syndrome Scale, and social function was evaluated using the Nurse's Observation Scale for Inpatient Evaluation-30. All patients were evaluated pre- and post-treatment. Forty-four individuals in the CRT group and 46 in the MDT group completed all of the planned treatments and analyses. Cognitive functions, especially cognitive flexibility and memory, showed significant improvement in the CRT group over the course of the study. The MDT group also showed improvement in several cognitive flexibility assessments, but the degree of improvement was significantly greater in the CRT group. Several social-function factors exhibited a significant improvement in the CRT group, but not in the MDT group. Cognitive function improvement correlated positively with social function without predicting social function change. We conclude that group-based CRT is an effective and promising therapy. Copyright © 2016. Published by Elsevier Ireland Ltd.

Sleep, Fatigue, and Problems with Cognitive Function in Adults Living with HIV

PubMed Central

Gay, Caryl L.; Lee, Kathryn A.

2015-01-01

Up to 50% of people living with HIV have some neurocognitive impairment. We examined associations of sleep and fatigue with self-reported cognitive problems in 268 adults living with HIV. Multivariate regression was used to examine associations between cognitive problems, self-reported sleep quality, actigraphy-measured total sleep time and wake after sleep onset, and fatigue severity. Poorer self-reported sleep quality (p < .001), short or long total sleep time (< 7 or > 8 vs. 7–8 hours, p = .015), and greater fatigue (p < .001) were associated with lower self-reported cognitive function scores after controlling for demographic and clinical characteristics. However, objective measure of wake after sleep onset was unrelated to self-reported cognitive function scores. Findings suggest that assessing and treating poor sleep and complaints about fatigue would be areas for intervention that could have a greater impact on improving cognition function than interventions that only target cognitive problems. PMID:26547298

Cognition and Health in African American Men

PubMed Central

Sims, Regina C.; Thorpe, Roland J.; Gamaldo, Alyssa A.; Aiken-Morgan, Adrienne T.; Hill, LaBarron K.; Allaire, Jason C.; Whitfield, Keith E.

2015-01-01

Objective Despite high rates of poor health outcomes, little attention has been focused on associations between prominent health factors and cognitive function in African American men, exclusively. The objective was to examine relationships between cardiovascular and pulmonary health, and cognitive function in African American men. Method Data from 257 men were pooled from two studies of African American aging. The mean age of participants was 58.15 and mean educational attainment was 11.78 years. Participants provided self-reported health and demographic information, completed cognitive measures, and had their blood pressure and peak expiratory flow assessed. Results After adjustment, significant relationships were found between average peak expiratory flow rate (APEFR) and cognitive performance measures. Discussion Results suggest that lung function is important to consider when examining cognitive function in African American men. Understanding the role of health in cognition and implications for quality of life in this population will be critical as life expectancies increase. PMID:25053802

Potential mechanisms for chemotherapy-induced impairments in cognitive function.

PubMed

Jansen, Catherine; Miaskowski, Christine; Dodd, Marilyn; Dowling, Glenna; Kramer, Joel

2005-11-03

To review the domains of cognitive function and their corresponding neuroanatomic structures as well as present current evidence for neurotoxicity associated with specific chemotherapeutic agents and potential mechanisms for chemotherapy-induced cognitive impairments. Published research articles, review articles, and textbooks. Chemotherapy does not appear to cross the blood-brain barrier when given in standard doses; however, many chemotherapy drugs have the potential to cause cognitive impairments through more than one mechanism. In addition, patient factors may be protective or place individuals at higher risk for cognitive impairments. Although evidence of chemotherapy-induced impairments in cognitive function exists, no clinical studies have attempted to elucidate the mechanisms for chemotherapy-induced impairments in cognitive function. In addition, further studies are needed to determine predictive factors, potential biomarkers, and relevant assessment parameters. The ability to identify high-risk patients has important implications for practice in regard to informed consent, patient education about the effects of treatment, and preventive strategies.

The effect of cognitive remediation in individuals at ultra-high risk for psychosis: a systematic review.

PubMed

Glenthøj, Louise Birkedal; Hjorthøj, Carsten; Kristensen, Tina Dam; Davidson, Charlie Andrew; Nordentoft, Merete

2017-01-01

Cognitive deficits are prominent features of the ultra-high risk state for psychosis that are known to impact functioning and course of illness. Cognitive remediation appears to be the most promising treatment approach to alleviate the cognitive deficits, which may translate into functional improvements. This study systematically reviewed the evidence on the effectiveness of cognitive remediation in the ultra-high risk population. The electronic databases MEDLINE, PsycINFO, and Embase were searched using keywords related to cognitive remediation and the UHR state. Studies were included if they were peer-reviewed, written in English, and included a population meeting standardized ultra-high risk criteria. Six original research articles were identified. All the studies provided computerized, bottom-up-based cognitive remediation, predominantly targeting neurocognitive function. Four out of five studies that reported a cognitive outcome found cognitive remediation to improve cognition in the domains of verbal memory, attention, and processing speed. Two out of four studies that reported on functional outcome found cognitive remediation to improve the functional outcome in the domains of social functioning and social adjustment. Zero out of the five studies that reported such an outcome found cognitive remediation to affect the magnitude of clinical symptoms. Research on the effect of cognitive remediation in the ultra-high risk state is still scarce. The current state of evidence indicates an effect of cognitive remediation on cognition and functioning in ultra-high risk individuals. More research on cognitive remediation in ultra-high risk is needed, notably in large-scale trials assessing the effect of neurocognitive and/or social cognitive remediation on multiple outcomes.

Long-Term Cognitive Impairment after Hospitalization for Community-Acquired Pneumonia: a Prospective Cohort Study.

PubMed

Girard, Timothy D; Self, Wesley H; Edwards, Kathryn M; Grijalva, Carlos G; Zhu, Yuwei; Williams, Derek J; Jain, Seema; Jackson, James C

2018-06-01

Recent studies suggest older patients hospitalized for community-acquired pneumonia are at risk for new-onset cognitive impairment. The characteristics of long-term cognitive impairment after pneumonia, however, have not been elucidated. To characterize long-term cognitive impairment among adults of all ages hospitalized for community-acquired pneumonia. Prospective cohort study. Adults without severe preexisting cognitive impairment who were hospitalized with community-acquired pneumonia. At enrollment, we estimated baseline cognitive function with the Short Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). At 2- and 12-month follow-up, we assessed cognition using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and tests of executive function, diagnosing cognitive impairment when results were ≥ 1.5 standard deviations below published age-adjusted means for the general population. We also identified subtypes of mild cognitive impairment using standard definitions. We assessed 58 (73%) of 80 patients who survived to 2-month follow-up and 57 (77%) of 74 who survived to 12-month follow-up. The median [range] age of survivors tested was 57 [19-97] years. Only 8 (12%) had evidence of mild cognitive impairment at baseline according to the Short IQCODE, but 21 (38%) at 2 months and 17 (30%) at 12 months had mild cognitive impairment per the RBANS. Moderate-to-severe cognitive impairment was common among adults ≥ 65 years [4/13 (31%) and 5/13 (38%) at 2 and 12 months, respectively] but also affected many of those < 65 years [10/43 (23%) and 8/43 (19%) at 2 and 12 months, respectively]. Deficits were most often noted in visuospatial function, attention, and memory. A year after hospitalization for community-acquired pneumonia, moderate-to-severe impairment in multiple cognitive domains affected one-third of patients ≥ 65 years old and 20% of younger patients, and another third of survivors had mild cognitive impairment.

Developing models of how cognitive improvements change functioning: Mediation, moderation and moderated mediation

PubMed Central

Wykes, Til; Reeder, Clare; Huddy, Vyv; Taylor, Rumina; Wood, Helen; Ghirasim, Natalia; Kontis, Dimitrios; Landau, Sabine

2012-01-01

Background Cognitive remediation (CRT) affects functioning but the extent and type of cognitive improvements necessary are unknown. Aim To develop and test models of how cognitive improvement transfers to work behaviour using the data from a current service. Method Participants (N49) with a support worker and a paid or voluntary job were offered CRT in a Phase 2 single group design with three assessments: baseline, post therapy and follow-up. Working memory, cognitive flexibility, planning and work outcomes were assessed. Results Three models were tested (mediation — cognitive improvements drive functioning improvement; moderation — post treatment cognitive level affects the impact of CRT on functioning; moderated mediation — cognition drives functioning improvements only after a certain level is achieved). There was evidence of mediation (planning improvement associated with improved work quality). There was no evidence that cognitive flexibility (total Wisconsin Card Sorting Test errors) and working memory (Wechsler Adult Intelligence Scale III digit span) mediated work functioning despite significant effects. There was some evidence of moderated mediation for planning improvement if participants had poorer memory and/or made fewer WCST errors. The total CRT effect on work quality was d = 0.55, but the indirect (planning-mediated CRT effect) was d = 0.082 Conclusion Planning improvements led to better work quality but only accounted for a small proportion of the total effect on work outcome. Other specific and non-specific effects of CRT and the work programme are likely to account for some of the remaining effect. This is the first time complex models have been tested and future Phase 3 studies need to further test mediation and moderated mediation models. PMID:22503640

Effect of Exercise and Cognitive Training on Falls and Fall-Related Factors in Older Adults With Mild Cognitive Impairment: A Systematic Review.

PubMed

Lipardo, Donald S; Aseron, Anne Marie C; Kwan, Marcella M; Tsang, William W

2017-10-01

To evaluate the effect of exercise and cognitive training on falls reduction and on factors known to be associated with falls among community-dwelling older adults with mild cognitive impairment (MCI). Seven databases (PubMed, CINAHL, Cochrane Library, Web of Science, ProQuest, ProQuest Dissertations and Theses, Digital Dissertation Consortium) and reference lists of pertinent articles were searched. Randomized controlled trials (RCTs) on the effect of exercise, cognitive training, or a combination of both on falls and factors associated with falls such as balance, lower limb muscle strength, gait, and cognitive function among community-dwelling older adults with MCI were included. Data were extracted using the modified Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) tool. Study quality was assessed using the JBI-MAStARI appraisal instrument. Seventeen RCTs (1679 participants; mean age ± SD, 74.4±2.4y) were included. Exercise improved gait speed and global cognitive function in MCI; both are known factors associated with falls. Cognitive training alone had no significant effect on cognitive function, while combined exercise and cognitive training improved balance in MCI. Neither fall rate nor the number of fallers was reported in any of the studies included. This review suggests that exercise, and combined exercise and cognitive training improve specific factors associated with falls such as gait speed, cognitive function, and balance in MCI. Further research on the direct effect of exercise and cognitive training on the fall rate and incidence in older adults with MCI with larger sample sizes is highly recommended. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

An Investigation of Emotion Recognition and Theory of Mind in People with Chronic Heart Failure

PubMed Central

Habota, Tina; McLennan, Skye N.; Cameron, Jan; Ski, Chantal F.; Thompson, David R.; Rendell, Peter G.

2015-01-01

Objectives Cognitive deficits are common in patients with chronic heart failure (CHF), but no study has investigated whether these deficits extend to social cognition. The present study provided the first empirical assessment of emotion recognition and theory of mind (ToM) in patients with CHF. In addition, it assessed whether each of these social cognitive constructs was associated with more general cognitive impairment. Methods A group comparison design was used, with 31 CHF patients compared to 38 demographically matched controls. The Ekman Faces test was used to assess emotion recognition, and the Mind in the Eyes test to measure ToM. Measures assessing global cognition, executive functions, and verbal memory were also administered. Results There were no differences between groups on emotion recognition or ToM. The CHF group’s performance was poorer on some executive measures, but memory was relatively preserved. In the CHF group, both emotion recognition performance and ToM ability correlated moderately with global cognition (r = .38, p = .034; r = .49, p = .005, respectively), but not with executive function or verbal memory. Conclusion CHF patients with lower cognitive ability were more likely to have difficulty recognizing emotions and inferring the mental states of others. Clinical implications of these findings are discussed. PMID:26529409

Cognitive-behavioral rehabilitation vs. treatment as usual for bipolar patients: study protocol for a randomized controlled trial.

PubMed

Gomes, Bernardo Carramão; Rocca, Cristiana Castanho; Belizario, Gabriel Okawa; Lafer, Beny

2017-03-28

Bipolar disorder (BD) is commonly associated with cognitive and functional impairments even during remission periods, and although a growing number of studies have demonstrated the benefits of psychotherapy as an add-on to pharmacological treatment, its effectiveness appears to be less compelling in severe presentations of the disorder. New interventions have attempted to improve cognitive functioning in BD patients, but results have been mixed. The study consists of a clinical trial comparing a new structured group intervention, called "Cognitive-Behavioral Rehabilitation," with treatment as usual (TAU) for bipolar patients. The new approach is a combination of cognitive behavioral strategies and cognitive remediation exercises, consisting of 12 weekly group sessions of 90 min each. To be included in the study, patients must be diagnosed with BD type I or II, aged 18-55 years, in full or partial remission, and have an IQ of at least 80. A comprehensive neuropsychological battery, followed by mood, social functioning, and quality of life assessments will occur in three moments: pre and post intervention and 12 months later. The primary outcome of the study is to compare the time, in weeks, that the first full mood episode appears in patients who participated in either group of the study. Secondary outcome will include improvement in cognitive functions. This is the first controlled trial assessing the validity and effectiveness of the new "Cognitive-Behavioral Rehabilitation" intervention in preventing new mood episodes and improving cognitive and functional impairments. Clinicaltrial.gov, NCT02766361 . Registered on 2 May 2016.

Associations of long-term exposure to air pollution and road traffic noise with cognitive function-An analysis of effect measure modification.

PubMed

Tzivian, Lilian; Jokisch, Martha; Winkler, Angela; Weimar, Christian; Hennig, Frauke; Sugiri, Dorothea; Soppa, Vanessa J; Dragano, Nico; Erbel, Raimund; Jöckel, Karl-Heinz; Moebus, Susanne; Hoffmann, Barbara

2017-06-01

Adverse effects of traffic-related air pollution (AP) and noise on cognitive functions have been proposed, but little is known about their interactions and the combined effect of co-exposure. Cognitive assessment was completed by 4086 participants of the population-based Heinz Nixdorf Recall cohort study using five neuropsychological subtests and an additively calculated global cognitive score (GCS). We assessed long-term residential concentrations for size-fractioned particulate matter (PM) and nitrogen oxides with land use regression. Road traffic noise (weighted 24-h (L DEN ) and night-time (L NIGHT ) means) was assessed according to the EU directive 2002/49/EC. Linear regression models adjusted for individual-level characteristics were calculated to estimate effect modification of associations between AP and noise with cognitive function. We used multiplicative interaction terms and categories of single or double high exposure, dichotomizing the potential effect modifier at the median (AP) or at an a priori defined threshold (road traffic noise). In fully adjusted models, high noise exposure increased the association of AP with cognitive function. For example, for an interquartile range increase of PM 2.5 (IQR 1.43), association s with GCS were: estimate (β)=-0.16 [95% confidence interval: -0.33; 0.01] and β=-0.48 [-0.72; -0.23] for low and high L DEN , respectively. The association of noise with GCS was restricted to highly AP-exposed participants. We observed stronger negative associations in those participants with double exposure compared to the addition of effect estimates of each single exposure. Our study suggests that AP and road traffic noise might act synergistically on cognitive function in adults. Copyright © 2017 Elsevier Ltd. All rights reserved.

Influence of working memory and executive function on stair ascent and descent in young and older adults.

PubMed

Gaillardin, Florence; Baudry, Stéphane

2018-06-01

This study assessed the influence of attention division, working memory and executive function on stair ascent and descent in young and older adults. Twenty young (25.5 ± 2.1 yrs) and 20 older adults (68.4 ± 5.4 yrs) ascended and descended a 3-step staircase with no simultaneous cognitive task (single-motor task) or while performing a cognitive task (dual-task condition). The cognitive task involved either 1) recalling a word list of the subject's word-span minus 2 words (SPAN-2) to assess the attention division effect, 2) a word list of subject's word-span (SPAN-O) to assess the working memory effect, or 3) recalling in alphabetical order, a word list of the subject's word-span (SPAN-A) to assess the executive function effect. Word-span corresponds to the longest string of words that can be recalled correctly. The duration of ascent and descent of stairs was used to assess the cognitive-motor interaction. Stair ascent and descent duration did not differ between age groups for the single-motor task, and was similar between single-motor task and SPAN-2 in both groups (p > 0.05). In contrast, stair ascent and descent duration increased with SPAN-O compared with SPAN-2 for both groups (p < 0.01). Stair ascent (p = 0.017) and descent (p = 0.008) were longer in SPAN-A than SPAN-O only in older adults. Healthy aging was not associated with a decrease in the capacity to perform motor-cognitive dual tasks that involved ascending and descending of stairs when the cognitive task only required working memory. However, the decrease in dual-task performance involving executive functioning may reflect a subclinical cognitive decline in healthy older adults. Copyright © 2018 Elsevier Inc. All rights reserved.

Prenatal exposure to polychlorinated biphenyls: a neuropsychologic analysis.

PubMed

Boucher, Olivier; Muckle, Gina; Bastien, Célyne H

2009-01-01

A large body of literature documents the effects of prenatal exposure to polychlorinated biphenyls (PCBs) on cognitive development of children. Despite this fact, no integrative synthesis has been published yet to identify the cognitive functions that are particularly affected. Our aim is to review this literature in an attempt to identify the cognitive profile associated with prenatal PCB exposure. Studies were identified by searching the PubMed database for articles published before June 2008. We reviewed data from nine prospective longitudinal birth cohorts for different aspects of cognition. Associations between indicators of prenatal PCB exposure and performance on cognitive tasks reported in the selected studies are summarized and classified as general cognitive abilities, verbal or visual-spatial skills, memory, attention, and executive functions. The most consistent effects observed across studies are impaired executive functioning related to increased prenatal PCB exposure. Negative effects on processing speed, verbal abilities, and visual recognition memory are also reported by most studies. Converging results from different cohort studies in which exposure arises from different sources make it unlikely that co-exposure with another associated contaminant is responsible for the observed effects. Prenatal PCB exposure appears to be related to a relatively specific cognitive profile of impairments. Failure to assess functions that are specifically impaired may explain the absence of effects found in some studies. Our findings have implications in the selection of cognitive assessment methods in future studies.

Cognitive Impairment in Adults with Non-CNS Cancers (PDQ®)—Health Professional Version

Cancer.gov

Cognitive impairment in adult cancer survivors may include problems with memory, concentration, information processing, and executive function. Get comprehensive information about assessing and managing cognitive impairment in this summary for clinicians.

Neuropsychological assessment in autism spectrum disorder and related conditions

PubMed Central

Zwick, Georg Peter

2017-01-01

Neuropsychological assessment provides a profound analysis of cognitive functioning in people with autism spectrum disorder (ASD). Individuals on the autistic spectrum often show a high level of anxiety and are frequently affected by comorbidities that influence their quality of life. Yet, they also have cognitive strengths that should be identified in order to develop effective support strategies. This article presents an overview of five cognitive areas that are essential for neuropsychological evaluation (ie, intelligence, attention, executive function, social cognition, and praxis) and explores the underlying causes of behavioral problems in persons with ASD. Furthermore, it stresses the importance of meticulous neuropsychological testing with regard to cognitive remediation, a method that can help to enhance single cognitive processes in a targeted manner. Objective test results suggest it might be possible to promote an improved sense of coherence. In line with the salutogenic model, this may be fundamental for human health and well-being. PMID:29398932

Nutritional status and cognitive impairment in elderly.

PubMed

Daradkeh, Ghazi; Essa, Musthafa M; Al-Adawi, S Samir; Koshy, Roopa P; Al-Asmi, Abdullah; Waly, Mostafa I

2014-10-01

The elderly population is increasing worldwide and it has been suggested that senior citizens will continue to constitute the bulk of the population in many countries. Nutritional status of senior citizens are adversely affected by their frailty, chronic condition and declining cognitive functioning. Conversely, malnourished elderly further deteriorate their frailty, chronic disease and cognitive functioning. The aim of this review article is to recognize the importance of nutritional assessment of elderly population particularly those with cognitive impairment. First part is to highlight characteristic cognitive impairment among senior citizens and the second one highlight t he background in which malnutrition is a factor that leads to increased risk of morbidity and mortality in the elderly. This review also highlight salgorithms for safeguarding nutritional status among senior citizen and focuses on importance of nutritional screening, assessment and early intervention for safeguarding further deterioration of elderly who are likely to prone to cognitive impairment.

The Association between Daytime Napping and Cognitive Functioning in Chronic Fatigue Syndrome

PubMed Central

Gotts, Zoe M.; Ellis, Jason G.; Deary, Vincent; Barclay, Nicola; Newton, Julia L.

2015-01-01

Objectives The precise relationship between sleep and physical and mental functioning in chronic fatigue syndrome (CFS) has not been examined directly, nor has the impact of daytime napping. This study aimed to examine self-reported sleep in patients with CFS and explore whether sleep quality and daytime napping, specific patient characteristics (gender, illness length) and levels of anxiety and depression, predicted daytime fatigue severity, levels of daytime sleepiness and cognitive functioning, all key dimensions of the illness experience. Methods 118 adults meeting the 1994 CDC case criteria for CFS completed a standardised sleep diary over 14 days. Momentary functional assessments of fatigue, sleepiness, cognition and mood were completed by patients as part of usual care. Levels of daytime functioning and disability were quantified using symptom assessment tools, measuring fatigue (Chalder Fatigue Scale), sleepiness (Epworth Sleepiness Scale), cognitive functioning (Trail Making Test, Cognitive Failures Questionnaire), and mood (Hospital Anxiety and Depression Scale). Results Hierarchical Regressions demonstrated that a shorter time since diagnosis, higher depression and longer wake time after sleep onset predicted 23.4% of the variance in fatigue severity (p <.001). Being male, higher depression and more afternoon naps predicted 25.6% of the variance in objective cognitive dysfunction (p <.001). Higher anxiety and depression and morning napping predicted 32.2% of the variance in subjective cognitive dysfunction (p <.001). When patients were classified into groups of mild and moderate sleepiness, those with longer daytime naps, those who mainly napped in the afternoon, and those with higher levels of anxiety, were more likely to be in the moderately sleepy group. Conclusions Napping, particularly in the afternoon is associated with poorer cognitive functioning and more daytime sleepiness in CFS. These findings have clinical implications for symptom management strategies. PMID:25575044

The association between daytime napping and cognitive functioning in chronic fatigue syndrome.

PubMed

Gotts, Zoe M; Ellis, Jason G; Deary, Vincent; Barclay, Nicola; Newton, Julia L

2015-01-01

The precise relationship between sleep and physical and mental functioning in chronic fatigue syndrome (CFS) has not been examined directly, nor has the impact of daytime napping. This study aimed to examine self-reported sleep in patients with CFS and explore whether sleep quality and daytime napping, specific patient characteristics (gender, illness length) and levels of anxiety and depression, predicted daytime fatigue severity, levels of daytime sleepiness and cognitive functioning, all key dimensions of the illness experience. 118 adults meeting the 1994 CDC case criteria for CFS completed a standardised sleep diary over 14 days. Momentary functional assessments of fatigue, sleepiness, cognition and mood were completed by patients as part of usual care. Levels of daytime functioning and disability were quantified using symptom assessment tools, measuring fatigue (Chalder Fatigue Scale), sleepiness (Epworth Sleepiness Scale), cognitive functioning (Trail Making Test, Cognitive Failures Questionnaire), and mood (Hospital Anxiety and Depression Scale). Hierarchical Regressions demonstrated that a shorter time since diagnosis, higher depression and longer wake time after sleep onset predicted 23.4% of the variance in fatigue severity (p <.001). Being male, higher depression and more afternoon naps predicted 25.6% of the variance in objective cognitive dysfunction (p <.001). Higher anxiety and depression and morning napping predicted 32.2% of the variance in subjective cognitive dysfunction (p <.001). When patients were classified into groups of mild and moderate sleepiness, those with longer daytime naps, those who mainly napped in the afternoon, and those with higher levels of anxiety, were more likely to be in the moderately sleepy group. Napping, particularly in the afternoon is associated with poorer cognitive functioning and more daytime sleepiness in CFS. These findings have clinical implications for symptom management strategies.

Subtle cognitive impairments in patients with long-term cure of Cushing's disease.

PubMed

Tiemensma, Jitske; Kokshoorn, Nieke E; Biermasz, Nienke R; Keijser, Bart-Jan S A; Wassenaar, Moniek J E; Middelkoop, Huub A M; Pereira, Alberto M; Romijn, Johannes A

2010-06-01

Active Cushing's disease is associated with cognitive impairments. We hypothesized that previous hypercortisolism in patients with Cushing's disease results in irreversible impairments in cognitive functioning. Therefore, our aim was to assess cognitive functioning after long-term cure of Cushing's disease. Cognitive assessment consisted of 11 tests, which evaluated global cognitive functioning, memory, and executive functioning. We included 74 patients cured of Cushing's disease and 74 controls matched for age, gender, and education. Furthermore, we included 54 patients previously treated for nonfunctioning pituitary macroadenomas (NFMA) and 54 controls matched for age, gender, and education. Compared with NFMA patients, patients cured from Cushing's disease had lower scores on the Mini Mental State Examination (P = 0.001), and on the memory quotient of the Wechsler Memory Scale (P = 0.050). Furthermore, patients cured from Cushing's disease tended to recall fewer words on the imprinting (P = 0.013), immediate recall (P = 0.012), and delayed recall (P = 0.003) trials of the Verbal Learning Test of Rey. On the Rey Complex Figure Test, patients cured from Cushing's disease had lower scores on both trials (P = 0.002 and P = 0.007) compared with NFMA patients. Patients cured from Cushing's disease also made fewer correct substitutions on the Letter-Digit Substitution Test (P = 0.039) and came up with fewer correct patterns on the Figure Fluency Test (P = 0.003) compared with treated NFMA patients. Cognitive function, reflecting memory and executive functions, is impaired in patients despite long-term cure of Cushing's disease. These observations indicate irreversible effects of previous hypercortisolism on cognitive function and, thus, on the central nervous system. These observations may also be of relevance for patients treated with high-dose exogenous glucocorticoids.

The relationship between sleep and cognitive function in patients with prediabetes and type 2 diabetes.

PubMed

Saetung, Sunee; Nimitphong, Hataikarn; Siwasaranond, Nantaporn; Sumritsopak, Rungtip; Jindahra, Panitha; Krairit, Orapitchaya; Thakkinstian, Ammarin; Anothaisintawee, Thunyarat; Reutrakul, Sirimon

2018-06-06

Diabetes is linked to cognitive impairment. Sleep plays a role in memory consolidation. Sleep disturbances, commonly found in patients with diabetes, were shown to be related to cognitive dysfunction. This study explored the role of sleep in cognitive function of patients with abnormal glucose tolerance. A total of 162 patients (81 type 2 diabetes and 81 prediabetes) participated. Sleep duration and sleep efficiency (an indicator of sleep quality) were obtained using 7-day actigraphy recordings. Obstructive sleep apnea (OSA) was screened using an overnight in-home monitor. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). Three sub-scores of MoCA, visuoexecutive function, attention and delayed recall, were also analyzed. Mean age was 54.8 (10.2) years. OSA was diagnosed in 123 participants (76.9%). Mean sleep duration was 6.0 (1.0) h and sleep efficiency was 82.7 (8.1) %. Sleep duration and OSA severity were not related to MoCA scores. Higher sleep efficiency was associated with higher MoCA scores (p = 0.003), and having diabetes (vs. prediabetes) was associated with lower MoCA scores (p = 0.001). After adjusting covariates, both having diabetes (vs. prediabetes) (B = - 1.137, p = 0.002) and sleep efficiency (B = 0.085, p < 0.001) were independently associated with MoCA scores. In addition, diabetes (B = - 0.608, p < 0.001) and sleep efficiency (B = 0.038, p < 0.001) were associated with visuoexecutive function. Sleep parameters were not related to delayed recall or attention scores. Lower sleep efficiency is independently associated with lower cognitive function in patients with abnormal glucose tolerance. Whether sleep optimization may improve cognitive function in these patients should be explored.

Association of Cognitive Function and Risk for Elder Abuse in a Community-Dwelling Population

PubMed Central

Dong, XinQi; Simon, Melissa; Rajan, Kumar; Evans, Denis A.

2011-01-01

Aim This study aimed to examine the cross-sectional association between cognitive function and elder abuse. Methods The Chicago Health and Aging Project (CHAP) is a population-based study conducted in a geographically defined community (n = 8,932). We identified 238 CHAP participants who had elder abuse reported to a social services agency. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), the Symbol Digit Modalities Test (perceptual speed), and both immediate and delayed recall of the East Boston Memory Test (episodic memory). An index of global cognitive function scores was derived by averaging the z-scores of all tests. Logistic regression models were used to assess the association of cognitive function domains and risk of elder abuse. Results After adjusting for confounders, lowest tertiles of global cognition (odd's ratio, OR 4.18, 95% confidence interval, 95% CI 2.44–7.15), MMSE (OR 2.97, 95% CI 1.93–4.57), episodic memory (OR 2.27, 95% CI 1.49–3.43) and perceptual speed (OR 2.37, 95% CI 1.51–3.73) were associated with increased risk of elder abuse. The lowest levels of global cognitive function were associated with an increased risk of physical abuse (OR 3.56, 95% CI 1.08–11.67), emotional abuse (OR 3.02, 95% CI 1.41–6.44), caregiver neglect (OR 6.24, 95% CI 2.68–14.54), and financial exploitation (OR 3.71, 95% CI 1.88–7.32). Conclusion Lower levels of global cognitive function, MMSE, episodic memory and perceptual speed are associated with an increased risk of elder abuse. PMID:22095098

Impact of poor sleep quality and physical inactivity on cognitive function in community-dwelling older adults.

PubMed

Nakakubo, Sho; Makizako, Hyuma; Doi, Takehiko; Tsutsumimoto, Kota; Lee, Sangyoon; Lee, Sungchul; Hotta, Ryo; Bae, Seongryu; Suzuki, Takao; Shimada, Hiroyuki

2017-11-01

The purpose of the present study was to examine whether the combination of subjective sleep quality and physical activity is associated with cognitive performance among community-dwelling older adults. Cross-sectional data on 5381 older adults who participated in part of the National Center for Geriatrics and Gerontology - Study of Geriatric Syndromes were analyzed. We assessed general cognitive impairment using the Mini-Mental State Examination, and also assessed story memory, attention, executive function and processing speed using the National Center for Geriatrics and Gerontology Functional Assessment Tool. Physical activity was assessed using two questionnaires, and participants were categorized as active or inactive. Sleep quality was assessed using the Pittsburgh Sleep Quality Index, and participants were categorized as having poor (PS) or good sleep quality (GS). Participants in the inactive + PS group had worse performances than those in the active + GS group in all cognitive measures (Mini-Mental State Examination: P = 0.008, story memory: P = 0.007, other cognitive measures: P < 0.001), and also had worse performances than those in the inactive + GS and active + PS groups in the trail-making test, part B, and the symbol digit substitution test (P < 0.001, respectively). Additionally, participants in the inactive + GS group had worse performances than in the active + GS in the trail-making test, part B, and the symbol digit substitution test (P = 0.002 and P = 0.001, respectively). Inactivity and poor sleep quality were associated with poor cognitive performance among community-dwelling older adults. The combination of poor sleep quality and physical inactivity also worsened cognitive performance. Geriatr Gerontol Int 2017; 17: 1823-1828. © 2017 Japan Geriatrics Society.

Beneficial effects of reading aloud and solving simple arithmetic calculations (learning therapy) on a wide range of cognitive functions in the healthy elderly: study protocol for a randomized controlled trial

PubMed Central

2012-01-01

Background Almost all cognitive functions decline with age. Results of previous studies have shown that cognitive training related to everyday life (reading aloud and solving simple arithmetic calculations), namely learning therapy, can improve two cognitive function (executive functions and processing speed) in elderly people. However, it remains unclear whether learning therapy engenders improvement of various cognitive functions or not. We investigate the impact of learning therapy on various cognitive functions (executive functions, episodic memory, short-term memory, working memory, attention, reading ability, and processing speed) in healthy older adults. Methods We use a single-blinded intervention with two parallel groups (a learning therapy group and a waiting list control group). Testers are blind to the study hypothesis and the group membership of participants. Through an advertisement in local newspaper, 64 healthy older adults are recruited. They will be assigned randomly to a learning therapy group or a waiting list control group. In the learning therapy group, participants are required to perform two cognitive tasks for 6 months: reading Japanese aloud and solving simple calculations. The waiting list group does not participate in the intervention. The primary outcome measure is the Stroop test score: a measure of executive function. Secondary outcome measures are assessments including the following: verbal fluency task, logical memory, first and second names, digit span forward, digit span backward, Japanese reading test, digit cancellation task, digit symbol coding, and symbol search. We assess these outcome measures before and after the intervention. Discussion This report is the first study which investigates the beneficial effects of learning therapy on a wide range of cognitive functions of elderly people. Our study provides sufficient evidence of learning therapy effectiveness. Most cognitive functions, which are correlated strongly with daily life activities, decrease with age. These study results can elucidate effects of cognitive training on elderly people. Trial registration This trial was registered in The University Hospital Medical Information Network Clinical Trials Registry (No. UMIN000006998). PMID:22483196

Beneficial effects of reading aloud and solving simple arithmetic calculations (learning therapy) on a wide range of cognitive functions in the healthy elderly: study protocol for a randomized controlled trial.

PubMed

Nouchi, Rui; Taki, Yasuyuki; Takeuchi, Hikaru; Hashizume, Hiroshi; Nozawa, Takayuki; Sekiguchi, Atsushi; Nouchi, Haruka; Kawashima, Ryuta

2012-04-06

Almost all cognitive functions decline with age. Results of previous studies have shown that cognitive training related to everyday life (reading aloud and solving simple arithmetic calculations), namely learning therapy, can improve two cognitive function (executive functions and processing speed) in elderly people. However, it remains unclear whether learning therapy engenders improvement of various cognitive functions or not. We investigate the impact of learning therapy on various cognitive functions (executive functions, episodic memory, short-term memory, working memory, attention, reading ability, and processing speed) in healthy older adults. We use a single-blinded intervention with two parallel groups (a learning therapy group and a waiting list control group). Testers are blind to the study hypothesis and the group membership of participants. Through an advertisement in local newspaper, 64 healthy older adults are recruited. They will be assigned randomly to a learning therapy group or a waiting list control group. In the learning therapy group, participants are required to perform two cognitive tasks for 6 months: reading Japanese aloud and solving simple calculations. The waiting list group does not participate in the intervention. The primary outcome measure is the Stroop test score: a measure of executive function. Secondary outcome measures are assessments including the following: verbal fluency task, logical memory, first and second names, digit span forward, digit span backward, Japanese reading test, digit cancellation task, digit symbol coding, and symbol search. We assess these outcome measures before and after the intervention. This report is the first study which investigates the beneficial effects of learning therapy on a wide range of cognitive functions of elderly people. Our study provides sufficient evidence of learning therapy effectiveness. Most cognitive functions, which are correlated strongly with daily life activities, decrease with age. These study results can elucidate effects of cognitive training on elderly people. This trial was registered in The University Hospital Medical Information Network Clinical Trials Registry (No. UMIN000006998).

Cognitive assessment: A challenge for occupational therapists in Brazil

PubMed Central

Conti, Juliana

2017-01-01

Cognitive impairment is a common dysfunction after neurological injury. Cognitive assessment tools can help the therapist understand how impairments are affecting functional status and quality of life. Objective The aim of the study was to identify instruments for cognitive assessment that Occupational Therapists (OT) can use in clinical practice. Methods The instruments published in English and Portuguese between 1999 and 2016 were systematically reviewed. Results The search identified 17 specific instruments for OT not validated in Brazilian Portuguese, 10 non-specific instruments for OT not validated in Brazilian Portuguese, and 25 instruments validated for Portuguese, only one of which was specific for OT (Lowenstein Occupational Therapy Cognitive Assessment). Conclusion There are few assessment cognitive tools validated for use in the Brazilian culture and language. The majority of the instruments appear not to be validated for use by OT in clinical practice. PMID:29213503

Functional and physical abilities in the early continuum of cognitive decline.

PubMed

Shin, Joon-Ho; Lim, Jae-Young; Kim, Ki Woong; Kim, Suyoung; Lee, Jaebong; Paik, Nam-Jong

2015-01-01

The early cognitive continuum has been emphasized recently. We sought to characterize the functional and physical aspects of the cognitive continuum in subjects with no cognitive impairment (NCI), subjective cognitive impairment (SCI), nonamnestic (NA-MCI), and amnestic mild cognitive impairment (A-MCI). Furthermore, we identified the potential diagnostic utility of specific functional tasks. A total of 702 participants, aged ≥65 years and defined as NCI, SCI, NA-MCI, and A-MCI according to the original Petersen criteria, were included. They completed the Korean basic (K-ADL) and Instrumental Activities of Daily Living Scales (K-IADL) and the Performance-Oriented Mobility Assessment (POMA). Significant differences were observed between the different cognitive status groups in three items and total scores on the K-ADL, six items and total scores on the K-IADL and POMA. Controlling for confounding factors revealed that subjects from the A-MCI group performed poorly at bathing, shopping, handling money, and the sum of assorted functional items. These findings demonstrated the declining feature of functional and physical performance according to the cognitive continuum, with A-MCI being discriminative with respect to specific functional tasks as compared to milder cognitive statuses. © 2014 S. Karger AG, Basel.

A protocol for a randomized clinical trial of interactive video dance: potential for effects on cognitive function

PubMed Central

2012-01-01

Background Physical exercise has the potential to affect cognitive function, but most evidence to date focuses on cognitive effects of fitness training. Cognitive exercise also may influence cognitive function, but many cognitive training paradigms have failed to provide carry-over to daily cognitive function. Video games provide a broader, more contextual approach to cognitive training that may induce cognitive gains and have carry over to daily function. Most video games do not involve physical exercise, but some novel forms of interactive video games combine physical activity and cognitive challenge. Methods/Design This paper describes a randomized clinical trial in 168 postmenopausal sedentary overweight women that compares an interactive video dance game with brisk walking and delayed entry controls. The primary endpoint is adherence to activity at six months. Additional endpoints include aspects of physical and mental health. We focus this report primarily on the rationale and plans for assessment of multiple cognitive functions. Discussion This randomized clinical trial may provide new information about the cognitive effects of interactive videodance. It is also the first trial to examine physical and cognitive effects in older women. Interactive video games may offer novel strategies to promote physical activity and health across the life span. The study is IRB approved and the number is: PRO08080012 ClinicalTrials.gov Identifier: NCT01443455 PMID:22672287

The association between cognitive deficits and prefrontal hemodynamic responses during performance of working memory task in patients with schizophrenia.

PubMed

Pu, Shenghong; Nakagome, Kazuyuki; Itakura, Masashi; Iwata, Masaaki; Nagata, Izumi; Kaneko, Koichi

2016-04-01

Schizophrenia-associated cognitive deficits are resistant to treatment and thus pose a lifelong burden. The Brief Assessment of Cognition in Schizophrenia (BACS) provides reliable and valid assessments across cognitive domains. However, because the prefrontal functional abnormalities specifically associated with the level of cognitive deficits in schizophrenia have not been examined, we explored this relationship. Patients with schizophrenia (N=87) and matched healthy controls (N=50) participated in the study. Using near-infrared spectroscopy (NIRS), we measured the hemodynamic responses in the prefrontal and superior temporal cortical surface areas during a working memory task. Correlation analyses revealed a relationship between the hemodynamics and the BACS composite and domain scores. Hemodynamic responses of the left dorsolateral prefrontal cortex (DLPFC) and left frontopolar cortex (FPC) in the higher-level-of-cognitive-function schizophrenia group were weaker than the responses of the controls but similar to those of the lower-level-of-cognitive-function schizophrenia group. However, hemodynamic responses in the right DLPFC, bilateral ventrolateral PFC (VLPFC), and right temporal regions decreased with increasing cognitive deficits. In addition, the hemodynamic response correlated positively with the level of cognitive function (BACS composite scores) in the right DLPFC, bilateral VLPFC, right FPC, and bilateral temporal regions in schizophrenia. The correlation was driven by all BACS domains. Our results suggest that the linked functional deficits in the right DLPFC, bilateral VLPFC, right FPC, and bilateral temporal regions may be related to BACS-measured cognitive impairments in schizophrenia and show that linking the neurocognitive deficits and brain abnormalities can increase our understanding of schizophrenia pathophysiology. Copyright © 2015 Elsevier B.V. All rights reserved.

Midlife sleep characteristics associated with late life cognitive function.

PubMed

Virta, Jyri J; Heikkilä, Kauko; Perola, Markus; Koskenvuo, Markku; Räihä, Ismo; Rinne, Juha O; Kaprio, Jaakko

2013-10-01

Previous studies with limited follow-up times have suggested that sleep-related traits are associated with an increased risk of incident dementia or cognitive decline. We investigated the association between midlife sleep characteristics and late life cognitive function. A follow-up study with a median follow-up time of 22.5 (range 15.8-25.7) years assessing the association between midlife sleep characteristics and later cognitive function. Questionnaire data from 1981 were used in the assessment of sleep characteristics, use of hypnotics, and covariates at baseline. Between 1999 and 2007, participants were assigned a linear cognitive score with a maximum score of 51 based on a telephone interview (mean score 38.3, SD 6.1). Linear regression analyses were controlled for age, sex, education, ApoE genotype, and follow-up time. 2,336 members of the Finnish Twin cohort who were at least 65 years of age. N/A. Baseline short (< 7 h/day) and long (> 8 h/day) sleepers had lower cognitive scores than participants sleeping 7-8 h/ day (β = -0.84, P = 0.014 and β = -1.66, P < 0.001, respectively). As compared to good sleep quality, poor or rather poor sleep quality was associated with a lower cognitive score (β = -1.00, P = 0.011). Also, the use of hypnotics ≥ 60 days per year was associated with poorer cognitive function (β = -1.92, P = 0.002). This is the first study indicating that midlife sleep length, sleep quality, and use of hypnotics are associated with late life cognitive function. Further confirmation is needed, but sleep-related characteristics may emerge as new risk factors for cognitive impairment.

Effect of six months of treatment with V0191 in patients with suspected prodromal Alzheimer's disease.

PubMed

Dubois, Bruno; Zaim, Mohammed; Touchon, Jacques; Vellas, Bruno; Robert, Philippe; Murphy, Michael F; Pujadas-Navinés, Francesc; Rainer, Michael; Soininen, Hilkka; Riordan, Henry J; Kanony-Truc, Claire

2012-01-01

New criteria related to prodromal Alzheimer's disease (AD) have been proposed to overcome the issue of heterogeneity of patients with mild cognitive impairment (MCI) and to better define patients in early stage AD. Only few therapeutic trials, if any, have been reported using this newly defined population. The objective of this study was to assess the clinical efficacy and safety of a novel pro-cholinergic drug (V0191) in patients with prodromal AD. Two hundred forty two (242) patients with a diagnosis of prodromal AD were randomized in an approximately 1 : 1 ratio to receive either 1500 mg V0191 or matching placebo once daily for 24 weeks. Changes in global cognitive functioning were assessed using the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-cog; responder rate as primary efficacy measure). Standardized measures of memory, executive function, attention, functional capacity, and apathy were also obtained. Despite some interesting trends at week 12 and conversion rates favoring V0191, no statistically significant differences in cognitive function between V0191 and placebo were noted. In addition to the absence of drug efficacy on this population, several design features may have hindered this study, including insufficient powering to assess changes in cognition over time, a relatively short duration of treatment, and the lack of validated clinical trial measures designed to assess the prodromal AD population. Lessons learned in AD study design optimization, including those presented in this paper, could be valuable for further investigation with pro-cholinergic drugs such as V0191.

Attention and executive functions in the early course of pediatric epilepsy.

PubMed

Reuner, Gitta; Kadish, Navah Esther; Doering, Jan Henje; Balke, Doreen; Schubert-Bast, Susanne

2016-07-01

Our prospective study aimed at exploring attention and executive functions in children with new-onset epilepsy prior to and during the early course of antiepileptic treatment. Sociodemographic and epilepsy-related factors were analyzed as potential predictors both of impaired cognitive functions as well as for changes in cognitive functioning in the early course of illness. From a total group of 115 children aged six to 17years without major disabilities, 76 children were assessed longitudinally with a screening tool for attention and executive functions (EpiTrack Junior®). Sociodemographic variables (gender, age at epilepsy onset, need of special education) and epilepsy-related variables (etiology of epilepsy, semiology of seizures, number of seizures) were considered as potential predictors for impaired functions prior to treatment and for deterioration/amelioration in cognitive functions in the early course. Attention and executive functions of children with new-onset epilepsy were significantly more often impaired when compared with a healthy population, but less often when compared with children with chronic epilepsy. The majority of children showed stable cognitive functioning in the early course of treatment. The risk of impaired cognitive functions was significantly heightened when etiology of epilepsy was unknown or not classifiable. The chance for improvement of functioning was lowered by having a genetic epilepsy, or an unknown semiology of seizures. Children with new-onset epilepsy are at high risk for impaired attention and executive functions even prior to antiepileptic treatment, especially when etiology of their epilepsy remains unclear. The high stability of cognitive functioning in the early course can be used in counseling of families who worry about negative side effects of drug treatment. Finally, a systematic assessment of cognitive functions in children with new-onset epilepsy is necessary to detect subtle deficits in the early course and adjust treatment accordingly. Copyright © 2016 Elsevier Inc. All rights reserved.

Assessment of Cognitive Function in the Water Maze Task: Maximizing Data Collection and Analysis in Animal Models of Brain Injury.

PubMed

Whiting, Mark D; Kokiko-Cochran, Olga N

2016-01-01

Animal models play a critical role in understanding the biomechanical, pathophysiological, and behavioral consequences of traumatic brain injury (TBI). In preclinical studies, cognitive impairment induced by TBI is often assessed using the Morris water maze (MWM). Frequently described as a hippocampally dependent spatial navigation task, the MWM is a highly integrative behavioral task that requires intact functioning in numerous brain regions and involves an interdependent set of mnemonic and non-mnemonic processes. In this chapter, we review the special considerations involved in using the MWM in animal models of TBI, with an emphasis on maximizing the degree of information extracted from performance data. We include a theoretical framework for examining deficits in discrete stages of cognitive function and offer suggestions for how to make inferences regarding the specific nature of TBI-induced cognitive impairment. The ultimate goal is more precise modeling of the animal equivalents of the cognitive deficits seen in human TBI.

Predicting functional ability in mild cognitive impairment with the Dementia Rating Scale-2.

PubMed

Greenaway, Melanie C; Duncan, Noah L; Hanna, Sherrie; Smith, Glenn E

2012-06-01

We examined the utility of cognitive evaluation to predict instrumental activities of daily living (IADLs) and decisional ability in Mild Cognitive Impairment (MCI). Sixty-seven individuals with single-domain amnestic MCI were administered the Dementia Rating Scale-2 (DRS-2) as well as the Everyday Cognition assessment form to assess functional ability. The DRS-2 Total Scores and Initiation/Perseveration and Memory subscales were found to be predictive of IADLs, with Total Scores accounting for 19% of the variance in IADL performance on average. In addition, the DRS-2 Initiation/Perseveration and Total Scores were predictive of ability to understand information, and the DRS-2 Conceptualization helped predict ability to communicate with others, both key variables in decision-making ability. These findings suggest that performance on the DRS-2, and specific subscales related to executive function and memory, is significantly related to IADLs in individuals with MCI. These cognitive measures are also associated with decision-making-related abilities in MCI.

Brain Morphology Links Systemic Inflammation to Cognitive Function in Midlife Adults

PubMed Central

Marsland, Anna L.; Gianaros, Peter J.; Kuan, Dora C-H.; Sheu, Lei K.; Krajina, Katarina; Manuck, Stephen B.

2015-01-01

Background Inflammation is linked to cognitive decline in midlife, but the neural basis for this link is unclear. One possibility is that inflammation associates with adverse changes in brain morphology, which accelerates cognitive aging and later dementia risk. Clear evidence is lacking, however, regarding whether inflammation relates to cognition in midlife via changes in brain morphology. Accordingly, the current study examines whether associations of inflammation with cognitive function are mediated by variation in cortical gray matter volume among midlife adults. Methods Plasma levels of interleukin (IL)-6 and C-reactive protein (CRP), relatively stable markers of peripheral systemic inflammation, were assessed in 408 community volunteers aged 30–54 years. All participants underwent structural neuroimaging to assess global and regional brain morphology and completed neuropsychological tests sensitive to early changes in cognitive function. Measurements of brain morphology (regional tissue volumes and cortical thickness and surface area) were derived using Freesurfer. Results Higher peripheral inflammation was associated with poorer spatial reasoning, short term memory, verbal proficiency, learning and memory, and executive function, as well as lower cortical gray and white matter volumes, hippocampal volume and cortical surface area. Mediation models with age, sex and intracranial volume as covariates showed cortical gray matter volume to partially mediate the association of inflammation with cognitive performance. Exploratory analyses of body mass suggested that adiposity may be a source of the inflammation linking brain morphology to cognition. Conclusions Inflammation and adiposity might relate to cognitive decline via influences on brain morphology. PMID:25882911

Blood Pressure Variability and Cognitive Function Among Older African Americans: Introducing a New Blood Pressure Variability Measure.

PubMed

Tsang, Siny; Sperling, Scott A; Park, Moon Ho; Helenius, Ira M; Williams, Ishan C; Manning, Carol

2017-09-01

Although blood pressure (BP) variability has been reported to be associated with cognitive impairment, whether this relationship affects African Americans has been unclear. We sought correlations between systolic and diastolic BP variability and cognitive function in community-dwelling older African Americans, and introduced a new BP variability measure that can be applied to BP data collected in clinical practice. We assessed cognitive function in 94 cognitively normal older African Americans using the Mini-Mental State Examination (MMSE) and the Computer Assessment of Mild Cognitive Impairment (CAMCI). We used BP measurements taken at the patients' three most recent primary care clinic visits to generate three traditional BP variability indices, range, standard deviation, and coefficient of variation, plus a new index, random slope, which accounts for unequal BP measurement intervals within and across patients. MMSE scores did not correlate with any of the BP variability indices. Patients with greater diastolic BP variability were less accurate on the CAMCI verbal memory and incidental memory tasks. Results were similar across the four BP variability indices. In a sample of cognitively intact older African American adults, BP variability did not correlate with global cognitive function, as measured by the MMSE. However, higher diastolic BP variability correlated with poorer verbal and incidental memory. By accounting for differences in BP measurement intervals, our new BP variability index may help alert primary care physicians to patients at particular risk for cognitive decline.

Peak oxygen uptake and left ventricular ejection fraction, but not depressive symptoms, are associated with cognitive impairment in patients with chronic heart failure.

PubMed

Steinberg, Gerrit; Lossnitzer, Nicole; Schellberg, Dieter; Mueller-Tasch, Thomas; Krueger, Carsten; Haass, Markus; Ladwig, Karl Heinz; Herzog, Wolfgang; Juenger, Jana

2011-01-01

The aim of the present study was to assess cognitive impairment in patients with chronic heart failure (CHF) and its associations with depressive symptoms and somatic indicators of illness severity, which is a matter of controversy. Fifty-five patients with CHF (mean age 55.3 ± 7.8 years; 80% male; New York Heart Association functional class I-III) underwent assessment with an expanded neuropsychological test battery (eg, memory, complex attention, mental flexibility, psychomotor speed) to evaluate objective and subjective cognitive impairment. Depressive symptoms were assessed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID) and a self-report inventory (Hospital Anxiety and Depression Scale [HADS]). A comprehensive clinical dataset, including left ventricular ejection fraction, peak oxygen uptake, and a 6-minute walk test, was obtained for all patients. Neuropsychological functioning revealed impairment in 56% of patients in at least one measure of our neuropsychological test battery. However, the Mini Mental State Examination (MMSE) could only detect cognitive impairment in 1.8% of all patients, 24% had HADS scores indicating depressive symptoms, and 11.1% met SCID criteria for a depressive disorder. No significant association was found between depressive symptoms and cognitive impairment. Left ventricular ejection fraction was related to subjective cognitive impairment, and peak oxygen uptake was related to objective cognitive impairment. Cognitive functioning was substantially reduced in patients with CHF and should therefore be diagnosed and treated in routine clinical practice. Caution is advised when the MMSE is used to identify cognitive impairment in patients with CHF.

Objectively Measured Physical Activity and Cognitive Function in Older Adults.

PubMed

Zhu, Wenfei; Wadley, Virginia G; Howard, Virginia J; Hutto, Brent; Blair, Steven N; Hooker, Steven P

2017-01-01

Emerging evidence suggests physical activity (PA) is associated with cognitive function. To overcome limitations of self-report PA measures, this study investigated the association of accelerometer-measured PA with incident cognitive impairment and longitudinal cognition among older adults. Participants were recruited from the cohort study Reasons for Geographic and Racial Differences in Stroke in the United States. Accelerometers provided PA measures, including the percentage of total accelerometer wearing time spent in moderate-to-vigorous-intensity PA (MVPA%), light-intensity PA, and sedentary time for four to seven consecutive days at baseline. Cognitive impairment was defined by the Six-Item Screener. Letter fluency, animal fluency, word list learning, and Montreal Cognitive Assessment (orientation and recall) were conducted to assess executive function and memory. Participants (N = 6452, 69.7 ± 8.5 yr, 55.3% women, 30.5% Black) with usable accelerometer and cognition measures spent extremely limited time in MVPA (1.5% ± 1.9% of accelerometer wearing time). During an average of 3 yr of follow-up, 346 cases of incident cognitive impairment were observed. After adjustments, participants in higher MVPA% quartiles had a lower risk of cognitive impairment (i.e., quartile 2: odds ratio = 0.64, 95% confidence interval = 0.48-0.84) and better maintenance in executive function (≥0.03 z-score units) and memory (≥0.12 z-score units) compared with quartile 1 (P < 0.05). Stratified analyses showed the same association among White adults, but higher MVPA% was associated with better maintenance of only memory among Black adults. No significance was found for light-intensity PA or sedentary time. There was a dose-response relationship between MVPA% and cognitive function in older adults, with higher levels associated with a 36% or lower risk of cognitive impairment and better maintenance of memory and executive function over time, particularly in White adults.

Association Between Montreal Cognitive Assessment Scores and Measures of Functional Mobility in Lower Extremity Amputees After Inpatient Rehabilitation.

PubMed

Frengopoulos, Courtney; Burley, Joshua; Viana, Ricardo; Payne, Michael W; Hunter, Susan W

2017-03-01

To determine whether scores on a cognitive measure are associated with walking endurance and functional mobility of individuals with transfemoral or transtibial amputations at discharge from inpatient prosthetic rehabilitation. Retrospective cohort study. Rehabilitation hospital. Consecutive admissions (N=176; mean age ± SD, 64.27±13.23y) with transfemoral or transtibial amputation that had data at admission and discharge from an inpatient prosthetic rehabilitation program. Not applicable. Cognitive status was assessed using the Montreal Cognitive Assessment (MoCA). The L Test and the 2-minute walk test (2MWT) were used to estimate functional mobility and walking endurance. The mean ± SD MoCA score was 24.05±4.09 (range, 6-30), and 56.3% of patients had scores <26. MoCA scores had a small positive correlation with the 2MWT (r=.29, P<.01), and a small negative correlation to the L Test (r=-.24, P<.01). In multivariable linear regression, compared with people with the highest MoCA score quartile, there was no difference on the 2MWT, but people in the lowest 2 quartiles took longer to complete the L Test. Cognitive impairment was very prevalent. The association between MoCA and functional mobility was statistically significant. These results highlight the potential for differences on complex motor tasks for individuals with cognitive impairment but does not indicate a need to exclude them from rehabilitation on the basis of cognitive impairment alone. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Neural activity during emotion recognition after combined cognitive plus social cognitive training in schizophrenia.

PubMed

Hooker, Christine I; Bruce, Lori; Fisher, Melissa; Verosky, Sara C; Miyakawa, Asako; Vinogradov, Sophia

2012-08-01

Cognitive remediation training has been shown to improve both cognitive and social cognitive deficits in people with schizophrenia, but the mechanisms that support this behavioral improvement are largely unknown. One hypothesis is that intensive behavioral training in cognition and/or social cognition restores the underlying neural mechanisms that support targeted skills. However, there is little research on the neural effects of cognitive remediation training. This study investigated whether a 50 h (10-week) remediation intervention which included both cognitive and social cognitive training would influence neural function in regions that support social cognition. Twenty-two stable, outpatient schizophrenia participants were randomized to a treatment condition consisting of auditory-based cognitive training (AT) [Brain Fitness Program/auditory module ~60 min/day] plus social cognition training (SCT) which was focused on emotion recognition [~5-15 min per day] or a placebo condition of non-specific computer games (CG) for an equal amount of time. Pre and post intervention assessments included an fMRI task of positive and negative facial emotion recognition, and standard behavioral assessments of cognition, emotion processing, and functional outcome. There were no significant intervention-related improvements in general cognition or functional outcome. fMRI results showed the predicted group-by-time interaction. Specifically, in comparison to CG, AT+SCT participants had a greater pre-to-post intervention increase in postcentral gyrus activity during emotion recognition of both positive and negative emotions. Furthermore, among all participants, the increase in postcentral gyrus activity predicted behavioral improvement on a standardized test of emotion processing (MSCEIT: Perceiving Emotions). Results indicate that combined cognition and social cognition training impacts neural mechanisms that support social cognition skills. Copyright © 2012 Elsevier B.V. All rights reserved.

Neural activity during emotion recognition after combined cognitive plus social-cognitive training in schizophrenia

PubMed Central

Hooker, Christine I.; Bruce, Lori; Fisher, Melissa; Verosky, Sara C.; Miyakawa, Asako; Vinogradov, Sophia

2012-01-01

Cognitive remediation training has been shown to improve both cognitive and social-cognitive deficits in people with schizophrenia, but the mechanisms that support this behavioral improvement are largely unknown. One hypothesis is that intensive behavioral training in cognition and/or social-cognition restores the underlying neural mechanisms that support targeted skills. However, there is little research on the neural effects of cognitive remediation training. This study investigated whether a 50 hour (10-week) remediation intervention which included both cognitive and social-cognitive training would influence neural function in regions that support social-cognition. Twenty-two stable, outpatient schizophrenia participants were randomized to a treatment condition consisting of auditory-based cognitive training (AT) [Brain Fitness Program/auditory module ~60 minutes/day] plus social-cognition training (SCT) which was focused on emotion recognition [~5–15 minutes per day] or a placebo condition of non-specific computer games (CG) for an equal amount of time. Pre and post intervention assessments included an fMRI task of positive and negative facial emotion recognition, and standard behavioral assessments of cognition, emotion processing, and functional outcome. There were no significant intervention-related improvements in general cognition or functional outcome. FMRI results showed the predicted group-by-time interaction. Specifically, in comparison to CG, AT+SCT participants had a greater pre-to-post intervention increase in postcentral gyrus activity during emotion recognition of both positive and negative emotions. Furthermore, among all participants, the increase in postcentral gyrus activity predicted behavioral improvement on a standardized test of emotion processing (MSCEIT: Perceiving Emotions). Results indicate that combined cognition and social-cognition training impacts neural mechanisms that support social-cognition skills. PMID:22695257

Skin picking disorder with co-occurring body dysmorphic disorder.

PubMed

Grant, Jon E; Redden, Sarah A; Leppink, Eric W; Odlaug, Brian L

2015-09-01

There is clinical overlap between skin picking disorder (SPD) and body dysmorphic disorder (BDD), but little research has examined clinical and cognitive correlates of the two disorders when they co-occur. Of 55 participants with SPD recruited for a neurocognitive study and two pharmacological studies, 16 (29.1%) had co-occurring BDD. SPD participants with and without BDD were compared to each other and to 40 healthy volunteers on measures of symptom severity, social functioning, and cognitive assessments using the Stop-signal task (assessing response impulsivity) and the Intra-dimensional/Extra-dimensional Set Shift task (assessing cognitive flexibility). Individuals with SPD and BDD exhibited significantly worse picking, significantly worse overall psychosocial functioning, and significantly greater dysfunction on aspects of cognitive flexibility. These results indicate that when SPD co-occurs with BDD unique clinical and cognitive aspects of SPD may be more pronounced. Future work should explore possible subgroups in SPD and whether these predict different treatment outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.

Physical Activity Is Positively Associated with Episodic Memory in Aging

PubMed Central

Hayes, Scott M.; Alosco, Michael L.; Hayes, Jasmeet P.; Cadden, Margaret; Peterson, Kristina M.; Allsup, Kelly; Forman, Daniel E.; Sperling, Reisa A.; Verfaellie, Mieke

2016-01-01

Aging is associated with performance reductions in executive function and episodic memory, although there is substantial individual variability in cognition among older adults. One factor that may be positively associated with cognition in aging is physical activity. To date, few studies have objectively assessed physical activity in young and older adults, and examined whether physical activity is differentially associated with cognition in aging. Young (n = 29, age 18–31 years) and older adults (n = 31, ages 55–82 years) completed standardized neuropsychological testing to assess executive function and episodic memory capacities. An experimental face-name relational memory task was administered to augment assessment of episodic memory. Physical activity (total step count and step rate) was objectively assessed using an accelerometer, and hierarchical regressions were used to evaluate relationships between cognition and physical activity. Older adults performed more poorly on tasks of executive function and episodic memory. Physical activity was positively associated with a composite measure of visual episodic memory and face-name memory accuracy in older adults. Physical activity associations with cognition were independent of sedentary behavior, which was negatively correlated with memory performance. Physical activity was not associated with cognitive performance in younger adults. Physical activity is positively associated with episodic memory performance in aging. The relationship appears to be strongest for face-name relational memory and visual episodic memory, likely attributable to the fact that these tasks make strong demands on the hippocampus. The results suggest that physical activity relates to cognition in older, but not younger adults. PMID:26581790

A 12-week randomized controlled trial of twice-daily intranasal oxytocin for social cognitive deficits in people with schizophrenia.

PubMed

Jarskog, L Fredrik; Pedersen, Cort A; Johnson, Jacqueline L; Hamer, Robert M; Rau, Shane W; Elliott, Tonya; Penn, David L

2017-07-01

Social cognition is impaired in people with schizophrenia and these deficits are strongly correlated with social functioning. Oxytocin is a hypothalamic peptide that contributes to maternal infant bonding and has diverse pro-social effects in adults. This study tested the hypothesis that 12weeks of intranasal oxytocin will improve social cognitive function in outpatients with schizophrenia and schizoaffective disorder. Sixty-eight eligible participants were randomized to oxytocin (24IU twice daily) or placebo. Social cognitive function was assessed using the Emotion Recognition-40, Brüne Theory of Mind, Reading the Mind in the Eyes test, Trustworthiness task and Ambiguous Intentions Hostility Questionnaire at baseline, 6weeks and 12weeks. In addition, social function was assessed using the Specific Levels of Functioning Scale and a role-play test, and psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS). Fifty-five participants completed the 12-week trial. The study found no evidence for a differential advantage of oxytocin over placebo on social cognition. Among secondary outcomes, there was a modest advantage for oxytocin over placebo on a component of social functioning, although there was also evidence that the placebo group outperformed the oxytocin group on the role-play task. No between-group differences emerged on measures of psychopathology in pre-specified comparisons, but oxytocin showed significant within-group reduction in PANSS negative symptoms and significant between-group improvement in negative symptoms in the schizophrenia subgroup. Further testing is needed to clarify whether oxytocin has therapeutic potential for social cognitive deficits and/or negative symptoms in people with schizophrenia. Copyright © 2017 Elsevier B.V. All rights reserved.

Carbohydrates for improving the cognitive performance of independent-living older adults with normal cognition or mild cognitive impairment.

PubMed

Ooi, Cheow Peng; Loke, Seng Cheong; Yassin, Zaitun; Hamid, Tengku-Aizan

2011-04-13

Mild cognitive impairment (MCI) is an intermediate state between normal cognition and dementia in which daily function is largely intact. This condition may present an opportunity for research into the prevention of dementia. Carbohydrate is an essential and easily accessible macronutrient which influences cognitive performance. A better understanding of carbohydrate-driven cognitive changes in normal cognition and mild cognitive impairment may suggest ways to prevent or reduce cognitive decline. To assess the effectiveness of carbohydrates in improving cognitive function in older adults. We searched ALOIS, the Cochrane Dementia and Cognitive Improvement Group Specialized Register on 22 June 2010 using the terms: carbohydrates OR carbohydrate OR monosaccharides OR disaccharides OR oligosaccharides OR polysaccharides OR CARBS. ALOIS contains records from all major healthcare databases (The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL, LILACS) as well as from many trial databases and grey literature sources. All randomised controlled trials (RCT) that have examined the efficacy of any form of carbohydrates in normal cognition and MCI. One review author selected and retrieved relevant articles for further assessment. The remaining authors independently assessed whether any of the retrieved trials should be included. Disagreements were resolved by discussion.  There is no suitable RCT of any form of carbohydrates involving independent-living older adults with normal cognition or mild cognitive impairment. There are no suitable RCTs on which to base any recommendations about the use of any form of carbohydrate for enhancing cognitive performance in older adults with normal cognition or mild cognitive impairment. More studies of many different carbohydrates are needed to tease out complex nutritional issues and further evaluate memory improvement.

Olfactory discrimination predicts cognitive decline among community-dwelling older adults

PubMed Central

Sohrabi, H R; Bates, K A; Weinborn, M G; Johnston, A N B; Bahramian, A; Taddei, K; Laws, S M; Rodrigues, M; Morici, M; Howard, M; Martins, G; Mackay-Sim, A; Gandy, S E; Martins, R N

2012-01-01

The presence of olfactory dysfunction in individuals at higher risk of Alzheimer's disease has significant diagnostic and screening implications for preventive and ameliorative drug trials. Olfactory threshold, discrimination and identification can be reliably recorded in the early stages of neurodegenerative diseases. The current study has examined the ability of various olfactory functions in predicting cognitive decline in a community-dwelling sample. A group of 308 participants, aged 46–86 years old, were recruited for this study. After 3 years of follow-up, participants were divided into cognitively declined and non-declined groups based on their performance on a neuropsychological battery. Assessment of olfactory functions using the Sniffin' Sticks battery indicated that, contrary to previous findings, olfactory discrimination, but not olfactory identification, significantly predicted subsequent cognitive decline (odds ratio=0.869; P<0.05; 95% confidence interval=0.764−0.988). The current study findings confirm previously reported associations between olfactory and cognitive functions, and indicate that impairment in olfactory discrimination can predict future cognitive decline. These findings further our current understanding of the association between cognition and olfaction, and support olfactory assessment in screening those at higher risk of dementia. PMID:22832962

Olfactory discrimination predicts cognitive decline among community-dwelling older adults.

PubMed

Sohrabi, H R; Bates, K A; Weinborn, M G; Johnston, A N B; Bahramian, A; Taddei, K; Laws, S M; Rodrigues, M; Morici, M; Howard, M; Martins, G; Mackay-Sim, A; Gandy, S E; Martins, R N

2012-05-22

The presence of olfactory dysfunction in individuals at higher risk of Alzheimer's disease has significant diagnostic and screening implications for preventive and ameliorative drug trials. Olfactory threshold, discrimination and identification can be reliably recorded in the early stages of neurodegenerative diseases. The current study has examined the ability of various olfactory functions in predicting cognitive decline in a community-dwelling sample. A group of 308 participants, aged 46-86 years old, were recruited for this study. After 3 years of follow-up, participants were divided into cognitively declined and non-declined groups based on their performance on a neuropsychological battery. Assessment of olfactory functions using the Sniffin' Sticks battery indicated that, contrary to previous findings, olfactory discrimination, but not olfactory identification, significantly predicted subsequent cognitive decline (odds ratio = 0.869; P<0.05; 95% confidence interval = 0.764-0.988). The current study findings confirm previously reported associations between olfactory and cognitive functions, and indicate that impairment in olfactory discrimination can predict future cognitive decline. These findings further our current understanding of the association between cognition and olfaction, and support olfactory assessment in screening those at higher risk of dementia.

Cognition, social cognition and functional disability in early-stage schizophrenia: A study from southern India.

PubMed

Kurtz, Matthew M; Gopal, Subhashini; John, Sujit; Thara, R

2018-04-24

In high-income countries a wealth of studies has revealed cognitive and social cognitive deficits in schizophrenia and a close relationship of these deficits to psychosocial functioning. Studies examining these illness features in middle and low-income countries are rare, particularly in early-stage samples. Sixty adult participants within 5 years of diagnosis with schizophrenia and 53 matched, healthy control were assessed with the MATRICS Consensus Cognitive Battery and the PEAT emotion identification task at study entry, and the WHODAS functioning scale one year later. Deficits on cognitive instruments ranged from d = 0.64-1.04 and were consistent with those reported in Western samples. Negative symptoms were linked to function longitudinally. Deficits in social cognitive skills and longitudinal links between cognition and functioning were not evident. These findings suggest a highly consistent magnitude of neurocognitive deficits in people with schizophrenia across widely varying cultures, but with limited evidence of social cognitive skill deficits using Western-based instruments. There was little evidence of a relationship between cognition and psychosocial disability in people with early-stage schizophrenia in this sample. Copyright © 2018 Elsevier B.V. All rights reserved.

Evaluation of Cognitive Functions in Iranian Children and Adolescents With Diabetes Mellitus.

PubMed

Pourabbasi, Ata; Tehrani-Doost, Mehdi; Ebrahimi Qavam, Soqra; Farzami, Jalal; Larijani, Bagher

2017-06-01

Diabetes in children and adolescents is a chronic condition with an expanding trend in the community. Several studies have shown cognitive dysfunctions are the most important side effects of diabetes among individuals of younger ages. Due to cultural differences and their impact on cognitive issues, the authors decided to assess the cognitive functions of Iranian children and adolescents with diabetes. Cognitive functions including memory, attention and executive functions were evaluated in 62 diabetic children and adolescents and healthy peers using CANTAB cognitive tests. Other data such as demographic, school performance and medical information were collected by questionnaires. Except in the case of few variables in RVP, SSP and SST, no significant difference exists between diabetic children and the control group in terms of different cognitive domains. But cognitive variables, especially in PRM, SWM and SOC test, has been shown to be deteriorated with increasing HbA1C values in serum levels. Diabetes has no impact on the cognitive functioning of children provided by maintaining a glycemic control. It is proposed that the adoption of appropriate parenting styles and family and social support can prevent cognitive changes in children with diabetes.

Modeling Deficits from Early Auditory Information Processing to Psychosocial Functioning in Schizophrenia

PubMed Central

Thomas, Michael L.; Green, Michael F.; Hellemann, Gerhard; Sugar, Catherine A.; Tarasenko, Melissa; Calkins, Monica E.; Greenwood, Tiffany A.; Gur, Raquel E.; Gur, Ruben C.; Lazzeroni, Laura C.; Nuechterlein, Keith H.; Radant, Allen D.; Seidman, Larry J.; Shiluk, Alexandra L.; Siever, Larry J.; Silverman, Jeremy M.; Sprock, Joyce; Stone, William S.; Swerdlow, Neal R.; Tsuang, Debby W.; Tsuang, Ming T.; Turetsky, Bruce I.; Braff, David L.; Light, Gregory A.

2017-01-01

Importance Neurophysiological measures of early auditory information processing (EAP) are used as endophenotypes in genomic studies and biomarkers in clinical intervention studies. Research in schizophrenia has established correlations among measures of EAP, cognition, clinical symptoms, and functional outcome. Clarifying these relationships by determining the pathways through which deficits in EAP affect functioning would suggest when and where to therapeutically intervene. Objective We sought to characterize the pathways from EAP to outcome and to estimate the extent to which enhancement of basic information processing might improve both cognition and psychosocial functioning in schizophrenia. Design Cross-sectional data were analyzed using structural equation modeling to examine the associations between EAP, cognition, negative symptoms, and functional outcome. Setting Participants were recruited from the community at five geographically distributed laboratories as part of the Consortium on the Genetics of Schizophrenia-2 (COGS-2). Participants This well-characterized cohort of schizophrenia patients (N = 1,415) underwent EAP and cognitive testing as well as thorough clinical and functional assessment. Main Outcome and Measures EAP was measured by mismatch negativity, P3a, and reorienting negativity. Cognition was measured by the Letter Number Span test and scales from the California Verbal Learning Test - Second Edition, the Wechsler Memory Scale Third Edition, and the Penn Computerized Neurocognitive Battery. Negative symptoms were measured by the Scale for the Assessment of Negative Symptoms. Functional outcome was measured by the Role Functioning Scale. Results EAP had a direct effect on cognition (β = 0.37, p < .001), cognition had a direct effect on negative symptoms (β = −0.16, p < .001), and both cognition (β = 0.26, p < .001) and experiential negative symptoms (β = −0.75, p < .001) had direct effects on functional outcome. Overall, EAP had a fully mediated effect on functional outcome, engaging general rather than modality-specific cognition, with separate pathways that either involved or bypassed negative symptoms. Conclusions and Relevance The data support a model where EAP deficits lead to poor functional outcome via impaired cognition and increased negative symptoms. Results can be used to help guide mechanistically informed, personalized treatments, and support the strategy of using EAP measures as surrogate endpoints in early stage pro-cognitive intervention studies. PMID:27926742

Assessing the association between homocysteine and cognition: reflections on Bradford Hill, meta-analyses, and causality.

PubMed

McCaddon, Andrew; Miller, Joshua W

2015-10-01

Hyperhomocysteinemia is a recognized risk factor for cognitive decline and incident dementia in older adults. Two recent reports addressed the cumulative epidemiological evidence for this association but expressed conflicting opinions. Here, the evidence is reviewed in relation to Sir Austin Bradford Hill's criteria for assessing "causality," and the latest meta-analysis of the effects of homocysteine-lowering on cognitive function is critically examined. The meta-analysis included 11 trials, collectively assessing 22,000 individuals, that examined the effects of B vitamin supplements (folic acid, vitamin B12, vitamin B6) on global or domain-specific cognitive decline. It concluded that homocysteine-lowering with B vitamin supplements has no significant effect on cognitive function. However, careful examination of the trials in the meta-analysis indicates that no conclusion can be made regarding the effects of homocysteine-lowering on cognitive decline, since the trials typically did not include individuals who were experiencing such decline. Further definitive trials in older adults experiencing cognitive decline are still urgently needed. © The Author(s) 2015. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Evaluation of a neuropsychological screen in an incarcerated population.

PubMed

Ball, Tabitha D; Pastore, Richard E; Sollman, Miriam J; Burright, Richard G; Donovick, Peter J

2009-08-01

The Brief Neuropsychological Cognitive Examination (BNCE) is a screening device designed to rapidly assess neuropsychological functioning. The availability of an effective and efficient screen for neuropsychological and/or cognitive disorders is an important concern within various settings such as correctional facilities, where there are likely to be large numbers of individuals in need of evaluation. In the current study the utility of the BNCE in detecting cognitive impairments among a clinical sample of incarcerated individuals was evaluated by comparing performance on this instrument to performance on measures of general cognitive functioning. Results indicate that the BNCE demonstrates some utility in its ability to determine those in need of further evaluation of cognitive functioning.

Smart Aging Platform for Evaluating Cognitive Functions in Aging: A Comparison with the MoCA in a Normal Population

PubMed Central

Bottiroli, Sara; Tassorelli, Cristina; Lamonica, Marialisa; Zucchella, Chiara; Cavallini, Elena; Bernini, Sara; Sinforiani, Elena; Pazzi, Stefania; Cristiani, Paolo; Vecchi, Tomaso; Tost, Daniela; Sandrini, Giorgio

2017-01-01

Background: Smart Aging is a Serious games (SGs) platform in a 3D virtual environment in which users perform a set of screening tests that address various cognitive skills. The tests are structured as 5 tasks of activities of daily life in a familiar environment. The main goal of the present study is to compare a cognitive evaluation made with Smart Aging with those of a classic standardized screening test, the Montreal Cognitive Assessment (MoCA). Methods: One thousand one-hundred thirty-one healthy adults aged between 50 and 80 (M = 64.3 ± 8.3) were enrolled in the study. They received a cognitive evaluation with the MoCA and the Smart Aging platform. Participants were grouped according to their MoCA global and specific cognitive domain (i.e., memory, executive functions, working memory, visual spatial elaboration, language, and orientation) scores and we explored differences among these groups in the Smart Aging indices. Results: One thousand eighty-six older adults (M = 64.0 ± 8.0) successfully completed the study and were stratified according to their MoCA score: Group 1 with MoCA < 27 (n = 360); Group 2 with 27 ≥ MoCA < 29 (n = 453); and Group 3 with MoCA ≥ 29 (n = 273). MoCA groups significantly differed in most of the Smart Aging indices considered, in particular as concerns accuracy (ps < 0.001) and time (ps < 0.001) for completing most of the platform tasks. Group 1 was outperformed by the other two Groups and was slower than them in these tasks, which were those supposed to assess memory and executive functions. In addition, significant differences across groups also emerged when considering the single cognitive domains of the MoCA and the corresponding performances in each Smart Aging task. In particular, this platform seems to be a good proxy for assessing memory, executive functions, working memory, and visual spatial processes. Conclusion: These findings demonstrate the validity of Smart Aging for assessing cognitive functions in normal aging. Future studies will validate this platform also in the clinical aging populations. PMID:29209200

Psychiatric disability as mediator of the neurocognition-functioning link in schizophrenia spectrum disorders: SEM analysis using the Evaluation of Cognitive Processes involved in Disability in Schizophrenia (ECPDS) scale.

PubMed

Roux, Paul; Urbach, Mathieu; Fonteneau, Sandrine; Berna, Fabrice; Brunel, Lore; Capdevielle, Delphine; Chereau, Isabelle; Dubreucq, Julien; Faget-Agius, Catherine; Fond, Guillaume; Leignier, Sylvain; Perier, Claire-Cécile; Richieri, Raphaëlle; Schneider, Priscille; Schürhoff, Franck; Tronche, Anne-Marie; Yazbek, Hanan; Zinetti-Bertschy, Anna; Passerieux, Christine; Brunet-Gouet, Eric

2018-06-22

The functional outcome in schizophrenia spectrum disorders is affected by multiple factors such as cognitive performance and clinical symptoms. Psychiatric disability may be another important determinant of functional outcome. The purpose of this study was to test whether schizophrenia symptoms and psychiatric disability mediated the association between cognition and functioning. Between April 2013 and July 2017, we included 108 community-dwelling adults with stable schizophrenia spectrum disorder in a multicenter study. Psychiatric disability was assessed with the Evaluation of Cognitive Processes involved in Disability in Schizophrenia (ECPDS) scale by relatives of patients. ECPDS focused on the broad array of motivational, neurocognitive, sociocognitive, and metacognitive impairments that result in activity restrictions. We used a battery of tests to assess seven cognition domains (processing speed, attention/vigilance, working, verbal and visual memory, reasoning and problem solving, and executive functioning) and cross-sectional structural equation modeling (SEM) for the mediation analyses. We estimated the one-year temporal stability of ECPDS scores in 45 participants. The model provided showed good fit and explained 43.9% of the variance in functioning. The effect of neurocognition on functioning was fully mediated by symptoms (proportion mediated: 36.5%) and psychiatric disability (proportion mediated: 31.3%). The ECPDS score had acceptable one-year temporal stability. The ECPDS scale has satisfactory psychometric properties, and shows significant convergence with neurocognition and functioning, suggesting a role for this tool in the routine evaluation of cognitive remediation needs. Our model validates psychiatric disability as a crucial step from cognitive impairment to restricted participation in life situations. Copyright © 2018 Elsevier B.V. All rights reserved.

The role of genes, intelligence, personality, and social engagement in cognitive performance in Klinefelter syndrome.

PubMed

Skakkebæk, Anne; Moore, Philip J; Pedersen, Anders Degn; Bojesen, Anders; Kristensen, Maria Krarup; Fedder, Jens; Laurberg, Peter; Hertz, Jens Michael; Østergaard, John Rosendahl; Wallentin, Mikkel; Gravholt, Claus Højbjerg

2017-03-01

The determinants of cognitive deficits among individuals with Klinefelter syndrome (KS) are not well understood. This study was conducted to assess the impact of general intelligence, personality, and social engagement on cognitive performance among patients with KS and a group of controls matched for age and years of education. Sixty-nine patients with KS and 69 controls were assessed in terms of IQ, NEO personality inventory, the Autism Spectrum Quotient (AQ) scale, and measures of cognitive performance reflecting working memory and executive function. Patients with KS performed more poorly on memory and executive-function tasks. Patients with KS also exhibited greater neuroticism and less extraversion, openness, and conscientiousness than controls. Memory deficits among patients with KS were associated with lower intelligence, while diminished executive functioning was mediated by both lower intelligence and less social engagement. Our results suggest that among patients with KS, memory deficits are principally a function of lower general intelligence, while executive-function deficits are associated with both lower intelligence and poorer social skills. This suggests a potential influence of social engagement on executive cognitive functioning (and/or vice-versa) among individuals with KS, and perhaps those with other genetic disorders. Future longitudinal research would be important to further clarify this and other issues discussed in this research.

Positive associations between physical and cognitive performance measures in fibromyalgia.

PubMed

Cherry, Barbara J; Zettel-Watson, Laura; Chang, Jennifer C; Shimizu, Renee; Rutledge, Dana N; Jones, C Jessie

2012-01-01

To investigate the associations between perceived physical function (self-report) and physical and cognitive performance (objective assessments) in persons with fibromyalgia (FM). Correlational study. Exercise testing laboratory in Southern California. Community-residing ambulatory adults meeting the American College of Rheumatology 1990 criteria for FM (N=68; mean age, 59.5y). Not applicable. Composite Physical Function scale, Senior Fitness Test (3 items), Fullerton Advanced Balance scale, 30-foot walk, Trail Making Test parts A and B, Digit Symbol Substitution Test, a composite score of these 3 cognitive measures, attention/executive function composite, processing speed composite, problem solving, inhibition, and episodic memory composite. Hierarchical regression analyses showed that after controlling for age and FM symptoms, better physical performance (based on assessments, not self-report) was associated with higher cognitive function in attention/executive function, processing speed, problem solving, and inhibition. Researchers should continue to investigate the relationship between physical and cognitive function in both clinical and nonclinical populations, as well as explore changes across time. Because physical activity has been associated with neural improvements, further research may identify whether particular mechanisms, such as neurogenesis, synaptogenesis, or changes in inflammatory marker levels, are involved. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Relating memory to functional performance in normal aging to dementia using hierarchical Bayesian cognitive processing models.

PubMed

Shankle, William R; Pooley, James P; Steyvers, Mark; Hara, Junko; Mangrola, Tushar; Reisberg, Barry; Lee, Michael D

2013-01-01

Determining how cognition affects functional abilities is important in Alzheimer disease and related disorders. A total of 280 patients (normal or Alzheimer disease and related disorders) received a total of 1514 assessments using the functional assessment staging test (FAST) procedure and the MCI Screen. A hierarchical Bayesian cognitive processing model was created by embedding a signal detection theory model of the MCI Screen-delayed recognition memory task into a hierarchical Bayesian framework. The signal detection theory model used latent parameters of discriminability (memory process) and response bias (executive function) to predict, simultaneously, recognition memory performance for each patient and each FAST severity group. The observed recognition memory data did not distinguish the 6 FAST severity stages, but the latent parameters completely separated them. The latent parameters were also used successfully to transform the ordinal FAST measure into a continuous measure reflecting the underlying continuum of functional severity. Hierarchical Bayesian cognitive processing models applied to recognition memory data from clinical practice settings accurately translated a latent measure of cognition into a continuous measure of functional severity for both individuals and FAST groups. Such a translation links 2 levels of brain information processing and may enable more accurate correlations with other levels, such as those characterized by biomarkers.

Correlation between the Quality of Attention and Cognitive Competence with Motor Action in Stroke Patients.

PubMed

Arsic, S; Konstantinovic, Lj; Eminovic, F; Pavlovic, D; Popovic, M B; Arsic, V

2015-01-01

It is considered that cognitive function and attention could affect walking, motion control, and proper conduct during the walk. To determine whether there is a difference in the quality of attention and cognitive ability in stroke patients and patients without neurological damage of similar age and education and to determine whether the connection of attention and cognition affects motor skills, the sample consisted of 50 stroke patients tested with hemiparesis, involved in the process of rehabilitation, and 50 persons, randomly chosen, without neurological damage. The survey used the following tests: Trail Making (TMT A B) test for assessing the flexibility of attention; Mini-Mental State Examination (MMSE) for cognitive status; Functional Ambulation Category (FAC) test to assess the functional status and parameters of walk: speed, frequency, and length of stride; STEP test for assessing the precision of movement and balance. With stroke patients, relationship between age and performance on the MMSE test was marginally significant. The ratio of performance to TMT A B test and years does not indicate statistical significance, while statistical significance between the MMSE test performance and education exists. In stroke patients, performance on MMSE test is correlated with the frequency and length of stride walk. The quality of cognitive function and attention is associated with motor skills but differs in stroke patients and people without neurological damage of similar age. The significance of this correlation can supplement research in neurorehabilitation, improve the quality of medical rehabilitation, and contribute to efficient recovery of these patients.

Impact of vocational rehabilitation on social functioning, cognitive functioning, and psychopathology in patients with chronic schizophrenia

PubMed Central

Suresh Kumar, P. N.

2008-01-01

Aim: To assess the impact of vocational rehabilitation on psychopathology, social functioning and cognitive functioning in schizophrenia Materials and Methods: 34 patients with DSM IV diagnosis of chronic schizophrenia were compared 40 patients with same diagnosis but not attending vocational rehabilitation using PANSS, SCARF social functioning Index and MMSE. Results and Discussion: Basic psycho-socio-demographic data were comparable in both groups except more hospitalization in the no rehabilitation group. Comparison of social functioning, cognitive functioning and psychopathology showed significant improvement in rehabilitated patients. Cognitive functioning had positive correlation with occupational role in the rehabilitated group and negative correlation in the rehabilitated group. Social functioning had negative correlation with positive and negative symptoms, general psychopathology and total PANSS score and cognitive symptoms in patients without rehabilitation. Conclusion: The present concludes that there is a definite limitation in the domains of social functioning, cognitive functioning and psychopathology in chronic schizophrenia patients who had no rehabilitation. However vocational rehabilitation significantly improves these limitations, which in turn help these patients to integrate into the society so as to function efficiently in their roles as parents, home makers and social beings. PMID:19823610

Association of social-environmental factors with cognitive function in children with sickle cell disease.

PubMed

Yarboi, Janet; Compas, Bruce E; Brody, Gene H; White, Desiree; Rees Patterson, Jenny; Ziara, Kristen; King, Allison

2017-04-01

The aim of this study was to examine the relationship between cognitive function in pediatric sickle cell disease (SCD) patients and mothers' reports of social-environmental stress, depressive symptoms, and parenting. A total of 65 children with SCD completed comprehensive neuropsychological testing to assess several domains of cognitive functioning, including general intellectual ability, academic achievement, and executive function. Mothers reported on demographics, social-environmental stress, depressive symptoms, and parenting. As predicted, children with SCD significantly underperformed relative to normative data on measures of cognitive function. Associations between maternal social-environmental stress, maternal depressive symptoms, and parenting were mixed. The results show partial support for the hypothesis that greater stress and depressive symptoms and less positive parenting are associated with poorer cognitive function in children with SCD. Linear regression analyses showed that maternal financial stress was the strongest predictor across all domains of cognitive function. The findings replicate and extend past research, reaffirming that children with SCD are at risk for cognitive impairment across multiple domains. Additionally, social-environmental stress, particularly financial strain, is linked to mothers' depressive symptoms and parenting behaviors as well as children's cognitive function. Future studies using direct observations of parenting behaviors are needed. These findings, along with recent research on parenting interventions, may inform the development of concrete, teachable parenting and coping skills to improve cognitive functioning in children with SCD.

The effects of cigarette smoking behavior and psychosis history on general and social cognition in bipolar disorder.

PubMed

Ospina, Luz H; Russo, Manuela; Nitzburg, George M; Cuesta-Diaz, Armando; Shanahan, Megan; Perez-Rodriguez, Mercedes M; Mcgrath, Meaghan; Levine, Hannah; Mulaimovic, Sandra; Burdick, Katherine E

2016-09-01

Several studies have documented the prevalence and effects of cigarette smoking on cognition in psychotic disorders; fewer have focused on bipolar disorder (BD). Cognitive and social dysfunction are common in BD, and the severity of these deficits may be related both to illness features (e.g., current symptoms, psychosis history) and health-related behaviors (e.g., smoking, alcohol use). The current study assessed the influence of cigarette smoking on general and social cognition in a BD cohort, accounting for illness features with a focus on psychosis history. We assessed smoking status in 105 euthymic patients with BD, who completed a comprehensive battery including social (facial affect recognition, emotional problem-solving, and theory of mind) and general (the MATRICS Consensus Cognitive Battery and executive functioning) cognitive measures. We compared smokers vs nonsmokers on cognitive performance and tested for the effects of psychosis history, premorbid intellectual functioning, substance use, and current affective symptoms. Within the nonpsychotic subgroup with BD (n=45), smokers generally outperformed nonsmokers; by contrast, for subjects with BD with a history of psychosis (n=41), nonsmokers outperformed smokers. This pattern was noted more globally using a general composite cognitive score and on social/affective measures assessing patients' ability to identify emotions of facial stimuli and solve emotional problems. Cigarette smoking differentially affects performance on both general and social cognition in patients with BD as a function of psychosis history. These results suggest that there may be at least partially divergent underlying neurobiological causes for cognitive dysfunction in patients with BD with and without psychosis. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Objective-subjective disparity in cancer-related cognitive impairment: does the use of change measures help reconcile the difference?

PubMed

O'Farrell, Erin; Smith, Andra; Collins, Barbara

2017-10-01

Studies to date have found little correlation between subjective and objective measures of cognitive function in cancer patients, making it difficult to interpret the significance of their cognitive complaints. The purpose of this study was to determine if a stronger correlation would be obtained using measures of cognitive change rather than static scores. Sixty women with early stage breast cancer underwent repeated cognitive assessment over the course of chemotherapy with a neuropsychological test battery (objective measure) and with the FACT-Cog (subjective measure). Their results were compared to 60 healthy women matched on age and education and assessed at similar intervals. We used multilevel modeling, with FACT-Cog as the dependent measure and ordinary least squares slopes of a neuropsychological summary score as the independent variable, to evaluate the co-variation between the subjective and objective measures over time RESULTS: Measures of both objective and subjective cognitive function declined over the course of chemotherapy in the breast cancer patients but there was no significant relationship between them, even when using change measures. Change in objective cognitive function was not related to change in anxiety or fatigue scores but the decline in perceived cognitive function was associated with greater anxiety and fatigue. The discrepancy in objective and subjective measures of cognition in breast cancer patients cannot be accounted for in terms of a failure to use change measures. Although the results are negative, we contend that this is the more appropriate methodology for analyzing cancer-related changes in cognition. Copyright © 2016 John Wiley & Sons, Ltd.

Systematic review of self-reported cognitive function in cancer patients following chemotherapy treatment.

PubMed

Bray, Victoria J; Dhillon, Haryana M; Vardy, Janette L

2018-05-04

Cognitive symptoms are common in cancer patients, with up to 70% reporting cognitive symptoms following chemotherapy. These symptoms can have a major impact on how an individual functions in all aspects of their lives. This review evaluates self-reported cognitive function and its associations with neuropsychological tests and patient-reported outcomes in adult cancer patients who received chemotherapy treatment for a solid cancer. A search of multiple databases (Medline, Ovid at Nursing, PsycINFO, Allied and Complementary Medicine) from 1936 to 2017 was conducted, identifying 1563 unique articles, of which 101 met inclusion criteria. Of the 101 included studies, 48 (47%) were cross-sectional and 38 (38%) longitudinal in design, with 12 (12%) randomised controlled trials. A minority (26%) incorporated a healthy control arm in the study design, whilst the majority (79%) were in women with breast cancer. There was diversity in the assessment of self-reported cognitive symptoms. A total of 43 of 44 studies that sought an association between self-reported cognitive function and patient-reported outcomes found a moderate to strong association. Overall, 31 studies showed a lack of association between self-reported cognitive symptoms and neuropsychological results, whilst 14 studies reported a significant association between the two, but the association was often restricted to limited cognitive domains. The review found widespread heterogeneity in the assessment of self-reported cognitive symptoms and consistently absent or weak association with neuropsychological test scores. This research highlights the need for a standardised approach to measurement of self-reported cognitive symptoms in cancer patients.

Does multitasking mediate the relationships between episodic memory, attention, executive functions and apathetic manifestations in traumatic brain injury?

PubMed

Arnould, Annabelle; Rochat, Lucien; Dromer, Emilie; Azouvi, Philippe; Van der Linden, Martial

2018-03-01

Apathy is frequently described in patients with traumatic brain injury (TBI); its negative consequences particularly affect functional independence. Among apathetic manifestations, lack of initiative and lack of interest have mainly been associated with cognitive impairments. However, few studies have been conducted to precisely identify the underlying cognitive processes. Our aims were (1) to determine the best predictor of apathy from among several cognitive processes, including episodic memory and attention/executive mechanisms and multitasking, and (2) to examine to what extent multitasking could mediate the relationships between specific cognitive processes and lack of initiative/interest. Seventy participants (34 patients with TBI matched with 36 control participants) were given a questionnaire to assess anxio-depressive symptoms, four tasks to assess specific cognitive processes, and one task to assess real-life multitasking. Participants' relatives completed an apathy questionnaire. Multitasking, as assessed by the number of goals not achieved, was the only significant predictor of apathetic manifestations. In addition, the mediation analyses revealed that multitasking performance mediated the relationships between verbal episodic memory and lack of initiative/interest, whereas executive and attentional functions were only indirectly related to lack of initiative/interest due to their significant impacts on multitasking. These results shed new light on the aetiology of apathetic manifestations in patients with TBI, indicating how specific cognitive deficits are expressed in real-life multitasking, and consequently, how they may lead to the development and/or maintenance of apathetic manifestations. © 2016 The British Psychological Society.

Randomized control trial of computer-based training targeting alertness in older adults: the ALERT trial protocol.

PubMed

VanVleet, Thomas; Voss, Michelle; Dabit, Sawsan; Mitko, Alex; DeGutis, Joseph

2018-05-03

Healthy aging is associated with a decline in multiple functional domains including perception, attention, short and long-term memory, reasoning, decision-making, as well as cognitive and motor control functions; all of which are significantly modulated by an individual's level of alertness. The control of alertness also significantly declines with age and contributes to increased lapses of attention in everyday life, ranging from minor memory slips to a lack of vigilance and increased risk of falls or motor-vehicle accidents. Several experimental behavioral therapies designed to remediate age-related cognitive decline have been developed, but differ widely in content, method and dose. Preliminary studies demonstrate that Tonic and Phasic Alertness Training (TAPAT) can improve executive functions in older adults and may be a useful adjunct treatment to enhance benefits gained in other clinically validated treatments. The purpose of the current trial (referred to as the Attention training for Learning Enhancement and Resilience Trial or ALERT) is to compare TAPAT to an active control training condition, include a larger sample of patients, and assess both cognitive and functional outcomes. We will employ a multi-site, longitudinal, blinded randomized controlled trial (RCT) design with a target sample of 120 patients with age-related cognitive decline. Patients will be asked to complete 36 training sessions remotely (30 min/day, 5 days a week, over 3 months) of either the experimental TAPAT training program or an active control computer games condition. Patients will be assessed on a battery of cognitive and functional outcomes at four time points, including: a) immediately before training, b) halfway through training, c) within forty-eight hours post completion of total training, and d) after a three-month no-contact period post completion of total training, to assess the longevity of potential training effects. The strengths of this protocol are that it tests an innovative, in-home administered treatment that targets a fundamental deficit in adults with age-related cognitive decline; employs highly sensitive computer-based assessments of cognition as well as functional abilities, and incorporates a large sample size in an RCT design. ClinicalTrials.gov identifier: NCT02416401.

Neuropsychological testing.

PubMed

Zucchella, Chiara; Federico, Angela; Martini, Alice; Tinazzi, Michele; Bartolo, Michelangelo; Tamburin, Stefano

2018-06-01

Neuropsychological testing is a key diagnostic tool for assessing people with dementia and mild cognitive impairment, but can also help in other neurological conditions such as Parkinson's disease, stroke, multiple sclerosis, traumatic brain injury and epilepsy. While cognitive screening tests offer gross information, detailed neuropsychological evaluation can provide data on different cognitive domains (visuospatial function, memory, attention, executive function, language and praxis) as well as neuropsychiatric and behavioural features. We should regard neuropsychological testing as an extension of the neurological examination applied to higher order cortical function, since each cognitive domain has an anatomical substrate. Ideally, neurologists should discuss the indications and results of neuropsychological assessment with a clinical neuropsychologist. This paper summarises the rationale, indications, main features, most common tests and pitfalls in neuropsychological evaluation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Cognitive assessments for the early diagnosis of dementia after stroke

PubMed Central

Al-Qazzaz, Noor Kamal; Ali, Sawal Hamid; Ahmad, Siti Anom; Islam, Shabiul

2014-01-01

The early detection of poststroke dementia (PSD) is important for medical practitioners to customize patient treatment programs based on cognitive consequences and disease severity progression. The aim is to diagnose and detect brain degenerative disorders as early as possible to help stroke survivors obtain early treatment benefits before significant mental impairment occurs. Neuropsychological assessments are widely used to assess cognitive decline following a stroke diagnosis. This study reviews the function of the available neuropsychological assessments in the early detection of PSD, particularly vascular dementia (VaD). The review starts from cognitive impairment and dementia prevalence, followed by PSD types and the cognitive spectrum. Finally, the most usable neuropsychological assessments to detect VaD were identified. This study was performed through a PubMed and ScienceDirect database search spanning the last 10 years with the following keywords: “post-stroke”; “dementia”; “neuro-psychological”; and “assessments”. This study focuses on assessing VaD patients on the basis of their stroke risk factors and cognitive function within the first 3 months after stroke onset. The search strategy yielded 535 articles. After application of inclusion and exclusion criteria, only five articles were considered. A manual search was performed and yielded 14 articles. Twelve articles were included in the study design and seven articles were associated with early dementia detection. This review may provide a means to identify the role of neuropsychological assessments as early PSD detection tests. PMID:25246795

ADRB2, brain white matter integrity and cognitive ageing in the Lothian Birth Cohort 1936.

PubMed

Lyall, Donald M; Lopez, Lorna M; Bastin, Mark E; Maniega, Susana Muñoz; Penke, Lars; Valdés Hernández, Maria del C; Royle, Natalie A; Starr, John M; Porteous, David J; Wardlaw, Joanna M; Deary, Ian J

2013-01-01

The non-synonymous mutations arg16gly (rs1042713) and gln27glu (rs1042714) in the adrenergic β-2 receptor gene (ADRB2) have been associated with cognitive function and brain white matter integrity. The current study aimed to replicate these findings and expand them to a broader range of cognitive and brain phenotypes. The sample used is a community-dwelling group of older people, the Lothian Birth Cohort 1936. They had been assessed cognitively at age 11 years, and undertook further cognitive assessments and brain diffusion MRI tractography in older age. The sample size range for cognitive function variables was N = 686-765, and for neuroimaging variables was N = 488-587. Previously-reported findings with these genetic variants did not replicate in this cohort. Novel, nominally significant associations were observed; notably, the integrity of the left arcuate fasciculus mediated the association between rs1042714 and the Digit Symbol Coding test of information processing speed. No significant associations of cognitive and brain phenotypes with ADRB2 variants survived correction for false discovery rate. Previous findings may therefore have been subject to type 1 error. Further study into links between ADRB2, cognitive function and brain white matter integrity is required.

The effects of exercise under hypoxia on cognitive function.

PubMed

Ando, Soichi; Hatamoto, Yoichi; Sudo, Mizuki; Kiyonaga, Akira; Tanaka, Hiroaki; Higaki, Yasuki

2013-01-01

Increasing evidence suggests that cognitive function improves during a single bout of moderate exercise. In contrast, exercise under hypoxia may compromise the availability of oxygen. Given that brain function and tissue integrity are dependent on a continuous and sufficient oxygen supply, exercise under hypoxia may impair cognitive function. However, it remains unclear how exercise under hypoxia affects cognitive function. The purpose of this study was to examine the effects of exercise under different levels of hypoxia on cognitive function. Twelve participants performed a cognitive task at rest and during exercise at various fractions of inspired oxygen (FIO2: 0.209, 0.18, and 0.15). Exercise intensity corresponded to 60% of peak oxygen uptake under normoxia. The participants performed a Go/No-Go task requiring executive control. Cognitive function was evaluated using the speed of response (reaction time) and response accuracy. We monitored pulse oximetric saturation (SpO2) and cerebral oxygenation to assess oxygen availability. SpO2 and cerebral oxygenation progressively decreased during exercise as the FIO2 level decreased. Nevertheless, the reaction time in the Go-trial significantly decreased during moderate exercise. Hypoxia did not affect reaction time. Neither exercise nor difference in FIO2 level affected response accuracy. An additional experiment indicated that cognitive function was not altered without exercise. These results suggest that the improvement in cognitive function is attributable to exercise, and that hypoxia has no effects on cognitive function at least under the present experimental condition. Exercise-cognition interaction should be further investigated under various environmental and exercise conditions.

[The Influence of the Functioning of Brain Regulatory Systems onto the Voluntary Regulation of Cognitive Performance in Children. Report 2. Neuropsychological and Electrophysiological Assessment of Brain Regulatory Functions in Children Aged 10-12 with Learning Difficulties].

PubMed

Semenova, O A; Machinskaya, R I

2015-01-01

A total number of 172 children aged 10-12 were electrophysiologically and neuropsychologically assessed in order to analyze the influence of the functioning of brain regulatory systems onto the voluntary regulation of cognitive performance during the preteen years. EEG patterns associated with the nonoptimal functioning of brain regulatory systems, particularly fronto-thalamic, limbic and fronto-striatal structures were significantly more often observed in children with learning and behavioral difficulties, as compared to the control group. Neuropsychological assessment showed that the nonoptimal functioning of different brain regulatory systems specifically affect the voluntary regulation of cognitive performance. Children with EEG patterns of fronto-thalamic nonoptimal functioning demonstrated poor voluntary regulation such as impulsiveness and difficulties in continuing the same algorithms. Children with EEG patterns of limbic nonoptimal functioning showed a less pronounced executive dysfunction manifested only in poor switching between program units within a task. Children with EEG patterns of fronto-striatal nonoptimal functioning struggled with such executive dysfunctions as motor and tactile perseverations and emotional-motivational deviations such as poor motivation and communicative skills.

Deconstructing Bipolar Disorder and Schizophrenia: A cross-diagnostic cluster analysis of cognitive phenotypes.

PubMed

Lee, Junghee; Rizzo, Shemra; Altshuler, Lori; Glahn, David C; Miklowitz, David J; Sugar, Catherine A; Wynn, Jonathan K; Green, Michael F

2017-02-01

Bipolar disorder (BD) and schizophrenia (SZ) show substantial overlap. It has been suggested that a subgroup of patients might contribute to these overlapping features. This study employed a cross-diagnostic cluster analysis to identify subgroups of individuals with shared cognitive phenotypes. 143 participants (68 BD patients, 39 SZ patients and 36 healthy controls) completed a battery of EEG and performance assessments on perception, nonsocial cognition and social cognition. A K-means cluster analysis was conducted with all participants across diagnostic groups. Clinical symptoms, functional capacity, and functional outcome were assessed in patients. A two-cluster solution across 3 groups was the most stable. One cluster including 44 BD patients, 31 controls and 5 SZ patients showed better cognition (High cluster) than the other cluster with 24 BD patients, 35 SZ patients and 5 controls (Low cluster). BD patients in the High cluster performed better than BD patients in the Low cluster across cognitive domains. Within each cluster, participants with different clinical diagnoses showed different profiles across cognitive domains. All patients are in the chronic phase and out of mood episode at the time of assessment and most of the assessment were behavioral measures. This study identified two clusters with shared cognitive phenotype profiles that were not proxies for clinical diagnoses. The finding of better social cognitive performance of BD patients than SZ patients in the Lowe cluster suggest that relatively preserved social cognition may be important to identify disease process distinct to each disorder. Copyright © 2016 Elsevier B.V. All rights reserved.

Approaches to Measuring the Effects of Wake-Promoting Drugs: A Focus on Cognitive Function

PubMed Central

Edgar, Christopher J.; Pace-Schott, Edward F.; Wesnes, Keith A.

2009-01-01

Objectives In clinical drug development, wakefulness and wake-promotion maybe assessed by a large number of scales and questionnaires. Objective assessment of wakefulness is most commonly made using sleep latency/maintenance of wakefulness tests, polysomnography and/or behavioral measures. The purpose of the present review is to highlight the degree of overlap in the assessment of wakefulness and cognition, with consideration of assessment techniques and the underlying neurobiology of both concepts. Design Reviews of four key areas were conducted: commonly used techniques in the assessment of wakefulness; neurobiology of sleep/wake and cognition; targets of wake promoting and/or cognition enhancing drugs; and ongoing clinical trials investigating wake promoting effects. Results There is clear overlap between the assessment of wakefulness and cognition. There are common techniques which may be used to assess both concepts; aspects of the neurobiology of both concepts may be closely related; and wake promoting drugs may have nootropic properties (and vice-versa). Clinical trials of wake promoting drugs often, though not routinely, assess aspects of cognition. Conclusions Routine and broad assessment of cognition in the development of wake promoting drugs may reveal important nootropic effects, which are not secondary to alertness/wakefulness, whilst existing cognitive enhancers may have under explored or unknown wake promoting properties. PMID:19565524

Lifting the veil: how to use clinical neuropsychology to assess dementia.

PubMed

Burrell, James R; Piguet, Olivier

2015-11-01

Neurologists often struggle to interpret the results of neuropsychological testing, even though cognitive assessments are an integral component of the diagnostic process in dementia syndromes. This article reviews the principles underlying clinical neuropsychology, background on common neuropsychological tests, and tips on how to interpret the results when assessing patients with dementia. General cognitive screening tools, appropriate for use by general neurologists and psychiatrists, as well as specific cognitive tests examining the main cognitive domains (attention and orientation, memory, visuospatial function, language and executive function) in patients with dementia are considered. Finally, the pattern of deficits, helpful in defining clinical dementia phenotypes and sometimes in predicting the underlying molecular pathology, are outlined. Such clinicopathological associations will become invaluable as disease-modifying treatments for dementia are developed and implemented. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Statistical Model of Dynamic Markers of the Alzheimer's Pathological Cascade.

PubMed

Balsis, Steve; Geraci, Lisa; Benge, Jared; Lowe, Deborah A; Choudhury, Tabina K; Tirso, Robert; Doody, Rachelle S

2018-05-05

Alzheimer's disease (AD) is a progressive disease reflected in markers across assessment modalities, including neuroimaging, cognitive testing, and evaluation of adaptive function. Identifying a single continuum of decline across assessment modalities in a single sample is statistically challenging because of the multivariate nature of the data. To address this challenge, we implemented advanced statistical analyses designed specifically to model complex data across a single continuum. We analyzed data from the Alzheimer's Disease Neuroimaging Initiative (ADNI; N = 1,056), focusing on indicators from the assessments of magnetic resonance imaging (MRI) volume, fluorodeoxyglucose positron emission tomography (FDG-PET) metabolic activity, cognitive performance, and adaptive function. Item response theory was used to identify the continuum of decline. Then, through a process of statistical scaling, indicators across all modalities were linked to that continuum and analyzed. Findings revealed that measures of MRI volume, FDG-PET metabolic activity, and adaptive function added measurement precision beyond that provided by cognitive measures, particularly in the relatively mild range of disease severity. More specifically, MRI volume, and FDG-PET metabolic activity become compromised in the very mild range of severity, followed by cognitive performance and finally adaptive function. Our statistically derived models of the AD pathological cascade are consistent with existing theoretical models.

Artificial Gravity as a Multi-System Countermeasure: Effects on Cognitive Function

NASA Technical Reports Server (NTRS)

Sipes, Walter E.; Seaton, Kim; Slack, Kellely; Bowie, Kendra

2007-01-01

The Space Flight Cognitive Assessment Tool for Windows (WinSCAT) is a medical requirement on the International Space Station, and its purpose is to evaluate cognitive functioning after physical insult (e.g., head trauma, decompression sickness, exposure to toxic gases, medication side effects). The current objective is to assess cognitive functioning in a long duration space mission analog environment where Artificial Gravity is being applied as a countermeasure in a Bed Rest study. Methods: Fifteen male subjects (8 treatment and 7 control) who participated in 21 days of -6 degree head-down bed rest were assessed. Three practice and three baseline WinSCAT test sessions were administered during the pre-bed rest phase of study participation. During the bed rest phase, the WinSCAT test was scheduled every other day, following the centrifuge, for a total of 10 test sessions. (The treatment group received 60 minutes of centrifugation each day during the 21 days of bed rest. The control subjects were strapped to the centrifuge for the same length of time as the treatment group but were not spun.) During the post-bed rest (reconditioning) phase, the test was administered 4 times. Results: Individual differences were found both within and between the treatment and control groups. After controlling for the number of subjects in each group, the treatment group accounted for more off-nominal WinSCAT scores than the control group. Conclusions:There is some preliminary evidence that centrifuge spinning might negatively impact cognitive functioning. However, due to sample size limitations, it cannot be ascertained whether there were significant differences in cognitive performance between the treatment and control groups. If centrifugation had a negative effect on cognitive functioning, consistent decrements would be expected to be found with all treatment subjects across time. Individual differences in underlying cognitive ability and motivation level are other possible explanations for the results found in this study.

Social cognition and work performance of persons with schizophrenia in a Chinese population.

PubMed

Lo, Panmi; Siu, Andrew M H

2015-01-01

Social-cognitive deficits have a significant impact on the community and vocational functioning of persons with schizophrenia. This study aimed to explore the relationship between social-cognitive abilities and vocational functioning in a Chinese population. We recruited 30 outpatients with schizophrenia to participate. We administered the Chinese Social Cognition and Screening Questionnaire (C-SCSQ) to assess Theory of Mind (ToM), attributional bias, and neurocognition; the Facial Expression Identification Test (FEIT) to assess emotion perception (EP) ability, and the Chinese Work Personality Profile (CWPP) to assess work performance in a simulated work setting. ToM showed a significant negative correlation with attributional bias. The neurocognitive measure displayed a significant positive correlation with ToM and EP. The structural equation model was a good fit to the data (CFI=0.91, RMSEA=0.12), and showed that social-cognitive abilities had a significant impact (-0.41) on work performance. Of the four social-cognitive domains, ToM and paranoid attributional style (PAS) contributed significantly to variations in work performance. These results support the theory that social-cognitive abilities have an impact on work performance. ToM has a positive impact whereas PAS has an adverse effect. Persons with schizophrenia present specific deficits in their social-cognitive abilities, which have significant impact on their work performance and employability.

Impact of neurocognition on social and role functioning in individuals at clinical high risk for psychosis.

PubMed

Carrión, Ricardo E; Goldberg, Terry E; McLaughlin, Danielle; Auther, Andrea M; Correll, Christoph U; Cornblatt, Barbara A

2011-08-01

Cognitive deficits have been well documented in schizophrenia and have been shown to impair quality of life and to compromise everyday functioning. Recent studies of adolescents and young adults at high risk for developing psychosis show that neurocognitive impairments are detectable before the onset of psychotic symptoms. However, it remains unclear how cognitive impairments affect functioning before the onset of psychosis. The authors assessed cognitive impairment in adolescents at clinical high risk for psychosis and examined its impact on social and role functioning. A sample of 127 treatment-seeking patients at clinical high risk for psychosis and a group of 80 healthy comparison subjects were identified and recruited for research in the Recognition and Prevention Program. At baseline, participants were assessed with a comprehensive neurocognitive battery as well as measures of social and role functioning. Relative to healthy comparison subjects, clinical high-risk patients showed significant impairments in the domains of processing speed, verbal memory, executive function, working memory, visuospatial processing, motor speed, sustained attention, and language. Clinical high-risk patients also displayed impaired social and role functioning at baseline. Among patients with attenuated positive symptoms, processing speed was related to social and role functioning at baseline. These findings demonstrate that cognitive and functional impairments are detectable in patients at clinical high risk for psychosis before the onset of psychotic illness and that processing speed appears to be an important cognitive predictor of poor functioning.

Impact of Neurocognition on Social and Role Functioning in Individuals at Clinical High Risk for Psychosis

PubMed Central

Carrión, Ricardo E.; Goldberg, Terry E.; McLaughlin, Danielle; Auther, Andrea M.; Correll, Christoph U.; Cornblatt, Barbara A.

2011-01-01

Objective Cognitive deficits have been well documented in schizophrenia and have been shown to impair quality of life and to compromise everyday functioning. Recent studies of adolescents and young adults at high risk for developing psychosis show that neurocognitive impairments are detectable before the onset of psychotic symptoms. However, it remains unclear how cognitive impairments affect functioning before the onset of psychosis. The authors assessed cognitive impairment in adolescents at clinical high risk for psychosis and examined its impact on social and role functioning. Method A sample of 127 treatment-seeking patients at clinical high risk for psychosis and a group of 80 healthy comparison subjects were identified and recruited for research in the Recognition and Prevention Program. At baseline, participants were assessed with a comprehensive neurocognitive battery as well as measures of social and role functioning. Results Relative to healthy comparison subjects, clinical high-risk patients showed significant impairments in the domains of processing speed, verbal memory, executive function, working memory, visuospatial processing, motor speed, sustained attention, and language. Clinical high-risk patients also displayed impaired social and role functioning at baseline. Among patients with attenuated positive symptoms, processing speed was related to social and role functioning at baseline. Conclusions These findings demonstrate that cognitive and functional impairments are detectable in patients at clinical high risk for psychosis before the onset of psychotic illness and that processing speed appears to be an important cognitive predictor of poor functioning. PMID:21536691

How do top cable news websites portray cognition as an aging issue?

PubMed

Vandenberg, Anna E; Price, Anna E; Friedman, Daniela B; Marchman, Graham; Anderson, Lynda A

2012-06-01

We examined messages that the websites of the top cable news companies (MSNBC, FOX, and CNN) conveyed about cognition between January 2007 and March 2010. Drawing on agenda-setting theory, this work assessed the frequency, prominence, and attributes of cognitive topics in messages targeting an aging audience. We used quantitative content analysis to examine the frequency and prominence of cognitive topics and cognitive goals, as well as how the cognitive discussions were framed. Chi-square analyses were conducted to compare cognitive health information discussed in news items that did and did not target an "aging audience." Qualitative analysis of the aging audience subgroup was used to further examine age-associated cognitive messages. Within the 229 cognitive items identified, we found significantly more coverage of cognitive functioning and unspecified dementia and significantly less coverage of cognitive disease not dementia, specified dementia, and accidents or injury for the aging audience. Our qualitative analysis of news items aimed at an aging audience documented a focus on maintaining functioning and avoiding decline through various individual lifestyle behaviors. However, contextual information about level of cognition to be maintained, particular cognitive functions targeted, specific norms about cognitive aging, and how cognitive function is determined was lacking. Our research points to a communication gap in the delivery of academic research findings to a lay audience through online journalism. We suggest more clarity by researchers in defining cognitive concepts and measurement of cognitive function for journalistic translation and public consumption.

Altered Odor-Induced Brain Activity as an Early Manifestation of Cognitive Decline in Patients With Type 2 Diabetes.

PubMed

Zhang, Zhou; Zhang, Bing; Wang, Xin; Zhang, Xin; Yang, Qing X; Qing, Zhao; Lu, Jiaming; Bi, Yan; Zhu, Dalong

2018-05-01

Type 2 diabetes is reported to be associated with olfactory dysfunction and cognitive decline. However, whether and how olfactory neural circuit abnormalities involve cognitive impairment in diabetes remains uncovered. This study thus aimed to investigate olfactory network alterations and the associations of odor-induced brain activity with cognitive and metabolic parameters in type 2 diabetes. Participants with normal cognition, including 51 patients with type 2 diabetes and 41 control subjects without diabetes, underwent detailed cognitive assessment, olfactory behavior tests, and odor-induced functional MRI measurements. Olfactory brain regions showing significantly different activation between the two groups were selected for functional connectivity analysis. Compared with the control subjects, patients with diabetes demonstrated significantly lower olfactory threshold score, decreased brain activation, and disrupted functional connectivity in the olfactory network. Positive associations of the disrupted functional connectivity with decreased neuropsychology test scores and reduced pancreatic function were observed in patients with diabetes. Notably, the association between pancreatic function and executive function was mediated by olfactory behavior and olfactory functional connectivity. Our results suggested the alteration of olfactory network is present before clinically measurable cognitive decrements in type 2 diabetes, bridging the gap between the central olfactory system and cognitive decline in diabetes. © 2018 by the American Diabetes Association.

Organisational justice and cognitive function in middle-aged employees: the Whitehall II study.

PubMed

Elovainio, Marko; Singh-Manoux, Archana; Ferrie, Jane E; Shipley, Martin; Gimeno, David; De Vogli, Roberto; Vahtera, Jussi; Virtanen, Marianna; Jokela, Markus; Marmot, Michael G; Kivimäki, Mika

2012-06-01

Little is known about the role that work-related factors play in the decline of cognitive function. This study examined the association between perceived organisational justice and cognitive function among middle-aged men and women. Perceived organisational justice was measured at phases 1 (1985-8) and 2 (1989-90) of the Whitehall II study when the participants were 35-55 years old. Assessment of cognitive function at the screening clinic at phases 5 (1997-9) and 7 (2003-4) included the following tests in the screening clinic: memory, inductive reasoning (Alice Heim 4), vocabulary (Mill Hill), and verbal fluency (phonemic and semantic). Mean exposure to lower organisational justice at phases 1 and 2 in relation to cognitive function at phases 5 and 7 were analysed using linear regression analyses. The final sample included 4531 men and women. Lower mean levels of justice at phases 1 and 2 were associated with worse cognitive function in terms of memory, inductive reasoning, vocabulary and verbal fluency at both phases 5 and 7. These associations were independent of covariates, such as age, occupational grade, behavioural risks, depression, hypertension and job strain. This study suggests an association between perceived organisational justice and cognitive function. Further studies are needed to examine whether interventions designed to improve organisational justice would affect employees' cognition function favourably.

Influence of Cognitive Functioning on Age-Related Performance Declines in Visuospatial Sequence Learning.

PubMed

Krüger, Melanie; Hinder, Mark R; Puri, Rohan; Summers, Jeffery J

2017-01-01

Objectives: The aim of this study was to investigate how age-related performance differences in a visuospatial sequence learning task relate to age-related declines in cognitive functioning. Method: Cognitive functioning of 18 younger and 18 older participants was assessed using a standardized test battery. Participants then undertook a perceptual visuospatial sequence learning task. Various relationships between sequence learning and participants' cognitive functioning were examined through correlation and factor analysis. Results: Older participants exhibited significantly lower performance than their younger counterparts in the sequence learning task as well as in multiple cognitive functions. Factor analysis revealed two independent subsets of cognitive functions associated with performance in the sequence learning task, related to either the processing and storage of sequence information (first subset) or problem solving (second subset). Age-related declines were only found for the first subset of cognitive functions, which also explained a significant degree of the performance differences in the sequence learning task between age-groups. Discussion: The results suggest that age-related performance differences in perceptual visuospatial sequence learning can be explained by declines in the ability to process and store sequence information in older adults, while a set of cognitive functions related to problem solving mediates performance differences independent of age.

The Role of Cognitive Factors in Predicting Balance and Fall Risk in a Neuro-Rehabilitation Setting.

PubMed

Saverino, A; Waller, D; Rantell, K; Parry, R; Moriarty, A; Playford, E D

2016-01-01

There is a consistent body of evidence supporting the role of cognitive functions, particularly executive function, in the elderly and in neurological conditions which become more frequent with ageing. The aim of our study was to assess the role of different domains of cognitive functions to predict balance and fall risk in a sample of adults with various neurological conditions in a rehabilitation setting. This was a prospective, cohort study conducted in a single centre in the UK. 114 participants consecutively admitted to a Neuro-Rehabilitation Unit were prospectively assessed for fall accidents. Baseline assessment included a measure of balance (Berg Balance Scale) and a battery of standard cognitive tests measuring executive function, speed of information processing, verbal and visual memory, visual perception and intellectual function. The outcomes of interest were the risk of becoming a faller, balance and fall rate. Two tests of executive function were significantly associated with fall risk, the Stroop Colour Word Test (IRR 1.01, 95% CI 1.00-1.03) and the number of errors on part B of the Trail Making Test (IRR 1.23, 95% CI 1.03-1.49). Composite scores of executive function, speed of information processing and visual memory domains resulted in 2 to 3 times increased likelihood of having better balance (OR 2.74 95% CI 1.08 to 6.94, OR 2.72 95% CI 1.16 to 6.36 and OR 2.44 95% CI 1.11 to 5.35 respectively). Our results show that specific subcomponents of executive functions are able to predict fall risk, while a more global cognitive dysfunction is associated with poorer balance.

The Role of Cognitive Factors in Predicting Balance and Fall Risk in a Neuro-Rehabilitation Setting

PubMed Central

Saverino, A.; Waller, D.; Rantell, K.; Parry, R.; Moriarty, A.; Playford, E. D.

2016-01-01

Introduction There is a consistent body of evidence supporting the role of cognitive functions, particularly executive function, in the elderly and in neurological conditions which become more frequent with ageing. The aim of our study was to assess the role of different domains of cognitive functions to predict balance and fall risk in a sample of adults with various neurological conditions in a rehabilitation setting. Methods This was a prospective, cohort study conducted in a single centre in the UK. 114 participants consecutively admitted to a Neuro-Rehabilitation Unit were prospectively assessed for fall accidents. Baseline assessment included a measure of balance (Berg Balance Scale) and a battery of standard cognitive tests measuring executive function, speed of information processing, verbal and visual memory, visual perception and intellectual function. The outcomes of interest were the risk of becoming a faller, balance and fall rate. Results Two tests of executive function were significantly associated with fall risk, the Stroop Colour Word Test (IRR 1.01, 95% CI 1.00–1.03) and the number of errors on part B of the Trail Making Test (IRR 1.23, 95% CI 1.03–1.49). Composite scores of executive function, speed of information processing and visual memory domains resulted in 2 to 3 times increased likelihood of having better balance (OR 2.74 95% CI 1.08 to 6.94, OR 2.72 95% CI 1.16 to 6.36 and OR 2.44 95% CI 1.11 to 5.35 respectively). Conclusions Our results show that specific subcomponents of executive functions are able to predict fall risk, while a more global cognitive dysfunction is associated with poorer balance. PMID:27115880

COBRA: A prospective multimodal imaging study of dopamine, brain structure and function, and cognition.

PubMed

Nevalainen, N; Riklund, K; Andersson, M; Axelsson, J; Ögren, M; Lövdén, M; Lindenberger, U; Bäckman, L; Nyberg, L

2015-07-01

Cognitive decline is a characteristic feature of normal human aging. Previous work has demonstrated marked interindividual variability in onset and rate of decline. Such variability has been linked to factors such as maintenance of functional and structural brain integrity, genetics, and lifestyle. Still, few, if any, studies have combined a longitudinal design with repeated multimodal imaging and a comprehensive assessment of cognition as well as genetic and lifestyle factors. The present paper introduces the Cognition, Brain, and Aging (COBRA) study, in which cognitive performance and brain structure and function are measured in a cohort of 181 older adults aged 64 to 68 years at baseline. Participants will be followed longitudinally over a 10-year period, resulting in a total of three equally spaced measurement occasions. The measurement protocol at each occasion comprises a comprehensive set of behavioral and imaging measures. Cognitive performance is evaluated via computerized testing of working memory, episodic memory, perceptual speed, motor speed, implicit sequence learning, and vocabulary. Brain imaging is performed using positron emission tomography with [(11)C]-raclopride to assess dopamine D2/D3 receptor availability. Structural magnetic resonance imaging (MRI) is used for assessment of white and gray-matter integrity and cerebrovascular perfusion, and functional MRI maps brain activation during rest and active task conditions. Lifestyle descriptives are collected, and blood samples are obtained and stored for future evaluation. Here, we present selected results from the baseline assessment along with a discussion of sample characteristics and methodological considerations that determined the design of the study. This article is part of a Special Issue entitled SI: Memory & Aging. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

The Effects of Simulated Wildland Firefighting Tasks on Core Temperature and Cognitive Function under Very Hot Conditions.

PubMed

Williams-Bell, F Michael; Aisbett, Brad; Murphy, Bernadette A; Larsen, Brianna

2017-01-01

Background: The severity of wildland fires is increasing due to continually hotter and drier summers. Firefighters are required to make life altering decisions on the fireground, which requires analytical thinking, problem solving, and situational awareness. This study aimed to determine the effects of very hot (45°C; HOT) conditions on cognitive function following periods of simulated wildfire suppression work when compared to a temperate environment (18°C; CON). Methods: Ten male volunteer firefighters intermittently performed a simulated fireground task for 3 h in both the CON and HOT environments, with cognitive function tests (paired associates learning and spatial span) assessed at baseline (cog 1) and during the final 20-min of each hour (cog 2, 3, and 4). Reaction time was also assessed at cog 1 and cog 4. Pre- and post- body mass were recorded, and core and skin temperature were measured continuously throughout the protocol. Results: There were no differences between the CON and HOT trials for any of the cognitive assessments, regardless of complexity. While core temperature reached 38.7°C in the HOT (compared to only 37.5°C in the CON; p < 0.01), core temperature declined during the cognitive assessments in both conditions (at a rate of -0.15 ± 0.20°C·hr -1 and -0.63 ± 0.12°C·hr -1 in the HOT and CON trial respectively). Firefighters also maintained their pre-exercise body mass in both conditions, indicating euhydration. Conclusions: It is likely that this maintenance of euhydration and the relative drop in core temperature experienced between physical work bouts was responsible for the preservation of firefighters' cognitive function in the present study.

The Effects of Simulated Wildland Firefighting Tasks on Core Temperature and Cognitive Function under Very Hot Conditions

PubMed Central

Williams-Bell, F. Michael; Aisbett, Brad; Murphy, Bernadette A.; Larsen, Brianna

2017-01-01

Background: The severity of wildland fires is increasing due to continually hotter and drier summers. Firefighters are required to make life altering decisions on the fireground, which requires analytical thinking, problem solving, and situational awareness. This study aimed to determine the effects of very hot (45°C; HOT) conditions on cognitive function following periods of simulated wildfire suppression work when compared to a temperate environment (18°C; CON). Methods: Ten male volunteer firefighters intermittently performed a simulated fireground task for 3 h in both the CON and HOT environments, with cognitive function tests (paired associates learning and spatial span) assessed at baseline (cog 1) and during the final 20-min of each hour (cog 2, 3, and 4). Reaction time was also assessed at cog 1 and cog 4. Pre- and post- body mass were recorded, and core and skin temperature were measured continuously throughout the protocol. Results: There were no differences between the CON and HOT trials for any of the cognitive assessments, regardless of complexity. While core temperature reached 38.7°C in the HOT (compared to only 37.5°C in the CON; p < 0.01), core temperature declined during the cognitive assessments in both conditions (at a rate of −0.15 ± 0.20°C·hr−1 and −0.63 ± 0.12°C·hr−1 in the HOT and CON trial respectively). Firefighters also maintained their pre-exercise body mass in both conditions, indicating euhydration. Conclusions: It is likely that this maintenance of euhydration and the relative drop in core temperature experienced between physical work bouts was responsible for the preservation of firefighters' cognitive function in the present study. PMID:29114230

Cognitive function during and six months following chemotherapy for front-line treatment of ovarian, primary peritoneal or fallopian tube cancer: An NRG oncology/gynecologic oncology group study.

PubMed

Hess, Lisa M; Huang, Helen Q; Hanlon, Alexandra L; Robinson, William R; Johnson, Rhonda; Chambers, Setsuko K; Mannel, Robert S; Puls, Larry; Davidson, Susan A; Method, Michael; Lele, Shashikant; Havrilesky, Laura; Nelson, Tina; Alberts, David S

2015-12-01

Changes in cognitive function have been identified in and reported by many cancer survivors. These changes have the potential to impact patient quality of life and functional ability. This prospective longitudinal study was designed to quantify the incidence of change in cognitive function in newly diagnosed ovarian cancer patients throughout and following primary chemotherapy. Eligible patients had newly diagnosed, untreated ovarian cancer and had planned to receive chemotherapy. Web-based and patient reported cognitive assessments and quality of life questionnaires were conducted prior to chemotherapy, prior to cycle four, after cycle six, and six months after completion of primary therapy. Two-hundred-thirty-one evaluable patients entered this study between May 2010 and October 2011. At the cycle 4 time point, 25.2% (55/218) of patients exhibited cognitive impairment in at least one domain. At the post-cycle 6 and 6-month follow up time points, 21.1% (44/208) and 17.8% (30/169) of patients, respectively, demonstrated impairment in at least one domain of cognitive function. There were statistically significant, but clinically small, improvements in processing speed (p<0.001) and attention (p<0.001) but not in motor response time (p=0.066), from baseline through the six-month follow up time period. This was a large, prospective study designed to measure cognitive function in ovarian cancer. A subset of patients had evidence of cognitive decline from baseline during chemotherapy treatment in this study as measured by the web-based assessment; however, changes were generally limited to no more than one domain. Copyright © 2015 Elsevier Inc. All rights reserved.

Adolescent Anorexia Nervosa: cognitive performance after weight recovery.

PubMed

Lozano-Serra, Estefanía; Andrés-Perpiña, Susana; Lázaro-García, Luisa; Castro-Fornieles, Josefina

2014-01-01

Although there is no definitive consensus on the impairment of neuropsychological functions, most studies of adults with Anorexia Nervosa (AN) find impaired functioning in cognitive domains such as visual-spatial abilities. The objective of this study is to assess the cognitive functions in adolescents with AN before and after weight recovery and to explore the relationship between cognitive performance and menstruation. Twenty-five female adolescents with AN were assessed by a neuropsychological battery while underweight and then following six months of treatment and weight recovery. Twenty-six healthy female subjects of a similar age were also evaluated at both time points. Underweight patients with AN showed worse cognitive performance than control subjects in immediate recall, organization and time taken to copy the Rey's Complex Figure Test (RCFT). After weight recovery, AN patients presented significant improvements in all tests, and differences between patients and controls disappeared. Patients with AN and persistence of amenorrhea at follow-up (n=8) performed worse on Block Design, delayed recall of Visual Reproduction and Stroop Test than patients with resumed menstruation (n=14) and the control group, though the two AN groups were similar in body mass index, age and psychopathological scale scores. Weight recovery improves cognitive functioning in adolescents with AN. The normalization of neuropsychological performance is better in patients who have recovered at least one menstrual cycle. The normalization of hormonal function seems to be essential for the normalization of cognitive performance, even in adolescents with a very short recovery time. © 2013.

Are we comparing frontotemporal dementia and Alzheimer disease patients with the right measures?

PubMed

Deutsch, Mariel B; Liang, Li-Jung; Jimenez, Elvira E; Mather, Michelle J; Mendez, Mario F

2016-09-01

Clinical research studies of behavioral variant frontotemporal dementia (bvFTD) often use Alzheimer disease (AD) as a comparison group for control of dementia variables, using tests of cognitive function to match the groups. These two dementia syndromes, however, are very different in clinical manifestations, and the comparable severity of these dementias may not be reflected by commonly used cognitive scales such as the Mini-Mental State Examination (MMSE). We evaluated different measures of dementia severity and symptoms among 20 people with bvFTD compared to 24 with early-onset AD. Despite similar ages, disease-duration, education, and cognitive performance on two tests of cognitive function, the MMSE and the Montreal Cognitive Assessment (MoCA), the bvFTD participants, compared to the AD participants, were significantly more impaired on other measures of disease severity, including function (Functional Assessment Questionnaire (FAQ)), neuropsychiatric symptoms (Neuropsychiatric Inventory (NPI)), and global dementia stage (Clinical Dementia Rating Scales (CDRs)). However, when we adjusted for the frontotemporal lobar degeneration-CDR (FTLD-CDR) in the analyses, the two dementia groups were comparable across all measures despite significant differences on the cognitive scales. We found tests of cognitive functions (MMSE and MoCA) to be insufficient measures for ensuring comparability between bvFTD and AD groups. In clinical studies, the FTLD-CDR, which includes additional language and behavior items, may be a better overall way to match bvFTD and AD groups on dementia severity.

Are we comparing frontotemporal dementia and Alzheimer disease patients with the right measures?

PubMed Central

Deutsch, Mariel B.; Liang, Li-Jung; Jimenez, Elvira E.; Mather, Michelle J.; Mendez, Mario F.

2016-01-01

Background Clinical research studies of behavioral variant frontotemporal dementia (bvFTD) often use Alzheimer disease (AD) as a comparison group for control of dementia variables, using tests of cognitive function to match the groups. These two dementia syndromes, however, are very different in clinical manifestations, and the comparable severity of these dementias may not be reflected by commonly used cognitive scales such as the Mini-Mental State Examination (MMSE). Methods We evaluated different measures of dementia severity and symptoms among 20 people with bvFTD compared to 24 with early-onset AD. Results Despite similar ages, disease-duration, education, and cognitive performance on two tests of cognitive function, the MMSE and the Montreal Cognitive Assessment (MoCA), the bvFTD participants, compared to the AD participants, were significantly more impaired on other measures of disease severity, including function (Functional Assessment Questionnaire (FAQ)), neuropsychiatric symptoms (Neuropsychiatric Inventory (NPI)), and global dementia stage (Clinical Dementia Rating Scales (CDRs)). However, when we adjusted for the frontotemporal lobar degeneration-CDR (FTLD-CDR) in the analyses, the two dementia groups were comparable across all measures despite significant differences on the cognitive scales. Conclusion We found tests of cognitive functions (MMSE and MoCA) to be insufficient measures for ensuring comparability between bvFTD and AD groups. In clinical studies, the FTLD-CDR, which includes additional language and behavior items, may be a better overall way to match bvFTD and AD groups on dementia severity. PMID:27079571

Cerebroprotective effect of piracetam in patients undergoing coronary bypass burgery.

PubMed

Holinski, Sebastian; Claus, Benjamin; Alaaraj, Nour; Dohmen, Pascal Maria; Kirilova, Kremena; Neumann, Konrad; Uebelhack, Ralf; Konertz, Wolfgang

2008-11-01

Reduction of cognitive function is a possible side effect after cardiac surgery using cardiopulmonary bypass. We investigated the cerebroprotective effect of piracetam on cognitive performance in patients undergoing coronary artery bypass surgery under cardiopulmonary bypass. Patients scheduled for elective, primary and isolated coronary bypass surgery were randomised either to piracetam or placebo group. The study was performed in a double blind fashion. Patients received either 12 g piracetam or placebo at the beginning of the operation. Six neuropsychological subtests from the Syndrom Kurz Test and the Alzheimer's Disease Assessment Scale were performed preoperatively and on the third postoperative day. To assess the overall cognitive function and the degree of cognitive decline across all tests after surgery we combined the six test-scores by principal component analysis. A total number of 120 patients were enrolled into the study. Preoperative overall cognitive function were not significantly different between the groups. The postoperative combined score of the neuropsychological tests showed a deterioration of cognitive function in both groups (placebo-pre: -0.06+/-0.99 vs placebo-post: -1.38+/-1.11; p<0.0005 and piracetam-pre: 0.06+/-1.02 vs piracetam-post: -0.65+/-0.93; p<0.0005). However, the piracetam patients performed significantly better compared to the placebo patients after the operation and had a less decline of overall cognitive function (p<0.0005). Piracetam has a cerebroprotective effect in patients undergoing coronary artery bypass surgery with the use of cardiopulmonary bypass. It reduces an early postoperative substantial decline of neuropsychological abilities.

Mediterranean diet and cognitive function in older age: results from the Women’s Health Study

PubMed Central

Samieri, Cécilia; Grodstein, Francine; Rosner, Bernard A.; Kang, Jae H.; Cook, Nancy R.; Manson, JoAnn E.; Buring, Julie E.; Willett, Walter C.; Okereke, Olivia I.

2013-01-01

Background Adherence to a Mediterranean diet may help prevent cognitive decline in older age, but studies are limited. We examined the association of adherence to the Mediterranean diet with cognitive function and decline. Methods We included 6,174 participants, aged 65+ years, from the cognitive sub-study of the Women’s Health Study. Women provided dietary information in 1998 and completed a cognitive battery 5 years later, followed by two assessments at 2-year intervals. The primary outcomes were composite scores of global cognition and verbal memory. The alternate Mediterranean diet adherence 9-point-score was constructed based on intakes of: vegetables, fruits, legumes, whole grains, nuts, fish, red and processed meats, moderate alcohol, and the ratio of monounsaturated-to-saturated fats. Results After multivariable adjustment, the alternate Mediterranean diet score was not associated with trajectories of repeated cognitive scores (P-trend across quintiles=0.26 and 0.40 for global cognition and verbal memory, respectively), nor with overall global cognition and verbal memory at older ages, assessed by averaging the three cognitive measures (P-trend=0.63 and 0.44, respectively). Among alternate Mediterranean diet components, higher monounsaturated-to-saturated fats ratio was associated with more favorable cognitive trajectories (P-trend=0.03 and 0.05 for global cognition and verbal memory, respectively). Greater whole grain intake was not associated with cognitive trajectories, but was related to better average global cognition (P-trend=0.02). Conclusions In this large study of older women, we observed no association of the Mediterranean diet with cognitive decline. Relations between individual Mediterranean diet components, particularly whole grains, and cognitive function merit further study. PMID:23676264

17-year outcome of preterm infants with diverse neonatal morbidities: part 2, impact on activities and participation.

PubMed

Sullivan, Mary C; Miller, Robin J; Msall, Michael E

2012-10-01

To examine functioning and participation in a diverse U.S. sample of 180 infants at age 17 years. The World Health Organization International Classification of Functioning, Disability and Health model framed functioning and participation domains and contextual factors. Assessment included cognition, executive functioning, academic achievement, personal functioning, community participation, and social involvement. Socioeconomic status, not prematurity, impacted cognitive and academic outcomes. Across neonatal morbidities, male gender and social disadvantage are key determinants of cognitive, academic, and social functioning. Interventions addressing academic and social-behavioral competencies in early school years may potentially optimize long-term preterm outcomes. © 2012, Wiley Periodicals, Inc.

Can Touch Screen Tablets be Used to Assess Cognitive and Motor Skills in Early Years Primary School Children? A Cross-Cultural Study.

PubMed

Pitchford, Nicola J; Outhwaite, Laura A

2016-01-01

Assessment of cognitive and motor functions is fundamental for developmental and neuropsychological profiling. Assessments are usually conducted on an individual basis, with a trained examiner, using standardized paper and pencil tests, and can take up to an hour or more to complete, depending on the nature of the test. This makes traditional standardized assessments of child development largely unsuitable for use in low-income countries. Touch screen tablets afford the opportunity to assess cognitive functions in groups of participants, with untrained administrators, with precision recording of responses, thus automating the assessment process. In turn, this enables cognitive profiling to be conducted in contexts where access to qualified examiners and standardized assessments are rarely available. As such, touch screen assessments could provide a means of assessing child development in both low- and high-income countries, which would afford cross-cultural comparisons to be made with the same assessment tool. However, before touch screen tablet assessments can be used for cognitive profiling in low-to-high-income countries they need to be shown to provide reliable and valid measures of performance. We report the development of a new touch screen tablet assessment of basic cognitive and motor functions for use with early years primary school children in low- and high-income countries. Measures of spatial intelligence, visual attention, short-term memory, working memory, manual processing speed, and manual coordination are included as well as mathematical knowledge. To investigate if this new touch screen assessment tool can be used for cross-cultural comparisons we administered it to a sample of children ( N = 283) spanning standards 1-3 in a low-income country, Malawi, and a smaller sample of children ( N = 70) from first year of formal schooling from a high-income country, the UK. Split-half reliability, test-retest reliability, face validity, convergent construct validity, predictive criterion validity, and concurrent criterion validity were investigated. Results demonstrate "proof of concept" that touch screen tablet technology can provide reliable and valid psychometric measures of performance in the early years, highlighting its potential to be used in cross-cultural comparisons and research.

Cognitive impairment, clinical severity and MRI changes in MELAS syndrome.

PubMed

Kraya, Torsten; Neumann, Lena; Paelecke-Habermann, Yvonne; Deschauer, Marcus; Stoevesandt, Dietrich; Zierz, Stephan; Watzke, Stefan

2017-12-29

To examine clinical severity, cognitive impairment, and MRI changes in patients with MELAS syndrome. Cognitive-mnestic functions, brain MRI (lesion load, cella media index) and clinical severity of ten patients with MELAS syndrome were examined. All patients carried the m.3243A>G mutation. The detailed neuropsychological assessment revealed cognitive deficits in attention, executive function, visuoperception, and -construction. There were significant correlations between these cognitive changes, lesion load in MRI, disturbances in everyday life (clinical scale), and high scores in NMDAS. Patients with MELAS syndrome showed no global neuropsychological deficit, but rather distinct cognitive deficits. Copyright © 2018 Elsevier B.V. and Mitochondria Research Society. All rights reserved.

Longitudinal relationships between resources, motivation, and functioning.

PubMed

Hess, Thomas M; Emery, Lisa; Neupert, Shevaun D

2012-05-01

We investigated how fluctuations and linear changes in health and cognitive resources influence the motivation to engage in complex cognitive activity and the extent to which motivation mediated the relationship between changing resources and cognitively demanding activities. Longitudinal data from 332 adults aged 20-85 years were examined. Motivation was assessed using a composite of Need for Cognition and Personal Need for Structure and additional measures of health, sensory functioning, cognitive ability, and self-reported activity engagement. Multilevel modeling revealed that age-typical changes in health, sensory functions, and ability were associated with changes in motivation, with the impact of declining health on motivation being particularly strong in older adulthood. Changes in motivation, in turn, predicted involvement in cognitive and social activities as well as changes in cognitive ability. Finally, motivation was observed to partially mediate the relationship between changes in resources and cognitively demanding activities. Our results suggest that motivation may play an important role in determining the course of cognitive change and involvement in cognitively demanding everyday activities in adulthood.

The Impact of Exercise, Cognitive Activities, and Socialization on Cognitive Function: Results From the National Long-Term Care Survey

PubMed Central

Jedrziewski, M. Kathryn; Ewbank, Douglas C.; Wang, Haidong; Trojanowski, John Q.

2014-01-01

Currently, there are no effective treatments for Alzheimer’s disease and related disorders and age continues to be a robust risk factor. Thus, population aging in the United States may have catastrophic results if interventions are not found and implemented. This study examines possible associations between cognitive impairment and exercise, cognitive activities, and socialization. Cognitive activities, socialization, and exercise were assessed at baseline, and cognitive function was measured at baseline, 5-year, and 10-year follow-up. Controlling for baseline cognitive function, age, sex, education, diabetes, and hypertension, linear regression was performed. Engagement in cognitive activities was inversely associated with the onset of cognitive impairment at 5-year follow-up but was no longer significant at 10-year follow-up. Exercise was associated with a lower risk of cognitive impairment at 10-year follow-up but was not significant at 5-year follow-up. Associations with socialization were not statistically significant at either follow-up. PMID:24408752

Predictors of subjective versus objective cognitive functioning in patients with stable grades II and III glioma

PubMed Central

Gehring, Karin; Taphoorn, Martin J.B.; Sitskoorn, Margriet M.; Aaronson, Neil K.

2015-01-01

Background Studies in cancer and noncancer populations demonstrate lower than expected correlations between subjective cognitive symptoms and cognitive functioning as determined by standardized neuropsychological tests. This paper systematically examines the association between subjective and objective cognitive functioning in patients with low-grade glioma and the associations of these indicators of cognitive function with clusters of sociodemographic, clinical, and self-reported physical and mental health factors. Methods Multiple regression analyses with the subjective and 2 objective indicators of cognitive functioning as dependent variables and 4 clusters of predictor variables were conducted in 169 patients with predominantly low-grade glioma. Results Correlations between the subjective and the 2 objective cognitive indicators were negligible (0.04) to low (0.24). Objective cognitive deficits were predominantly associated with sociodemographic (older age, lower education, male sex) and clinical (left hemisphere tumor) variables, while lower ratings of subjective cognitive function were more closely related to self-reported mental health symptoms (fatigue, lower mental well-being), physical (motor) dysfunction and female sex. Self-reported communication deficits were associated significantly with both subjective and objective dysfunction. Conclusions We recommend that both subjective and objective measures of cognitive functioning, together with a measure of psychological distress, be used for comprehensive neuropsychological assessments of patients with glioma to determine which areas are most affected and which specific intervention strategies are most appropriate. PMID:26034638

Physical Activity Interventions in Preventing Cognitive Decline and Alzheimer-Type Dementia: A Systematic Review.

PubMed

Brasure, Michelle; Desai, Priyanka; Davila, Heather; Nelson, Victoria A; Calvert, Collin; Jutkowitz, Eric; Butler, Mary; Fink, Howard A; Ratner, Edward; Hemmy, Laura S; McCarten, J Riley; Barclay, Terry R; Kane, Robert L

2018-01-02

The prevalence of cognitive impairment and dementia is expected to increase dramatically as the population ages, creating burdens on families and health care systems. To assess the effectiveness of physical activity interventions in slowing cognitive decline and delaying the onset of cognitive impairment and dementia in adults without diagnosed cognitive impairments. Several electronic databases from January 2009 to July 2017 and bibliographies of systematic reviews. Trials published in English that lasted 6 months or longer, enrolled adults without clinically diagnosed cognitive impairments, and compared cognitive and dementia outcomes between physical activity interventions and inactive controls. Extraction by 1 reviewer and confirmed by a second; dual-reviewer assessment of risk of bias; consensus determination of strength of evidence. Of 32 eligible trials, 16 with low to moderate risk of bias compared a physical activity intervention with an inactive control. Most trials had 6-month follow-up; a few had 1- or 2-year follow-up. Evidence was insufficient to draw conclusions about the effectiveness of aerobic training, resistance training, or tai chi for improving cognition. Low-strength evidence showed that multicomponent physical activity interventions had no effect on cognitive function. Low-strength evidence showed that a multidomain intervention comprising physical activity, diet, and cognitive training improved several cognitive outcomes. Evidence regarding effects on dementia prevention was insufficient for all physical activity interventions. Heterogeneous interventions and cognitive test measures, small and underpowered studies, and inability to assess the clinical significance of cognitive test outcomes. Evidence that short-term, single-component physical activity interventions promote cognitive function and prevent cognitive decline or dementia in older adults is largely insufficient. A multidomain intervention showed a delay in cognitive decline (low-strength evidence). Agency for Healthcare Research and Quality.

Evolving methods to combine cognitive and physical training for individuals with mild cognitive impairment: study protocol for a randomized controlled study.

PubMed

Lee, Ya-Yun; Wu, Ching-Yi; Teng, Ching-Hung; Hsu, Wen-Chuin; Chang, Ku-Chou; Chen, Poyu

2016-10-28

Nonpharmacologic interventions, such as cognitive training or physical exercise, are effective in improving cognitive functions for older adults with mild cognitive impairment (MCI). Some researchers have proposed that combining physical exercise with cognitive training may augment the benefits of cognition. However, strong evidence is lacking regarding whether a combined therapy is superior to a single type of training for older adults with MCI. Moreover, which combination approach - combining physical exercise with cognitive training sequentially or simultaneously - is more advantageous for cognitive improvement is not yet clear. This proposed study is designed to clarify these questions. This study is a single-blinded, multicenter, randomized controlled trial. Eighty individuals with MCI will be recruited and randomly assigned to cognitive training (COG), physical exercise training (PE), sequential training (SEQ), and dual-task training (DUAL) groups. The intervention programs will be 90 min/day, 2-3 days/week, for a total of 36 training sessions. The participants in the SEQ group will first perform 45 min of physical exercise followed by 45 min of cognitive training, whereas those in the DUAL group will perform physical exercise and cognitive training simultaneously. Participants will be assessed at baseline, after the intervention, and at 6-month follow-up. The primary cognitive outcome tests will include the Montreal Cognitive Assessment and the color-naming Stroop test. Other outcomes will include assessments that evaluate the cognitive, physical, and daily functions of older adults with MCI. The results of this proposed study will provide important information regarding the feasibility and intervention effects of combining physical exercise and cognitive training for older individuals with MCI. ClinicalTrials.gov Identifier: NCT02512627 , registered on 20 July 2015.

Effect of Carotid Artery Stenting on Cognitive Function in Patients with Internal Carotid Artery Stenosis and Cerebral Lacunar Infarction: A 3-Year Follow-Up Study in China

PubMed Central

Xia, Zhang Yong; Sun, Qin Jian; Yang, Hua; Zhang, Ming Xia; Ban, Ru; Xu, Ge Lin; Wu, Ya Ping; Wang, Le Xin; Du, Yi Feng

2015-01-01

Background and Objectives Carotid artery stenting (CAS) is an important therapeutic strategy for patients with carotid artery stenosis. However, the potential influence of CAS on cognitive function in patients with carotid artery stenosis and cerebral lacunar infarction has not been determined. This study investigated changes in cognitive function associated with CAS and the factors related to these changes. Methods This prospective cohort study comprised 579 Chinese patients with cerebral lacunar infarction and carotid artery stenosis for whom CAS was indicated, and a matched control group of 552 healthy individuals. Cognitive function before CAS and at scheduled intervals from 6 months to 3 years was assessed with instruments that included the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scale. Potential factors that might affect cognitive function were analyzed via logistic regression. Results The MMSE and MoCA scores of the patients before CAS were significantly lower than that of the control subjects. These scores were significantly higher 6 months after CAS and sustained or increased throughout the 3-year follow-up. Also significantly improved after CAS from baseline were scores for an alternating trail test, cube copying, clock-drawing, attention, and delayed recall in an auditory-verbal learning test. Logistic regression analyses showed that age greater than 65 y, little education, diabetes, and hypertension were independent risk factors for deteriorated MoCA scores 3 years after CAS. Conclusion CAS was associated with significantly improved cognitive function in cerebral lacunar infarction patients with severe stenosis. PMID:26067432

Loewenstein Occupational Therapy Cognitive Assessment to Evaluate People with Addictions

PubMed Central

Pedrero-Pérez, Eduardo J.; Ruiz-Sánchez de León, José M.; León-Frade, Irene; Aldea-Poyo, Patricia; Alonso-Rodríguez, Marina; Pedrero-Aguilar, Jara; Morales-Alonso, Sara

2017-01-01

Background The LOTCA (Loewenstein Occupational Therapy Cognitive Assessment) battery is a cognitive screening test which is widely used in occupational health. However, no work has been found that explores its use in addiction treatment. Objectives of Study To explore the convergent validity of LOTCA with neuropsychological tests that assess related cerebral functional areas. Methods The LOTCA, along with a battery of neuropsychological tests, was administered to a sample of 48 subjects who start a treatment by substance or gambling addictions. Findings A correlational pattern was observed of a considerable magnitude between the effects of the LOTCA scales and those of some neuropsychological tests, but not with others. There is barely any convergence in measures with memory and executive function tests. Relevance to Clinical Practice There is a lack of research applying test of occupational assessment to populations of patients treated by addictive behaviors. The LOTCA seems to be a reliable and valid test for preliminary screening of function in certain cognitive areas, easy, and quick to use (around 30 minutes). However, it must be supplemented with other tests for a full and ecological assessment of patients. Limitations An incident, small-size sample. Recommendations for Further Research New studies are needed to explore the applicability, diagnostic validity, and whole psychometric quality of the test in addiction-related treatment. PMID:29097963

The Contribution of Generative Leisure Activities to Cognitive Function among Sri Lankan Elderly

PubMed Central

Maselko, Joanna; Sebranek, Matthew; Mun, Mirna Hodzic; Perera, Bilesha; Ahs, Jill; Østbye, Truls

2014-01-01

OBJECTIVES Although a substantive body of research has shown a protective association between leisure activities and cognitive function, consistent evidence is lacking about which specific types of activities should be promoted. The objective of this analysis was to examine the unique contribution of generative leisure activities, defined as activities motivated by “a concern for others and a need to contribute something to the next generation” (Erikson). DESIGN Cross-sectional survey. SETTING Peri-urban and rural area in southern Sri Lanka. PARTICIPANTS Community dwelling adults aged 60+ (n=252). MEASUREMENTS Main predictors were leisure activities grouped into generative, social, or solitary. Main outcome was cognitive function assessed with Montreal Cognitive Assessment (MoCA) and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). RESULTS We found that more frequent engagement in generative leisure activities was associated with higher levels of cognitive function, independent of the impact of other social and solitary leisure activities. In a fully adjusted model combining all three leisure activities, generative activities independently predicted cognitive function as measured with the MoCA (β =0.47 (0.11 to 0.83) and the IQCODE (β = -0.81 (-1.54 to -0.09)). In this combined model, solitary activities were also independently associated with slower cognitive decline with the MoCA (β =0.40 (0.16, 0.64), but not with IQCODE (β =-0.38 (-0.88, 0.12)); the association with social activities did not reach statistical significance with either measure. These associations did not differ meaningfully by gender. CONCLUSION Generative leisure activities are a promising area for the development of interventions aimed at reducing cognitive decline among the elderly. PMID:25139145

Vitamin D Insufficiency and Cognitive Function Trajectories in Older Adults: The Rancho Bernardo Study.

PubMed

Laughlin, Gail A; Kritz-Silverstein, Donna; Bergstrom, Jaclyn; Reas, Emilie T; Jassal, Simerjot K; Barrett-Connor, Elizabeth; McEvoy, Linda K

2017-01-01

Evidence of a role for vitamin D (VitD) in cognitive aging is mixed and based primarily on extreme VitD deficiency. We evaluated the association of VitD insufficiency with cognitive function in older, community-dwelling adults living in a temperate climate with year-round sunshine. A population-based longitudinal study of 1,058 adults (median age 75; 62% women) who had cognitive function assessed and serum levels of 25-hydroxyvitaminD (25OHD) measured in 1997-99 and were followed for up to three additional cognitive function assessments over a 12-year period. Overall, 14% (n = 145) of participants had VitD insufficiency defined as 25OHD <30 ng/ml. Adjusting for age, sex, education, and season, VitD insufficiency was associated with poorer baseline performance on the Mini-Mental Status Exam (MMSE) (p = 0.013), Trails Making Test B (Trails B) (p = 0.015), Category Fluency (p = 0.006), and Long Term Retrieval (p = 0.019); differences were equivalent to 5 years of age. For those with VitD insufficiency, the odds of mildly impaired performance at baseline were 38% higher for MMSE (p = 0.08), 78% higher for Trails B (p = 0.017), and 2-fold higher for Category Fluency and Long Term Retrieval (both p = 0.001). VitD insufficiency was not related to the rate of cognitive decline on any test or the risk of developing impaired performance during follow-up. In this population with little VitD deficiency, even moderately low VitD was associated with poorer performance on multiple domains of cognitive function. Low VitD did not predict 12-year cognitive decline. Clinical trials are essential to establish a causal link between VitD and cognitive well-being.

Anesthesia and Surgery Impair Blood–Brain Barrier and Cognitive Function in Mice

PubMed Central

Yang, Siming; Gu, Changping; Mandeville, Emiri T.; Dong, Yuanlin; Esposito, Elga; Zhang, Yiying; Yang, Guang; Shen, Yuan; Fu, Xiaobing; Lo, Eng H.; Xie, Zhongcong

2017-01-01

Blood–brain barrier (BBB) dysfunction, e.g., increase in BBB permeability, has been reported to contribute to cognitive impairment. However, the effects of anesthesia and surgery on BBB permeability, the underlying mechanisms, and associated cognitive function remain largely to be determined. Here, we assessed the effects of surgery (laparotomy) under 1.4% isoflurane anesthesia (anesthesia/surgery) for 2 h on BBB permeability, levels of junction proteins and cognitive function in both 9- and 18-month-old wild-type mice and 9-month-old interleukin (IL)-6 knockout mice. BBB permeability was determined by dextran tracer (immunohistochemistry imaging and spectrophotometric quantification), and protein levels were measured by Western blot and cognitive function was assessed by using both Morris water maze and Barnes maze. We found that the anesthesia/surgery increased mouse BBB permeability to 10-kDa dextran, but not to 70-kDa dextran, in an IL-6-dependent and age-associated manner. In addition, the anesthesia/surgery induced an age-associated increase in blood IL-6 level. Cognitive impairment was detected in 18-month-old, but not 9-month-old, mice after the anesthesia/surgery. Finally, the anesthesia/surgery decreased the levels of β-catenin and tight junction protein claudin, occludin and ZO-1, but not adherent junction protein VE-cadherin, E-cadherin, and p120-catenin. These data demonstrate that we have established a system to study the effects of perioperative factors, including anesthesia and surgery, on BBB and cognitive function. The results suggest that the anesthesia/surgery might induce an age-associated BBB dysfunction and cognitive impairment in mice. These findings would promote mechanistic studies of postoperative cognitive impairment, including postoperative delirium. PMID:28848542

Infant motor and cognitive abilities and subsequent executive function.

PubMed

Wu, Meng; Liang, Xi; Lu, Shan; Wang, Zhengyan

2017-11-01

Although executive function (EF) is widely considered crucial to several aspects of life, the mechanisms underlying EF development remain largely unexplored, especially for infants. From a behavioral or neurodevelopmental perspective, motor and general cognitive abilities are linked with EF. EF development is a multistage process that starts with sensorimotor interactive behaviors, which become basic cognitive abilities and, in turn, mature EF. This study aims to examine how infant motor and general cognitive abilities are linked with their EF at 3 years of age. This work also aims to explore the potential processes of EF development from early movement. A longitudinal study was conducted with 96 infants (55 girls and 41 boys). The infants' motor and general cognitive abilities were assessed at 1 and 2 years of age with Bayley Scales of Infant and Toddler Development, Second and Third Editions, respectively. Infants' EFs were assessed at 3 years of age with Working Memory Span task, Day-Night task, Wrapped Gift task, and modified Gift-in-Bag task. Children with higher scores for cognitive ability at 2 years of age performed better in working memory, and children with higher scores for gross motor ability at 2 years performed better in cognitive inhibitory control (IC). Motor ability at 1 year and fine/gross motor ability at 2 years indirectly affected cognitive IC via general cognitive ability at 2 years and working memory. EF development is a multistage process that originates from physical movement to simple cognitive function, and then to complex cognitive function. Infants and toddlers can undergo targeted motor training to promote EF development. Copyright © 2017 Elsevier Inc. All rights reserved.