WorldWideScience

Sample records for cognitive impairment role

  1. Revisiting nicotine's role in the ageing brain and cognitive impairment

    DEFF Research Database (Denmark)

    Majdi, Alireza; Kamari, Farzin; Vafaee, Manouchehr Seyedi

    2017-01-01

    Brain ageing is a complex process which in its pathologic form is associated with learning and memory dysfunction or cognitive impairment. During ageing, changes in cholinergic innervations and reduced acetylcholinergic tonus may trigger a series of molecular pathways participating in oxidative...... in optimum therapeutic effects without imparting abuse potential or toxicity. Overall, this review aims to compile the previous and most recent data on nicotine and its effects on cognition-related mechanisms and age-related cognitive impairment....

  2. Revisiting nicotine's role in the ageing brain and cognitive impairment

    DEFF Research Database (Denmark)

    Majdi, Alireza; Kamari, Farzin; Vafaee, Manouchehr Seyedi

    2017-01-01

    stress, excitotoxicity, amyloid-β toxicity, apoptosis, neuroinflammation, and perturb neurotrophic factors in the brain. Nicotine is an exogenous agonist of nicotinic acetylcholine receptors (nAChRs) and acts as a pharmacological chaperone in the regulation of nAChR expression, potentially intervening...... in age-related changes in diverse molecular pathways leading to pathology. Although nicotine has therapeutic potential, paradoxical effects have been reported, possibly due to its inverted U-shape dose-response effects or pharmacokinetic factors. Additionally, nicotine administration should result...... in optimum therapeutic effects without imparting abuse potential or toxicity. Overall, this review aims to compile the previous and most recent data on nicotine and its effects on cognition-related mechanisms and age-related cognitive impairment....

  3. The role of cognitive impairment in the quality of life after ischaemic stroke

    NARCIS (Netherlands)

    Kwa, V. I.; Limburg, M.; de Haan, R. J.

    1996-01-01

    Many patient- and disease-related factors influence the quality of life (QL) after stroke. Few studies address the direct relation between cognition and quality of life. The objective of this study was to investigate the role of cognitive impairment in the QL of patients after stroke. We evaluated

  4. Mild Cognitive Impairment (MCI)

    Science.gov (United States)

    Mild cognitive impairment (MCI) Overview Mild cognitive impairment (MCI) is an intermediate stage between the expected cognitive decline of normal aging and the more-serious decline of dementia. It ...

  5. The role of cognitive impairment in psychosocial functioning in remitted depression.

    Science.gov (United States)

    Knight, Mattew J; Air, Tracy; Baune, Bernhard T

    2018-08-01

    Cognitive dysfunction is a prevalent and disabling symptom of Major Depressive Disorder (MDD), and is often retained in the remitted stage of illness. Emerging evidence suggests that cognitive impairment may be associated with dysfunction in a number of psychosocial domains (e.g., workplace productivity, social relationships). The current study explored the relationship between cognition and psychosocial functioning in remitted MDD and in healthy controls. Data were obtained from 182 participants of the Cognitive Function and Mood Study (CoFaM-S), a cross-sectional study of cognition, mood, and social cognition in mood disorders. Participants' (Remitted MDD n = 72, Healthy n = 110) cognition was assessed with a battery of cognitive tests including the Repeatable Battery for the Assessment of Neuropsychological Function (RBANS) and other standard measures of cognition (e.g., The Tower of London task). Psychosocial functioning was clinically evaluated with the Functioning Assessment Short Test (FAST). The results indicated that executive functioning was the strongest independent predictor of functioning in remitted MDD patients, whereas various cognitive domains predicted psychosocial functioning in healthy individuals. Psychosocial functioning was measured with a clinical interview, and was therefore reliant on clinicians' judgement of impairment, as opposed to more objective measures of functioning. These findings suggest that executive cognition plays an important role in functional recovery in remitted depression, and may be a crucial target in adjunctive treatment. Copyright © 2018 Elsevier B.V. All rights reserved.

  6. Cognitive Impairment in Chronic Kidney Disease: Vascular Milieu and the Potential Therapeutic Role of Exercise

    Directory of Open Access Journals (Sweden)

    Ulf G. Bronas

    2017-01-01

    Full Text Available Chronic kidney disease (CKD is considered a model of accelerated aging. More specifically, CKD leads to reduced physical functioning and increased frailty, increased vascular dysfunction, vascular calcification and arterial stiffness, high levels of systemic inflammation, and oxidative stress, as well as increased cognitive impairment. Increasing evidence suggests that the cognitive impairment associated with CKD may be related to cerebral small vessel disease and overall impairment in white matter integrity. The triad of poor physical function, vascular dysfunction, and cognitive impairment places patients living with CKD at an increased risk for loss of independence, poor health-related quality of life, morbidity, and mortality. The purpose of this review is to discuss the available evidence of cerebrovascular-renal axis and its interconnection with early and accelerated cognitive impairment in patients with CKD and the plausible role of exercise as a therapeutic modality. Understanding the cerebrovascular-renal axis pathophysiological link and its interconnection with physical function is important for clinicians in order to minimize the risk of loss of independence and improve quality of life in patients with CKD.

  7. Role of cognitive reserve in progression from mild cognitive impairment to dementia

    Directory of Open Access Journals (Sweden)

    Ricardo F. Allegri

    Full Text Available Abstract Cognitive reserve is the ability to optimize performance through differential recruitment of brain networks, which may reflect the use of alternative cognitive strategies. Objectives: To identify factors related to cognitive reserve associated with progression from mild cognitive impairment (MCI to degenerative dementia. Methods: A cohort of 239 subjects with MCI (age: 72.2±8.1 years, 58% women, education: 12 years was assessed and followed for five years (2001 to 2006. Results: In the first year, 13.7% of MCI converted to dementia and 34.7% converted within three years (78.3% converted to Alzheimer's dementia. Risk factors for those who converted were education less than 12 years, MMSE score less than 27, Boston naming test score less than 51, IQ (Intelligence Quotient less than 111, age over 75 years, lack of occupation at retirement, and presence of intrusions in memory recall (all account for 56% of the variability of conversion. Conclusions: MCI patients are a population at high risk for dementia. The study of risk factors (e.g. IQ, education and occupation, particularly those related to cognitive reserve, can contribute important evidence to guide the decision-making process in routine clinical activity and public health policy.

  8. Cognitive impairments in epilepsy

    Directory of Open Access Journals (Sweden)

    Aleksandr Anatolyevich Kostylev

    2013-01-01

    Full Text Available Cognitive impairments in epilepsy are a current problem in neurology. The basis of the idea on the pathogenesis of higher nervous system dysfunctions is the interaction of a few factors that include the form and duration of the disease, gender differences, and the impact of antiepileptic therapy. The role of interattack epileptiform changes in the development of cognitive deficit in adults and epileptic encephalopathies in children is discussed. Up-to-date neurophysiological and neuroimaging diagnostic methods allow the detection of new features in the course and progression of higher nervous system dysfunctions in epilepsy.

  9. Roles of Education and IQ in Cognitive Reserve in Parkinson’s Disease-Mild Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    M.J. Armstrong

    2012-08-01

    Full Text Available Background/Aims: The role of cognitive reserve in Parkinson’s disease (PD-mild cognitive impairment (MCI is incompletely understood. Methods: The relationships between PD-MCI, years of education, and estimated premorbid IQ were examined in 119 consecutive non-demented PD patients using logistic regression models. Results: Higher education and IQ were associated with reduced odds of PD-MCI in univariate analysis. In multivariable analysis, a higher IQ was associated with a significantly decreased odds of PD-MCI, but education was not. Conclusion: The association of higher IQ and decreased odds of PD-MCI supports a role for cognitive reserve in PD, but further studies are needed to clarify the interaction of IQ and education and the impact of other contributors such as employment and hobbies.

  10. The role of white matter lesions in cognitive impairment of vascular origin

    International Nuclear Information System (INIS)

    Kazakov, D.

    2003-01-01

    Abnormalities involving the cerebral white matter, in particular the centrum semiovale, are a subject of great current interest. Partly this is because modern neuroimaging methods detect white matter changes with increasing frequency in persons older than 60 years and also because these abnormalities may be associated with specific neuro behavioral deficits, including cognitive impairment. The significance of these changes, as well as their pathophysiological background is incompletely understood. The aim of this paper is to critically review the existing knowledge about the role of the white matter lesions, based on the critical analysis of over 100 publications (most appearing in the last decade). (author)

  11. Critical Role of Endoplasmic Reticulum Stress in Cognitive Impairment Induced by Microcystin-LR

    Directory of Open Access Journals (Sweden)

    Fei Cai

    2015-11-01

    Full Text Available Recent studies showed that cyanobacteria-derived microcystin-leucine-arginine (MCLR can cause hippocampal pathological damage and trigger cognitive impairment; but the underlying mechanisms have not been well understood. The objective of the present study was to investigate the mechanism of MCLR-induced cognitive deficit; with a focus on endoplasmic reticulum (ER stress. The Morris water maze test and electrophysiological study demonstrated that MCLR caused spatial memory injury in male Wistar rats; which could be inhibited by ER stress blocker; tauroursodeoxycholic acid (TUDCA. Meanwhile; real-time polymerase chain reaction (real-time PCR and immunohistochemistry demonstrated that the expression level of the 78-kDa glucose-regulated protein (GRP78; C/EBP homologous protein (CHOP and caspase 12 were significantly up-regulated. These effects were rescued by co-administration of TUDCA. In agreement with this; we also observed that treatment of rats with TUDCA blocked the alterations in ER ultrastructure and apoptotic cell death in CA1 neurons from rats exposed to MCLR. Taken together; the present results suggested that ER stress plays an important role in potential memory impairments in rats treated with MCLR; and amelioration of ER stress may serve as a novel strategy to alleviate damaged cognitive function triggered by MCLR.

  12. Cognitive impairment in anxiety disorders

    Directory of Open Access Journals (Sweden)

    B. A. Volel

    2018-01-01

    Full Text Available Anxiety disorders are an important biomedical problem due to the high prevalence and significant negative impact on the quality of life and the course of concomitant somatic and neurological diseases. Cognitive impairment (CI is one of the most intensively studied aspects of pathological anxiety. Impairments in attention, executive functions, memory, cognitive deficit, as well as abnormal cognitions and metacognitions are identified in anxiety disorders. Moreover, the treatment of the latter with the most frequently used drugs (antidepressants, atypical antipsychotics, anticonvulsants, tranquilizers does not lead to a significant improvement in cognitive functions, and often contributes to their worsening. In this connection, in addition to psychotherapy, cognitive function-improving agents play a large role in treating anxiety diseases associated with cognitive dysfunction. Ginkgo Biloba extract (EGb 761, Tanakan® that positively affects cognitive functions, especially in the domains of memory, concentration and attention deserves special attention.

  13. Improving dementia care: The role of screening and detection of cognitive impairment

    Science.gov (United States)

    Borson, Soo; Frank, Lori; Bayley, Peter J.; Boustani, Malaz; Dean, Marge; Lin, Pei-Jung; McCarten, J. Riley; Morris, John C.; Salmon, David P.; Schmitt, Frederick A.; Stefanacci, Richard G.; Mendiondo, Marta S.; Peschin, Susan; Hall, Eric J.; Fillit, Howard; Ashford, J. Wesson

    2014-01-01

    The value of screening for cognitive impairment, including dementia and Alzheimer's disease, has been debated for decades. Recent research on causes of and treatments for cognitive impairment has converged to challenge previous thinking about screening for cognitive impairment. Consequently, changes have occurred in health care policies and priorities, including the establishment of the annual wellness visit, which requires detection of any cognitive impairment for Medicare enrollees. In response to these changes, the Alzheimer's Foundation of America and the Alzheimer's Drug Discovery Foundation convened a workgroup to review evidence for screening implementation and to evaluate the implications of routine dementia detection for health care redesign. The primary domains reviewed were consideration of the benefits, harms, and impact of cognitive screening on health care quality. In conference, the workgroup developed 10 recommendations for realizing the national policy goals of early detection as the first step in improving clinical care and ensuring proactive, patient-centered management of dementia. PMID:23375564

  14. Prevalence of Cognitive Impairment Among Peritoneal Dialysis Patients, Impact on Peritonitis and Role of Assisted Dialysis.

    Science.gov (United States)

    Shea, Yat Fung; Lam, Man Fai; Lee, Mi Suen Connie; Mok, Ming Yee Maggie; Lui, Sing-Leung; Yip, Terence P S; Lo, Wai Kei; Chu, Leung Wing; Chan, Tak-Mao

    2016-01-01

    ♦ Chronic renal failure and aging are suggested as risk factors for cognitive impairment (CI). We studied the prevalence of CI among peritoneal dialysis (PD) patients using Montreal Cognitive Assessment (MoCA), its impact on PD-related peritonitis in the first year, and the potential role of assisted PD. ♦ One hundred fourteen patients were newly started on PD between February 2011 and July 2013. Montreal Cognitive Assessment was performed in the absence of acute illness. Data on patient characteristics including demographics, comorbidities, blood parameters, dialysis adequacy, presence of helpers, medications, and the number PD-related infections were collected. ♦ The age of studied patients was 59±15.0 years, and 47% were female. The prevalence of CI was 28.9%. Patients older than 65 years old (odds ratio [OR] 4.88, confidence interval [CI] 1.79 - 13.28 p = 0.002) and with an education of primary level or below (OR 4.08, CI 1.30 - 12.81, p = 0.016) were independent risk factors for CI in multivariate analysis. Patients with PD-related peritonitis were significantly older (p peritonitis among self-care PD patients (OR 2.20, CI 0.65 - 7.44, p = 0.20). When we compared patients with MoCA-defined CI receiving self-care and assisted PD, there were no statistically significant differences between the 2 groups in terms of age, MoCA scores, or comorbidities. There were also no statistically significant differences in 1-year outcome of PD-related peritonitis rates or exit-site infections. ♦ Cognitive impairment is common among local PD patients. Even with CI, peritonitis rate in self-care PD with adequate training is similar to CI patients on assisted PD. Copyright © 2016 International Society for Peritoneal Dialysis.

  15. Role of inflammatory markers in Elderly Type 2 Diabetic Patients with Mild Cognitive Impairment.

    Science.gov (United States)

    Hosny, Salwa S; Bahaaeldin, Ahmed M; Khater, Mohamed S; Bekhet, Meram M; Hebah, Hayam A; Hasanin, Ghada A

    2018-04-22

    Type 2 diabetes (T2DM) is a risk factor for Alzheimer's disease and mild cognitive impairment. The etiology of cognitive impairment in people with T2DM is uncertain but, chronic hyperglycemia, cerebral micro vascular disease, severe hypoglycemia, and increased prevalence of macro vascular disease are implicated. to determine the serum levels of soluble vascular adhesion molecule (sVCAM-1) and highly sensitive C-reactive protein (hs-CRP) in elderly type 2 diabetics with mild cognitive impairment (MCI). Our study was conducted on 90 elderly subjects (aged 60 years old or more). They were divided into Group І, 30 patients with T2DM and mild cognitive impairment, group ІІ, 30 patients with T2DM without cognitive impairment and group III, 30 healthy subjects as a control group. They were subjected to history taking, full clinical examination, anthropometric measurement, the Addenbrooke's Cognitive Examination III (ACE---III 2012), Fasting plasma glucose, 2 hours plasma glucose, HbA1c, lipid profile, protein/creatinine ratio, serum sVCAM-1 and hs-CRP. Serum levels of sVCAM-1 in diabetic elderly patients with MCI were significantly higher (946.7 ± 162.01 ng/ml) than diabetic elderly patients without cognitive impairment (479.06 ± 65.27 ng/ml) and control (263.7 ± 72.05 ng/ml) with (P=0.002). Serum levels of Hs-CRP in diabetic elderly patients with MCI were significantly higher than as diabetic elderly patients without cognitive impairment and control with (P=0.005). Elderly diabetic patients with mild cognitive impairment, have higher levels of soluble adhesion molecules and markers of low-grade systemic inflammation than other groups. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  16. Neurocognitive markers of cognitive impairment: exploring the roles of speed and inconsistency.

    Science.gov (United States)

    Dixon, Roger A; Garrett, Douglas D; Lentz, Tanya L; MacDonald, Stuart W S; Strauss, Esther; Hultsch, David F

    2007-05-01

    A well-known challenge for research in the cognitive neuropsychology of aging is to distinguish between the deficits and changes associated with normal aging and those indicative of early cognitive impairment. In a series of 2 studies, the authors explored whether 2 neurocognitive markers, speed (mean level) and inconsistency (intraindividual variability), distinguished between age groups (64-73 and 74-90+ years) and cognitive status groups (nonimpaired, mildly impaired, and moderately impaired). Study 1 (n = 416) showed that both level and inconsistency distinguished between the age and 2 cognitive status (not impaired, mildly impaired) groups, with a modest tendency for inconsistency to predict group membership over and above mean level. Study 2 (n = 304) replicated these results but extended them because of the qualifying effects associated with the unique moderately impaired oldest group. Specifically, not only were the groups more firmly distinguished by both indicators of speed, but evidence for the differential contribution of performance inconsistency was stronger. Neurocognitive markers of speed and inconsistency may be leading indicators of emerging cognitive impairment. (c) 2007 APA, all rights reserved

  17. A Social Model of Loneliness: The Roles of Disability, Social Resources, and Cognitive Impairment.

    Science.gov (United States)

    Burholt, Vanessa; Windle, Gill; Morgan, Deborah J

    2017-11-10

    We consider the points at which cognitive impairment may impact on the pathway to loneliness for older people, through impeding social interaction with family and friends, or by interfering with judgments concerning satisfaction with relationships. We conceptualize a mediation model anticipating that social resources (LSNS-6) will mediate the pathway between disability (Townsend Disability Scale) and loneliness (De Jong Gierveld 6-item scale) and a moderated-mediation model in which we hypothesize that cognitive impairment (MMSE) will moderate the association between disability and social resources and between social resources and loneliness. To validate the hypothesized pathways, we draw on the CFAS Wales data set (N = 3,593) which is a nationally representative study of community-dwelling people aged 65 and older in Wales. Disability had a significant indirect effect on loneliness through the mediating variable social resources. Cognitive impairment was significantly associated with social resources, but did not moderate the relationship between disability and social resources. Cognitive impairment had a significant impact on loneliness, and moderated the effect of social resources on loneliness. Social structures can (dis)empower people with cognitive impairment and lead to exclusion from social resources or impact on the social construction of aging, cognitive impairment, and dementia. The sense of self for an older person with cognitive impairment may be influenced by social norms and stereotypes, or through a temporal social comparison with an "earlier" sense of self. We conclude that loneliness interventions should be theoretically informed to identify key areas for modification. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America.

  18. Impaired cognitive control mediates the relationship between cortical thickness of the superior frontal gyrus and role functioning in schizophrenia.

    Science.gov (United States)

    Tully, Laura M; Lincoln, Sarah Hope; Liyanage-Don, Nadia; Hooker, Christine I

    2014-02-01

    Structural abnormalities in the lateral prefrontal cortex (LPFC) are well-documented in schizophrenia and recent evidence suggests that these abnormalities relate to functional outcome. Cognitive control mechanisms, reliant on the LPFC, are impaired in schizophrenia and predict functional outcome, thus impaired cognitive control could mediate the relationship between neuroanatomical abnormalities in the LPFC and functional outcome. We used surface-based morphometry to investigate relationships between cortical surface characteristics, cognitive control, and measures of social and role functioning in 26 individuals with schizophrenia and 29 healthy controls. Results demonstrate that schizophrenia participants had thinner cortex in a region of the superior frontal gyrus (BA10). Across all participants, decreased cortical thickness in this region related to decreased cognitive control and decreased role functioning. Moreover, cognitive control fully mediated the relationship between cortical thickness in the superior frontal gyrus and role functioning, indicating that neuroanatomical abnormalities in the LPFC adversely impact role functioning via impaired cognitive control processes. Copyright © 2013 Elsevier B.V. All rights reserved.

  19. Rehabilitation of stroke patients with apraxia: the role of additional cognitive and motor impairments.

    Science.gov (United States)

    van Heugten, C M; Dekker, J; Deelman, B G; Stehmann-Saris, J C; Kinebanian, A

    2000-08-15

    The present study investigated which additional cognitive and motor impairments were present in stroke patients with apraxia and which of these factors influenced the effects of treatment. A group of 33 patients with apraxia were treated according to the guidelines of a therapy programme based on teaching patients strategies to compensate for the presence of apraxia. Patients were treated at occupational therapy departments in general hospitals, rehabilitation centres and nursing homes. The outcome of the strategy training was studied in a pre-post test design; measurements were conducted at baseline and after 12 weeks of therapy. The pretreatment scores of the patients with apraxia were compared to normscores and scores of a control group of patients without apraxia (n = 36) to investigate which impairments are present. The following variables were analysed in order to determine which factors influence outcome: additional neuropsychological deficits (comprehension of language, cognitive impairments due to dementia, neglect and short term memory), level of motor functioning, severity of apraxia and performance on activities of daily living (ADL), and some relevant patient characteristics (gender, age, type of stroke, time since stroke, and location of treatment). The results showed that the presence of apraxia is associated with the presence of additional cognitive and motor impairments. The successful outcome of strategy training was not negatively influenced by cognitive comorbidity. The outcome seemed to be more prominent in patients who were more severely impaired at the start of rehabilitation in terms of the degree of motor impairments, the severity of apraxia and the initial ADL dependence. The ADL observations, however, displayed a ceiling effect, which was taken into account in discussing the results. Demographic variables, especially age, did not predict the outcome of treatment. We suggest that the effect of this training is stronger in more severely

  20. Vascular cognitive impairment

    Directory of Open Access Journals (Sweden)

    N.V. Vakhnina

    2014-01-01

    Full Text Available Vascular pathology of the brain is the second most common cause of cognitive impairment after Alzheimer's disease. The article describes the modern concepts of etiology, pathogenetic mechanisms, clinical features and approaches to diagnosis and therapy of vascular cognitive impairment (VCI. Cerebrovascular accident, chronic cerebral circulatory insufficiency and their combination, sometimes in combination with a concomitant neurodegenerative process, are shown to be the major types of brain lesions leading to VCI. The clinical presentation of VCI is characterized by the neuropsychological status dominated by impairment of the executive frontal functions (planning, control, attention in combination with focal neurological symptoms. The diagnosis is based on comparing of the revealed neuropsychological and neurological features with neuroimaging data. Neurometabolic, acetylcholinergic, glutamatergic, and other vasoactive drugs and non-pharmacological methods are widely used to treat VCI. 

  1. Rehabilitation of stroke patients with apraxia : the role of additional cognitive and motor impairments

    NARCIS (Netherlands)

    van Heugten, C.M.; Dekker, J.; Deelman, B.G.; Stehmann-Saris, J.C; Kinebanian, A

    Purpose : The present study investigated which additional cognitive and motor impairments were present in stroke patients with apraxia and which of these factors influenced the effects of treatment. Method: A group of 33 patients with apraxia were treated according to the guidelines of a therapy

  2. Rehabilitation of stroke patients with apraxia: the role of additional cognitive and motor impairments.

    NARCIS (Netherlands)

    Heugten, C.M. van; Dekker, J.; Deelman, B.G.; Stehmann-Saris, J.C.; Kinebanian, A.

    2000-01-01

    PURPOSE: The present study investigated which additional cognitive and motor impairments were present in stroke patients with apraxia and which of these factors influenced the effects of treatment. METHOD: A group of 33 patients with apraxia were treated according to the guidelines of a therapy

  3. Cardiovascular disease risk factors and cognitive impairment.

    Science.gov (United States)

    Nash, David T; Fillit, Howard

    2006-04-15

    The role of cardiovascular disease risk factors in the occurrence and progression of cognitive impairment has been the subject of a significant number of publications but has not achieved widespread recognition among many physicians and educated laymen. It is apparent that the active treatment of certain of these cardiovascular disease risk factors is accompanied by a reduced risk for cognitive impairment. Patients with hypertension who are treated experience fewer cardiovascular disease events as well as less cognitive impairment than similar untreated patients. Patients who exercise may present with less cognitive impairment, and obesity may increase the risk for cognitive impairment. Lipid abnormalities and genetic markers are associated with an increased risk for cardiovascular disease and cognitive impairment. Autopsy studies have demonstrated a correlation between elevated levels of cholesterol and amyloid deposition in the brain. Research has demonstrated a relation between atherosclerotic obstruction lesions in the circle of Willis and dementia. Diabetes mellitus is associated with an increased risk for cardiovascular disease and cognitive impairment. A number of nonpharmacologic factors have a role in reducing the risk for cognitive impairment. Antioxidants, fatty acids, and micronutrients may have a role, and diets rich in fruits and vegetables and other dietary approaches may improve the outlook for patients considered at risk for cognitive impairment.

  4. Meta-Analysis of Social Cognition in Mild Cognitive Impairment.

    Science.gov (United States)

    Bora, Emre; Yener, Görsev G

    2017-07-01

    Social cognitive abilities are impaired in Alzheimer disease and other dementias. Recent studies suggested that social cognitive abilities might be also impaired in mild cognitive impairment (MCI). Current meta-analysis aimed to summarize available evidence for deficits in theory of mind (ToM) and emotion recognition in MCI. In this meta-analysis of 17 studies, facial emotion recognition and ToM performances of 513 individuals with MCI and 693 healthy controls were compared. Mild cognitive impairment was associated with significant impairments falling in the medium effect sizes range in ToM ( d = 0.63) and facial emotion recognition ( d = 0.58). Among individual emotions, recognition of fear and sadness were particularly impaired. There were no significant between-group differences in recognition of disgust, happiness, and surprise. Social cognitive deficits were more severe in multidomain MCI. There is a need for longitudinal studies investigating the potential role of social cognitive impairment in predicting conversion to dementia.

  5. Cognitive impairment and electroconvulsive therapy in geriatric depression, what could be the role of rivastigmine? A case series

    NARCIS (Netherlands)

    van Schaik, Audrey Monica; Rhebergen, Didi; Henstra, Marieke Jantien; Kadouch, Daniel J.; van Exel, Eric; Stek, Maximilianus Lourentius

    2015-01-01

    Electroconvulsive therapy (ECT), albeit highly effective in treating depression, is frequently associated with cognitive impairment, either temporary or more persistent. Especially in older patients, who generally respond even better, serious cognitive impairment during the course of ECT may lead to

  6. Education and dementing disorders : The role of schooling in dementia and cognitive impairment

    OpenAIRE

    De Ronchi, Diana

    2005-01-01

    This doctoral thesis aimed to investigate the complex relationship between education, dementias, and cognitive impairment. Two different databases were used: the Faenza and the AIDS Projects. The Faenza Project is a longitudinal study on ageing and dementia, targeting 7,930 inhabitants of Faenza (including the village of Granarolo), Italy, aged 61 years and older in 1991. The study population derives from an area which has been one of the wealthiest in Italy since the beginn...

  7. Rehabilitation of stroke patients with apraxia: the role of additional cognitive and motor impairments.

    OpenAIRE

    Heugten, C.M. van; Dekker, J.; Deelman, B.G.; Stehmann-Saris, J.C.; Kinebanian, A.

    2000-01-01

    PURPOSE: The present study investigated which additional cognitive and motor impairments were present in stroke patients with apraxia and which of these factors influenced the effects of treatment. METHOD: A group of 33 patients with apraxia were treated according to the guidelines of a therapy programme based on teaching patients strategies to compensate for the presence of apraxia. Patients were treated at occupational therapy departments in general hospitals, rehabilitation centres and nur...

  8. The role of social frailty in explaining the association between hearing problems and mild cognitive impairment in older adults.

    Science.gov (United States)

    Bae, Seongryu; Lee, Sangyoon; Lee, Sungchul; Jung, Songee; Makino, Keitaro; Park, Hyuntae; Shimada, Hiroyuki

    2018-06-01

    We examined the role of social frailty in the association between hearing problems and mild cognitive impairment (MCI), and investigated which cognitive impairment domains are most strongly involved. Participants were 4251 older adults (mean age 72.5 ± 5.2 years, 46.1% male) who met the study inclusion criteria. Hearing problems were measured using the Hearing Handicap Inventory for the Elderly. Social frailty was identified using responses to five questions. Participants were divided into four groups depending on the presence of social frailty and hearing problems: control, social frailty, hearing problem, and co-occurrence. We assessed memory, attention, executive function, and processing speed using the National Center for Geriatrics and Gerontology-Functional Assessment Tool. Participants were categorized into normal cognition, single- and multiple-domain MCI, depending on the number of impaired cognitive domains. Participants with multiple-domain MCI exhibited the highest odds ratios (OR) of the co-occurrence group (OR: 3.89, 95% confidence intervals [CI]: 1.96-7.72), followed by the social frailty (OR: 2.65, 95% CI: 1.49-4.67), and hearing problem (OR: 1.90, 95% CI: 1.08-3.34) groups, compared with the control group. However, single-domain MCI was not significantly associated with any group. Cognitive domain analysis revealed that impaired executive function and processing speed were associated with the co-occurrence, hearing problem, and social frailty groups, respectively. Social frailty and hearing problems were independently associated with multiple-domain MCI. Comorbid conditions were more strongly associated with multiple-domain MCI. Longitudinal studies are needed to elucidate the causal role of social frailty in the association between hearing impairment and MCI. Copyright © 2018 Elsevier B.V. All rights reserved.

  9. Cognitive decision modelling of emotion-based learning impairment in schizophrenia: the role of awareness.

    Science.gov (United States)

    Cella, Matteo; Dymond, Simon; Cooper, Andrew; Turnbull, Oliver H

    2012-03-30

    Individuals with schizophrenia often lack insight or awareness. Resulting impairment has been observed in various cognitive domains and, recently, linked to problems in emotion-based learning. The Iowa Gambling Task (IGT) has been used to assess emotion-based decision-making in patients with schizophrenia, but results have been inconclusive. The current study further investigates emotion-based decision-making in schizophrenia by elucidating the unique contribution of awareness. Twenty-five patients with schizophrenia and 24 healthy controls were assessed with a modified version of the IGT recording awareness at regular intervals. Symptom assessment, medication and medical history were recorded for the clinical group. Patients with schizophrenia underperformed on the IGT compared to controls. Subjective awareness levels were significantly lower in the schizophrenia group and were associated with hallucination severity. Cognitive decision modelling further indicated that patients with schizophrenia had impaired attention to losses, compared to controls. This parameter was positively correlated with awareness. We also found that positive symptoms altered awareness levels and suggest that this disruption may contribute to sub-optimal decision-making. Overall, a lack of awareness may be an important aspect in understanding impaired social cognitive functioning and emotion-based learning observed in schizophrenia. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. Cognitive Impairment in Infratentorial Strokes

    Directory of Open Access Journals (Sweden)

    Melek Kandemir

    2009-12-01

    Full Text Available OBJECTIVE: Beginning in the mid-1980s, with anatomical, behavioral, and neuropsychological evidence, it was suggested that the role of the cerebellum extends beyond a purely motor domain. A series of articles were published reviewing the potential role of the cerebellum in cognition. Both of these functions are supported by connections of dentate nucleus and frontal cortex through the thalamus. The cognitive profile of isolated subtentorial and cerebellar infarcts is related to the involved frontal circuit (especially executive functions. In this study, we aimed to demonstrate the cognitive profile of cerebellar and subtentorial infarcts. METHODS: Nineteen patients with infratentorial infarcts and 19 neurologically healthy individuals as a control group were included in this study. Neuropsychometric test battery was employed in both of the groups. RESULTS: Age, sex, education, clinical syndrome, and localization had no effect on the cognitive test performances. Performance on the California Verbal Learning Test, a verbal memory test, was worse in the patient group. Patients had difficulties in recognizing the items of the Rey-Osterrieth Complex Figure Test, and spent significantly more time to complete the trail making test part B. The patient group also demonstrated lower performance level in the verbal fluency test when compared to the control group. CONCLUSION: The cognitive impairment pattern of the verbal and visual memory tests and impairment determined on the verbal fluency test and the trail making tests may imply frontal impairment. Our results support the knowledge that cerebellar or brainstem strokes cause mild frontal type cognitive syndrome by damaging cerebello-ponto-thalamo-cortical pathways

  11. Cognitive impairment and pragmatics.

    Science.gov (United States)

    Gutiérrez-Rexach, Javier; Schatz, Sara

    2016-01-01

    One of the most important ingredients of felicitous conversation exchanges is the adequate expression of illocutionary force and the achievement of perlocutionary effects, which can be considered essential to the functioning of pragmatic competence. The breakdown of illocutionary and perlocutionary functions is one of the most prominent external features of cognitive impairment in Alzheimer's Disease, with devastating psychological and social consequences for patients, their family and caregivers. The study of pragmatic functions is essential for a proper understanding of the linguistic and communicative aspects of Alzheimer's disease.

  12. Cognitive Impairment Associated with Cancer

    Science.gov (United States)

    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

  13. The role of low cognitive effort and negative symptoms in neuropsychological impairment in schizophrenia.

    Science.gov (United States)

    Strauss, Gregory P; Morra, Lindsay F; Sullivan, Sara K; Gold, James M

    2015-03-01

    Two experiments were conducted to examine whether insufficient effort, negative symptoms (e.g., avolition, anhedonia), and psychological variables (e.g., anhedonia and perception of low cognitive resources) predict generalized neurocognitive impairment in individuals with schizophrenia (SZ). In Experiment 1, participants included 97 individuals with SZ and 63 healthy controls (CN) who completed the Victoria Symptom Validity Test (VSVT), the MATRICS Consensus Cognitive Battery (MCCB), and self-report anhedonia questionnaires. In Experiment 2, participants included 46 individuals with SZ and 33 CN who completed Green's Word Memory Test (WMT), the MCCB, and self-reports of anhedonia, defeatist performance beliefs, and negative expectancy appraisals. RESULTS indicated that a low proportion of individuals with SZ failed effort testing (1.0% Experiment 1; 15.2% Experiment 2); however, global neurocognitive impairment was significantly predicted by low effort and negative symptoms. Findings indicate that low effort does not threaten the validity of neuropsychological test results in the majority of individuals with schizophrenia; however, effort testing may be useful in SZ patients with severe negative symptoms who may be more likely to put forth insufficient effort due to motivational problems. Although the base rate of failure is relatively low, it may be beneficial to screen for insufficient effort in SZ and exclude individuals who fail effort testing from pharmacological or cognitive remediation trials. PsycINFO Database Record (c) 2015 APA, all rights reserved.

  14. Impaired self-agency inferences in schizophrenia: The role of cognitive capacity and causal reasoning style.

    Science.gov (United States)

    Prikken, M; van der Weiden, A; Kahn, R S; Aarts, H; van Haren, N E M

    2018-01-01

    The sense of self-agency, i.e., experiencing oneself as the cause of one's own actions, is impaired in patients with schizophrenia. Normally, inferences of self-agency are enhanced when actual outcomes match with pre-activated outcome information, where this pre-activation can result from explicitly set goals (i.e., goal-based route) or implicitly primed outcome information (i.e., prime-based route). Previous research suggests that patients show specific impairments in the prime-based route, implicating that they do not rely on matches between implicitly available outcome information and actual action-outcomes when inferring self-agency. The question remains: Why? Here, we examine whether neurocognitive functioning and self-serving bias (SSB) may explain abnormalities in patients' agency inferences. Thirty-six patients and 36 healthy controls performed a commonly used agency inference task to measure goal- and prime-based self-agency inferences. Neurocognitive functioning was assessed with the Brief Assessment of Cognition in Schizophrenia (BACS) and the SSB was assessed with the Internal Personal and Situational Attributions Questionnaire. Results showed a substantial smaller effect of primed outcome information on agency experiences in patients compared with healthy controls. Whereas patients and controls differed on BACS and marginally on SSB scores, these differences were not related to patients' impairments in prime-based agency inferences. Patients showed impairments in prime-based agency inferences, thereby replicating previous studies. This finding could not be explained by cognitive dysfunction or SSB. Results are discussed in the context of the recent surge to understand and examine deficits in agency experiences in schizophrenia. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  15. Post-stroke cognitive impairments

    Directory of Open Access Journals (Sweden)

    Elena Anatolyevna Katunina

    2013-01-01

    Full Text Available Post-stroke cognitive impairments are common effects of stroke. Vascular cognitive impairments are characterized by the heterogeneity of the neuropsychological profile in relation to the site and pattern of stroke. Their common trait is the presence of dysregulation secondary to frontal dysfunction. The treatment of vascular cognitive impairments should be multimodality and aimed at stimulating neuroplasticity processes, restoring neurotransmitter imbalance, and preventing recurrent vascular episodes.

  16. Cognitive Impairment in Temporal Lobe Epilepsy: Role of Online and Offline Processing of Single Cell Information

    Science.gov (United States)

    Titiz, A. S.; Mahoney, J. M.; Testorf, M. E.; Holmes, G. L.; Scott, R. C.

    2014-01-01

    Cognitive impairment is a common comorbidity in temporal lobe epilepsy (TLE) and is often considered more detrimental to quality of life than seizures. While it has been previously shown that the encoding of memory during behavior is impaired in the pilocarpine model of TLE in rats, how this information is consolidated during the subsequent sleep period remains unknown. In this study, we first report marked deficits in spatial memory performance and severe cell loss in the CA1 layer of the hippocampus lower spatial coherence of firing in TLE rats. We then present the first evidence that the reactivation of behavior-driven patterns of activity of CA1 place cells in the hippocampus is intact in TLE rats. Using a template-matching method, we discovered that real-time (3–5 s) reactivation structure was intact in TLE rats. Furthermore, we estimated the entropy rate of short time scale (~250 ms) bursting activity using block entropies and found that significant, extended temporal correlations exist in both TLE and Control rats. Fitting a first order Markov Chain model to these bursting time series, we found that long sequences derived from behavior were significantly enriched in the Markov model over corresponding models fit on randomized data confirming the presence of replay in shorter time scales. We propose that the persistent consolidation of poor spatial information in both real-time and during bursting activity may contribute to memory impairments in TLE rats. PMID:24799359

  17. Intracranial stenosis in cognitive impairment and dementia.

    Science.gov (United States)

    Hilal, Saima; Xu, Xin; Ikram, M Kamran; Vrooman, Henri; Venketasubramanian, Narayanaswamy; Chen, Christopher

    2017-06-01

    Intracranial stenosis is a common vascular lesion observed in Asian and other non-Caucasian stroke populations. However, its role in cognitive impairment and dementia has been under-studied. We, therefore, examined the association of intracranial stenosis with cognitive impairment, dementia and their subtypes in a memory clinic case-control study, where all subjects underwent detailed neuropsychological assessment and 3 T neuroimaging including three-dimensional time-of-flight magnetic resonance angiography. Intracranial stenosis was defined as ≥50% narrowing in any of the intracranial arteries. A total of 424 subjects were recruited of whom 97 were classified as no cognitive impairment, 107 as cognitive impairment no dementia, 70 vascular cognitive impairment no dementia, 121 Alzheimer's Disease, and 30 vascular dementia. Intracranial stenosis was associated with dementia (age/gender/education - adjusted odds ratios (OR): 4.73, 95% confidence interval (CI): 1.93-11.60) and vascular cognitive impairment no dementia (OR: 3.98, 95% CI: 1.59-9.93). These associations were independent of cardiovascular risk factors and MRI markers. However, the association with Alzheimer's Disease and vascular dementia became attenuated in the presence of white matter hyperintensities. Intracranial stenosis is associated with vascular cognitive impairment no dementia independent of MRI markers. In Alzheimer's Disease and vascular dementia, this association is mediated by cerebrovascular disease. Future studies focusing on perfusion and functional markers are needed to determine the pathophysiological mechanism(s) linking intracranial stenosis and cognition so as to identify treatment strategies.

  18. Cognitive impairment in elderly women

    DEFF Research Database (Denmark)

    Rasmussen, Henrik Berg; Bagger, Yu Z; Tankó, László B

    2006-01-01

    BACKGROUND: A variety of factors contribute to the development of cognitive impairment in elderly people. Previous studies have focused upon a single or a few risk factors. In this study we assessed and compared the significance of a wide variety of potential risk factors for cognitive impairment...... in postmenopausal women. METHODS: A total of 208 pairs of elderly women (mean age = 73.2 years) were examined in a cross-sectional case-control study. Each pair consisted of a case (with impaired cognition) and a control subject matched by age and educational status. Cognitive functions were determined using...

  19. Nutrition and cognitive impairment

    Science.gov (United States)

    Hernando-Requejo, Virgilio

    2016-07-12

    Dementia, closely linked to environmental predisposing factors such as diet, is a public health problem of increasing magnitude: currently there are more than 35 million patients with Alzheimer´s disease, and is expected to exceed 135 million by 2050. If we can delay the development of dementia 5 years will reduce its prevalence by 50%. Patients with dementia modify their diet, and it has been reported in them deficits, among others, of folic acid, vitamin B12, B6, C, E, A, D, K, beta carotene and omega 3 fatty acids, that must be resolved with proper diet and with extra contributions if needed in some cases. But to reduce, or at least delay, the prevalence of dementia we advocate prevention through proper diet from the beginning of life, an idea that is reinforced given that cardiovascular risk factors are related directly to the development of dementia. A lot of literature are available that, although with limits, allows us to make nutritional recommendations for preventing cognitive impairment. Better results are achieved when complete diets have been studied and considered over specific nutrients separately. Particularly, the Mediterranean diet has great interest in this disease, since it ensures a high intake of vegetables, fruits, nuts, legumes, cereals, fish and olive oil, and moderate intake of meat, dairy products and alcohol. We will focus more on this article in this type of diet.

  20. Preexisting cognitive impairment in intracerebral hemorrhage.

    Science.gov (United States)

    Laible, M; Horstmann, S; Möhlenbruch, M; Schueler, S; Rizos, T; Veltkamp, R

    2017-06-01

    Preexisting cognitive impairment is a predictor of cognitive decline after ischemic stroke, but evidence in intracerebral hemorrhage (ICH) is limited. We aimed to determine the prevalence of premorbid cognitive impairment in patients with ICH. We included patients with acute ICH. Pre-ICH cognitive impairment was determined based on the results of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) that uses information from close relatives. Patients were assessed as having been cognitively impaired with an IQCODE score of ≥3.44; an IQCODE ≥4.00 indicated pre-ICH dementia. CT and MRI images were reviewed to determine the extent of white matter lesions and to measure the radial width of the temporal horn as marker of brain atrophy. We investigated differences of cardiovascular risk factors and imaging data between patients with and without pre-ICH cognitive impairment using correlation analyses, uni- and multivariable regression models. Functional neurological state was assessed using the modified Rankin Scale (mRS). The mRS was dichotomized at the level of 3, and a premorbid mRS of 0-2 was considered as functional independency. Among the 89 participants, median age was 70 years (interquartile range 58-78) and 52 (58.4%) were male. IQCODE indicated pre-ICH cognitive impairment in 18.0% (16 of 89), and 83.1% were functionally independent before ICH. Cognitive impairment was associated with a premorbid mRS≥3 (chi squared test, P=0.009). In multivariable analysis, prior stroke/transient ischemic attack (OR 18.29, 95%-CI 1.945-172.033, P=.011) and hematoma volume (OR 0.90, 95%-CI 0.812-0.991, P=.033) were independently associated with pre-ICH cognitive impairment. In conclusion, cognitive impairment frequently precedes ICH. A higher frequency of cerebrovascular events suggests a role of vascular processes in the development of cognitive impairment before ICH. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Arterial stiffness and cognitive impairment.

    Science.gov (United States)

    Li, Xiaoxuan; Lyu, Peiyuan; Ren, Yanyan; An, Jin; Dong, Yanhong

    2017-09-15

    Arterial stiffness is one of the earliest indicators of changes in vascular wall structure and function and may be assessed using various indicators, such as pulse-wave velocity (PWV), the cardio-ankle vascular index (CAVI), the ankle-brachial index (ABI), pulse pressure (PP), the augmentation index (AI), flow-mediated dilation (FMD), carotid intima media thickness (IMT) and arterial stiffness index-β. Arterial stiffness is generally considered an independent predictor of cardiovascular and cerebrovascular diseases. To date, a significant number of studies have focused on the relationship between arterial stiffness and cognitive impairment. To investigate the relationships between specific arterial stiffness parameters and cognitive impairment, elucidate the pathophysiological mechanisms underlying the relationship between arterial stiffness and cognitive impairment and determine how to interfere with arterial stiffness to prevent cognitive impairment, we searched PUBMED for studies regarding the relationship between arterial stiffness and cognitive impairment that were published from 2000 to 2017. We used the following key words in our search: "arterial stiffness and cognitive impairment" and "arterial stiffness and cognitive impairment mechanism". Studies involving human subjects older than 30years were included in the review, while irrelevant studies (i.e., studies involving subjects with comorbid kidney disease, diabetes and cardiac disease) were excluded from the review. We determined that arterial stiffness severity was positively correlated with cognitive impairment. Of the markers used to assess arterial stiffness, a higher PWV, CAVI, AI, IMT and index-β and a lower ABI and FMD were related to cognitive impairment. However, the relationship between PP and cognitive impairment remained controversial. The potential mechanisms linking arterial stiffness and cognitive impairment may be associated with arterial pulsatility, as greater arterial pulsatility

  2. The Role of Brain-Reactive Autoantibodies in Brain Pathology and Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Simone Mader

    2017-09-01

    Full Text Available Antibodies to different brain proteins have been recently found to be associated with an increasing number of different autoimmune diseases. They need to penetrate the blood–brain barrier (BBB in order to bind antigens within the central nervous system (CNS. They can target either neuronal or non-neuronal antigen and result in damage either by themselves or in synergy with other inflammatory mediators. Antibodies can lead to acute brain pathology, which may be reversible; alternatively, they may trigger irreversible damage that persists even though the antibodies are no longer present. In this review, we will describe two different autoimmune conditions and the role of their antibodies in causing brain pathology. In systemic lupus erythematosus (SLE, patients can have double stranded DNA antibodies that cross react with the neuronal N-methyl-d-aspartate receptor (NMDAR, which have been recently linked to neurocognitive dysfunction. In neuromyelitis optica (NMO, antibodies to astrocytic aquaporin-4 (AQP4 are diagnostic of disease. There is emerging evidence that pathogenic T cells also play an important role for the disease pathogenesis in NMO since they infiltrate in the CNS. In order to enable appropriate and less invasive treatment for antibody-mediated diseases, we need to understand the mechanisms of antibody-mediated pathology, the acute and chronic effects of antibody exposure, if the antibodies are produced intrathecally or systemically, their target antigen, and what triggers their production. Emerging data also show that in utero exposure to some brain-reactive antibodies, such as those found in SLE, can cause neurodevelopmental impairment since they can penetrate the embryonic BBB. If the antibody exposure occurs at a critical time of development, this can result in irreversible damage of the offspring that persists throughout adulthood.

  3. Cognitive Impairment in Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Farnaz Etesam

    2014-01-01

    Full Text Available Cognitive impairment can emerge in the earliest phases of multiple sclerosis. It strongly impacts different aspects of Multiple Sclerosis (MS patients' lives, like employment, social relationships and the overall quality of life; thus, its on-time recognition and treatment is mandatory. This paper discusses issues, diagnostic methods and treatment options for cognitive dysfunctions in MS. This paper is a descriptive review of the related studies in the recent 10 years, performing a keyword search in the main databases4T. Cognitive impairment mostly involves aspects of information processing, memory and executive functioning in MS. Neuropsychological tests like MACFIMS and BRB-N are recommended for its assessment. Still, there is no fully efficient treatment for cognitive impairment. Researchers have shown some positive effects, using disease-modifying therapies and cognitive rehabilitation. Depression, pain, fatigue and other factors influencing cognitive functions must be paid attention to4T. Recognizing cognitive impairment as a major symptom for MS, makes studying this subject one of the priorities in dealing with the disease. Therefore, a consecutive research for identification and management of this part of quality of life in MS patients is obligatory4T.4T

  4. Cognitive impairment in Chinese neuromyelitis optica

    NARCIS (Netherlands)

    Zhang, N.; Li, Y.J.; Fu, Y.; Shao, J.H.; Luo, L.L.; Yang, L.; Shi, F.D.; Liu, Y.

    2015-01-01

    Background: Cognitive dysfunction is frequently seen in neuromyelitis optica (NMO). However, the features and influencing factors of cognitive impairment of Chinese NMO patients are unclear. Objective: To investigate the patterns of cognitive impairment in Chinese NMO patients, and correlate the

  5. The role of B-vitamins in preventing and treating cognitive impairment and decline

    Science.gov (United States)

    Many epidemiologic studies have considered the question of whether markers of B-vitamin status are associated with cognitive function and cognitive decline. This avenue of research was sparked by the homocysteine (Hcy) theory of cardiovascular disease (CVD), which was extended to Alzheimer’s disease...

  6. Cognitive impairment and driving safety.

    Science.gov (United States)

    Eby, David W; Molnar, Lisa J

    2012-11-01

    As the populations of many countries continue to age, cognitive impairment will likely become more common. Individuals with cognitive impairment pose special challenges for families, health professionals, driving safety professionals, and the larger community, particularly if these older adults depend on driving as their primary means of community mobility. It is vital that we continue to extend our knowledge about the driving behavior of individuals' with cognitive impairment, as well as try to develop effective means of screening and assessing these individuals for fitness to drive and help facilitate their transition to non-driving when appropriate. This special issue is intended to provide researchers and practitioners an opportunity to present the most recent research findings on driving-related issues among older adults with cognitive impairment. The issue contains 11 original contributions from seven countries. The topics covered by these papers are: crash risks; screening, assessment, and fitness to drive; driving performance using a driving simulator; and driving behaviors and driving-related decisions of people with cognitive impairments. Copyright © 2012. Published by Elsevier Ltd.

  7. The role of cognitive impairment in fall risk among older adults: a systematic review and meta-analysis.

    Science.gov (United States)

    Muir, Susan W; Gopaul, Karen; Montero Odasso, Manuel M

    2012-05-01

    cognitive impairment is an established fall risk factor; however, it is unclear whether a disease-specific diagnosis (i.e. dementia), measures of global cognition or impairments in specific cognitive domains (i.e. executive function) have the greatest association with fall risk. Our objective was to evaluate the epidemiological evidence linking cognitive impairment and fall risk. studies were identified through systematic searches of the electronic databases of MEDLINE, EMBASE, PyschINFO (1988-2009). Bibliographies of retrieved articles were also searched. A fixed-effects meta-analysis was performed using an inverse-variance method. twenty-seven studies met the inclusion criteria. Impairment on global measures of cognition was associated with any fall, serious injuries (summary estimate of OR = 2.13 (1.56, 2.90)) and distal radius fractures in community-dwelling older adults. Executive function impairment, even subtle deficits in healthy community-dwelling older adults, was associated with an increased risk for any fall (summary estimate of OR = 1.44 (1.20, 1.73)) and falls with serious injury. A diagnosis of dementia, without specification of dementia subtype or disease severity, was associated with risk for any fall but not serious fall injury in institution-dwelling older adults. the method used to define cognitive impairment and the type of fall outcome are both important when quantifying risk. There is strong evidence global measures of cognition are associated with serious fall-related injury, though there is no consensus on threshold values. Executive function was also associated with increased risk, which supports its inclusion in fall risk assessment especially when global measures are within normal limits.

  8. Mild Cognitive Impairment

    Science.gov (United States)

    ... more: Key Types of Dementia , What Is Alzheimer's? , Alzheimer's Risk Factors Symptoms back to top Experts classify Mild cognitive ... in Chronic Traumatic Encephalopathy 2014 Thor Stein Genetic Risk Factors Underlying Chronic Trauma and Alzheimer's Disease Pathology 2014 Kun Ping Lu Validation of ...

  9. Cognitive impairment of dementias

    OpenAIRE

    Medina, L. D.; Rodríguez-Agudelo, Yaneth

    2012-01-01

    Dementia is a clinical syndrome characterized by a loss of cognitive and emotional abilities of sufficient severity to infer with social or occupational functioning, or both. Although the causes of dementia and characteristics are not always fully understood, it is understood that it is not a natural part of aging. Definitive diagnosis of dementia is made only through the autopsy and although the diagnosis of probable or possible dementia is complex is achieved by the intervention of several ...

  10. Cognitive impairment in Parkinson's disease

    Directory of Open Access Journals (Sweden)

    Jing YUAN

    2017-07-01

    Full Text Available Parkinson's disease cognitive impairment (PD-CI is one of the major non-motor symtoms (NMS of PD, including Parkinson's disease with mild cognitive impairment (PD - MCI and Parkinson's disease dementia (PDD. Executive dysfunction is relatively prominent, but other cognitive domains as visuospatial ability, memory and language can also be affected. Main risk factors for PD-CI include male gender, advanced age, low education, severe motor symptoms, low baseline cognitive function and excessive daytime sleepiness (EDS. Lewy bodies are main pathological changes, and Alzheimer's disease (AD related pathological changes can also be seen. The application value of decreased α?synuclein (α-Syn and β-amyloid 1-42 (Aβ1-42 levels in cerebrospinal fluid (CSF as biomarkers remains controversial. There are few related research and no defined pathogenic genes currently. Both dopaminergic pathway and acetylcholinergic pathway are involved in the occurrence of PD - CI as demonstrated in PET studies. Cortical and subcortical atrophy are associated with PD - CI as observed in MRI studies. Olfactory dysfunction may be one of the predictors of cognitive impairment. PDD and dementia with Lewy bodies (DLB share common biological characteristics, therefore the differential diagnosis sometimes is difficult. Cholinesterase inhibitors (ChEIs and memantine help to improve clinical symptoms, but treatment decision should be made with individualization. Cognitive behavioral treatment (CBT has potential clinical value and should be investigated by more studies. DOI: 10.3969/j.issn.1672-6731.2017.06.004

  11. Current therapy for cognitive impairments

    OpenAIRE

    Natalia Vasilyevna Vakhnina

    2011-01-01

    Cognitive impairments (CIs) are a highly common type of neurological disorders particularly in elderly patients. Choice of a therapeutic strategy for CI is determined by the etiology of abnormalities and their degree. Measures to prevent CI progression and dementia: adequate treatment of existing cardiovascular diseases, prevention of stroke, balanced nutrition, moderate physical and intellectual exercises, and combatting overweight and low activity are of ba...

  12. Exploring nursing assistants' roles in the process of pain management for cognitively impaired nursing home residents: a qualitative study.

    Science.gov (United States)

    Liu, Justina Y W

    2014-05-01

    To explore nursing assistants' roles during the actual process of pain management (assessment, reporting, implementation of pain-relieving interventions and re-assessment) for cognitively impaired home residents with pain. Nursing assistants provide most of the direct care to residents and represent the major taskforce in nursing homes. They may develop specialized knowledge of residents' pain experience that enables them to play both a pivotal role in pain assessment and possibly a supporting role in pain treatment. Currently, there is a lack of research into nursing assistants' functions in pain management. This is a descriptive, exploratory qualitative study. Forty-nine nursing assistants were recruited from 12 nursing homes, 12 of them participating in semi-structured individual interviews and 37 in 8 semi-structured focus groups. All interviews were carried out from May to September 2010. Data collected via both data collection methods were transcribed verbatim and analysed by content analysis. Nursing assistants were found to play four roles in the pain management process: (1) pain assessor; (2) reporter; (3) subordinate implementing prescribed medications; and (4) instigator implementing non-pharmacological interventions. This study highlights the importance of nursing assistants in successful pain assessment and identifies their possible supporting roles in other aspects of pain management. However, nursing assistants' scope of practice resulted in their functions in pain management being continually undervalued by other healthcare professionals. Continuous in-service training, the use of a standardized pain management protocol and strategies for building coherent work teams in nursing homes are suggested to improve this situation. © 2013 John Wiley & Sons Ltd.

  13. Measurement of overall quality of life in nursing homes through self report : the role of cognitive impairment

    NARCIS (Netherlands)

    Gerritsen, Debby Lydia; Steverink, Nardi; Ooms, Marcel E.; de Vet, Henrica C. W.; Ribbe, Miel W.

    Measuring quality of life is a necessity for adequate interventions. This paper concerns the usefulness of six self-report measures for overall quality of life for nursing home residents with various levels of cognitive impairment. It was investigated which proportion of residents from four

  14. Sustaining prospective memory functioning in amnestic mild cognitive impairment: A lifespan approach to the critical role of encoding.

    Science.gov (United States)

    Pereira, Antonina; Altgassen, Mareike; Atchison, Lesley; de Mendonça, Alexandre; Ellis, Judi

    2018-04-16

    Prospective memory (PM), the ability to remember to perform future activities, is a fundamental requirement for independent living. PM tasks pervade our daily lives, and PM failures represent one of the most prominent memory concerns across the entire life span. This study aimed to address this issue by exploring the potential benefits of specific encoding strategies on memory for intentions across healthy adulthood and in the early stages of cognitive impairment. PM performance was explored through an experimental paradigm in 96 participants: 32 amnestic mild cognitively impaired patients aged 64-87 years (M = 6.75, SD = 5.88), 32 healthy older adults aged 62-84 years (M = 76.06, SD = 6.03), and 32 younger adults 18-22 years (M = 19.75, SD = 1.16). The potential benefit of the use of enactment (i.e., physically simulating the intended action) at encoding to support an autonomous performance despite neuronal degeneration was assessed. PM was consistently identified as a sensitive and specific indicator of cognitive impairment. Importantly, enacted encoding was consistently beneficial for PM performance of all the participants, but especially so in the case of healthy and cognitively impaired older adults. These positive results have unveiled the potential of this encoding technique to optimize attentional demands through an adaptive allocation of strategic resources across both healthy and cognitively impaired samples. Theoretical implications of this work are discussed as well as the considerable translational potential to improve social well-being. A better understanding of the strategies that can enhance PM offers the potential for cost-effective and widely applicable tools which may support independent living across the adult life span. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  15. Screening for Cognitive Impairments in Primary Blepharospasm.

    Science.gov (United States)

    Yang, Jing; Song, Wei; Wei, Qianqian; Ou, Ruwei; Cao, Bei; Liu, Wanglin; Shao, Na; Shang, Hui-Fang

    2016-01-01

    Studies have reported that non-motor symptoms are an important component of primary dystonia. However, evidence supporting cognitive impairment in primary dystonia is limited and contradictory. We applied the Chinese version of the Addenbrooke's Cognitive Examination-Revised and the Mini-Mental State Examination (MMSE) to screen for cognitive impairment in patients with primary blepharospasm. In addition, we investigated the relationship between performance on the Addenbrooke's Cognitive Examination-Revised and quality of life as measured by the Medical Outcomes Study 36-item Short-Form (SF36). The study included 68 primary blepharospasm patients and 68 controls matched by age, sex and education. The prevalence of cognitive deficits was 22.0% and 32.3% in primary blepharospasm patients group, as measured by the MMSE and the Addenbrooke's Cognitive Examination-Revised, respectively. Primary blepharospasm patents had a broad range of cognitive deficits, with the most frequently affected domains being visuospatial function (30.9%) and language (30.9%), followed by memory (27.9%), orientation/attention (26.4%) and verbal fluency (22.0%). Patients with cognitive deficits had lower total SF36 scores, especially in the subdomains of physical functioning, role-physical and social functioning, compared to those without cognitive deficits. Scores on the Addenbrooke's Cognitive Examination-Revised were significantly correlated with both the SF36 scores and the scores on the subdomains of physical functioning and social functioning. Some patients with primary blepharospasm have cognitive deficits. Poor performance on the Addenbrooke's Cognitive Examination-Revised is related to poorer quality of life.

  16. "Let him speak:" a descriptive qualitative study of the roles and behaviors of family companions in primary care visits among older adults with cognitive impairment.

    Science.gov (United States)

    Vick, Judith B; Amjad, Halima; Smith, Katherine C; Boyd, Cynthia M; Gitlin, Laura N; Roth, David L; Roter, Debra L; Wolff, Jennifer L

    2018-01-01

    Cognitive impairment poses communication challenges in primary care. Although family "companions" commonly attend primary care visits of older adults with cognitive impairment, little is known about how their involvement affects communication. Therefore, we sought to understand how companion involvement affects the quality of primary care visit communication for older adults with cognitive impairment. Cross-sectional, descriptive qualitative study participants were as follows: (1) English-speaking adults age 65 or older with mild, moderate, or severe cognitive impairment; (2) family members or other unpaid companions who accompany older adults to primary care visits; and (3) primary care clinicians. Twenty semi-structured and in-depth qualitative interviews of older adults and their companions (N = 20 dyads) and two focus groups (N = 10 primary care clinicians) were conducted. Interviews and focus groups were transcribed and analyzed thematically. Family companions commonly facilitate communication by advocating for patients, ensuring the accuracy of information exchange and understanding, and preserving rapport. Significant communication challenges were also identified, including patient and companion role ambiguity, competing visit agendas, and primary care clinician confusion regarding the most accurate source of information. Patients, companions, and clinicians each identified strategies to improve communication, chief among them being to identify, differentiate, and respect both patient and companion priorities and perspectives. Family companions actively participate in primary care visits of older adults with cognitive impairment in ways that promote and inhibit effective communication. Findings suggest the need for strategies that more effectively and purposefully involve family in the care of primary care patients with cognitive impairment. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  17. Cognitive Impairment in Heart Failure

    Directory of Open Access Journals (Sweden)

    Efthimios Dardiotis

    2012-01-01

    Full Text Available Cognitive impairment (CI is increasingly recognized as a common adverse consequence of heart failure (HF. Although the exact mechanisms remain unclear, microembolism, chronic or intermittent cerebral hypoperfusion, and/or impaired cerebral vessel reactivity that lead to cerebral hypoxia and ischemic brain damage seem to underlie the development of CI in HF. Cognitive decline in HF is characterized by deficits in one or more cognition domains, including attention, memory, executive function, and psychomotor speed. These deficits may affect patients’ decision-making capacity and interfere with their ability to comply with treatment requirements, recognize and self-manage disease worsening symptoms. CI may have fluctuations in severity over time, improve with effective HF treatment or progress to dementia. CI is independently associated with disability, mortality, and decreased quality of life of HF patients. It is essential therefore for health professionals in their routine evaluations of HF patients to become familiar with assessment of cognitive performance using standardized screening instruments. Future studies should focus on elucidating the mechanisms that underlie CI in HF and establishing preventive strategies and treatment approaches.

  18. Treatment of Cognitive Impairment in Multiple Sclerosis

    Science.gov (United States)

    Pierson, Susan H.; Griffith, Nathan

    2006-01-01

    Cognitive impairment in multiple sclerosis is an increasingly recognized entity. This article reviews the cognitive impairment of multiple sclerosis, its prevalence, its relationship to different types of multiple sclerosis, and its contribution to long-term functional prognosis. The discussion also focuses on the key elements of cognitive dysfunction in multiple sclerosis which distinguish it from other forms of cognitive impairment. Therapeutic interventions potentially effective for the cognitive impairment of multiple sclerosis are reviewed including the effects of disease modifying therapies and the use of physical and cognitive interventions. PMID:16720960

  19. Treatment of Cognitive Impairment in Multiple Sclerosis

    OpenAIRE

    Pierson, Susan H.; Griffith, Nathan

    2006-01-01

    Cognitive impairment in multiple sclerosis is an increasingly recognized entity. This article reviews the cognitive impairment of multiple sclerosis, its prevalence, its relationship to different types of multiple sclerosis, and its contribution to long-term functional prognosis. The discussion also focuses on the key elements of cognitive dysfunction in multiple sclerosis which distinguish it from other forms of cognitive impairment. Therapeutic interventions potentially effective for the co...

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

    Science.gov (United States)

    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

  1. Dispositional Optimism and Incidence of Cognitive Impairment in Older Adults.

    Science.gov (United States)

    Gawronski, Katerina A B; Kim, Eric S; Langa, Kenneth M; Kubzansky, Laura D

    2016-09-01

    Higher levels of optimism have been linked with positive health behaviors, biological processes, and health conditions that are potentially protective against cognitive impairment in older adults. However, the association between optimism and cognitive impairment has not been directly investigated. We examined whether optimism is associated with incident cognitive impairment in older adults. Data are from the Health and Retirement Study. Optimism was measured by using the Life Orientation Test-R and cognitive impairment with a modified version of the Telephone Interview for Cognitive Status derived from the Mini-Mental State Examination. Using multiple logistic regression models, we prospectively assessed whether optimism was associated with incident cognitive impairment in 4624 adults 65 years and older during a 4-year period. Among participants, 312 women and 190 men developed cognitive impairment during the 4-year follow-up. Higher optimism was associated with decreased risk of incident cognitive impairment. When adjusted for sociodemographic factors, each standard deviation increase in optimism was associated with reduced odds (odds ratio [OR] = 0.70, 95% confidence interval [CI] = 0.61-0.81) of becoming cognitively impaired. A dose-response relationship was observed. Compared with those with the lowest levels of optimism, people with moderate levels had somewhat reduced odds of cognitive impairment (OR = 0.78, 95% CI = 0.59-1.03), whereas people with the highest levels had the lowest odds of cognitive impairment (OR = 0.52, 95% CI = 0.36-0.74). These associations remained after adjusting for health behaviors, biological factors, and psychological covariates that could either confound the association of interest or serve on the pathway. Optimism was prospectively associated with a reduced likelihood of becoming cognitively impaired. If these results are replicated, the data suggest that potentially modifiable aspects of positive psychological functioning such

  2. Age-Related Sensory Impairments and Risk of Cognitive Impairment

    Science.gov (United States)

    Fischer, Mary E; Cruickshanks, Karen J.; Schubert, Carla R; Pinto, Alex A; Carlsson, Cynthia M; Klein, Barbara EK; Klein, Ronald; Tweed, Ted S.

    2016-01-01

    Background/Objectives To evaluate the associations of sensory impairments with the 10-year risk of cognitive impairment. Previous work has primarily focused on the relationship between a single sensory system and cognition. Design The Epidemiology of Hearing Loss Study (EHLS) is a longitudinal, population-based study of aging in the Beaver Dam, WI community. Baseline examinations were conducted in 1993 and follow-up exams have been conducted every 5 years. Setting General community Participants EHLS members without cognitive impairment at EHLS-2 (1998–2000). There were 1,884 participants (mean age = 66.7 years) with complete EHLS-2 sensory data and follow-up information. Measurements Cognitive impairment was a Mini-Mental State Examination score of impairment was a pure-tone average of hearing thresholds (0.5, 1, 2 and 4 kHz) of > 25 decibel Hearing Level in either ear. Visual impairment was Pelli-Robson contrast sensitivity of impairment was a San Diego Odor Identification Test score of impairment were independently associated with cognitive impairment risk [Hearing: Hazard Ratio (HR) = 1.90, 95% Confidence Interval (C.I.) = 1.11, 3.26; Vision: HR = 2.05, 95% C.I. = 1.24, 3.38; Olfaction: HR = 3.92, 95% C.I. = 2.45, 6.26]. However, 85% with hearing impairment, 81% with visual impairment, and 76% with olfactory impairment did not develop cognitive impairment during follow-up. Conclusion The relationship between sensory impairment and cognitive impairment was not unique to one sensory system suggesting sensorineural health may be a marker of brain aging. The development of a combined sensorineurocognitive measure may be useful in uncovering mechanisms of healthy brain aging. PMID:27611845

  3. Assessment of Extent and Role of Tau in Subcortical Vascular Cognitive Impairment Using 18F-AV1451 Positron Emission Tomography Imaging.

    Science.gov (United States)

    Kim, Hee Jin; Park, Seongbeom; Cho, Hanna; Jang, Young Kyoung; San Lee, Jin; Jang, Hyemin; Kim, Yeshin; Kim, Ko Woon; Ryu, Young Hoon; Choi, Jae Yong; Moon, Seung Hwan; Weiner, Michael W; Jagust, William J; Rabinovici, Gil D; DeCarli, Charles; Lyoo, Chul Hyoung; Na, Duk L; Seo, Sang Won

    2018-05-14

    Amyloid-β (Aβ), tau, and cerebral small vessel disease (CSVD), which occasionally coexist, are the most common causes of cognitive impairments in older people. However, whether tau is observed in patients with subcortical vascular cognitive impairment (SVCI), as well as its associations with Aβ and CSVD, are not yet established. More importantly, the role of tau underlying cognitive impairments in SVCI is unknown. To investigate the extent and the role of tau in patients with SVCI using 18F-AV1451, which is a new ligand to detect neurofibrillary tangles in vivo. This cross-sectional study recruited 64 patients with SVCI from June 2015 to December 2016 at Samsung Medical Center, Seoul, Korea. The patients had significant ischemia on brain magnetic resonance imaging, defined as periventricular white matter hyperintensity at least 10 mm and deep white matter hyperintensity at least 25 mm. We excluded 3 patients with SVCI owing to segmentation error during AV1451 positron emission tomography analysis. We calculated CSVD scores based on the volumes of white matter hyperintensities, numbers of lacunes, and microbleeds using magnetic resonance imaging data. The presence of Aβ was assessed using fluorine 18-labeled (18F) florbetaben positron emission tomography. Tau was measured using 18F-AV1451 positron emission tomography. We determined the spreading order of tau by sorting the regional frequencies of cortical involvement. We evaluated the complex associations between Aβ, CSVD, AV1451 uptake, and cognition in patients with SVCI. Of the 61 patients with SVCI, 44 (72.1%) were women and the mean (SD) age was 78.7 (6.3) years. Patients with SVCI, especially patients with Aβ-negative SVCI, showed higher AV1451 uptake in the inferior temporal areas compared with normal control individuals. In patients with SVCI, Aβ positivity and CSVD score were each independently associated with increased AV1451 uptake in the medial temporal and inferior temporal regions, respectively

  4. Cognitive impairment in COPD: a systematic review

    Directory of Open Access Journals (Sweden)

    Irene Torres-Sánchez

    2015-04-01

    Full Text Available The objectives of this study were to characterize and clarify the relationships between the various cognitive domains affected in COPD patients and the disease itself, as well as to determine the prevalence of impairment in the various cognitive domains in such patients. To that end, we performed a systematic review using the following databases: PubMed, Scopus, and ScienceDirect. We included articles that provided information on cognitive impairment in COPD patients. The review of the findings of the articles showed a significant relationship between COPD and cognitive impairment. The most widely studied cognitive domains are memory and attention. Verbal memory and learning constitute the second most commonly impaired cognitive domain in patients with COPD. The prevalence of impairment in visuospatial memory and intermediate visual memory is 26.9% and 19.2%, respectively. We found that cognitive impairment is associated with the profile of COPD severity and its comorbidities. The articles reviewed demonstrated that there is considerable impairment of the cognitive domains memory and attention in patients with COPD. Future studies should address impairments in different cognitive domains according to the disease stage in patients with COPD.

  5. Cognitive impairment in COPD: a systematic review.

    Science.gov (United States)

    Torres-Sánchez, Irene; Rodríguez-Alzueta, Elisabeth; Cabrera-Martos, Irene; López-Torres, Isabel; Moreno-Ramírez, Maria Paz; Valenza, Marie Carmen

    2015-01-01

    The objectives of this study were to characterize and clarify the relationships between the various cognitive domains affected in COPD patients and the disease itself, as well as to determine the prevalence of impairment in the various cognitive domains in such patients. To that end, we performed a systematic review using the following databases: PubMed, Scopus, and ScienceDirect. We included articles that provided information on cognitive impairment in COPD patients. The review of the findings of the articles showed a significant relationship between COPD and cognitive impairment. The most widely studied cognitive domains are memory and attention. Verbal memory and learning constitute the second most commonly impaired cognitive domain in patients with COPD. The prevalence of impairment in visuospatial memory and intermediate visual memory is 26.9% and 19.2%, respectively. We found that cognitive impairment is associated with the profile of COPD severity and its comorbidities. The articles reviewed demonstrated that there is considerable impairment of the cognitive domains memory and attention in patients with COPD. Future studies should address impairments in different cognitive domains according to the disease stage in patients with COPD.

  6. Vascular Contributions to Cognitive Impairment and Dementia

    Science.gov (United States)

    Gorelick, Philip B.; Scuteri, Angelo; Black, Sandra E.; DeCarli, Charles; Greenberg, Steven M.; Iadecola, Costantino; Launer, Lenore J.; Laurent, Stephane; Lopez, Oscar L.; Nyenhuis, David; Petersen, Ronald C.; Schneider, Julie A.; Tzourio, Christophe; Arnett, Donna K.; Bennett, David A.; Chui, Helena C.; Higashida, Randall T.; Lindquist, Ruth; Nilsson, Peter M.; Roman, Gustavo C.; Sellke, Frank W.; Seshadri, Sudha

    2013-01-01

    Background and Purpose This scientific statement provides an overview of the evidence on vascular contributions to cognitive impairment and dementia. Vascular contributions to cognitive impairment and dementia of later life are common. Definitions of vascular cognitive impairment (VCI), neuropathology, basic science and pathophysiological aspects, role of neuroimaging and vascular and other associated risk factors, and potential opportunities for prevention and treatment are reviewed. This statement serves as an overall guide for practitioners to gain a better understanding of VCI and dementia, prevention, and treatment. Methods Writing group members were nominated by the writing group co-chairs on the basis of their previous work in relevant topic areas and were approved by the American Heart Association Stroke Council Scientific Statement Oversight Committee, the Council on Epidemiology and Prevention, and the Manuscript Oversight Committee. The writing group used systematic literature reviews (primarily covering publications from 1990 to May 1, 2010), previously published guidelines, personal files, and expert opinion to summarize existing evidence, indicate gaps in current knowledge, and, when appropriate, formulate recommendations using standard American Heart Association criteria. All members of the writing group had the opportunity to comment on the recommendations and approved the final version of this document. After peer review by the American Heart Association, as well as review by the Stroke Council leadership, Council on Epidemiology and Prevention Council, and Scientific Statements Oversight Committee, the statement was approved by the American Heart Association Science Advisory and Coordinating Committee. Results The construct of VCI has been introduced to capture the entire spectrum of cognitive disorders associated with all forms of cerebral vascular brain injury—not solely stroke—ranging from mild cognitive impairment through fully developed

  7. Volunteering Is Associated with Lower Risk of Cognitive Impairment.

    Science.gov (United States)

    Infurna, Frank J; Okun, Morris A; Grimm, Kevin J

    2016-11-01

    To examine whether psychosocial factors that can be a target for interventions, such as volunteering, are associated with risk of cognitive impairment. Health and Retirement Study (HRS) data from 1998 to 2012, a nationally representative longitudinal panel survey of older adults assessed every 2 years, were used. The HRS interviews participants aged 50 and older across the contiguous United States. Individuals aged 60 and older in 1998 (N = 13,262). Personal interviews were conducted with respondents to assess presence of cognitive impairment, measured using a composite across cognitive measures. Volunteering at the initial assessment and volunteering regularly over time independently decreased the risk of cognitive impairment over 14 years, and these findings were maintained independent of known risk factors for cognitive impairment. Greater risk of onset of cognitive impairment was associated with being older, being female, being nonwhite, having fewer years of education, and reporting more depressive symptoms. Consistent civic engagement in old age is associated with lower risk of cognitive impairment and provides impetus for interventions to protect against the onset of cognitive impairment. Given the increasing number of baby boomers entering old age, the findings support the public health benefits of volunteering and the potential role of geriatricians, who can promote volunteering by incorporating "prescriptions to volunteer" into their patient care. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  8. Hearing and Cognitive Impairment and the Role of the International Classification of Functioning, Disability and Health as a Rehabilitation Framework

    Science.gov (United States)

    Lind, Christopher; Meyer, Carly; Young, Jessica

    2016-01-01

    The International Classification of Functioning, Disability and Health (ICF) has been applied widely in the literature to describe and differentiate the broad implications of hearing impairment (HI) and cognitive impairment (CI) on communication. As CI and HI are largely age-related conditions, the likelihood of comorbidity of these conditions is high. In the context of an aging population, the prevalence of comorbidity is likely to rise, yet much of the clinical assessment and intervention in HI and CI occur separately. The benefit of addressing the dual impact of these conditions is of increasing clinical importance for all clinicians working with older adults and for audiologists and speech pathologists in particular. In this article, the ICF model will be applied to explore the everyday implications of HI and CI. Furthermore, the clinical implications of the ICF model are explored with particular respect to communication assessment and intervention options. The potential benefit of combining activity- and participation-focused interventions currently offered for HI and CI independently is examined. PMID:27489399

  9. Cognitive impairment and mortality among nonagenarians

    DEFF Research Database (Denmark)

    Andersen, Kjeld; Nybo, Hanne; Gaist, David

    2002-01-01

    Cognitive impairment has been associated with increased mortality. Most studies, however, have only included small numbers, if at all, of the very old. In a large nationwide survey of all Danes born in 1905 and still alive in 1998, where the baseline examination was conducted, we examined...... the impact of cognitive impairment on mortality over a 2-year period. No cognitive impairment was defined as a score of 24-30 points on the Mini Mental State Examination, mild cognitive impairment was defined as a score of 18-23 points, and severe impairment was defined as a score of 0-17 points. Cox...... regression analysis was applied to adjust for a number of known and suspected factors known or suspected of being associated with cognition and mortality (e.g. sociodemographic factors, sex, smoking, alcohol consumption, depressive symptoms, and physical abilities), and yielded hazard ratios (95% confidence...

  10. Preventing cognitive impairment in children with epilepsy

    NARCIS (Netherlands)

    Braun, Kees P J

    PURPOSE OF REVIEW: Cognitive impairments are common in children with epilepsy. They may already be present before the onset of epilepsy or occur – and even progress – during its course. Many variables contribute to cognitive dysfunction. Those that can be targeted to prevent (further) cognitive

  11. Cognitive impairments, HCI and daily living

    DEFF Research Database (Denmark)

    Keates, Simeon; Kozloski, James; Varker, Philip

    2009-01-01

    As computer systems become increasingly more pervasive in everyday life, it is simultaneously becoming ever more important that the concept of universal access is accepted as a design mantra. While many physical impairments and their implications for human-computer interaction are well understood......, cognitive impairments have received comparatively little attention. One of the reasons for this is the general lack of sufficiently detailed cognitive models. This paper examines how cognitive impairments can affect human-computer interaction in everyday life and the issues involved in trying to make...

  12. Cognitive impairment in multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Kutashov V.A.

    2016-06-01

    Full Text Available Aim: to identify the degree of cognitive impairment (CN and to optimize the treatment of patients with multiple sclerosis (MS. Material and methods. A total of 695 patients (278 men and 417 women were ranged from 18 to 63 years. The mean age was 30.2±0.7 years: women (417 28.5±0.5 years, while for men (278 31.8±0.7 years. Relaps-ing-remitting type (RT of MS was established in 520 patients (74.8%, secondary progressive type (VPT MS in 132 patients (18.9% and primary progressive type (PPT MS in 10 patients (1.5%. Clinically isolated syndrome (CIS was detected in 33 patients (4.8%. The diagnosis of MS 662 patients according to the criteria McDonald etal. (2005. Score of neurologic deficit was carried out on an extended scale of disability (Expanded Disability Status Scale — EDSS. CN were evaluated by conventional tests. To estimate the orientation in time, assessment of short-term and long-term memory, attention and concentration, as well as executive functions, memory, language, evaluation of optical-spatial activities, conceptual thinking, the account used by the Montreal Cognitive Assessment Scale (MoCA. For the screening of dementia with a primary lesion of the frontal lobes and subcortical cerebral structures used battery frontal test to assess frontal dysfunction. Results. The ratio of male (265 and female (397 was 1:1.5. The severity of the condition patients EDSS scale ranged from 1.5 to 8.0 points, and the average score was 3.5±1.2. In the group of patients with RT RS average score EDSS was more than a half (2.5±1.1, than in the group of patients with MS VAC (5.5±1.2 and POS PC (6.5±1.2. In the study of history, it was found that the development of the RS (662 patients was preceded by the following conditions: a viral infection in 277 patients (41.84%; fatigue in 147 patients (22.21%; transferred psycho-emotional load from 218 (32.93%; after pregnancy and childbirth in 20 patients (3.02%. Conclusion. Among the patients with MS

  13. Comparison of the quick mild cognitive impairment (Qmci) screen and the SMMSE in screening for mild cognitive impairment.

    LENUS (Irish Health Repository)

    O'Caoimh, Rónán

    2012-09-01

    differentiating mild cognitive impairment (MCI) from normal cognition (NC) is difficult. The AB Cognitive Screen (ABCS) 135, sensitive in differentiating MCI from dementia, was modified to improve sensitivity and specificity, producing the quick mild cognitive impairment (Qmci) screen.

  14. Cross-sectional and longitudinal relationship between neuroticism and cognitive ability in advanced old age: the moderating role of severe sensory impairment.

    Science.gov (United States)

    Wettstein, Markus; Kuźma, Elżbieta; Wahl, Hans-Werner; Heyl, Vera

    2016-09-01

    Gaining a comprehensive picture of the network of constructs in which cognitive functioning is embedded is crucial across the full lifespan. With respect to personality, previous findings support a relationship between neuroticism and cognitive abilities. However, findings regarding old age are inconsistent. In particular, little is known about potentially moderating variables which might explain some of the inconsistency. Our aim was to examine the moderating effect of severe sensory impairment on cross-sectional and longitudinal associations between neuroticism and cognitive functioning. The study sample consisted of 121 visually impaired (VI), 116 hearing impaired (HI), and 150 sensory unimpaired older adults (UI). Mean age was 82.50 years (SD = 4.71 years). Neuroticism was assessed by the NEO Five Factor Inventory, and multiple established tests were used for the assessment of cognitive performance (e.g., subtests of the revised Wechsler Adult Intelligence Scale). Bivariate correlations and multi-group structural equation models indicated stronger relationships between cognitive abilities and neuroticism in both sensory impaired groups (VI and HI) compared to UI older individuals. This relationship was attenuated but still significant in both sensory impaired groups when controlling for age, education and health (number of chronic conditions). In cross-lagged panel models, higher baseline neuroticism was significantly associated with lower cognitive performance four years later in VI and HI individuals. Our results suggest that sensory impairment moderates both cross-sectional and longitudinal associations between neuroticism and cognitive function in advanced old age.

  15. POST-STROKE COGNITIVE IMPAIRMENT – PHENOMENOLOGY AND PROGNOSTIC FACTORS

    Directory of Open Access Journals (Sweden)

    Maya Danovska

    2012-09-01

    Full Text Available Stroke patients are at higher risk of developing cognitive impairment. Cognitive dysfunctions, especially progressive ones, worsen stroke prognosis and outcome. A longitudinal follow-up of cognitive disorders, however, is rendered difficult by their heterogeneity and the lack of definitions generally agreed upon. Stroke is a major cause of cognitive deficit. The identification of risk factors, clinical determinants and laboratory markers of post-stroke cognitive deficit may help detect patients at increased risk of cognitive deterioration, and prevent or delay the occurrence of post-stroke cognitive impairments. Though inflammatory processes have been implicated in the pathogenesis of stroke, their role in the complex pathophysiological mechanisms of post-stroke cognitive impairment is not completely understood. Evidence suggests that elevated serum C-reactive protein is associated with both the increased risk of stroke and post-stroke cognitive deficit. The hypothesis of a possible relationship between markers of systemic inflammation and cognitive dysfunctions raises the question of how rational the option of applying non-steroidal anti-inflammatory drugs in a proper therapeutic window will be, especially during the acute phase of stroke, to prevent cognitive decline and dementia.

  16. Pain in cognitively impaired older persons.

    Science.gov (United States)

    Parmelee, P A

    1996-08-01

    To summarize, there has been shamefully little empirical research directly examining the prevalence and correlates of pain among cognitively impaired older people. Even less is known about techniques for assessing and managing pain in this group. Existing evidence suggests that cognitively impaired older persons may voice fewer complaints about pain, but there is no reason to believe that they are in fact at less risk of pain than their cognitively intact age-mates. Rather, for whatever reason, persons with cognitively deficits appear to be less inclined to report pain than are intact elders of similar health status. This reporting difference may account at least in part for the fact that pain is less likely to be treated aggressively among cognitively impaired individuals. Unfortunately, knowing the reason for this state of affairs does not mitigate its implication: cognitive deficits place frail older persons at risk of unnecessary pain simply because it is not properly identified. Data reviewed in this chapter suggest that accurate assessment of pain in cognitively impaired older persons, far from being impossible, may actually be only slightly more demanding than it is in intact individuals. Even among markedly impaired elders, self-reports should certainly be taken as valid indicators; early evidence suggests promising avenues for developing reliable, clear-cut guidelines for the nonverbal assessment of pain in very severely demented individuals. As the nation grows older and medical care advances, a growing proportion of individuals can expect to live well into their eighth and even ninth decades. Unfortunately, with this extended life span comes increased likelihood of both cognitive impairment and pain. Thus, expansion of our repertoire of techniques for assessing and managing pain among cognitively impaired older persons must be a central priority for research on pain in late life.

  17. Measuring and managing cognitive impairment in HIV.

    Science.gov (United States)

    Nightingale, Sam; Winston, Alan

    2017-06-01

    : Cognitive impairment remains a frequently reported complaint in HIV-positive patients despite virologically suppressive antiretroviral therapy. Rates of cognitive impairment in antiretroviral treated HIV-positive cohorts vary and strongly depend on definitions utilized.The underlying pathogenesis is likely to be multifactorial and includes immune activation, neuroinflammation, antiretroviral neurotoxicity, the presence of noninfectious comorbidities such as vascular disease and depression and patient lifestyle factors such as recreational drug use.Contributing factors to cognitive impairment may change over time with ageing HIV-positive populations. Cerebrovascular disease and neurodegenerative causes of cognitive impairment may become more common with advancing age; how these factors interact with HIV-associated cognitive impairment is not yet known.Cerebrospinal fluid HIV RNA escape may occur in up to 10% of patients undergoing lumbar puncture clinically and can be associated with compartmentalized and resistant virus.Changes in antiretroviral therapy in patients with cognitive impairment should be based on current and historic resistance profiles of cerebrospinal fluid and plasma virus, or on potential antiretroviral drug neurotoxicity. Whether and how antiretroviral therapy should be changed in the absence of these factors is not known and requires study in adequately powered randomized trials in carefully selected clinical cohorts.

  18. [Clinical characteristics in Parkinson's disease patients with cognitive impairment and effects of cognitive impairment on sleep].

    Science.gov (United States)

    Gong, Yan; Xiong, Kang-ping; Mao, Cheng-jie; Huang, Juan-ying; Hu, Wei-dong; Han, Fei; Chen, Rui; Liu, Chun-feng

    2013-09-03

    To analyze the clinical characteristics, correlation factors and clinical heterogeneities in Parkinson's disease (PD) patients with cognitive impairment and identify whether cognitive impairment could influence the aspect of sleep. A total of 130 PD outpatients and inpatients of sleep center at our hospital were eligible for participation. According to Montreal cognitive assessment (MOCA), they were divided into cognitive normal group (MOCA ≥ 26) (n = 51) and cognitive impairment group (MOCA cognitive impairment (MOCA cognitive impairment, the PD patients with cognitive impairment had significantly higher score of HAMD (10 ± 7 vs 7 ± 4), increased incidence of hallucinations (40.50% vs 19.60%) and REM behavior disorders (RBD) (63.29% vs 39.21%), significantly higher H-Y stage [2.5(2.0-3.0) vs 2.0 (2.0-2.5)] , United Kingdom Parkinson Disease Society (UPDRS) part III (22 ± 10 vs 19 ± 10) and levodopa-equivalent daily dose (LED) (511 ± 302vs 380 ± 272) (all P 0.05). Non-conditional Logistic regression analysis showed that PD duration, score of HAMD and H-Y stage were the major influencing factors of cognition. On PSG, significantly decreased sleep efficiency (57% ± 21% vs 66% ± 17%), higher percentage of non-REM sleep stage 1 (NREMS1) (37% ± 21% vs 27% ± 13%), lower percentage of NREMS2 (40% ± 17% vs 46% ± 13%) and REM sleep (39% ± 28% vs 54% ± 36%) were found for PD patients with cognitive impairment (all P cognitive impairment have more severe disease and partial nonmotor symptoms. And the severity of disease and depression is closely associated with cognitive impairment. Cognitive impairment may also affect sleep to cause decreased sleep efficiency and severe sleep structure disorder.

  19. Cognitive impairment and stroke in elderly patients

    Directory of Open Access Journals (Sweden)

    Lo Coco D

    2016-03-01

    Full Text Available Daniele Lo Coco,1 Gianluca Lopez,1 Salvatore Corrao,2,31Neurology and Stroke Unit, 2Department of Internal Medicine, National Relevance and High Specialization Hospital Trust ARNAS Civico, Di Cristina, Benfratelli, Palermo, 3Centre of Research for Effectiveness and Appropriateness in Medicine (C.R.E.A.M., Di.Bi.M.I.S., University of Palermo, Palermo, Italy Abstract: We reviewed current knowledge about the interaction between stroke and vascular risk factors and the development of cognitive impairment and dementia. Stroke is increasingly recognized as an important cause of cognitive problems and has been implicated in the development of both Alzheimer's disease and vascular dementia. The prevalence of cognitive impairment after stroke is high, and their combined effects significantly increase the cost of care and health resource utilization, with reflections on hospital readmissions and increased mortality rates. There is also substantial evidence that vascular risk factors (such as hypertension, diabetes, obesity, dyslipidemia, and tobacco smoking are independently associated with an increased risk of cognitive decline and dementia. Thus, a successful management of these factors, as well as optimal acute stroke management, might have a great impact on the development of cognitive impairment. Notwithstanding, the pathological link between cognitive impairment, stroke, and vascular risk factors is complex and still partially unclear so that further studies are needed to better elucidate the boundaries of this relationship. Many specific pharmacological treatments, including anticholinergic drugs and antihypertensive medications, and nonpharmacological approaches, such as diet, cognitive rehabilitation, and physical activity, have been studied for patients with vascular cognitive impairment, but the optimal care is still far away. Meanwhile, according to the most recent knowledge, optimal stroke care should also include cognitive assessment in the

  20. Subjective Cognitive Complaints and Objective Cognitive Impairment in Parkinson's Disease.

    Science.gov (United States)

    Hong, Jin Yong; Lee, Yoonju; Sunwoo, Mun Kyung; Sohn, Young H; Lee, Phil Hyu

    2018-01-01

    Subjective cognitive complaints (SCCs) are very common in patients with Parkinson's disease (PD). However, the relationship between SCCs and objective cognitive impairment is still unclear. This study aimed to determine whether SCCs are correlated with objective cognitive performance in patients with PD. Totals of 148 cognitively normal patients, 71 patients with mild cognitive impairment (MCI), and 31 demented patients were recruited consecutively from a movement-disorders clinic. Their SCCs and cognitive performances were evaluated using the Cognitive Complaints Interview (CCI) and a comprehensive neuropsychological battery. The CCI score increased with age, duration of PD, and depression score, and was inversely correlated with cognitive performance. The association between CCI score and performance remained significant after adjustment for the depression score, age, and duration of PD. The CCI score could be used to discriminate patients with dementia from cognitively normal and MCI patients [area under the receiver operating characteristics curve (AUC) of 0.80], but not patients with MCI or dementia from cognitively normal patients (AUC of 0.67). SCCs as measured by the CCI are strongly correlated with objective cognitive performance in patients with PD. The CCI can also be used to screen for dementia in patients with PD. Copyright © 2018 Korean Neurological Association.

  1. Polypharmacy Cutoff for Gait and Cognitive Impairments

    Directory of Open Access Journals (Sweden)

    Antoine Langeard

    2016-08-01

    Full Text Available BACKGROUND: Polypharmacy is a well-established risk factor for falls, and these are one of the major health problems that affect the quality of life as people age. However, the risk of mobility and cognitive impairments consecutive to polypharmacy has been little addressed, despite the association between these adverse outcomes and falls. Moreover, the rare polypharmacy cut-offs were all but one arbitrarily determined. OBJECTIVE: Studying relationships between polypharmacy and both mobility and cognitive impairments, and statistically determining a cut-off point in the number of drugs beyond which polypharmacy has deleterious consequences with respect to mobility and cognitive impairment. METHODS: We enrolled 113 community-dwelling adults aged 55 years and older with a fall history, with or without injury, in the previous year. We carefully collected information about daily medications taken. We assessed basic mobility and global cognition with the Time-Up-and-Go and the Montreal Cognitive Assessment (MoCA test, respectively. (clinicaltrials.gov NCT02292316RESULTS: TUG and MoCA scores were both significantly correlated with the number of medications used. ROC curves indicate, with high prediction (p<0.002, that daily consumption of five or more medications is associated with risk for both impaired mobility and global cognition. These relationships were independent of the number of comorbidities and of the pharmacological class. CONCLUSION: Community-dwelling adults aged 55 years and older who take five or more daily drugs are at high risk for both mobility and cognitive impairments. Physicians and patients should be aware of these new findings, especially when there are multiple prescribers involved in the care of the patient.

  2. Mild Cognitive Impairment Status and Mobility Performance

    DEFF Research Database (Denmark)

    Pedersen, Mette; Holt, Nicole E; Grande, Laura

    2014-01-01

    : An analysis was conducted on baseline data from the Boston Rehabilitative Impairment Study in the Elderly study, a cohort study of 430 primary care patients aged 65 or older. Neuropsychological tests identified participants with MCI and further subclassified those with impairment in memory domains (a......BACKGROUND: The prevalence of mild cognitive impairment (MCI) and mobility limitations is high among older adults. The aim of this study was to investigate the association between MCI status and both performance-based and self-report measures of mobility in community-dwelling older adults. METHODS...

  3. Multiple sclerosis with predominant, severe cognitive impairment

    Science.gov (United States)

    Staff, Nathan P.; Lucchinetti, Claudia F.; Keegan, B. Mark

    2009-01-01

    Objective To describe the characteristics of multiple sclerosis (MS) presenting with severe cognitive impairment as its primary disabling manifestation. Design Retrospective case series. Setting Tertiary referral center. Patients Patients were identified through the Mayo Clinic data retrieval system (1996–2008) with definite MS (McDonald criteria) and severe cognitive impairment as their primary neurological symptom without accompanying significant MS-related impairment or alternative diagnosis for cognitive dysfunction. Twenty-three patients meeting inclusion criteria were compared regarding demographics, clinical course and radiological features. Main Outcome Measures Demographic, clinical, and radiological characteristics of the disease. Results Twelve patients were men. The median age of the first clinical symptom suggestive of CNS demyelination was 33 years, and severe MS-related cognitive impairment developed at a median of 39 years. Cognitive impairment could be dichotomized as subacute fulminant (n=9) or chronic progressive (n=14) in presentation, which corresponded to subsequent relapsing or progressive MS courses. Study patients commonly exhibited psychiatric (65%), mild cerebellar (57%) and cortical symptoms and signs (e.g. seizure, aphasia, apraxia) (39%). Fourteen of 21 (67%), where documented, smoked cigarettes. Brain MRI demonstrated diffuse cerebral atrophy in 16 and gadolinium enhancing lesions in 11. Asymptomatic spinal cord MRI lesions were present in 12 of 16 patients (75%). Immunomodulatory therapies were generally ineffective in improving these patients. Conclusions We describe patients with MS whose clinical phenotype is characterized by severe cognitive dysfunction and prominent cortical and psychiatric signs presenting as a subacute fulminant or chronic progressive clinical course. Cigarette smokers may be over represented in this phenotype. PMID:19752304

  4. Cognitive impairment in heart failure patients

    Science.gov (United States)

    Leto, Laura; Feola, Mauro

    2014-01-01

    Cognitive damage in heart failure (HF) involves different domains thus interfering with the ability for single patient to self-care and to cope with treatment regimens, modifying symptoms and health behaviours. Many cerebral and functional changes were detected in brain imaging, involving areas of both grey and white matter deputed to cognition. Although various instruments are available to explore cognition, no consensus was obtained on better tools to be used in HF population. Reduction in cerebral blood flow, decreased cardiac output, alterations of cerebrovascular reactivity and modification of blood pressure levels are the main features involved in the etiopathogenetic mechanisms of cognitive deficit. Several cardiac variables, laboratory parameters, demographic and clinical elements were studied for their possible relation with cognition and should be properly evaluated to define patients at increased risk of impairment. The present review gathers available data pointing out assured information and discussing possible areas of research development. PMID:25593581

  5. Cognitive impairment in relapsing remitting Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Saška Roškar

    2003-06-01

    Full Text Available The purpose of the study was to identify changes in cognitive abilities that affect patients with relapsing remitting form of multiple sclerosis (MS and to find out which instrument manifests them best. The performance of MS patients was compared to a matched group of healthy people using three neuropsychological tests: Wisconsin card sorting test (WCST, Stroop color and word test and Trail making test (TMT part B. Results on all three tests indicate general cognitive impairments in the group of patients. Compared to the group of healthy people patients with MS exhibited impaired ability of abstract reasoning (WCST, impaired cognitive flexibility and less resistance to irrelevant stimuli (Stroop color and word test, slowed information processing and impaired ability of shifting attention from one symbol to another (TMT. The largest differences between groups occured in Stroop color and word test as well as in TMT. The estimation of cognitive abilities of MS patients is of high importance and sistematicaly observing of changes in those abilities should be considered.

  6. B vitamins influence vascular cognitive impairment

    Science.gov (United States)

    As the number of elderly in the USA and globally continues to increase, age-related neurological disorders, such as Alzheimer's disease and vascular dementia, are a growing concern. The loss of memory, emotional changes, and impairments in general cognitive functioning frequently result in social is...

  7. Estrogen replacement therapy, Alzheimer's disease, and mild cognitive impairment.

    Science.gov (United States)

    Mulnard, Ruth A; Corrada, Marìa M; Kawas, Claudia H

    2004-09-01

    This article highlights the latest findings regarding estrogen replacement therapy in the treatment and prevention of Alzheimer's disease (AD) and mild cognitive impairment in women. Despite considerable evidence from observational studies, recent randomized clinical trials of conjugated equine estrogens, alone and in combination with progestin, have shown no benefit for either the treatment of established AD or for the short-term prevention of AD, mild cognitive impairment, or cognitive decline. Based on the evidence, there is no role at present for estrogen replacement therapy in the treatment or prevention of AD or cognitive decline, despite intriguing results from the laboratory and from observational studies. However, numerous questions remain about the biologic effects of estrogens on brain structure and function. Additional basic and clinical investigations are necessary to examine different forms and dosages of estrogens, other populations, and the relevance of timing and duration of exposure.

  8. Piracetam treatment in patients with cognitive impairment.

    Science.gov (United States)

    Rao, Mukund G; Holla, Bharath; Varambally, Shivarama; Raveendranathan, Dhanya; Venkatasubramanian, Ganesan; Gangadhar, Bangalore N

    2013-01-01

    Piracetam is a cognitive-enhancing agent that is used for the treatment of cognitive impairments of various etiologies. Little is known about its side effect profile, especially in those with psychiatric illness. We herewith present two cases with cognitive impairment who had contrasting responses to piracetam. One of them with organic amnestic syndrome had significant improvement, whereas the other who had an organic personality change as well as a family history of mental illness had significant worsening of behavioral problems after piracetam was introduced. This report highlights the need for caution in the use of piracetam, especially in those with past or family history of psychiatric illness. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Patterns of Semantic Memory Impairment in Mild Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Sven Joubert

    2008-01-01

    Full Text Available Although the semantic memory impairment has been largely documented in Alzheimer's disease, little is known about semantic memory in the preclinical phase of the disease (Mild Cognitive Impairment. The purpose of this study was to document the nature of semantic breakdown using a battery of tests assessing different aspects of conceptual knowledge: knowledge about common objects, famous people and famous public events. Results indicate that all domains of semantic memory were impaired in MCI individuals but knowledge about famous people and famous events was affected to a greater extent than knowledge about objects. This pattern of results suggests that conceptual entities with distinctive and unique properties may be more prone to semantic breakdown in MCI. In summary, results of this study support the view that genuine semantic deficits are present in MCI. It could be useful to investigate the etiological outcome of patients failing or succeeding at such tests.

  10. Carotid Atherosclerosis and Cognitive Impairment in Nonstroke Patients

    Directory of Open Access Journals (Sweden)

    Wei-Hong Chen

    2017-01-01

    Conclusions: Carotid atherosclerosis can be used to predict the risk of cognitive impairment. Furthermore, diagnosing and treating carotid atherosclerosis at early stage might help clinicians prevent and treat vascular cognitive impairment in nonstroke patients.

  11. Mild Cognitive Impairment and Progession to Dementia: New Findings

    Science.gov (United States)

    ... David C. Spencer, MD Steven Karceski, MD Mild cognitive impairment and progression to dementia New findings John C.S. ... exami- nations showed that 534 persons had mild cognitive impairment, or MCI (see About MCI, following sec- tion). ...

  12. Minocycline protects against lipopolysaccharide-induced cognitive impairment in mice.

    Science.gov (United States)

    Hou, Yue; Xie, Guanbo; Liu, Xia; Li, Guoxun; Jia, Congcong; Xu, Jinghua; Wang, Bing

    2016-03-01

    The role of glial cells, especially microglia and astrocytes, in neuroinflammation and cognition has been studied intensively. Lipopolysaccharide (LPS), a commonly used inducer of neuroinflammation, can cause cognitive impairment. Minocycline is known to possess potent neuroprotective activity, but its effect on LPS-induced cognitive impairment is unknown. This study aims to investigate the effects of minocycline on LPS-induced cognitive impairment and glial cell activation in mice. Behavioral tests were conducted for cognitive function, immunohistochemistry for microglial and astrocyte response, and quantitative PCR for mRNA expression of proinflammatory cytokines. Minocycline significantly reversed the decreased spontaneous alternation induced by intrahippocampal administration of LPS in the Y-maze task. In the Morris water maze place navigation test, minocycline decreased the escape latency and distance traveled compared to LPS-treated mice. In the probe test, minocycline-treated mice spent more time in the target quadrant and crossed the platform area more frequently than animals in the LPS-treated group. Minocycline produced a significant decrease in the number of Iba-1- and GFAP-positive hippocampal cells compared to the LPS-treated group. Minocycline-treated mice had significantly reduced hippocampal TNF-α and IL-1β mRNA levels compared with LPS-treated animals. Minocycline caused a significant increase in hippocampal BDNF expression compared to the LPS-treated group. Minocycline can attenuate LPS-induced cognitive impairments in mice. This effect may be associated with its action to suppress the activation of microglia and astrocytes and to normalize BDNF expression. Since neuroinflammatory processes and cognitive impairments are implicated in neurodegenerative disorders, minocycline may be a promising candidate for treating such diseases.

  13. Behavioral symptoms related to cognitive impairment

    Directory of Open Access Journals (Sweden)

    Dillon C

    2013-09-01

    Full Text Available Carol Dillon,1 Cecilia M Serrano,1 Diego Castro,1 Patricio Perez Leguizamón,1 Silvina L Heisecke,1,2 Fernando E Taragano1 1CEMIC (Centro de Educación Médica e Investigaciones Clínicas University Institute, 2CONICET (Consejo Nacional de Investigaciones Cientificas y Técnicas, Buenos Aires, Argentina Abstract: Neuropsychiatric symptoms (NPS are core features of Alzheimer's disease and related dementias. On one hand, behavioral symptoms in patients with mild cognitive impairment (MCI can indicate an increased risk of progressing to dementia. On the other hand, mild behavioral impairment (MBI in patients who usually have normal cognition indicates an increased risk of developing dementia. Whatever the cause, all dementias carry a high rate of NPI. These symptoms can be observed at any stage of the disease, may fluctuate over its course, are a leading cause of stress and overload for caregivers, and increase rates of hospitalization and early institutionalization for patients with dementia. The clinician should be able to promptly recognize NPI through the use of instruments capable of measuring their frequency and severity to support diagnosis, and to help monitor the treatment of behavioral symptoms. The aims of this review are to describe and update the construct ‘MBI’ and to revise the reported NPS related to prodromal stages of dementia (MCI and MBI and dementia stages of Alzheimer’s disease and frontotemporal lobar degeneration. Keywords: behavioral or neuropsychiatric symptoms, cognitive impairment, dementia

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

    Science.gov (United States)

    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.

  15. Subjective cognitive impairment: Towards early identification of Alzheimer disease.

    Science.gov (United States)

    Garcia-Ptacek, S; Eriksdotter, M; Jelic, V; Porta-Etessam, J; Kåreholt, I; Manzano Palomo, S

    2016-10-01

    Neurodegeneration in Alzheimer disease (AD) begins decades before dementia and patients with mild cognitive impairment (MCI) already demonstrate significant lesion loads. Lack of information about the early pathophysiology in AD complicates the search for therapeutic strategies.Subjective cognitive impairment is the description given to subjects who have memory-related complaints without pathological results on neuropsychological tests. There is no consensus regarding this heterogeneous syndrome, but at least some of these patients may represent the earliest stage in AD. We reviewed available literature in order to summarise current knowledge on subjective cognitive impairment. Although they may not present detectable signs of disease, SCI patients as a group score lower on neuropsychological tests than the general population does, and they also have a higher incidence of future cognitive decline. Depression and psychiatric co-morbidity play a role but cannot account for all cognitive complaints. Magnetic resonance imaging studies in these patients reveal a pattern of hippocampal atrophy similar to that of amnestic mild cognitive impairment and functional MRI shows increased activation during cognitive tasks which might indicate compensation for loss of function. Prevalence of an AD-like pattern of beta-amyloid (Aβ42) and tau proteins in cerebrospinal fluid is higher in SCI patients than in the general population. Memory complaints are relevant symptoms and may predict AD. Interpatient variability and methodological differences between clinical studies make it difficult to assign a definition to this syndrome. In the future, having a standard definition and longitudinal studies with sufficient follow-up times and an emphasis on quantifiable variables may clarify aspects of early AD. Copyright © 2012 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Vascular cognitive impairment neuropathology guidelines (VCING): the contribution of cerebrovascular pathology to cognitive impairment.

    Science.gov (United States)

    Skrobot, Olivia A; Attems, Johannes; Esiri, Margaret; Hortobágyi, Tibor; Ironside, James W; Kalaria, Rajesh N; King, Andrew; Lammie, George A; Mann, David; Neal, James; Ben-Shlomo, Yoav; Kehoe, Patrick G; Love, Seth

    2016-11-01

    There are no generally accepted protocols for post-mortem assessment in cases of suspected vascular cognitive impairment. Neuropathologists from seven UK centres have collaborated in the development of a set of vascular cognitive impairment neuropathology guidelines (VCING), representing a validated consensus approach to the post-mortem assessment and scoring of cerebrovascular disease in relation to vascular cognitive impairment. The development had three stages: (i) agreement on a sampling protocol and scoring criteria, through a series of Delphi method surveys; (ii) determination of inter-rater reliability for each type of pathology in each region sampled (Gwet's AC2 coefficient); and (iii) empirical testing and validation of the criteria, by blinded post-mortem assessment of brain tissue from 113 individuals (55 to 100 years) without significant neurodegenerative disease who had had formal cognitive assessments within 12 months of death. Fourteen different vessel and parenchymal pathologies were assessed in 13 brain regions. Almost perfect agreement (AC2 > 0.8) was found when the agreed criteria were used for assessment of leptomeningeal, cortical and capillary cerebral amyloid angiopathy, large infarcts, lacunar infarcts, microhaemorrhage, larger haemorrhage, fibrinoid necrosis, microaneurysms, perivascular space dilation, perivascular haemosiderin leakage, and myelin loss. There was more variability (but still reasonably good agreement) in assessment of the severity of arteriolosclerosis (0.45-0.91) and microinfarcts (0.52-0.84). Regression analyses were undertaken to identify the best predictors of cognitive impairment. Seven pathologies-leptomeningeal cerebral amyloid angiopathy, large infarcts, lacunar infarcts, microinfarcts, arteriolosclerosis, perivascular space dilation and myelin loss-predicted cognitive impairment. Multivariable logistic regression determined the best predictive models of cognitive impairment. The preferred model included moderate

  17. Risk of impaired cognition after prenatal exposure to psychotropic drugs

    DEFF Research Database (Denmark)

    Wibroe, M A; Mathiasen, R; Pagsberg, A K

    2017-01-01

    OBJECTIVE: Prenatal exposure to psychotropic drugs may affect the trajectories of brain development. In a register study, we investigated whether such exposure is associated with long-term impaired cognitive abilities. METHOD: Individuals born in Denmark in 1995-2008 were included. As proxies...... of a neurological/mental disorder after prenatal exposure to psychoanaleptics (primarily antidepressants) (OR: 1.86[1.24-2.78). CONCLUSION: Prenatal exposure to psychotropic drugs affects proxy outcomes of cognitive disabilities at school age. Exposure to psycholeptics carries the largest risk. The role...

  18. Cognitive impairment in methadone maintenance patients.

    Science.gov (United States)

    Mintzer, Miriam Z; Stitzer, Maxine L

    2002-06-01

    Few well-controlled studies have examined psychomotor and cognitive performance in methadone maintenance patients (MMP). In the present study, performance of 18 opioid-dependent MMP was evaluated relative to that of 21 control participants without substance abuse histories. The MMP and control groups were balanced with respect to gender, race, age, years of education, current employment status, current reading level, and estimated IQ score. Recent drug abstinence was verified by urine testing. Participants with a urine screen positive for benzodiazepines or a breathalyzer test positive for alcohol prior to performance testing were excluded. To avoid testing under conditions of acute heroin or cocaine intoxication, but without testing under conditions of acute withdrawal, participants with current use of heroin or cocaine were only required to abstain for 24 h prior to performance testing. MMP exhibited impairment relative to controls in psychomotor speed (digit symbol substitution and trail-making tests), working memory (two-back task), decision making (gambling task), and metamemory (confidence ratings on a recognition memory test); results also suggested possible impairment in inhibitory mechanisms (Stroop color-word paradigm). MMP did not exhibit impairment in time estimation, conceptual flexibility or long-term memory. The wide range of impaired functions is striking, and may have important implications for daily functioning in MMP. Further research is necessary to determine the clinical significance of the impairments in laboratory-based tests for daily performance in the natural environment, as well as to differentiate impairments due to acute methadone dosing, chronic methadone maintenance, chronic poly-drug abuse, and other factors. Copyright 2002 Elsevier Science Irealnd Ltd.

  19. The relationship between diabetic retinopathy and cognitive impairment.

    Science.gov (United States)

    Crosby-Nwaobi, Roxanne R; Sivaprasad, Sobha; Amiel, Stephanie; Forbes, Angus

    2013-10-01

    Recent studies have shown an increased risk for cognitive impairment and dementia in patients with diabetes. An association between diabetic retinopathy (DR) and retinal microvasculature disease and cognitive impairment has been reported as potential evidence for a microvascular component to the cognitive impairment. It was hypothesized that severity of DR would be associated with cognitive impairment in individuals with type 2 diabetes. Three hundred eighty patients with type 2 diabetes were recruited from a population-based eye screening program and grouped by severity of DR as follows: no/mild DR (n=252) and proliferative diabetic retinopathy (PDR) (n=128). Each participant underwent psychosocial assessment; depression screening; ophthalmic and physical examination, including blood assays; and cognitive assessment with the Addenbrooke's Cognitive Examination-Revised (ACE-R), Mini-Mental State Examination (MMSE), and the Mini-Cog. General linear modeling was used to examine severity of DR and cognitive impairment, adjusting for confounders. Severity of DR demonstrated an inverse relationship with cognitive impairment (fully adjusted R2=0.415, Pcognitive impairment scores on ACE-R (adjusted mean±SE 77.0±1.9) compared with the PDR group (82.5±2.2, Pcognitive impairment compared with 5% in the PDR group (n=6). Patients with minimal DR demonstrated more cognitive impairment than those with advanced DR. Therefore, the increased prevalence of cognitive impairment in diabetes may be associated with factors other than evident retinal microvascular disease.

  20. Nutraceuticals in cognitive impairment and Alzheimer's disease.

    Science.gov (United States)

    Mecocci, P; Tinarelli, C; Schulz, R J; Polidori, M C

    2014-01-01

    Several chemical substances belonging to classes of natural dietary origin display protective properties against some age-related diseases including neurodegenerative ones, particularly Alzheimer's disease (AD). These compounds, known as nutraceuticals, differ structurally, act therefore at different biochemical and metabolic levels and have shown different types of neuroprotective properties. The aim of this review is to summarize data from observational studies, clinical trials, and randomized clinical trials (RCTs) in humans on the effects of selected nutraceuticals against age-related cognitive impairment and dementia. We report results from studies on flavonoids, some vitamins and other natural substances that have been studied in AD and that might be beneficial for the maintenance of a good cognitive performance. Due to the substantial lack of high-level evidence studies there is no possibility for recommendation of nutraceuticals in dementia-related therapeutic guidelines. Nevertheless, the strong potential for their neuroprotective action warrants further studies in the field.

  1. Functional Hubs in Mild Cognitive Impairment

    Science.gov (United States)

    Navas, Adrián; Papo, David; Boccaletti, Stefano; Del-Pozo, F.; Bajo, Ricardo; Maestú, Fernando; Martínez, J. H.; Gil, Pablo; Sendiña-Nadal, Irene; Buldú, Javier M.

    We investigate how hubs of functional brain networks are modified as a result of mild cognitive impairment (MCI), a condition causing a slight but noticeable decline in cognitive abilities, which sometimes precedes the onset of Alzheimer's disease. We used magnetoencephalography (MEG) to investigate the functional brain networks of a group of patients suffering from MCI and a control group of healthy subjects, during the execution of a short-term memory task. Couplings between brain sites were evaluated using synchronization likelihood, from which a network of functional interdependencies was constructed and the centrality, i.e. importance, of their nodes was quantified. The results showed that, with respect to healthy controls, MCI patients were associated with decreases and increases in hub centrality respectively in occipital and central scalp regions, supporting the hypothesis that MCI modifies functional brain network topology, leading to more random structures.

  2. Serial position effects in mild cognitive impairment.

    Science.gov (United States)

    Howieson, Diane B; Mattek, Nora; Seeyle, Adriana M; Dodge, Hiroko H; Wasserman, Dara; Zitzelberger, Tracy; Jeffrey, Kaye

    2011-03-01

    Mild cognitive impairment (MCI) is often associated with the preclinical phase of Alzheimer's disease (AD). Special scoring of word-list recall data for serial position has been suggested to improve discrimination of normal aging from dementia. We examined serial position effects in word-list recall for MCI participants compared to Alzheimer patients and controls. Individuals with MCI, like Alzheimer patients, had a diminished primacy effect in recalling words from a list. No alternative scoring system was better than standard scoring of word-list recall in distinguishing MCI patients from controls. Retention weighted scoring improved the discrimination of MCI and AD groups.

  3. Which part of the Quick mild cognitive impairment screen (Qmci) discriminates between normal cognition, mild cognitive impairment and dementia?

    LENUS (Irish Health Repository)

    O'Caoimh, Rónán

    2013-05-01

    the Qmci is a sensitive and specific test to differentiate between normal cognition (NC), mild cognitive impairment (MCI) and dementia. We compared the sensitivity and specificity of the subtests of the Qmci to determine which best discriminated NC, MCI and dementia.

  4. [Patterns of detection of mild cognitive impairment in nursing].

    Science.gov (United States)

    Sebastián Hernández, Ana J; Arranz Santamaría, Luís Carlos

    2017-06-01

    Mild cognitive impairment (MCI) is characterized by an acquired cognitive loss that places individuals, mainly older adults, in an intermediate stage between normal cognitive functioning and dementia. This impairment has a high risk of progression to dementia and is suitable for screening, which allows more effective early intervention. Nursing professionals, especially community-based primary care nurses, play an important role in the detection and follow-up of MCI and in interventions for this condition. The first step should be to take a thorough history from both the patient and his or her carers, which should assess the changes occurring in the patient's daily, family and social life through functional patterns. In subsequent assessment of cognitive function, brief screening tests can be used such as the Mini Mental State Examination (MMSE) or other similar tests. Special attention should be paid to the presence of affective or depressive symptoms, sensory deficits, polypharmacy, decompensated cardiovascular risk factors, and rapid functional deterioration, given their particular influence on MCI. Finally, various nurse-led, non-pharmacological interventions that are effective in MCI can be recommended, based on cardiovascular risk factor control, physical exercise, and cognitive and psychosocial interventions. Copyright © 2017 Sociedad Española de Geriatría y Gerontología. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Can you spell dyslexia without SLI? Comparing the cognitive profiles of dyslexia and specific language impairment and their roles in learning.

    Science.gov (United States)

    Alloway, Tracy Packiam; Tewolde, Furtuna; Skipper, Dakota; Hijar, David

    2017-06-01

    The aim of the present study is to explore whether those with Specific Language Impairment (SLI) and dyslexia display distinct or overlapping cognitive profiles with respect to learning outcomes. In particular, we were interested in two key cognitive skills associated with academic performance - working memory and IQ. We recruited three groups of children - those with SLI, those with dyslexia, and a control group. All children were given standardized tests of working memory, IQ (vocabulary and matrix), spelling, and math. The pattern of results suggests that both children with dyslexia and SLI are characterized with poorer verbal working memory and IQ compared to controls, but preserved nonverbal cognitive skills. It appears that that these two disorder groups cannot be distinguished by the severity of their cognitive deficits. However, there was a differential pattern with respect to learning outcomes, where the children with dyslexia rely more on visual skills in spelling, while those with SLI use their relative strengths in vocabulary. These findings can have important implications for how intervention is tailored in the classroom, as disorder-specific support could yield important gains in learning. Copyright © 2017. Published by Elsevier Ltd.

  6. Does my older cancer patient have cognitive impairment?

    Science.gov (United States)

    Snaedal, Jon

    2018-05-01

    Cancer and impaired cognition are both frequent conditions in old age and consequently coexist to certain degree. The prevalence of impaired cognition increases sharply after the age of 65 and the more advanced form of cognitive impairment; dementia, is exceeding 30% by the age of 85years. Adequate cognition is crucial for understanding important facts and for giving consent for intervention. There are many different stages of cognitive impairment, ranging from subjective cognitive impairment to severe dementia. The mildest stages of cognitive impairment are sometimes reversible but in more severe stages, there is brain damage of some kind, most frequently caused by neurodegenerative disorder such as Alzheimer's disease. Therefore, some kind of evaluation of cognition should be offered to all older individuals with cancer and in need for intervention. In this evaluation, information should also be sought from a close relative. In the earlier stages of cognitive impairment, the individual usually retains ability to give consent and understands information given but in later stages of dementia, a surrogate decision maker is needed. In milder stages of dementia, an individual evaluation is needed for decision of capability for consent. A specific diagnosis of a disorder such as Alzheimer's disease does not in itself preclude the individual from giving consent, the degree of cognitive impairment, impaired judgement and poor insight are more decisive in this regard. It is also important to know the difference of delirium, most often a time limited condition and dementia that usually is progressive. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Behavioral symptoms related to cognitive impairment.

    Science.gov (United States)

    Dillon, Carol; Serrano, Cecilia M; Castro, Diego; Leguizamón, Patricio Perez; Heisecke, Silvina L; Taragano, Fernando E

    2013-01-01

    Neuropsychiatric symptoms (NPS) are core features of Alzheimer's disease and related dementias. On one hand, behavioral symptoms in patients with mild cognitive impairment (MCI) can indicate an increased risk of progressing to dementia. On the other hand, mild behavioral impairment (MBI) in patients who usually have normal cognition indicates an increased risk of developing dementia. Whatever the cause, all dementias carry a high rate of NPI. These symptoms can be observed at any stage of the disease, may fluctuate over its course, are a leading cause of stress and overload for caregivers, and increase rates of hospitalization and early institutionalization for patients with dementia. The clinician should be able to promptly recognize NPI through the use of instruments capable of measuring their frequency and severity to support diagnosis, and to help monitor the treatment of behavioral symptoms. The aims of this review are to describe and update the construct 'MBI' and to revise the reported NPS related to prodromal stages of dementia (MCI and MBI) and dementia stages of Alzheimer's disease and frontotemporal lobar degeneration.

  8. Associations of Subjective Sleep Quality and Daytime Sleepiness With Cognitive Impairment in Adults and Elders With Heart Failure.

    Science.gov (United States)

    Byun, Eeeseung; Kim, Jinyoung; Riegel, Barbara

    2017-01-01

    This study examined the association of subjective nighttime sleep quality and daytime sleepiness with cognitive impairment in 105 adults (sleep quality and daytime sleepiness were measured by the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale. Cognitive impairment was assessed using a neuropsychological battery measuring attention, memory, and processing speed. Multivariate logistic regression was used. In adults, daytime sleepiness was associated with cognitive impairment, whereas poor nighttime sleep quality was associated with cognitive impairment in elders. Age may play an important role in how sleep impacts cognition in persons with heart failure. Improving nighttime sleep quality and daytime sleepiness in this population may improve cognition.

  9. Vascular cognitive impairments in chronic kidney disease

    Directory of Open Access Journals (Sweden)

    I. V. Rogova

    2015-01-01

    Full Text Available Objective: to study the specific features of development of cognitive impairments (CIs, the role of traditional cardiovascular risk factors and renal failure-induced factors in patients with Stages I–IV chronic kidney disease (CKD and to assess an association of CIs with the signs of vascular wall remodeling in them. Patients and methods. Fifty-one patients aged 53±10 years with CKD were examined. Among them, there were 20 patients with Stages I–II CKD: a glomerular filtration rate (GFR of і60 ml/min/1.73 m2, signs of renal lesion; 20 with Stages III CKD: a GFR of <60–30 ml/min/1.73 m2, and 11 with Stages VI CKD: a GFR of <30–15 ml/min/1.73 m2. Results and discussion. CIs were more common in the patients with Stages III–IV than in those with Stages I–II, as shown by the scores of the mini-mental state examination (p<0.001, the frontal assessment battery (p=0.001, and the regulatory function test (p<0.001. These tests showed that the magnitude of CIs increased with the higher stage of CKD. Stages III–IV CKD is an independent predictor of CIs in persons with predialysis-stage kidney lesion. CIs were found to be related to hyperhomocysteinemia, anemia, abdominal obesity, left ventricular hypertrophy, and patient age. The signs of atherosclerotic lesion of the common carotid arteries and the indicators of arterial stiffness were also associated with the incidence and magnitude of CIs in CKD. The detection of CIs in patients with early CKD allows one to timely initiate adequate therapy aimed particularly at improving cerebral circulation, eliminating the impact of risk factors, and slowing down the vascular remodeling. The management tactics for patients with CKD must involve the identification and correction of cardiovascular risk factors, and duplex scanning of the wall of the common carotid arteries may be used as a noninvasive method to assess the risk of the development and progression of CIs in predialysis CKD. 

  10. Cognitive impairment in chronic obstructive pulmonary disease.

    Directory of Open Access Journals (Sweden)

    Alexandru F Crişan

    Full Text Available Chronic obstructive pulmonary disease (COPD, especially in severe forms, is commonly associated with multiple cognitive problems. Montreal Cognitive Assessment test (MoCA is used to detect cognitive impairment evaluating several areas: visuospatial, memory, attention and fluency. Our study aim was to evaluate the impact of stable COPD and exacerbation (AECOPD phases on cognitive status using MoCA questionnaire.We enrolled 39 patients (pts, smokers with COPD group D (30 stable and 9 in AECOPD and 13 healthy subjects (control group, having similar level of education and no significant differences regarding the anthropometric measurements. We analyzed the differences in MoCA score between these three groups and also the correlation between this score and inflammatory markers.Patients with AECOPD had a significant (p<0.001 decreased MoCA score (14.6±3.4 compared to stable COPD (20.2±2.4 and controls (24.2±5.8. The differences between groups were more accentuated for the language abstraction and attention (p<0.001 and delayed recall and orientation (p<0.001 sub-topics. No significant variance of score was observed between groups regarding visuospatial and naming score (p = 0.095. The MoCA score was significantly correlated with forced expiratory volume (r = 0.28 and reverse correlated with C-reactive protein (CRP (r = -0.57, fibrinogen (r = -0.58, erythrocyte sedimentation rate (ESR (r = -0.55 and with the partial pressure of CO2 (r = -0.47.According to this study, COPD significantly decreases the cognitive status in advanced and acute stages of the disease.

  11. Cognitive Impairment and Pain Among Nursing Home Residents With Cancer.

    Science.gov (United States)

    Dubé, Catherine E; Mack, Deborah S; Hunnicutt, Jacob N; Lapane, Kate L

    2018-06-01

    The prevalence of pain and its management has been shown to be inversely associated with greater levels of cognitive impairment. To evaluate whether the documentation and management of pain varies by level of cognitive impairment among nursing home residents with cancer. Using a cross-sectional study, we identified all newly admitted U.S. nursing home residents with a cancer diagnosis in 2011-2012 (n = 367,462). Minimum Data Set 3.0 admission assessment was used to evaluate pain/pain management in the past five days and cognitive impairment (assessed via the Brief Interview for Mental Status or the Cognitive Performance Scale for 91.6% and 8.4%, respectively). Adjusted prevalence ratios with 95% CI were estimated from robust Poisson regression models. For those with staff-assessed pain, pain prevalence was 55.5% with no/mild cognitive impairment and 50.5% in those severely impaired. Pain was common in those able to self-report (67.9% no/mild, 55.9% moderate, and 41.8% severe cognitive impairment). Greater cognitive impairment was associated with reduced prevalence of any pain (adjusted prevalence ratio severe vs. no/mild cognitive impairment; self-assessed pain 0.77; 95% CI 0.76-0.78; staff-assessed pain 0.96; 95% CI 0.93-0.99). Pharmacologic pain management was less prevalent in those with severe cognitive impairment (59.4% vs. 74.9% in those with no/mild cognitive impairment). In nursing home residents with cancer, pain was less frequently documented in those with severe cognitive impairment, which may lead to less frequent use of treatments for pain. Techniques to improve documentation and treatment of pain in nursing home residents with cognitive impairment are needed. Copyright © 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  12. Conversion Discriminative Analysis on Mild Cognitive Impairment Using Multiple Cortical Features from MR Images

    NARCIS (Netherlands)

    Guo, Shengwen; Lai, Chunren; Wu, Congling; Cen, Guiyin; Hariharan, A.; Vijayakumari, Anupa A.; Aarabi, Mohammad Hadi; Aballi, John; Nour, Abd Elazeim Abd Alla Mohamed; Abdelaziz, Mohammed; Abdolalizadeh, AmirHussein; Abdollahi, Mahsa; Abdul Aziz, Siti Aishah; Salam, Amritha Abdul; Abdulaziz, Nidhal; Abdulkadir, Ahmed; Abdullah, Sachal; Abdullah, Osama; Abrigo, Jill; Adachi, Noriaki; Adamson, Christopher; Adduru, Viraj; Adel, Tameem; Aderghal, Karim; Ades-Aron, Benjamin; Adeyosoye, Michael; Adlard, Paul; Srinivasa, Ag; Aganj, Iman; Agarwal, Ayush; Agarwal, Anupam; Agarwal, Anchit; Aguero, Cinthya; Aguiar, Pablo; Ahdidan, Jamila; Ahmad, Fayyaz; Ahmad, Rziwan; Ahmadi, Hessam; Ahmed, Nisar; Sid, Farid Ahmed; Ai, Edward; Ai, Qing; Aicha, Benyahia; Aitharaju, Sai; Aiyer, Aditya; Akkus, Zeynettin; Akodad, Sanae; Akramifard, Hamid; Aksman, Leon; Aktas, Said; Al-Janabi, Omar; Al-Nuaimi, Ali; AlAila, BahaaEddin; Alakwaa, Fadhl; Alam, Saruar; Alam, Fakhre; Alam Zaidi, Syed Farhan; Alan, Wiener; Alansari, Mukhtar; Alareqi, Ebrahim; Alberdi, Ane; Albsoul, Mohammad; Alderson, Thomas; Aleem, Hassan; Alex, Aishwarya; Alexander, Jacob; Alexopoulos, Panagiotis; Alfoldi, Jessica; Ali, Ayesha; Ali, Imdad; Alimoradian, Shirin; Aljabar, Paul; Aljabbouli, Hasan; Aljovic, Almir; Allen, Genevera; Alliende, Luz Maria; Almaguel, Frankis; Almgren, Hannes; Montes, Carmen Alonso; Alowaisheq, Tasneem; Alryalat, Saif Aldeen; Alsado, Majd; Alsaedi, Abdalrahman; Alshehri, Haifa; Altaf, Tooba; Altendahl, Marie; Altmann, Andre; Alvand, Ashkan; Filho, Manoel Alves; Alzubi, Raid; Amaral, Robert; Ambatipudi, Mythri; Amernath, Remya; Amlien, Inge; Amoroso, Nicola; Amri, Hakima; Anastasiou, Athanasios; Anbarasi, Jani; Anbarjafari, Gholamreza; Anderson, Wes; Anderson, Jeff; Anderson, Valerie; Anderson, Loretta; Andonov, Jovan; Andova, Vesna; Andreopoulou, Irene; Andrews, K. Abigail; Andrews, Cameron; Angeles, Michel; Anne-Laure, Aziz; Ansari, Ghulam Jillani; Ansari, Sharaf; Anstey, Kaarin; Antunes, Augusto; Aoshuang, Zhang; Aouf, Mazin; Aow Yong, Li Yew; Aporntewan, Chatchawit; Apostolova, Liana; Appiah, Frank; Apsvalka, Dace; Arab, Abazar; Araque Caballero, Miguel Ángel; Arbabyazd, Mohammad; Arbelaez, Pablo; Archer, Kellie; Ardekani, Babak; Aretouli, Eleni; Arfanakis, Konstantinos; Arisi, Ivan; Armentrout, Steven; Arnold, Matthias; Arnold, Steven; Arslan, Salim; Artacho-Perula, Emilio; Arthofer, Christoph; Aruchamy, Srinivasan; Arya, Zobair; Pizarro, Carlos Asensio; Ashford, Wes; Ashraf, Azhaar; Askland, Kathleen; Aslaksen, Per; Aslakson, Eric; Aso, Toshihiko; Astphan, Michele; Ataloglou, Dimitrios; Atay, Meltem; Athanas, Argus; Atri, Roozbeh; Au, April; Aurich, Maike; Avants, Brian; Awasthi, Niharika; Awate, Suyash; Ayaz, Aymen; Son, Yesim Aydin; Aydogan, Dogu Baran; Ayhan, Murat; Ayton, Scott; Aziz, Adel; Azmi, Mohd Hafrizal; Ba, Maowen; Bach, Kevin; Badea, Alexandra; Bag, Asim; Bagewadi, Shweta; Bai, Xiangqi; Bai, Zilong; Bai, Haoli; Baird, Geoffrey; Baiwen, Zhang; Baker, Elizabeth; Baker, John; Bakker, Arnold; Ball, Erika; Ballén Galindo, Miguel Ángel; Banaei, Amin; Bandyopadhyay, Dipankar; Bang, Ki Hun; Bangen, Katherine; Banks, Sarah; Banning, Leonie; Bao, Wan Yun; Barakat, Rita; Barbará, Eduardo; Barber, Philip; Barber, Robert; de Araujo, Flavia Roberta Barbosa; Barnes, Josephine; Barredo, Jennifer; Barret, Olivier; Barrett, Matthew; Barsamian, Barsam; Barsky, Andrey; Bartel, Fabian; Bartoszewicz, Jakub; Bartram-Shaw, David; Barwood, Caroline; Basavaraj, Suryakanth; Basavaraj, Arshitha; Basiouny, Ahmed; Baskaran, Bhuvaneshwari; Basu, Arindam; Baths, Veeky; Bathula, Deepti; Batmanghelich, Nematollah Kayhan; Bauer, Roman; Bauer, Corinna; Bawa, Vanshika; Bayley, Peter; Bayram, Ali; Bazi, Yakoub; Beach, Thomas; Beaudoin, Kristin; Beaulieu, Christian; Becker, Cassiano; Beckett, Laurel; Bedding, Alun; Beer, Simone; Beer, Joanne; Beg, Mirza Faisal; Behfar, Qumars; Behjat, Hamed; Behjat, Hamid; Behseta, Sam; Bekris, Lynn; Suresh, Mahanand Belathur; Belichenko, Nadia; Bellio, Maura; Belyaev, Mikhail; Bemiller, Shane; Ahmed, Olfa Ben; Ben Bouallègue, Fayçal; Benedikt, Michael; Benge, Jared; Benitez, Andreana; Benlloch, Jose María; Benn, Marianne; Benyoussef, El Mehdi; Bergeron, David; Bermudez, Elaine; Bessadok, Alaa; Betzel, Richard; Bezuidenhoudt, Mauritz; Bhagwat, Nikhil; Bhalerao, Shailesh; Bhandari, Anindya; Bhasin, Harsh; Bhati, Radhika; Bhatkoti, Pushkar; Bhatt, Priya; Bhattacharjee, Debotosh; Bhattacharyya, Sudeepa; Bi, Rui; Bi, Jinbo; Bi, Harvy; Biancardi, Alberto; Bidart, Rene; Bilgel, Murat; Billiet, Thibo; Binczyk, Franciszek; Bingsheng, Huang; Bird, Christopher; Bischof, Gérard; Bishnoi, Ram; Biswas, Shameek; Bjelke, David; Black, Sandra; Blackwood, Jennifer; Blaese, Elise; Blair, James; Blanchard, Gilles; Bloom, Toby; Blujus, Jenna; Blusztajn, Jan Krzysztof; Bo, Wu; Bo, Jun; Boda, Ravi; Boellaard, Ronald; Bogorodzki, Piotr; Bokde, Arun; Bolhasani, Ehsan; Bonakdarpour, Borna; Bonazzoli, Matthew; Bône, Alexandre; Borkowsky, Jennifer; Borrajo, Danielle; Bos, Isabelle; Bosco, Paolo; Bott, Nicholas; Rodrigues, Renato Botter Maio Lopes; Boughanmi, Amani; Bougias, Haralabos; Boulier, Thomas; Bourgeat, Pierrick; Bouyagoub, Samira; Bowes, Mike; Boyes, Richard; Bozoki, Andrea; Bradshaw, Tyler; Pereira, Joana Braga; Brahami, Yoann; Brambati, Simona Maria; Bras, Jose; Braskie, Meredith; Brecheisen, Ralph; Bregman, Noa; Brewer, James; Briassouli, Alexia; Brickman, Adam; Bridges, Robert; Brihmat, Nabila; Brinkmann, Benjamin; Britschgi, Markus; Broers, Thomas; Bron, Esther; Brown, Jesse; Brown, Matthew; Brown, Abel; Brown, Maria; Brunberg, James; Bu, Tao; Bubbico, Giovanna; Bubenik, Peter; Bubu, Omonigho; Buchanan, Daniel; Buchholz, Hans-Georg; Buchsbaum, Bradley; Buck, Katharina; Buckley, Rachel; Budgeon, Charley; Buhl, Derek; Sánchez, Manuel Buitrago; Bundela, Saurabh; Burciu, Irina; Burgos, Ninon; Burke, Shanna; Burn, Katherine; Burns, Jeffrey; Burns, Gully; Burzykowski, Tomasz; Bush, Sammie; Buss, Stephanie; Butcher, Bradley; Butt, Victoria; Buxbaum, Joseph; Sandeep, C. S.; Cabrera, Cristóbal; Cahyaningrum, Winda; Cai, Zhen-Nao; Cai, Siqi; Cai, Erik; Cajka, Tomas; Calamia, Matthew; Caligiuri, Maria Eugenia; Calixte, Christopher; Calon, Frederic; Cameron, Briana; Campbell, Roy; Lopez, Jose Antonio Campos; Cao, Hongliu; Cao, Jiguo; Cao, Guanqun; Cao, Bo; Capizzano, Aristides; Capon, Daniel; Carmasin, Jeremy; Carmichael, Owen; Carr, Sarah; Carrier, Jason; Carter, Greg; Carvalho, Luis; Carvalho, Janessa; Carvalho, Carolina; Casamitjana, Adrià; Casanova, Ramon; Casas, Josep R.; Cash, David; Castelluccio, Pete; Castiglioni, Isabella; Caswell, Carrie; Cattell, Liam; Cauda, Franco; Cepeda, Ileana; Çevik, Alper; Cha, Jungho; Chakrabarti, Shreya; Chakraborty, Shouvik; Chammam, Takwa; Chan, Christina; Chand, Ganesh; Chang, Catie; Chang, Yu-Ming; Chang, Rui; Chang, Hyunggi; Chang, Yu-Chuan; Chang, Ki Jung; Chang, Che-Wei; Chantrel, Steeve; Chao, Justin; Chao, Linda; Chapleau, Marianne; Charil, Arnaud; Chatterjee, Pratishtha; Chatterjee, Sambit; Chaudhry, Zainab; Chauhan, Harmanpreet; Chehade, Abdallah; Chekuri, Omkar; Cheloshkina, Kseniia; Chen, Jianhong; Chen, Gang; Chen, Geng; Chen, Ting-Huei; Chen, Yin Jie; Chen, Xi; Chen, Tzu-Chieh; Chen, Guojun; Chen, Shuzhong; Chen, Jerome; Chen, Fang; Chen, Kaifeng; Chen, Gennan; Chen, Jason; Chen, Guanhua; Chen, Ying-Hsiang; Chen, Ming-Hui; Chen, Chenbingyao; Chen, S. Y.; Chen, Hsu-Hsin; Chen, Xing; Chen, Kewei; Chen, Yuhan; Chen, Hugo; Chen, Rong; Chen, Ing-jou; Chen, Jun; Chen, Jean; Chen, Bo; Cheng, Danni; Cheng, Hewei; Cheng, Yong; Cheng, Yang; Cheng, Zhang; Cheng, Wai Ho; Chenhall, Tanya; Chepkoech, Joy-Loi; Cherukuri, Venkateswararao; Chhibber, Aparna; Chi, Haoyuan; Chi, Chih-Lin; Chiang, Gloria; Chiesa, Patrizia; Childress, Daniel Micah; Chilukuri, Yogitha; Fatt, Cherise Chin; Chincarini, Andrea; Ching, Christopher; Chiotis, Konstantinos; Cho, Soo Hyun; Cho, Yongrae; Cho, Sooyun; Choi, Jun-Sik; Choi, Hongyoon; Choi, Yeoreum; Choi, Sophia; Choi, Jaesik; Choi, Euna; Choo, I. L. Han; Chopra, Vishal; Chougrad, Hiba; Chouraki, Vincent; Christini, Amanda; Chu, Yufang; Chuang, Tzu-Chao; Chuanji, Luo; Chuanjian, Yu; Chun, Marvin; Chun, Sung; Chung, Ai; Chung, Yu-Min; Chung, Jung-Che; Chung, Ai Wern; Chung, Jaeeun; Chyzhyk, Darya; Ciarleglio, Adam; Cioli, Claudia; Cittanti, Corrado; Cives, Ana; Clark, Marissa; Clayton, David; Clement, Mark; Clifft, Daniel; Climer, Sharlee; Clouston, Sean; Clunie, David; Cohen, Phoebe; Cohen, Taco; Cole, Michael; Cole, James; Colletti, Patrick; Collingwood, Joanna; Comley, Robert; Conklin, Bryan; Conner, Lindsay; Conover, Joanne; Contardo-Berning, Ivona; Conway, Ronan; Copani, Agata; Coppola, Giovanni; Corbett, Syl; Corlier, Fabian; Correia, Rui; Cosman, Joshua; Costantino, Sebastian; Coubard, Olivier; Coulson, Elizabeth; Couser, Elizabeth; Cox, Kris; Coyle, Patrick; Cozzi, Brian; Craddock, Cameron; Crawford, Karen; Creese, Byron; Cribben, Ivor; Crisostomo-Wynne, Theodore; Crossley, Nicolas; Croteau, Etienne; Cruchaga, Carlos; Cuajungco, Math; Cui, Jing; Cui, Sue; Cullen, Nicholas; Cuneo, Daniel; Cutanda, Vicente; Cynader, Max; Binu, D.; D'Avossa, Giovanni; Dai, Tian; Dai, Peng; Dai, Hui; Davied Hong, Daivied Hong; Dakovic, Marko; Dalca, Adrian; Damiani, Stefano; Dammak, Mouna; Damoiseaux, Jessica; Dan, Zou; Dang, Xuan Hong; Dang, Shilpa; Daniel, Zinkert; Danjou, Fabrice; Darby, Eveleen; Darby, Ryan; Dardzinska, Agnieszka; Darst, Burcu; Darvesh, Sultan; Das, Kalyan; Das, Devsmita; Das, Sandhitsu; Das, Dulumani; Datta, Shounak; Dauvillier, Jérôme; Davatzikos, Christos; Davidson, Ian; de Boer, Renske; de Bruijne, Marleen; de Buhan, Maya; de Jager, Philip; de La Concha Vega, Nuño; de Lange, Siemon; de Luis Garcia, Rodrigo; de Marco, Matteo; de Sitter, Alexandra; Dean, Scott; Decarli, Charles; Decker, Summer; del Gaizo, John; Demir, Zeynep; Denby, Charles; Deng, Yanjia; Deng, Wanyu; Denisova, Kristina; Denney, William; Depue, Brendan; DeRamus, Thomas; Desikan, Rahul; Desplats, Paula; Desrosiers, Christian; Devadas, Vivek; Devanarayan, Viswanath; Devarajan, Sridharan; Devenyi, Gabriel; Dezhina, Zalina; Dhami, Devendra; Dharsee, Moyez; Dhillon, Permesh; Di, Xin; Di Mauro, Nicola; Diah, Kimberly; Diamond, Sara; Diaz-Asper, Catherine; Diciotti, Stefano; Dickerson, Bradford; Dickie, David Alexander; Dickinson, Philip; Dicks, Ellen; Diedrich, Karl; Dieumegarde, Louis; Dill, Vanderson; Dilliott, Allison; Ding, Zhaohua; Ding, Shanshan; Ding, Yanhui; Ding, Xiuhua; Ding, Xuemei; Dinov, Ivo; Dinu, Valentin; Diouf, Ibrahima; Dmitriev, Phillip; Dobromyslin, Vitaly; Dodge, Hiroko; Dolui, Sudipto; Dona, Olga; Dondelinger, Frank; Dong, Wen; Dong, Hao-Ming; Kehoe, Patricio Donnelly; Donohue, Michael; Dore, Vincent; Dougherty, Chase; Doughty, Mitchell; Dowling, N. Maritza; Doyle, Senan; Doyle, Andrew; Dragan, Matthew; Draganski, Bogdan; Draghici, Sorin; Dragomir, Andrei; Drake, Derek; Drake, Erin; Drd, Shilpa; Dronkers, Nina; Drozdowski, Madelyn; Du, Changde; Du, Yuhui; Du, Lei; Du, Guangwei; Du, Xingqi; Duan, Fang; Duan, Yuzhuo; Duan, Kuaikuai; Duchesne, Simon; Duggento, Andrea; Dukart, Juergen; Dumont, Matthieu; Dunn, Ruth; Duong, Vu; Duraisamy, Baskar; Duran, Tugce; Durrleman, Stanley; Dutta, Joyita; Dyrba, Martin; Dyvorne, Hadrien; R, Amulya E.; Eads, Jennifer; Eastman, Jennifer; Eaton, Susan; Edlund, Christopher; Edmonds, Emily; Edmondson, Mackenzie; Ehsan, Fatima; El-Gabalawy, Fady; Elander, Annie; Elango, Vidhya E.; Eldeeb, Ghaidaa; Elgamal, Fatmaelzahraa; Rodrigues, Yuri Elias; Elman, Jeremy; Elrakaiby, Nada; Emahazion, Tesfai; Emami, Behnaz; Embrechts, Jurriën; Emran Khan Emon, Mohammad Asif; Emrani, Saba; Emrani, Asieh; Emri, Miklós; Engelhardt, Barbara; Engle, Bob; Epstein, Noam; Er, Fusun; Erhardt, Erik; Eriksson, Oscar; Omay, Zeynep Erson; Escudero, Javier; Eshleman, Jason; Eskildsen, Simon; Espinosa, Luis; Essex, Ryan; Esteban, Oscar; Estrada, Karol; Ethell, Douglas; Ethridge, Kimberly; Ettehadi, Seyedrohollah; Eva, Bouguen; Evenden, Dave; Evtikheeve, Rina; Ewert, Siobhan; Fague, Scot; Fahmi, Rachid; Faizal, Sherin; Falahati, Farshad; Fan, Li; Fan, Zhen; Fan, Yong; Fan, Maohua; Fan, Yonghui; Fan, Sili; Fan, Ruzong; Fang, Chen; Fang, Xiaoling; Fanjul-Vélez, Félix; Fanti, Alessandro; Far, Bab; Farah, Martha; Farahani, Naemeh; Farahibozorg, Seyedehrezvan; Farahnak, Farhood; Farajpour, Maryam; Fardo, David; Farkhani, Sadaf; Farnsworth, Bryn; Farooq, Hamza; Farooq, Ammarah; Farouk, Yasmeen; Farrar, Danielle; Farrer, Lindsay; Fatemehh, Fatemeh; Fatemizadeh, Emad; Fatfat, Kim; Fatima, Shizza; Faux, Noel; Favan-Niven, Anne; Favary, Clélia; Fazlollahi, Amir; Fei, Gao; Feingold, Franklin; Feizi, Soheil; Félix, Eloy; Femminella, Grazia Daniela; Feng, Zijun; Feng, Ao; Feng, Brad; Feng, Xinyang; Feragen, Aasa; Fereidouni, Marzieh; Fernandes, Miguel; Fernández, Víctor; Ferrari, Ricardo; Ferraris, Sebastiano; Ferreira, Francisco; Ferreira, Luiz Kobuti; Ferreira, Hugo; Fiecas, Mark; Fieremans, Els; Fiford, Cassidy; Figurski, Michal; Filippi, Massimo; Filshtein, Teresa; Findley, Caleigh; Finger, Elizabeth; Firth, Nicholas; Fischer, Christopher; Fischer, Florian; Fitall, Simon; Fleet, Blair; Fleishman, Greg; Flokas, Lambros; Flores, Alberto; Focke, Niels; Fok, Wai Yan; Foldi, Nancy; Fôlego, Guilherme; Forero, Aura; Fornage, Myriam; Fos Guarinos, Belén; Founshtein, Gregory; Franc, Benjamin; Francois, Clement; Franke, Katja; Fraser, Mark; Frasier, Mark; Frederick, Blaise; Freitas, Fernandho; Escalin, Frency Jj; Freudenberg-Hua, Yun; Friedman, Brad; Friedmann, Theodore; Friedrich, Christoph M.; Frings, Lars; Frisoni, Giovanni; Fritzsche, Klaus; Frolov, Alexander; Frost, Robert; Fu, Ling; Fu, Zening; Fudao, Ke; Fuentes, Emmanuel; Fujishima, Motonobu; Fujiwara, Ken; Fukami, Tadanori; Funk, Cory; Furcila, Diana; Fuselier, Jessica; Nagarjuna Reddy, G.; Gaasterland, Terry; Gabelle, Audrey; Gahm, Jin; Gaiteri, Chris; Gajawelli, Niharika; Galantino, Alexis; Galarza Hernández, Javier; Galasko, Douglas; Galea, Liisa; Galisot, Gaetan; Sánchez, Antonio Javier Gallego; Gallins, Paul; Gamberger, Dragan; Gan, Hong Seng; Gan, Gavin; Ganapathi, Subha; Gancayco, Christina; Gangishetti, Umesh; Ganzetti, Marco; Gao, Fei; Gao, Jingjing; Gao, Linlin; Gao, Tianxiang; Gao, Yuanyuan; Gao, Xiaohong; Garani, Ranjini; Garbarino, Sara; Garcia, Ivan; Garcia, Xiadnai; Garcia, Jorge; Garcia, Tanya; Garcia Arias, Hernan Felipe; de La Garza, Angel Garcia; Gaig, Mireia Garcia; Novoa, Jorge Garcia; Valero, Mar Garcia; Garcia-Ojalvo, Jord; García-Polo, Pablo; Garg, Rahul; Garg, Gaurav; Garg, Divya; Garibotto, Valentina; Garvey, Matthew; Garza-Villarreal, Eduardo; Gaubert, Malo; Gauthier, Serge; Gavett, Brandon; Gavidia, Giovana; Gavtash, Barzin; Gawryluk, Jodie; Gbah, Messon; Ge, Tian; Geerts, Hugo; Geisser, Niklaus; Geng, Junxian; Gentili, Claudio; Gess, Felix; Ghaderi, Halleh; Ghahari, Shabnam; Ghanbari, Yaghoob; Ghazi-Saidi, Ladan; Ghodrati, Mojgan; Ghorbani, Behnaz; Ghoreishiamiri, Reyhaneh; Ghosal, Sayan; Ghosh, Sukanta; Ghosh, Saheb; Ghosh, Sreya; Ghoshal, Ankur; Giannicola, Galetta; Gibert, Karina; Gibson, Gary; Gieschke, Ronald; Gil Valencia, Jorge Mario; Gillen, Daniel; Giordani, Alessandro; Giraldo, Diana; Gispert, Juan D.; Gitelman, Darren; Giuffrida, Mario Valerio; Madhu, G. K.; Glass, Jesse; Glazier, Brad; Gleason, Carey; Glerean, Enrico; Glozman, Tanya; Godbey, Michael; Goettlich, Martin; Gogoi, Minakshi; Gola, Kelly; Golbabaei, Soroosh; Golden, Daniel; Goldstein, Felicia; Gomes, Carlos; de Olivera, Ramon Gomes Durães; Gomez, Isabel; Gomez Gonzalez, Juan Pablo; Gomez-Verdejo, Vanessa; Gong, Weikang; Gong, Enhao; Gong, Kuang; Gonneaud, Julie; Gonzalez, Clio; Gonzalez, Evelio; Gonzalez, Gerardo; Moreira, Eduardo Gonzalez; Goodman, James; Gopinath, Srinath; Gopu, Anusharani; Gordon, Brian; Gordon, David; Gordon, Mark; Gorriz, Juan Manuel; Gors, Dorothy; Göttler, Jens; Gounari, Xanthippi; Goyal, Devendra; Graf, John; Graff, Ariel; Graham, Leah; Graham, Jinko; Grajski, Kamil; Grami, Maziyar; Grand'Maison, Marilyn; Grant, Kiran; Grassi, Elena; Gray, Katherine; Grecchi, Elisabetta; Green, Robert; Green, Elaine; Greenberg, Jonathan; Greening, Steven; Greenwood, Bryson; Gregori, Johannes; Gregory, Michael; Greicius, Michael; Greve, Douglas; Griffin, Jason; Grill, Joshua; Grodner, Kelsey; Grolmusz, Vince; Groot, Perry; Groothuis, Irme; Gross, Alden; Grundstad, Arne; Grundy, Edward; Grzegorczyk, Tomasz; Nandith, G. S.; Gu, David; Gu, Jiena; Gu, Yun; Gu, Ginam; Guan, Sheng; Guan, Yuanfang; Guennel, Tobias; Guerin, Laurent; Guerrero, Ricardo; Guerrier, Laura; Guevara, Pamela; Guggari, Shankru; Roy, Abhijit Guha; Guidotti, Roberto; Guillon, Jérémy; Gulcher, Jeff; Gulia, Sarita; Gumedze, Freedom; Gunawardena, Nishan; Gunn, Roger; Guo, Michael; Guo, Xiao; Guo, Xingzhi; Guo, Yi; Kai, Zhang Guo; Zhao, Ma Guo; Gupta, Navin; Gupta, Anubha; Gupta, Ishaan; Guren, Onan; Gurnani, Ashita; Gurol, Mahmut Edip; Guzman, Gloria; Gyy, Gyy; Rajanna, Vanamala H.; Ha, Seongwook; Haacke, Ewart; Haaksma, Miriam; Habadi, Maryam; Habeck, Christian; Habes, Mohamad; Hackspiel Zarate, Maria Mercedes; Hadimani, Ravi; Hahn, William; Hahn, Tim; Haight, Thaddeus; Hair, Nicole; Haixing, Wang; Hajarolasvadi, Noushin; Hajjar, Ihab; Hajjo, Rima; Halchenko, Yaroslav; Hall, Anette; Hallock, Kevin; Hamdi, Shah Muhammad; Hameed, Farhan; Hamidian, Hajar; Han, Dong; Han, Yang; Han, Hio-Been; Han, Qingchang; Han, Beomsoo; Han, Duke; Han, Shizhong; Han, Xiaoxia; Han, Peipei; Han, Joo Yoon; Han, Dong-Sig; Handsaker, Robert; Hanna-Pladdy, Brenda; Hanseeuw, Bernard; Hansson, Björn; Hao, Yang; Hao, Jhon; Happ, Clara; Harischandra, Dilshan; Haritaoglu, Esin; Harris, Richard; Harris, Breanna; Hart, Brian; Hartzell, James; Harvey, Danielle; Hashimoto, Tsuyoshi; Hasooni, Hossein; Hassan, Moaied; Hassan, Mehdi; Hassanzadeh, Hamid Reza; Hassanzadeh, Oktie; Hatton, Sean; Hawchar, Jinan; Hayashi, Toshihiro; Hayashi, Norio; Hayes, Jasmeet; Hayete, Boris; Haynor, David; He, Linchen; He, Yan; He, Yao; He, Huiguang; Heegaard, Niels; Hefny, Mohamed; Heil, Julius; Heindel, William; Henderson, Samuel; Henf, Judith; Henriquez, Claudio; Herholz, Karl; Hermessi, Haithem; Hernandez, Monica; Herrera, Luis; Hibar, Derrek; Hidane, Moncef; Higuchi, Satomi; Hind, Jade; Hives, Florent; Hoang, Mimi; Hobel, Zachary; Hoffman, John; Hofmeister, Jeremy; Hohman, Timothy; Holder, Daniel; Holguin, Jess; Holmes, Robin; Hong, John; Hongliang, Zou; Hongyu, Guo; Hopkins, Paul; Hor, Soheil; Hornbeck, Russ; Horng, Andy; Horton, Wesley; Hosny, Khalid; Hosseini, Eghbal; Hosseini, Hadi; Hosseini, Zahra; Asl, Ehsan Hosseini; Hou, Beibei; Houghton, Richard; Houghton, Katherine; Householder, Erin; Howlett, James; Hsiao, John; Hsiao, Ing-Tsung; Hsu, Chih-Chin; Hu, Xixi; Hu, Lingjing; Hu, Nan; Hu, Kun; Hu, Tao; Hu, Li; Hu, Xiaolan; Hua, Fei; Huang, Marissa; Huang, Qi; Huang, Michelle; Huang, Chao; Huang, JunMing; Huang, Xingyuan; Huang, Yuhan; Huang, Sing-Hang; Huang, Shuai; Huang, Peiyu; Huang, Chun-Chao; Huang, Zhiyue; Huang, Meiyan; Huang, Zhiwen; Hubrich, Markus; Huestis, Michael; Huey, Edward; Hufton, Andrew; Huijbers, Willem; Huisman, Sjoerd; Hung, Joe; Hunsaker, Naomi; Hunt, Fostor; Huppertz, Hans-Jürgen; Huser, Vojtech; Hussain, Lal; Hutchison, R. Matthew; Hutton, Alexandre; Huyck, Els; Hwang, Jihye; Hyun, JungMoon; Iakovakis, Dimitris; Ibañez, Victoria; Ide, Kayoko; Igarashi, Takuma; Iglesias, Juan Eugenio; Muñoz, Laura Igual; Iidaka, Tetsuya; Ikeuchi, Takeshi; Ikhena, John; Ikuta, Toshikazu; Im, Hyung-Jun; Insausti, Ana; Insel, Philip; Invernizzi, Azzurra; Iosif, Ana-Maria; Ip, Nancy; Irizarry, Sierra; Irmak, Emrah; Irwin, David; Isaza, Mariano; Ishii, Makoto; Ishii, Kenji; Islam, Jyoti; Israel, Ariel; Isufi, Elvin; Ito, Kaori; Ito, Masato; Izquierdo, Walter; Alphin, J.; Akhila, J. A.; Jaberzadeh, Amir; Jackowiak, Edward; Jackson, Eric; Jackson, Chris; Jackson, Jonathan; Jacob, Samson; Jacobsen, Nina; Jacobsen, Jörn; Jacquemont, Thomas; Jacques, Nerline; Jaeger, Ralf; Jafari, Tahere; Jafari-Khouzani, Kourosh; Jagadish, Akshay Kumar; Jagtap, Priti; Jagust, William; Jahr, Joseph; Jain, Shubhankar; Jain, Shubham; Jaiswal, Ayush; Jaiswal, Akshay; Jait, Amine; Jakkoju, Chetan; Jakobsson, Andreas; James, Olga; James, Oliver; Jamlai, Maedeh; Jammeh, Emmanuel; Janardhana, Lajavanthi; Jang, Jinseong; Jang, Jae-Won; Jang, Jinhee; Jang, Hyesue; Janghel, Rekh Ram; Jawahar, Shasvat; Jean, Kharne; Jean-Baptiste, Schiratti; Jedynak, Bruno; Jefferson, Angela; Jennings, Danna; Jennings, Dominique; Jeon, Seun; Jeong, Yong; Jester, Charles; Jethwa, Ketan; Jha, Debesh; Ji, Gong-Jun; Ji, Chong; Ji, Jin; Jia, Bowen; Jiacheng, Lee; Jiajia, Guo; Jian, Weijian; Jiang, Shan; Jiang, Chunxiang; Jianhua, Gao; Jiao, Zhuqing; Jiao, Zeyu; Jiao, Du; Jimenez Alaniz, Juan Ramon; Gomez, Carolina Jimenez; Jiménez-Huete, Adolfo; Jimura, Koji; Jin, Yan; Jin, Zhu; Jogia, Jigar; Johansson, Per; John, Kimberley; Johnsen, Stian; Johnson, Leonard; Johnson, Sterling; Johnson, Kent; Johnston, Jane; Johnston, Stephen; Jomeiri, Alireza; Jonas, Katherine; Jones, Richard; Jones-Davis, Dorothy; Jönsson, Linus; Joseph, Jane; Joshi, Himanshu; Joshi, Shantanu; Joshi, Abhinay; Joyce, Katherine; Juengling, Freimut; Jung, Youngjin; Junker, Viv; Junwei, Ding; Jyothi, Singaraju; Jyotiyana, Monika; Sarthaj, K.; Kachouane, Mouloud; Kadian, Amit; Kaewaramsri, Yothin; Kaicheng, Li; Kaiser, Marcus; Kakinami, Lisa; Kalra, Sanjay; Kam, Hye Jin; Kamarudin, Nur Shazwani; Kaminker, Josh; Kandel, Benjamin; Kandiah, Nagaendran; Kaneko, Tomoki; Kang, Yun Seok; Kang, Ju Hee; Kang, Hakmook; Kang, Jian; Kansal, Anuraag; Kaouache, Mohammed; Kaplan, Adam; Kottaram, Akhil Karazhma; Karim, Faizan; Karimi-Mostowfi, Nicki; Karjoo, Mahboobe; Karlin, Daniel; Karp, Juliana; Karray, Chiheb; Kartsonis, Nick; Karu, Naama; Kasa, Jaya; Kasiri, Keyvan; Katako, Audrey; Kato, Ryo; Katsonis, Panagiotis; Katti, Hkkatti; Kaur, Prabhjot; Kauwe, John; Kawaguchi, Atsushi; Kazemi, Samaneh; Kazemi, Yosra; Rijan, K. C.; Kechin, Andrey; Kelkhoff, Douglas; Kelleher, Thomas; Kellner-Weldon, Frauke; Kennion, Oliver; Kerr, Daniel; Kesler, Shelli; Kesselman, Carl; Kessler, Daniel; Keuken, Max; Keyvanfard, Farzaneh; Khademi, April; Khajehnejad, Moein; Khan, Wasim; Khan, Tabrej; Khan, Hikmat; Khan, Anzalee; Khan, Samreen; Khanmohammadi, Sina; Khasanova, Tatiana; Khazaee, Ali; Khazan, Lenny; Kherif, Ferath; Khl, Aym; KHlif, Mohamed Salah; Khondoker, Mizanur; Khoo, Sok Kean; Khosrowabadi, Reza; Khurshid, Kiran; Kianfard, Reihaneh; Kida, Satoshi; Kiddle, Steven; Kikuchi, Masashi; Killiany, Ron; Kim, Jeongchul; Kim, Jong Hun; Kim, Hyunwoo; Kim, Jongin; Kim, Yeo Jin; Kim, Jung-Jae; Kim, Hang-Rai; Kim, Jaeyeol; Kim, Ki Hwan; Kim, Joseph; Kim, Younghoon; Kim, Mijung; Kim, Jeongsik; Kim, Bohyun; Kim, Taehyun; Kim, Heeyoung; Kim, Seonjik; Kim, Nakyoung; Kim, Byeongnam; Kim, ChanMi; Kim, Jeonghun; Kim, Seong Yoon; Kim, Sunhee; Kingery, Lisle; Kinnunen, Kirsi; Kinomes, Marie; Kirchner, Jan Hendrik; Caldwell, Jessica Kirkland; Kirwan, Brock; Kitamura, Chiemi; Kitty, Kitty; Kiviat, David; Kiyasova, Vera; Klein, Richard; Klein, Alison; Klein, Gregory; Klein, Jan; Kleinman, Aaron; Kling, Mitchel; Klinger, Joern; Klinger, Rebecca; Klink, Katharina; Kocaturk, Mustafa; Koch, Philipp Johannes; Kochova, Elena; Koenig, Loren; Koh, Natalie; Köhler, Jens Erik; Koikkalainen, Juha; Koini, Marisa; Kolachalama, Vijaya; Koncz, Rebecca; Kong, Xiang-Zhen; Kong, Vincent; Kong, Xiangzhen; Kong, Dehan; Kong, Linglong; Konukoglu, Ender; Kopeinigg, Daniel; Kopera, Krzysztof; Koppers, Simon; Korb, Matheus; Korfiatis, Panagiotis; Korolev, Igor; Korolev, Sergey; Korostyshevskiy, Valeriy; Koshiya, Heena; Kost, James; Kotari, Vikas; Koutra, Danai; Koychev, Ivan; Kruthika, K. R.; Krahnke, Tillmann; Krause, Matthew; Kraybill, Matt; Kriebel, Martin; Hari Krishna, M.; Krohn, Stephan; Kruggel, Frithjof; Kuceyeski, Amy; Kuhl, Donald; Kulshreshtha, Devang; Kumar, Santosh; Kumar, Sambath; Kumar, Kuldeep; Kumar, Anil; Kumar, Abhishek; Kumar, A.; Kumar, Saurabh; Kumar, Ashwani; Kumar, Ambar; Kumar, Dinesh; Kumar, Rishab; Kumarasinghe, Janaka; Kundu, Suprateek; Kung, Te-Han; Kuo, Li-Wei; Kuo, Phillip; Channappa, Usha Kuppe; Kuriakose, Elmy; Kurian, P.; Kwan, Kenneth; Kwasigroch, Arkadiusz; Kwon, Young Hye; Kyeong, Sunghyon; Fleur, Claire La; Wungo, Supriyadi La; Labbe, Tomas; Lacombe, Daniel; Lad, Meher; Lahoti, Geet; Lai, Ying Liang; Lai, Catherine; Lai, Dongbing; Laird, Dillon; Lakatos, Anita; Lam, Alice; Lama, Ramesh; Lambert, Christian; Landau, Susan; Landman, Bennett; Landre, Victor; Lane, Elizabeth; Lange, Catharina; Langenieux, Alexandre; Lareau, Caleb; Larson, Katelyn; Latif, Ghazanfar; Lauber, Ross; Lawliet, Z. H.; Lawrence, Emma; Lazar, Anca; Le, Ngan; Le, Thi Khuyen; Le, Matthieu; Guen, Yann Le; Scouiller, Stephanie Le; Leandrou, Stephanos; Leatherday, Christopher; Leavitt, Mackenzie; Ledbetter, Christina; Lee, Hyekyoung; Lee, Wook; Lee, Annie; Lee, Jaehong; Lee, Dongyoung; Lee, Joel; Lee, Song-Ting; Lee, Kuo-Jung; Lee, Subin; Lee, Jaeho; Lee, Catherine; Lee, Gyungtae; Lee, Suzee; Lee, Erik; Lee, Yunseong; Lee, Sang-Gil; Lee, Seonjoo; Lee, Peng Jung; Lee, Hyunna; Lee, Cheng-Hsien; Lee, Hengtong; Lee, Mi Ri; Lee, Ilgu; Lee, Qixiang; Lefterov, Iliya; Leger, Charlie; Lehallier, Benoit; Lei, B.; Lei, Shi; Lei, Hongxing; Lei, Haoyun; Leong, Tze Yun; Leong, Sharlene; Leoutsakos, Jeannie-Marie; Lepore, Natasha; Lerch, Ondrej; Leung, Yip Sang; Leung, Yuk Yee; Leung, Shuyu; Leung, Hoi-Chung; Leung, Ming-Ying; Levakov, Gidon; Levine, Abraham; Li, Chawn; Li, Miranda; Li, Huijie; Li, Junning; Li, Xiaofeng; Li, Yi; Li, Jinchao; Li, Tianhong; Li, Yongming; Li, Xiangrui; Li, Tieqiang; Li, Yan; Li, Fuhai; Li, Feijiang; Li, Shuyang; Li, Zhi; Li, Xing; Li, Rongjian; Li, Rui; Li, Y. U.; Li, Kang; Li, Zhenzhen; Li, Qingqin; Li, Wenjun; Li, Yang; Li, Jialu; Li, Guangyu; Li, Michelle; Li, Yibai; Li, Yupeng; Li, Tao; Li, Zhujun; Li, Yafen; Li, Muwei; Li, Xuan; Li, Yi-Ju; Li, Cen Sing; Li, X. W.; Li, Yingjie; Li, Lin; Li, Yihan Jessie; Li, Yaqing; Li, Xiantao; Li, Xingfeng; Li, Chenxi; Li, Chao; Li, Jicong; Li, Jiewei; Li, Tengfei; Li, Wei; Li, Xinzhong; Li, Nannan; Li, Chunfei; Li, Yeshu; Liang, Chen; Liang, Nanying; Liang, Jingjing; Liang, Shengxiang; Liang, Xiaoyun; Liang, Xia; Liang, Ying; Liberman, Sofia; Libon, David; Liébana, Sergio; Liedes, Hilkka; Lim, Wee Keong; Lim, Yen Ying; Lin, Yenching; Lin, Katherine; Lin, Ming; Lin, Ai-Ling; Lin, Ching-Heng; Lin, Bing; Lin, Lin; Lin, Jyh-Miin; Lin, W. M.; Lin, Chien-Tong; Lin, Liyan; Lin, Jing; Lindberg, Olof; Linesch, Paul; Linn, Kristin; Lippert, Christoph; Litovka, Nikita; Little, Graham; Liu, Man-Yun; Liu, Jin; Liu, Chin-Fu; Liu, Zhaowen; Liu, Eulanca; Liu, Weixiang; Liu, K. E.; Liu, Hao Chen; Liu, Jia; Liu, Richann; Liu, Dongbo; Liu, Victor; Liu, Wenjie; Liu, Tao; Liu, Xiaoli; Liu, Yong; Liu, Lin; Liu, Dan; Liu, Xiuwen; Liu, Mengmeng; Liu, Chia-Shang; Liu, Ying; Liu, Yan; Liu, Xueqing; Liu, Han; Liu, Chien-Liang; Liu, Sidong; Liu, Jundong; Liu, Yang; Liu, Tianming; Liu, Tingshan; Liu, Ning; Liu, Lan; Liuyu, Liuyu; Lizarraga, Gabriel; Llido, Jerome; Lobach, Iryna; Lockhart, Samuel; Loft, Henrik; Lohr, Kelly; Lon, Hoi Kei; Lone, Kashif Javed; Long, Ziyi; Long, Xiaojing; Longo, Frank; Alves, Isadora Lopes; Lopez, Guadalupe; Lorenzi, Marco; Lotan, Eyal; Louie, Gregory; Louis, Maxime; Loukas, Andreas; Love, Seth; Lowe, Deborah; Lu, Bin; Lu, Chia-Feng; Lu, Zixiang; Lu, Lijun; Lu, Pascal; Lu, Shen; Lu, Qing; Lu, Zheshen; Lu, Chuan; Lu, Patty; Lu, Hangquan; Lu, Bo; Luktuke, Yadnyesh; Luo, Wei; Luo, Suhuai; Luo, Sheng; Luo, Shaojun; Luo, Peggy; Luo, Shan; Luo, Weidong; Luo, Liao; Luo, Xiao; Lupton, Michelle; Lutz, Michael; Lv, Eric; Lyu, Juan; Angshul, M.; Radha, M. R.; Dinesh, M. S.; Ma, Xiangyu; Ma, Chao; Ma, Li; Ma, Yu; Ma, Qianli; MacArthur, Daniel; Macey, Paul; Mach, Eric; MacPhee, Imola; Madadi, Mahboubeh; Madan, Christopher; Madan, Bharat; Madero, Giovanny; Madhavan, Radhika; Madhyastha, Tara; Maeno, Nobuhisa; Magsood, Hamzah; Mah, Linda; Mahdavi, Shirin; Mahdavi, Asef; Mahmoud, Abeer; Mahmoud, Hentati; Mahmoud, Kariman; Mahmoudi, Ahmad; Dehkordi, Siamak Mahmoudian; Mahor, Monika; Mahseredjian, Taleen; Mai, Cha; Maia, Rui; Maiti, Taps; Maj, Carlo; Maji, Pradipta; Majidpour, Jafar; Makhlouf, Laouchedi; Makino, Satoshi; Makrievski, Stefan; Makse, Hernan; Malagi, Archana; Malakhova, Katerina; Malamon, John; Malashenkova, Irina; Malchano, Zach; Maleki-Balajoo, Somayeh; Malik, Sadia; Malik, Tamoor; Mallik, Abhirup; Malm, Tarja; Malpas, Charles; Malpica, Norberto; Malviya, Meenakshi; Mamandi, A.; Manandhar, Abinash; Mandal, Pravat; Mandali, Alekhya; Mane, Prajakta; Manning, Emily; Manoufali, Mohamed; Manser, Paul; Mantini, Dante; Mantri, Ninad; Manyakov, Nikolay; Manzak, Dİlek; Mao, Shuai; Maoyu, Tian; Maple Grødem, Jodi; Maravilla, Kenneth; Marco, Simonetti; Marcus, Daniel; Margetis, John; Margolin, Richard; Mariano, Laura; Marinescu, Razvan Valentin; Markett, Sebastian; Markiewicz, Pawel; Marnane, Michael; Maroof, Asif; Marple, Laura; Marques, Cristiane; Marrakchi, Linda; Marshall, Gad; Märtens, Kaspar; Mårtensson, Gustav; Marti, Cristian; Martin, Harold; Martinaud, Olivier; Martinez, Victor; Martinez, Oliver; Martinez, Jesus; Martinez, Carlos; Abadías, Neus Martinez; Torteya, Antonio Martinez; Martini, Jean-Baptiste; Martins, Samuel; Masciotra, Viviane; Masmoudi, Ahmed; Masny, Aliaksandr; Shah, Pir Masoom; Massaro, Tyler; Masumoto, Jun; Matan, Cristy; Mate, Karen; Mateus, Pedro; Mather, Mara; Mather, Karen; Mathew, Jesia; Mathias, Samuel; Mathiyalagan, Tamilalaghan; Matloff, Will; Matsubara, Keisuke; Matsubara, Takashi; Matsuda, Yukihisa; Matthews, Dawn; Mattis, Paul; May, Patrick; Mayburd, Anatoly; Mayo, Chantel; Mayordomo, Elvira; Mbuyi, Gaylord; McCallum, Colleen; McCann, Bryony; McCollough, Todd; McCormick, Shannon; McCurdy, Sean; McDonald, Carrie; McEligot, Archana; McEvoy, Linda; McGeown, William; McGinnis, Scott; McHugh, Thomas; McIntosh, Elissa; McIntosh, Randy; McKenzie, Andrew; McLaren, Donald; McMillan, Corey; McMillan, Alan; McPherson, Brent; McRae-McKee, Kevin; Zaini, Muhammad Hafiz Md; Meadowcroft, Mark; Mecca, Adam; Meda, Shashwath; Medikonda, Venkata Srinu; Meeker, Karin; Megherbi, Thinhinane; Mehmood, Anum; Mehrtash, Alireza; Meiberth, Dix; Meier, Dominik; Meijerman, Antoine; Mejia, Jose; Mekkayil, Lasitha; Meles, Sanne; Melie-Garcia, Lester; Melo, Hans; Melrose, Rebecca; Melzer, Corina; Mendes, Aline; Leon, Ricardo Antonio Mendoza; Gonzalez, Manuel Menendez; Meng, Dewen; Meng, Xianglai; Meng, Guilin; Mengel, David; Menon, Ramesh; Menon, Ravi; Mercado, Flavio; Messick, Viviana; Meyer, Pierre-Francois; Meyer, Carsten; Mezher, Adam; Mi, Liang; Miao, Hongyu; Michailovich, Oleg; Michels, Lars; Mickael, Guedj; Mikhail, Mark; Mikhno, Arthur; Milana, Diletta; Miller, Rachel; Miller, Brendan; Millikin, Colleen; Min, Byung Wook; Minadakis, George; Minghui, Hu; Chinh, Truong Minh; Minkova, Lora; Miranda, Michelle; Misevic, Dusan; Mishra, Amit; Mishra, Chetan; Mishra, Shiwangi; Mishra, Ashutosh; Mishra, Krishna; Misquitta, Karen; Mitchell, Brian; Mithawala, Keyur; Mitnitski, Arnold; Mitra, Sinjini; Mittal, Gaurav; Mittner, Matthias; Miyapuram, Krishna Prasad; Mlalazi, Rebaone; Mo, Daojun; Moghekar, Abhay; Moguilner, Sebastian; Moh, Heba; Mohabir, Mark; Mohajer, Bahram; Mohamed, Moataz; Mohammadi, Sadeq; Mohammadi-Nejad, Ali-Reza; Mohammady, Saed; Taqi, Arwa Mohammed; Mohan, Kishore Kumar; Mohy-Ud-Din, Hassan; Moitra, Dipanjan; Mojaradi, Mehdi; Mojtabavi, Alireza; Molina, Helena; Mollon, Jennifer; Molteni, Erika; Montajabi, Mohaddeseh; Montal, Victor; Montazami, Aram; Monté-Rubio, Gemma; Montembeault, Maxime; Montero-Odasso, Manuel; Montillo, Albert; Moon, Byung-Seung; Moon, Chan; Moon, Chooza; Moore, Archer; Morabito, Francesco C.; Moradi, Masoud; Moraes, Renato; Ballesteros, Orlando Morales; Morales-Henriquez, Daniela; Moratal, David; Moreno, Herman; Morihara, Ryuta; Mormino, Elizabeth; Morris, Jeffrey; Mortamet, Bénédicte; Morton, John; Moscato, Pablo; Rial, Alexis Moscoso; Mossa, Abdela Ahmed; Mottaghi, Setare; Mouelhi, Aymen; Moussavi, Arezou; Moustafa, Ahmed; Mowrey, Wenzhu; Mtetwa, Lungile; Muehlboeck, Sebastian; Mueller, Susanne; Mueller-Sarnowski, Felix; Mufidah, Ratna; Mukherjee, Rik; Mukherjee, Shubhabrata; Müller, Christian; Müller, Hans-Peter; Mullins, Paul; Mullins, Roger; Muncy, Nathan; Munir, Akhtar; Munirathinam, Ramesh; Munoz, David; Munro, Catherine; Muranevici, Gabriela; Rendon, Santiago Murillo; Murilo, Robson; Murphy, Sonya; Muscio, Cristina; Musso, Gabriel; Mustafa, Yasser; Myall, Daniel; Gayathri, N.; Nabavi, Shahab; Nabeel, Eman; Nagele, Robert; Naghshbandi, Hane; Naik, Shruti; Najmitabrizi, Neda; Nakawah, Mohammad Obadah; Nalls, Mike; Namboori, Krishnan; Nancy, Annie; Napolitano, Giulio; Narayan, Manjari; Narkhede, Atul; Naseri, Mahsa; Nasrallah, Ilya; Nasrallah, Fatima; Nassif, Rana; Nath, Sruthi R.; Nathoo, Farouk; Nation, Daniel; Naughton, Brian; Nault, Larry; Nautiyal, Deeksha; Nayak, Deepak Ranjan; Naz, Mufassra; Nazemian, Shayan; Nazeri, Arash; Neckoska, Emilija; Neelamegam, Malinee; Nehary, Ebrahim; Nelson, Peter; Nelson, Linda; Nematzadeh, Hosein; Nerur, Shubha; Nesteruk, Thomas; Neu, Scott; Ng, Yen-Bee; Nguyen, Tin; Nguyen, Thanh; Nguyen, Harrison; Nguyen, Nghi; Trung, Hieu Nguyen; Ni, Lucy; Nian, Yongjian; Nichols, Thomas; Nicodemus, Kristin; Nie, Yunlong; Nielsen, Casper; Nikolov, Robert; Nila, Jessica; Nishioka, Christopher; Njeh, Ines; Njie, Emalick; Nobakht, Samaneh; Noble, Andrew; Noda, Art; Noroozi, Ali; Norton, Derek; Nosarti, Chiara; Nosheny, Rachel; Notsu, Akifumi; Novak, Gerald; Nozadi, Seyed Hossein; Nu, Fen; Nudelman, Kelly; Nunes, Adonay; Nunes, Ana; Núñez, Christian; Nuno, Michelle; Nuriel, Tal; Nygaard, Haakon; Nyquist, Paul; O'Bott, Jacob; O'Charoen, Sirimon; O'Neill, William; O'Rawe, Jonathan; Obrzut, Grzegorz; Och, Ganzorig; Odaibo, David; Odry, Benjamin; Oehmichen, Axel; Ofori, Edward; Ogunsanmi, Abdulfatai; Oguz, Kaya; Oh, Jungsu; Oh, Minyoung; Oh, Hwamee; Ohigashi, Hironori; Oishi, Kenichi; Oishi, Naoya; Okhravi, Hamid; Okonkwo, Ozioma; Okyay, Savaş; Oliveira, Cyrill; Oliveira, João; Oliveira, Francisco; Oliver, Ruth; Olmos, Salvador; Olszowy, Wiktor; Oltra-Cucarella, Javier; Önen, Zehra; Ong, Rowena; Onoda, Keiichi; Onyike, Chiadi; Operto, Grégory; Oppedal, Ketil; Orejuela, Juan; Orhon, Atila; Orozco, Max; Ortuño, Juan; Osadebey, Michael; Osborn, Joseph; Osoba, Osonde; Ostadrahimi, Hamid; Ostovari, Parisa; Otis, Sarah; Overgaard, Shauna; Owen, Catrin Elin; Oxtoby, Neil; Öziç, Muhammet Üsame; Ozkaya, Gorkem; Okur, Ozlem Ozmen; Ozsolak, Fatih; Ozyildirim, Melis; Pa, Judy; Pacheco, Joe; Pack, Gary; Padilla, Daniel; Cerezo, Berizohar Padilla; Padovese, Bruno; Pae, Chongwon; Pagano, Gennaro; Pahuja, Gunjan; Pai, Shraddha; Pajavand, Shahryar; Pajula, Juha; Pak, Kyoungjune; Pakzad, Ashkan; Palaniappan, Mathiyalagan; Palanisamy, Sindhu; Palmqvist, Sebastian; Palsson, Frosti; Pan, Dan; Pan, Tiffany; Pan, Yuqing; Pan, Wei; Pan, Sun; Pan, Hongliang; Pan, Xiaoxi; Pandey, Lokesh; Pang, Qiaoyu; Pangilinan, Erin; Pannetier, Nicolas; Panpan, Xu; Panyavaraporn, Jantana; Pardini, Matteo; Paredes, José; Parikh, Jignesh; Park, Seongbeom; Park, Young Ho; Park, Min Tae; Park, Hyunjin; Park, Sejin; Park, JongSeong; Park, DooHyun; Park, Ji Eun; Park, Yuhyun; Park, Jiyong; Parker, Jason; Parker, Richard; Parodi, Alice; Bautista, Yohn Jairo Parra; Parrish, Marcus; Parthiban, Preethy; Pascariello, Guido; Pascual, Belen; Paskov, Hristo; Pasquini, Lorenzo; Tantaleán, Julio Sergio Eduardo Pastor; Pastur, Lucas; Patel, Raihaan; Patel, Sejal; Paterson, Ross; Paton, Bryan; Patriarche, Julia; Patriat, Rémi; Pattichis, Constantinos; Paul, Debashis; Pawar, Kuldeep; Pawlak, Mikolaj; Paz, Rotem; Pedroto, Maria; Pelekanos, Matthew; Péléraux, Annick; Peng, Dan; Peng, Jing; Pengfei, Tian; Perani, Daniela; Peraza, Luis; Pereira, Fabricio; Pereira, Francisco; Perkins, Diana; Perneczky, Robert; Persad, Umesh; Peter, Jessica; Peters, Mette; Peters, Ruth; Pether, Mark; Petrella, Jeffrey; Petrenko, Roman; Petrone, Paula; Petrov, Dmitry; Pezzatini, Daniele; Pfenning, Andreas; Pham, Chi-Tuan; Philipson, Pete; Phillips, Jeffrey; Phillips, Nicole; Phophalia, Ashish; Phuah, Chia-Ling; Pichai, Shanthi; Pichardo, Cesar; Binette, Alexa Pichet; Pietras, Olga; Pietrzyk, Mariusz; Pike, Kerryn; Pillai, Jagan; Piludu, Francesca; Pineda, Joanna; Ping, He; Pirraglia, Elizabeth; Pither, Richard; Piyush, Ranjan; Pizzi, Nick; Gonzalez, Luis Fernando Planella; Plassard, Andrew; Platero, Carlos; Plocharski, Maciej; Podhorski, Adam; Poggiali, Davide; Poghosyan, Mher; Pohl, Kilian; Poirier, Judes; Polakow, Jean Jacques; Politis, Marios; Poljak, Anne; Poloni, Katia Maria; Poole, Victoria; Poppenk, Jordan; Porsteinsson, Anton; Portelius, Erik; Posta, Filippo; Posthuma, Danielle; Potashman, Michele; Poulin, Stephane; Pourmennati, Bahar; Prahlad, Tejas; Pranav, Lee; Prasanth, Isaac; Prashar, Ajay; Prescott, Jeff; Prevedello, Luciano; Previtali, Fabio; Pricer, James; Prichard, James; Prince, Jerry; Prins, Samantha; Pritchard, Christopher; Priya, Priya; Priya, Anandh; Priyanka, Ahana; Properzi, Michael; Prosser, Angus; Proust-Lima, Cécile; Pruessner, Jens; Pu, Jian; Punjabi, Arjun; Punugu, Venkatapavani Pallavi; Puri, Dilip; Renjini, Anurenjan Purushothaman; Pyeon, DoYeong; Qader, Abu; Qi, Zeyao; Qi, Baihong; Qian, Xiaoning; Qian, Long; Qiao, Ju; Qiao, Jocelin; Qiaoli, Zhang; Qin, Hongsen; Qin, Wang; Qin, Tian; Qin, Yuanyuan; Qin, Qinxiaotie; Qin, Qiao; Qing, Zhao; Qiongling, Li; Qiu, Yu; Qiu, Wendy; Qiu, Deqiang; Qiu, Yingwei; Quadrelli, Scott; Qualls, Jake; Quan, Li; Quarg, Peter; Qureshi, Adnan; Anand, R.; Chitra, R.; Balaji, R.; Madhusudhan, R. N.; Raamana, Pradeep Reddy; Rabbia, Michael; Rabin, Laura; Radke, David; Pc, Muhammed Raees; Rafeiean, Mahsa; Raha, Oindrila; Rahimi, Amir; Arashloo, Shervin Rahimzadeh; Rai, Vipin; Rajamanickam, Karunanithi; Rajan, Surya; Rajapakse, Jagath; Rajaram, Sampath; Rajendran, Rajeswari; Rakovski, Cyril; Ramalhosa, Ivo; Raman, Fabio; Ramasamy, Ellankavi; Ramasangu, Hariharan; Ramirez, Alfredo; Ramos Pérez, Ana Victoria; Rana, Rahul; Rane, Swati; Rao, Anil; Rao, Vikram; Rashidi, Arash; Rasoanaivo, Oly; Rassem, Taha; Rastgoo, Hossein; Rath, Daniel; Ratnarajah, Nagulan; Ravikirthi, Prabhasa; Ravipati, Kaushik; RaviPrakash, Harish; Rawdha, Bousseta; Ray, Meredith; Ray, Debashree; Ray, Nilanjan; Ray, Dipankar; Ray, Soumi; Rebbah, Sana; Redding, Morgan; Regnerus, Bouke; Rehn, Patrick; Rehouma, Rokaya; Reid, Robert; Reimer, Alyssa; Reiss, Philip; Reitz, Christiane; Rekabi, Maryam; Rekik, Islem; Ren, Xuhua; Ren, Fujia; Ren, Xiaowei; Ren, Weijie; Renehan, William; Rennert, Lior; Rey, Samuel; Reyes, Pablo; Reza, Rifat; Rezaee, Khosro; Rhinn, Herve; Lorenzo, Pablo Ribalta; Ribeiro, Adèle Helena; Richards, John; Richards, Burt; Richards, Todd; Richardson, Hamish; Richiardi, Jonas; Richter, Nils; Ridge, Perry; Ridgway, Gerard; Ridha, Basil; Ried, Janina; Riedel, Brandalyn; Riphagen, Joost; Ritter, Kerstin; Rivaz, Hassan; Rivers-Auty, Jack; Allah, Mina Rizk; Rizzi, Massimo; Roalf, David; Robb, Catherine; Roberson, Erik; Robieson, Weining; Rocca-Serra, Philippe; Rodrigues, Marcos Antonio; Rodriguez, Alain; Aguiar, Güise Lorenzo Rodríguez; Rodriguez-Sanchez, Antonio; Rodriguez-Vieitez, Elena; Roes, Meighen; Rogalski, Emily; Rogers, James; Rogers, Baxter; Rohani, Hosna; Rollins, Carin; Rollo, Jenny; Romanillos, Adrian; Romero, Marcelo; Romero, Klaus; Rominger, Axel; Rondina, Jane; Ronquillo, Jeremiah; Roohparvar, Sanaz; Rosand, Jonathan; Rose, Gregory; Roshchupkin, Gennady; Rosoce, Jeremy; Ross, David; Ross, Joel; Ross, Owen; Rossi, Stephanie; Roussarie, Jean-Pierre; Roy, Arkaprava; Roy, Snehashis; Ruble, Cara; Rubright, Jonathan; Rudovic, Ognjen; Ruggiero, Denise; Rui, Qiao; Ruiz, Pablo; Rullmann, Michael; Rusmevichientong, Pimbucha; Russell, Rolf; Rutten, Julie; Saadatmand-Tarzjan, Mahdi; Saba, Valiallah; Sabuncu, Mert; Sacuiu, Simona; Sampathkumar, Srihari Sadhu; Sadikhov, Shamil; Saeedi, Sarah; Saf, Naz; Safapur, Alireza; Safi, Asad; Saint-Aubert, Laure; Saito, Noboru; Saito, Naomi; Sakata, Muneyuki; Frigerio, Carlo Sala; Sala-Llonch, Roser; Salah, Zainab; Salamanca, Luis; Salat, David; Salehzade, Mahdi; Salter, Hugh; Samatova, Nagiza; Sampat, Mehul; Gonzalez, Jorge Samper; Samtani, Mahesh; Samuel, Pearl; Bohorquez, Sandra Sanabria; Sanbao, Cheng; Sanchez, Iñigo; Sánchez, Irina; Sandella, Nick; Sanderlin, Ashley Hannah; Sanders, Elizabeth; Sankar, Tejas; Sanroma, Gerard; Sanson, Horacio; Santamaria, Mar; de Lourdes, Daniella; de Andrade, Luna Santana; Santhanam, Prasanna; Ribeiro, Andre Santos; Sardi, Pablo; Sardina, Davide; Saremi, Arvin; Sarica, Alessia; Sarnowski, Chloé; Sarraf, Saman; Saslow, Adam; Sato, Takayuki; Sato, Joao; Sattler, Sophia; Savic, Milos; Saxon, Jillian; Saya, Boson; Saykin, Andrew; Sbeiti, Elia; Scarapicchia, Vanessa; Scelsi, Marzia Antonella; Schaerer, Joel; Scharre, Douglas; Scherr, Martin; Schevenels, Klara; Schibler, Tony; Schiller, Florian; Schirmer, Markus; Schmansky, Nick; Schmidt, Marco; Schmidt, Paul; Schmitz, Taylor; Schmuker, Michael; Schneider, Anja; Schneider, Reinhard; Schoemaker, Dorothee; Schöll, Michael; Schouten, Tijn; Schramm, Hauke; Schreiber, Frank; Schultz, Timothy; Schultz, Aaron; Schürmann, Heike; Schwab, Patrick; Schwartz, Pamela; Schwarz, Adam; Schwarz, Christopher; Schwarzbauer, Christian; Scott, Julia; Scott, F. Jeffrey; Scott, David; Scussel, Artur; Seale, William; Seamons, John; Seemiller, Joseph; Sekine, Tetsuro; Selnes, Per; Sembritzki, Klaus; Senanayake, Vijitha; Seneca, Nicholas; Senjem, Matthew; Filho, Antonio Carlos Senra; Sensi, Stefano; Seo, Eun Hyun; Seo, Kangwon; Seong, Sibaek; Sepeta, Leigh; Seraji-Bozorgzad, Navid; Serra-Cayuela, Arnau; Seshadri, Sudha; Sgouros, Nicholas; Sha, Miao; Shackman, Alexander; Shafee, Rebecca; Shah, Rupali; Shah, Hitul; Shahid, Mohammad; Shahparian, Nastaran; Shakeri, Mahsa; Shams, Sara; Shams, Ali; Baboli, Aref Shams; Shamul, Naomi; Shan, Guogen; Shang, Yuan; Shao, Rui; Shao, Hanyu; Shao, Xiaozhe; Shaoxun, Yuan; Noghabi, Hossein Sharifi; Sharlene, Newman; Sharma, Avinash; Sharma, Ankita; Sharma, Aman; Shaw, Leslie; Shaw, Saurabh; Shcherbinin, Sergey; Sheline, Yvette; Shen, Li; Shen, Yanhe; Shen, Qian; Sherriff, Ian; Shi, Xin; Shi, Lei; Shi, Yonggang; Shi, Yue; Shi, Yupan; Shi, Jie; Shi, Feng; Shiban, Nisreen; Shields, Trevor; Shiiba, Takuro; Shiino, Akihiko; Shin, Peter; Shin, Hoo Chang; Shin, Daniel; Shine, James; Shinohara, Russell; Shirakashi, Yoshitomo; Shirali, Ramin; Shirer, William; Shiva, Karthik; Shmuel, Amir; Shojaei, Zahra; Shojaei, Samane; Shokouhi, Sepideh; Short, Jennifer; Shu, Qing; Shu, Ziyu; Shu, Hao; Shu, Xinghui; Shukla, Rahul; Sibilia, Francesca; Sikka, Apoorva; Rincón, Santiago Smith Silva; Silveira, Margarida; Simon, Howard; Simonneau, Michel; Simonovsky, Martin; Singanamalli, Asha; Singh, TirathaRaj; Singh, Ambuj; Singh, Satya; Singlelob, John; Sinha, Sampada; Sipko, Maciej; Sistla, Kamala; Sivera, Raphael; Skillbäck, Tobias; Skocik, Michael; Slade, Emily; Smisek, Miroslav; Smith, Louise; Smith, Emily; Smith, Elliot; Smith, Lidia; de Lima, John Wesley Soares; Soemedi, Rachel; Sohail, Aamir; Soheili-Nezhad, Sourena; Sokolow, Sophie; Sokurenko, Maria; Soldan, Anja; Soman, Salil; Sone, Je Yeong; Song, Joonyoung; Song, Xiaowei; Soni, Ameet; Soni, Priyank; Sonkar, Gaurav; Sonmez, Ege; Sonpatki, Pranali; Sorooshyari, Siamak; Diaz, Roberto Carlos Sotero; Sotolongo-Grau, Oscar; Sou, Ka Lon; Soursou, Georgia; Spampinato, Maria Vittoria; Spedding, Alexander; Spenger, Christian; Spiegel, Jonathan; Spiegel, RenÃ; Spies, Lothar; Spiro, Oliver; Spooner, Annette; Springate, Beth; Spronk, Marjolein; Squillario, Margherita; Sreenivasan, Karthik; Srikanth, Velandai; Srinivasan, Sneha; Srivastava, Mashrin; Srivastava, Anant; Srivatsa, Shantanu; Stage, Eddie; Stanley-Olson, Alexis; Steenland, Nelson; Steffener, Jason; Steyvers, Mark; Stickel, Ariana; Stone, David; Storkey, Amos; Storrs, Judd; Straminsky, Axel; Strittmatter, Stephen; Su, Yi; Sudmann-Day, Matthew; Sudre, Carole; Sudsanguan, Salintip; Sugishita, Morihiro; Suh, Devin; Suk, Heung-Il; Sulimov, Pavel; Sullivan, Margot; Sullivan, Kenneth; Sullivan, Jenna; Sumbaly, Ronak; Sun, Liyan; Sun, Xinwei; Sun, Haoran; Sun, Chung-Kai; Sun, Yongcong; Sun, Yu; Sun, Mingjie; Sun, Qian; Sun, Zeyu; Sun, Liang; Sun, Xiaoyan; Sun, Wei; Sundaramoorthy, Karthik Prakash; Sundaresan, Mali; Sunderland, John; Sundermann, Erin; Sunkishala, Raja; Surampudi, Govinda; Surampudi Venkata, Suresh Kumar; Surendran, Neha; Suresh, Adarsh; Suryavanshi, Priya; Susi, Gianluca; Suthaharan, Praveen; Sutphen, Courtney; Swati, Zar Nawab Khan; Sweet, Robert; Swinford, Cecily; Syaifullah, Ali Haidar; Szoeke, Cassandra; Sørensen, Lauge; Cuenco, Karen T.; Jafari, Hossein Tabatabaei; Tadayon, Ehsan; Taebi, Yasaman; Tahaei, Marzieh S.; Tahmasebi, Amir; Tai, Leon; Takahashi, Ryoji; Takahashi, Ryuichi; Takahashi, Hideyuki; Takao, Hidemasa; Takeuchi, Tomoko; Talib, Sophie; Taljan, Kyle; Tam, Angela; Tam, Roger; Tamang, Kishan; Tan, Chin Hong; Tan, Luqiao; Tan, Lin; Tan, Tian Swee; Tancredi, Daniel; Tanenbaum, Aaron; Tang, Yucong; Tang, Xiaoying; Tang, Chuangao; Tang, Cheng; Tang, Lingkai; Tang, Min; Tang, Hao; Tanigaki, Kenji; Tanoori, Betsabeh; Tansey, Wesley; Tantiwetchayanon, Khajonsak; Tanveer, M.; Tao, Qiushan; Tao, Chong; Tarawneh, Rawan; Tarnow, Eugen; Tartaglia, Maria Carmela; Tasaki, Shinya; Taswell, Koby; Taswell, Carl; Tatsuoka, Curtis; Taylan, Pakize; Taylor, Jonathan; Taylor, Brad; Tayubi, Iftikhar; Tchistiakova, Ekaterina; tee, Yee Kai; Teipel, Stefan; Temizer, Leyla; Kate, Mara Ten; Tenbergen, Carlijn; Tenenbaum, Jessica; Teng, Zi; Teng, Yuan-Ching; Teng, Edmond; Termenon, Maite; Terry, Eloise; Thaker, Ashesh; Theobald, Chuck; Thiel, Taylor; Thiele, Ines; Thiele, Frank; Thierry, Jean Pierre; Thirunavu, Vineeth; Thomas, Chris; Thomas, Kelsey; Thomas, Anoop Jacob; Thomas, Benjamin; Thomas, Ronald; Thomas, Adam; Thomopoulos, Sophia; Thompson, Gerard; Thompson, Jeff; Thompson, Will; Thompson, Paul; Thung, Kimhan; Tian, Sijia; Tierney, Mary; Tilquin, Florian; Tingay, Karen; Tirrell, Lee; Tirumalai, Sindhuja; Tobis, Jonathan; Todkari, Suhasini; Tohka, Jussi; Tokuda, Takahiko; Toledo, Juan B.; Toledo, Jon; Tolonen, Antti; Tombari, Federico; Tomiyama, Tetsuro; Tomola, Lauren; Tong, Yunjie; Tong, Liz; Tong, Li; Tong, Xiaoran; Torgerson, Carinna; Toro, Roberto; Torok, Levente; Toschi, Nicola; Tosto, Giuseppe; Tosun, Duygu; Tourandaz, Morteza; Toussaint, Paule; Towhidi, Sasan Maximilian; Towler, Stephen; Toyama, Teruhide; Tractenberg, Rochelle E.; Tran, Thao; Tran, Daniel; Trapani, Benjamin; Tremolizzo, Lucio; Tripathi, Shashi; Trittschuh, Emily; Trivedi, Ashish; Trojacanec, Katarina; Truong, Dennis; Tsanas, Athanasios; Tse, Kai-Hei; Tsoy, Elena; Tu, Yanshuai; Tubeleviciute-Aydin, Agne; Tubi, Meral; Tucholka, Alan; Tufail, Ahsan; Tumati, Shankar; Tuo, Shouheng; Tuovinen, Timo; Tustison, Nicholas; Tutunji, Rayyan; Tward, Daniel; Tyagi, Gaurav; Tzioras, Nikolaos; Raghavendra, U.; Uberti, Daniela; Uchiyama, Yoshikazu; Ueki, Masao; Ulug, Aziz; Umek, Robert; University, Northwestern; de Almeida, Sofia Urioste Y. Nunes; Urrutia, Leandro; Usama, Ahmed; Ustun, Ali Alp; Uus, Alena; Uyar, Muharrem Umit; Visalatchi, V.; Rajinikanth, V.; Vafaei, Amin; Vairre, Darlene; Vaishnavi, Sanjeev; Vaithinathan, Krishnakumar; Vakorin, Vasily; Hernández, Maria Valdés; van Bokhoven, Pieter; Deerlin, Vivianna Van; van der Brug, Marcel; Dijk, Koene Van; van Duijn, Cornelia; van Erp, Theo; van Hooren, Roy; Leemput, Koen Van; van Loenhoud, Anita; Schependom, Jeroen Van; van Velden, Floris; van Westen, Danielle; Vandekar, Simon; Vandijck, Manu; Vanhoutte, Matthieu; Vannini, Patrizia; Vansteenkiste, Elias; Varatharajah, Yogatheesan; Vardarajan, Badri; Varey, Stephen; Vargas, Hernan; Varkey, Julia; Varma, Susheel; Varma, Vijay; Varma, Sudhr; Vasanthakumar, Aparna; Vashi, Tejal; Vasilchuk, Kseniia; Vassileva, Albena; Vatsalan, Dinusha; Vb, Nastaran; Veeramacheneni, Teja; Veeranah, Darvesh; Vejdani, Kaveh; Veldsman, Michele; Velgos, Stefanie; Veloso, Adriano; Vemuri, Prashanthi; Venero, Cesar; Venkataraman, Ashwin; Venkatasubramanian, Palamadai; Venkatraghavan, Vikram; Venugopal, Vinisha; Venugopalan, Janani; Verbeeck, Rudi; Verbel, David; Verbist, Bie; Verdoliva, Luisa; Verma, Ajay Kumar; Verma, Tarun; Verma, Ishan; Veronese, Mattia; Grabovetsky, Alejandro Vicente; Victor, Jonathan; Vieira, Domingos; Vijayaraj, Vinesh Raja; Vikas, Vinutha; Vilaplana, Veronica; Vilaplana, Eduard; Villar, José Ramón; Vincent, Fabrice; Vinkler, Mojmir; Viswanath, Satish; Viswanathan, Srikrishnan; Vitek, Michael; Viti, Mario; Vladutu, Liviu; Vlock, Daniel; Voineskos, Aristotle; Vora, Anvi; Vos, Stephanie; Voyle, Nicola; Vrenken, Hugo; Vu, Tien Duong; Vucetic, Zivjena; Vuksanovic, Vesna; Wachinger, Christian; Wada, Masataka; Wade, Sara; Wagstyl, Konrad; Wahba, Grace; Waldorf, Johannes; Walker, Douglas; Moore, Kim Poki Walker; Walsh, Dominic; Wan, Lin; Wang, Di; Wang, Jane-Ling; Wang, Yongmao; Wang, Huaming; Wang, Miao; Wang, Zi-Rui; Wang, Zheyu; Wang, Z. E.; Wang, Lucy; Wang, Bin; Wang, Lei; Wang, Jason; Wang, Cathy; Wang, Jing; Wang, Xiuyuan; Wang, Dai; Wang, Lingyu; Wang, Jianjia; Wang, Yuan; Wang, Yujiang; Wang, Ming-Liang; Wang, De; Wang, Ling; Wang, Liangliang; Wang, Jianxin; Wang, Zhanyu; Wang, William Shi-Yuan; Wang, HuiFu; Wang, Weixin; Wang, Zhenxun; Wang, Wei; Wang, Junwen; Wang, Yipei; Wang, Shanshan; Wang, Yinying; Wang, Chengjia; Wang, Yuanjia; Wang, Kerry; Wang, Li-San; Wang, Kangcheng; Wang, Rui; Wang, Kai; Wang, Qian; Wang, Xinying; Wang, Xinglong; Wang, Jeff; Wang, Tianyi; Wang, Honglang; Wang, Xuekuan; Wang, Yongxiang; Wang, Hong; Wang, Silun; Waring, Stephen; Warren, David; Wasule, Vijay; Watanabe, Yoshiyuki; Wearn, Alfie; Wee, Chong-Yaw; Wegmayr, Viktor; Wehenkel, Marie; Wei, Rizhen; Wei, Zheng; Wei, Penghu; Wei, Yongbin; Wei, Guohui; Wei, Changshuai; Weichart, Emily; Weiler, Marina; Weise, Christopher; Weisong, Zhong; Weisshuhn, Philip; Weizheng, Yan; Wen, Canhong; Wen, Junhao; Wen, Wei; Wen, Zhenfu; Wen, Hao; Wenzel, Fabian; Werhane, Madeleine; Westaway, Shawn; Westlye, Lars T.; Westman, Eric; Whardana, Adithya; Whitcher, Brandon; Whittington, Alexander; Wicks, Stephen; Wiens, Jenna; Wildsmith, Kristin; Wilhelmsen, Kirk; Wilkinson, Andrea; Willette, Auriel; Williams, Kristin; Williams, Robert; Williams, Rebecca; Wilman, Alan; Wilmot, Beth; Wilson, Lorraine; Win, Juliet; Windpass, F. C.; Wink, Alle Meije; Winter, Nils; Winzeck, Stefan; Wirth, Miranka; Wishart, Heather; Wisniewski, Gary; Wiste, Heather; Wolpe, Noham; Wolz, Robin; Wong, Stephen; Wong, Swee Seong; Wong, Tak-Lam; Woo, Jongwook; Woo, Taekang; Woo, Young; Wood, Levi; Worth, Andrew; Wrenn, Jesse; Wright, Paul; Wu, Guorong; Wu, Lynn; Wu, Shawn; Wu, Menglin; Wu, Ruige; Wu, Shaoju; Wu, Chong; Wu, Juhao; Wu, Liyun; Wu, Yu-Te; Wu, Yuankai; Wu, Helen; Xia, Weiming; Xiang, Xu; Xiangmao, Kong; Xiao, Yiming; Xiao, Jie; Xiao, Y. U.; Xiaoxi, Ji; Xiaoya, Zhu; Xiaoying, Qi; Xie, Yuchen; Xie, Zhiyong; Xie, Lei; Xie, Xiancheng; Xin, Huang; Xingyi, Huang; Xiong, Yuanpeng; Xiong, Momiao; Xu, Yongchao; Xu, XiaoYing; Xu, Qiqi; Xu, Lijun; Xu, Hewen; Xu, Yunlong; Xu, Zhilei; Xu, Ziliang; Xu, Jiayuan; Xu, Yadong; Xu, Lu; Xu, Shuoyu; Xue, Fei; Xuesong, Yang; Xz, Zarric; Yadav, Rishi; Yaish, Aviv; Yakushev, Igor; Yamada, Shigeki; Yamamoto, Utako; Yamashita, Alexandre; Yamashita, Fumio; Yan, Li; Yan, Yu; Yan, Jianhua; Yan, Shiju; Yan, Chao-Gan; Yan, Qingyu; Yan, Jingwen; Yan, Chen; Yan, Meng; Yang, Meng; Yang, Bin; Yang, Jiarui; Yang, Zhi; Yang, Xianfeng; Yang, Sli; Yang, Liang; Yang, Robert; Yang, Aleex; Yang, Hyungjeong; Yang, ChengHao; Yang, Haiwei; Yang, Jhih-Ying; Yang, Xu; Yangyang, Xia; Yao, Xufeng; Yaping, Wang; Yaqiong, Bi; Yared, Surafael; Yashin, Anatoliy; Yassine, Hussein; Yau, Tat; Yavorsky, Christian; Ye, Chang; Ye, Byoung Seok; Ye, Joy; Ye, Yongkai; Ye, Yuting; Ye, Wu; Yelampalli, Praveen Kumar Reddy; Thomas Yeo, B. T.; Yi, Zhao; Yi, Wang; Yi, Yuan; Yijing, Ruan; Yilmaz, Zeynep; Yin, Baocai; Yin, Tang-Kai; Ying, Li; Yingjiang, Wu; Yiyun, Yu; Yoichiro, Sato; Yokoyama, Jennifer; Yong, Zhang; Yonghong, Shi; Yonghu, Guo; Yongqi, Huang; Yoo, Inwan; Yoon, So Hoon; Yoon, Jee Seok; Yoon, Seung-Yong; Yoshida, Hisako; Yoshio, Kiyofumi; You, Jia; You, You; You, Xiaozhen; Young, Alexandra; Yu, Peng; Yu, Jaemin; Yu, Lin; Yu, Sui; Yu, Philip S.; Yu, Guan; Yu, Fengli; Yu, Jiaxin; Yu, Shaode; Yu, Suizhi; Yu, Donghyeon; Yuan, Yue; Yuan, Shaofeng; Yuan, Shuai; Yuanyuan, Chen; Yue, Ye; Yue, Cynthia; Yunaiyama, Daisuke; YushaoChen, YushaoChen; Yushkevich, Paul; Yx, W.; Zafeiris, Dimitrios; Zagorchev, Lyubomir; Zalocusky, Kelly; Zamorano, Francisco; Zandifar, Azar; Zanella, Laura; Zang, Yufeng; Zanke, Brent; Zaranek, Alexander Wait; Zawaideh, Mazen; Zawawi, Nour; Zee, Jarcy; Zeighami, Yashar; Zeitzer, Jamie; Zemla, Jeffrey; Zeng, Qi; Zeng, Fan; Zeng, Donglin; Zeng, Wei; Zeng, Yingying; Ženko, Bernard; Zereshki, Ehsan; Zeskind, Benjamin; Zhan, Justin; Zhang, Chenghui; Zhang, Yixuan; Zhang, Xiong; Zhang, Li; Zhang, Zhi; Zhang, Jianlun; Zhang, Jing; Zhang, Jianwei; Zhang, Yufei; Zhang, Sai; Zhang, Shan; Zhang, Xiaoling; Zhang, Changle; Zhang, Qingtian; Zhang, Fan; Zhang, Xiangliang; Zhang, Linda; Zhang, Yingteng; Zhang, Jianhua; Zhang, Xiaoqun; Zhang, Ziwei; Zhang, Ping; Zhang, Tuo; Zhang, Bin; Zhang, Hong; Zhang, Yuping; Zhang, Zhan; Zhang, Yu; Zhang, Jie; Zhang, Lijun; Zhang, ChengZhi; Zhang, Jian; Zhang, Peng; Zhang, Zhengjun; Zhang, Wen; Zhang, Guishan; Zhang, Xixue; Zhang, Tianhao; Zhangyi, Zhangyi; Zhao, Wenting; Zhao, Xuewu; Zhao, Peng; Zhao, Yifei; Zhao, Xing-Ming; Zhao, Di; Zhao, Qian; Zhao, Yang; Zhao, Lu; Zheng, Lijuan; Zheng, Kaiping; Zheng, Weihao; Zheng, Du; Zheng, Muhua; Zheng, Qiang; Zheng, Bichen; Zheng, Lihong; Zhong, Wenxuan; Zhong, Yujia; Zhou, Tian; Zhou, Jiayin; Zhou, Zhen; Zhou, Yongxia; Zhou, Lixin; Zhou, Bowei; Zhou, Juan; Zhou, Qixin; Zhou, Levi; Zhou, Fengfeng; Zhou, Jiayu; Zhou, Luping; Zhou, Yun; Zhou, Yingjie; Zhou, Ying; Zhou, Frankie; Zhu, Zonghai; Zhu, Xiaoya; Zhu, Xiaolu; Zhu, Shanfeng; Zhu, David; Zhu, Hongxiao; Zhu, Lida; Zhu, Xiaofeng; Zhuxin, Jin; Zigon, Robert; Zille, Pascal; Zimmer, Eduardo; Zimmer, Jennifer; Zimmerman, Earl; Zimmerman, Karl; Zimmermann, Joelle; Zipperer, Erin; Zito, Giancarlo; Zou, Yang; Zuo, Maria; Zywiec, Andrew

    2017-01-01

    Neuroimaging measurements derived from magnetic resonance imaging provide important information required for detecting changes related to the progression of mild cognitive impairment (MCI). Cortical features and changes play a crucial role in revealing unique anatomical patterns of brain regions,

  13. Cognitive impairment in patients with type 2 diabetes mellitus ...

    African Journals Online (AJOL)

    Cognitive impairment in patients with type 2 diabetes mellitus: Perspectives and ... may have a deteriorating effect on mental health including a decline in cognitive ... of Diabetes; Functional Foods and Human Diet; Quality of Life and Wellness ...

  14. Pediatric frontal lobe epilepsy : white matter abnormalities and cognitive impairment

    NARCIS (Netherlands)

    Braakman, H.M.H.; Vaessen, M.J.; Jansen, J.F.A.; Debeij-van Hall, M.H.J.A.; Louw, de A.; Hofman, P.A.M.; Vles, J.S.H.; Aldenkamp, A.P.; Backes, W.H.

    2014-01-01

    Objectives: Cognitive impairment is frequent in children with frontal lobe epilepsy (FLE). Its etiology remains unknown. With diffusion tensor imaging, we have studied cerebral white matter properties and associations with cognitive functioning in children with FLE and healthy controls.

  15. Cognitive Impairment in Chronic Alcoholics: Some Cause for Optimism.

    Science.gov (United States)

    Goldman, Mark S.

    1983-01-01

    It appears that, although the cognitive functioning of many alcoholics remains impaired even after drinking has stopped, considerable recovery can occur. New findings now suggest the possibility of reducing cognitive dysfunction and enhancing alcoholism treatment outcomes. (CMG)

  16. Sensory Impairments and Cognitive Function in Middle-Aged Adults.

    Science.gov (United States)

    Schubert, Carla R; Cruickshanks, Karen J; Fischer, Mary E; Chen, Yanjun; Klein, Barbara E K; Klein, Ronald; Pinto, A Alex

    2017-08-01

    Hearing, visual, and olfactory impairments have been associated with cognitive impairment in older adults but less is known about associations with cognitive function in middle-aged adults. Sensory and cognitive functions were measured on participants in the baseline examination (2005-2008) of the Beaver Dam Offspring Study. Cognitive function was measured with the Trail Making tests A (TMTA) and B (TMTB) and the Grooved Peg Board test. Pure-tone audiometry, Pelli-Robson letter charts, and the San Diego Odor Identification test were used to measure hearing, contrast sensitivity, and olfaction, respectively. There were 2,836 participants aged 21-84 years with measures of hearing, visual, olfactory, and cognitive function at the baseline examination. Nineteen percent of the cohort had one sensory impairment and 3% had multiple sensory impairments. In multivariable adjusted linear regression models that included all three sensory impairments, hearing impairment, visual impairment, and olfactory impairment were each independently associated with poorer performance on the TMTA, TMTB, and Grooved Peg Board (p cognitive function tests independent of the other sensory impairments and factors associated with cognition. Sensory impairments in midlife are associated with subtle deficits in cognitive function which may be indicative of early brain aging. © 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.

  17. The Impact of Microbiota-Gut-Brain Axis on Diabetic Cognition Impairment

    Directory of Open Access Journals (Sweden)

    Youhua Xu

    2017-04-01

    Full Text Available Progressive cognitive dysfunction is a central characteristic of diabetic encephalopathy (DE. With an aging population, the incidence of DE is rising and it has become a major threat that seriously affects public health. Studies within this decade have indicated the important role of risk factors such as oxidative stress and inflammation on the development of cognitive impairment. With the recognition of the two-way communication between gut and brain, recent investigation suggests that “microbiota-gut-brain axis” also plays a pivotal role in modulating both cognition function and endocrine stability. This review aims to systemically elucidate the underlying impact of diabetes on cognitive impairment.

  18. Protective effects of telmisartan and tempol on lipopolysaccharide-induced cognitive impairment, neuroinflammation, and amyloidogenesis: possible role of brain-derived neurotrophic factor.

    Science.gov (United States)

    Khallaf, Waleed A I; Messiha, Basim A S; Abo-Youssef, Amira M H; El-Sayed, Nesrine S

    2017-07-01

    Angiotensin II has pro-inflammatory and pro-oxidant potentials. We investigated the possible protective effects of the Angiotensin II receptor blocker telmisartan, compared with the superoxide scavenger tempol, on lipopolysaccharide (LPS)-induced cognitive decline and amyloidogenesis. Briefly, mice were allocated into a normal control group, an LPS control group, a tempol treatment group, and 2 telmisartan treatment groups. A behavioral study was conducted followed by a biochemical study via assessment of brain levels of beta amyloid (Aβ) and brain-derived neurotropic factor (BDNF) as amyloidogenesis and neuroplasticity markers, tumor necrosis factor alpha (TNF-α), nitric oxide end products (NOx), neuronal and inducible nitric oxide synthase (nNOS and iNOS) as inflammatory markers, and superoxide dismutase (SOD), malondialdehyde (MDA), glutathione reduced (GSH), and nitrotyrosine (NT) as oxido-nitrosative stress markers. Finally, histopathological examination of cerebral cortex, hippocampus, and cerebellum sections was performed using routine and special Congo red stains. Tempol and telmisartan improved cognition, decreased brain Aβ deposition and BDNF depletion, decreased TNF-α, NOx, nNOS, iNOS, MDA, and NT brain levels, and increased brain SOD and GSH contents, parallel to confirmatory histopathological evidences. In conclusion, tempol and telmisartan are promising drugs in managing cognitive impairment and amyloidogenesis, at least via upregulation of BDNF with inhibition of neuroinflammation and oxido-nitrosative stress.

  19. Executive cognitive impairment detected by simple bedside testing ...

    African Journals Online (AJOL)

    Aims. Cognitive impairment in people with type 2 diabetes is a barrier to successful disease management. We sought to determine whether impaired executive function as detected by a battery of simple bedside cognitive tests of executive function was associated with inadequate glycaemic control. Methods. People with ...

  20. Awareness of deficits in mild cognitive impairment and Alzheimer's disease

    DEFF Research Database (Denmark)

    Vogel, Asmus; Stokholm, Jette; Gade, Anders

    2004-01-01

    In this study we investigated impaired awareness of cognitive deficits in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). Very few studies have addressed this topic, and methodological inconsistencies make the comparison of previous studies difficult. From a prospective...

  1. White Matter Damage and Cognitive Impairment after Traumatic Brain Injury

    Science.gov (United States)

    Kinnunen, Kirsi Maria; Greenwood, Richard; Powell, Jane Hilary; Leech, Robert; Hawkins, Peter Charlie; Bonnelle, Valerie; Patel, Maneesh Chandrakant; Counsell, Serena Jane; Sharp, David James

    2011-01-01

    White matter disruption is an important determinant of cognitive impairment after brain injury, but conventional neuroimaging underestimates its extent. In contrast, diffusion tensor imaging provides a validated and sensitive way of identifying the impact of axonal injury. The relationship between cognitive impairment after traumatic brain injury…

  2. Selective Impairment of Auditory Selective Attention under Concurrent Cognitive Load

    Science.gov (United States)

    Dittrich, Kerstin; Stahl, Christoph

    2012-01-01

    Load theory predicts that concurrent cognitive load impairs selective attention. For visual stimuli, it has been shown that this impairment can be selective: Distraction was specifically increased when the stimulus material used in the cognitive load task matches that of the selective attention task. Here, we report four experiments that…

  3. Parental Cognitive Impairment and Child Maltreatment in Canada

    Science.gov (United States)

    McConnell, David; Feldman, Maurice; Aunos, Marjorie; Prasad, Narasimha

    2011-01-01

    Objectives: The aim of this study was to determine the prevalence of parental cognitive impairment in cases opened for child maltreatment investigation in Canada, and to examine the relationship between parental cognitive impairment and maltreatment investigation outcomes including substantiation, case disposition and court application. Methods:…

  4. Cerebral microbleeds, cognitive impairment, and MRI in patients with diabetes mellitus.

    Science.gov (United States)

    Zhou, Hong; Yang, Juan; Xie, Peihan; Dong, Yulan; You, Yong; Liu, Jincai

    2017-07-01

    Cerebral microbleeds (CMBs), a typical imaging manifestation marker of sporadic cerebral small vessel disease, play a critical role in vascular cognitive impairment, which is often accompanied by diabetes mellitus (DM). Hence, CMBs may, in part, be responsible for the occurrence and development of cognitive impairment in patients with diabetes. Novel magnetic resonance imaging (MRI) sequences, such as susceptibility-weighted imaging and T2*-weighted gradient-echo, have the capability of noninvasively revealing CMBs in the brain. Moreover, a correlation between CMBs and cognitive impairment in patients with diabetes has been suggested in applications of functional MRI (fMRI). Since pathological changes in the brain occur prior to observable decline in cognitive function, neuroimaging may help predict the progression of cognitive impairment in diabetic patients. In this article, we review the detection of CMBs using MRI in diabetic patients exhibiting cognitive impairment. Future studies should emphasize the development and establishment of a novel MRI protocol, including fMRI, for diabetic patients with cognitive impairment to detect CMBs. A reliable MRI protocol would also be helpful in understanding the pathological mechanisms of cognitive impairment in this important patient population. Copyright © 2017. Published by Elsevier B.V.

  5. [Voting by cognitively impaired persons: legal and ethical issues].

    Science.gov (United States)

    Bosquet, Antoine; Medjkane, Amar; Vinceneux, Philippe; Mahé, Isabelle

    2010-03-01

    In democratic countries, cognitively impaired persons are a substantial and growing group of citizens. Most of them are citizens with dementia. In dementia, cognitive impairment induces a loss of some capacities, resulting in vulnerability and increased need for assistance. Voting by cognitively impaired persons raises any questions about the integrity of the electoral process, the risk of fraud and the respect of their citizenship. In France, the law is not definite about the voting of cognitively impaired persons. An objective assessment for voting capacity may be useful both for professionals in charge of voting organisation and for guardianship judge in order to help him in his decision to remove or keep the voting right of persons placed under guardianship. Assessing the reality of voting by cognitively impaired citizens is necessary to advance respect for their right to vote.

  6. [Cognitive impairments accompanying the burnout syndrome - a review].

    Science.gov (United States)

    Riedrich, Karin; Weiss, Elisabeth M; Dalkner, Nina; Reininghaus, Eva; Papousek, Ilona; Schwerdtfeger, Andreas; Lackner, Helmut K; Reininghaus, Bernd

    2017-03-01

    The rising prevalence of the burnout syndrome has increasingly moved it into the focus of scientific interest. In addition to emotional exhaustion and depersonalization, particularly reduced personal accomplishment has strong societal and economic effects. In recent years reduced personal accomplishment has increasingly been linked to cognitive impairment. However, up to now only a few studies have objectively assessed cognitive deficits in burnout patients. This article gives an overview of 16 studies which examined cognitive abilities in burnout patients. The findings are partly contradictory, probably due to methodical differences. Consensus has emerged concerning impairments of executive functions, i.a. vigilance, and memory updating and monitoring. Multifactorial causation may underlie the cognitive impairments. Targeted longitudinal studies are necessary in order to identify the affected cognitive functions and be able to make causal inferences on links between the burnout syndrome and specific cognitive impairments.

  7. Estrogen and cognitive functioning in men with mild cognitive impairment.

    Science.gov (United States)

    Sherwin, Barbara B

    2002-01-01

    Although men do not experience an abrupt cessation of gonadal hormone production at midlife as do women, levels of testosterone (T) decrease gradually with aging. Because estradiol (E2) arises mainly from the conversion of T in men, the availability of E2 also decreases with increasing age. In randomized clinical trials, E2 replacement therapy has been shown to maintain aspects of cognition in postmenopausal women, specifically with regard to verbal memory. The present prospective, randomized, cross-over trial is being undertaken in order to determine whether E2 will enhance verbal memory in men with Mild Cognitive Impairment (MCI). Men with MCI will randomly receive E2 or placebo for the first 3 mo of treatment and will then be crossed-over to the other treatment for an additional 3 mo. A battery of neuropsychological tests will be administered at pretreatment and, again, following each 3-mo treatment phase. It is hypothesized that elderly men with MCI will perform better on tests of explicit memory when they are being treated with E2 compared to their performance under placebo conditions.

  8. Neuropathology of mild cognitive impairment (MCI)

    International Nuclear Information System (INIS)

    Murayama, Shigeo; Saito, Yuko

    2007-01-01

    Described are retrospective pathological studies on mild cognitive impairment (MCI) of brain specimens in the brain bank of authors' institute and current clinical studies of outpatients for screening of MCI based on those pathological findings. The study projects, aided by Ministry of Health, Labour and Welfare (MHLW) from 2003 and from 2007, have aimed to develop the optimal way for prophylaxis of dementia. In the former autopsy, about 10% of the elderly dead registered in the institute are found to have pathological changes of the clinical dementia rating 0.5, in whom the early Alzheimer disease (AD), Lewy body dementia, argentaffin granular disease and neurofibrillary tangle dominant disease are involved in a similar ratio to each other. Clinically, new patients with memory complaint are first screened by neurological tests involving CT, and then those with suspicious dementia undergo the second screening (2-day hospitalization) involving MRI with VSRAD (Voxel-based Specific Regional Analysis System for AD), ECD single photon emission computed tomography (SPECT) with eZis (easy Z-score imaging system), myocardial scintigraphy with homovanillic acid (HVA)/m-iodobenzylguanidine (MIBG), and if necessary, PET with fluorodeoxyglucose (FDG), PIB (Pittsburgh Compound B, an amyloid prove) and/or 11 C-CFT and 11 C-raclopride. Further, new patients with suspicious Parkinson disease undergo the screening (3-day) of various tests involving MRI with voxel-based morphometry and VSRAD, cerebral blood flow ECD SPECT with eZis and MIBG myocardial scintigraphy. It is concluded that AD is the most important subject in MCI and systemic diseases can also affect the cognitive ability as well. (R.T.)

  9. First translational 'Think Tank' on cerebrovascular disease, cognitive impairment and dementia

    NARCIS (Netherlands)

    Barone, F.C.; Gustafson, D.; Crystal, H.A.; Moreno, H.; Adamski, M.G.; Arai, K.; Baird, A.E.; Balucani, C.; Brickman, A.M.; Cechetto, D.; Gorelick, P.; Biessels, G.J.; Kiliaan, A.J.; Launer, L.; Schneider, J.; Sorond, F.A.; Whitmer, R.; Wright, C.; Zhang, Z.G.

    2016-01-01

    As the human population continues to age, an increasing number of people will exhibit significant deficits in cognitive function and dementia. It is now recognized that cerebrovascular, metabolic and neurodegenerative diseases all play major roles in the evolution of cognitive impairment and

  10. Cognitive and Linguistic Precursors to Early Literacy Achievement in Children With Specific Language Impairment

    NARCIS (Netherlands)

    Weerdenburg, M.W.C. van; Verhoeven, L.T.W.; Balkom, L.J.M. van; Bosman, A.M.T.

    2009-01-01

    This study investigated the role of cognitive and language skills as predictors of early literacy skills in children with Specific Language Impairment. A range of cognitive and linguistic skills were assessed in a sample of 137 eight-year-old children with SLI at the beginning of the school year,

  11. Prevalence of cognitive impairment in major depression and bipolar disorder.

    Science.gov (United States)

    Douglas, Katie M; Gallagher, Peter; Robinson, Lucy J; Carter, Janet D; McIntosh, Virginia Vw; Frampton, Christopher Ma; Watson, Stuart; Young, Allan H; Ferrier, I Nicol; Porter, Richard J

    2018-05-01

    The current study examines prevalence of cognitive impairment in four mood disorder samples, using four definitions of impairment. The impact of premorbid IQ on prevalence was examined, and the influence of treatment response. Samples were: (i) 58 inpatients in a current severe depressive episode (unipolar or bipolar), (ii) 69 unmedicated outpatients in a mild to moderate depressive episode (unipolar or bipolar), (iii) 56 outpatients with bipolar disorder, in a depressive episode, and (iv) 63 outpatients with bipolar disorder, currently euthymic. Cognitive assessment was conducted after treatment in Studies 1 (6 weeks of antidepressant treatment commenced on admission) and 2 (16-week course of cognitive behaviour therapy or schema therapy), allowing the impact of treatment response to be assessed. All mood disorder samples were compared with healthy control groups. The prevalence of cognitive impairment was highest for the inpatient depression sample (Study 1), and lowest for the outpatient depression sample (Study 2). Substantial variability in rates was observed depending on the definition of impairment used. Correcting cognitive performance for premorbid IQ had a significant impact on the prevalence of cognitive impairment in the inpatient depression sample. There was minimal evidence that treatment response impacted on prevalence of cognitive impairment, except in the domain of psychomotor speed in inpatients. As interventions aiming to improve cognitive outcomes in mood disorders receive increasing research focus, the issue of setting a cut-off level of cognitive impairment for screening purposes becomes a priority. This analysis demonstrates important differences in samples likely to be recruited depending on the definition of cognitive impairment and begins to examine the importance of premorbid IQ in determining who is impaired. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Drug abusers have impaired cerebral oxygenation and cognition during exercise.

    Directory of Open Access Journals (Sweden)

    Kell Grandjean da Costa

    Full Text Available Individuals with Substance Use Disorder (SUD have lower baseline metabolic activity of the prefrontal cortex (PFC associated with impairment of cognitive functions in decision-making and inhibitory control. Aerobic exercise has shown to improve PFC function and cognitive performance, however, its effects on SUD individuals remain unclear.To verify the cognitive performance and oxygenation of the PFC during an incremental exercise in SUD individuals.Fourteen individuals under SUD treatment performed a maximum graded exercise test on a cycle ergometer with continuous measurements of oxygen consumption, PFC oxygenation, and inhibitory control (Stroop test every two minutes of exercise at different intensities. Fifteen non-SUD individuals performed the same protocol and were used as control group.Exercise increased oxyhemoglobin (O2Hb and total hemoglobin (tHb by 9% and 7%, respectively. However, when compared to a non-SUD group, this increase was lower at high intensities (p<0.001, and the inhibitory cognitive control was lower at rest and during exercise (p<0.007. In addition, PFC hemodynamics during exercise was inversely correlated with inhibitory cognitive performance (reaction time (r = -0.62, p = 0.001, and a lower craving perception for the specific abused substance (p = 0.0189 was reported immediately after exercise.Despite SUD individuals having their PFC cerebral oxygenation increased during exercise, they presented lower cognition and oxygenation when compared to controls, especially at elevated intensities. These results may reinforce the role of exercise as an adjuvant treatment to improve PFC function and cognitive control in individuals with SUD.

  13. Mild Cognitive Impairment in Parkinson's Disease-What Is It?

    Science.gov (United States)

    Weil, Rimona S; Costantini, Alyssa A; Schrag, Anette E

    2018-03-10

    Mild cognitive impairment is a common feature of Parkinson's disease, even at the earliest disease stages, but there is variation in the nature and severity of cognitive involvement and in the risk of conversion to Parkinson's disease dementia. This review aims to summarise current understanding of mild cognitive impairment in Parkinson's disease. We consider the presentation, rate of conversion to dementia, underlying pathophysiology and potential biomarkers of mild cognitive impairment in Parkinson's disease. Finally, we discuss challenges and controversies of mild cognitive impairment in Parkinson's disease. Large-scale longitudinal studies have shown that cognitive involvement is important and common in Parkinson's disease and can present early in the disease course. Recent criteria for mild cognitive impairment in Parkinson's provide the basis for further study of cognitive decline and for the progression of different cognitive phenotypes and risk of conversion to dementia. Improved understanding of the underlying pathology and progression of cognitive change are likely to lead to opportunities for early intervention for this important aspect of Parkinson's disease.

  14. The combined effect of visual impairment and cognitive impairment on disability in older people.

    Science.gov (United States)

    Whitson, Heather E; Cousins, Scott W; Burchett, Bruce M; Hybels, Celia F; Pieper, Carl F; Cohen, Harvey J

    2007-06-01

    To determine the risk of disability in individuals with coexisting visual and cognitive impairment and to compare the magnitude of risk associated with visual impairment, cognitive impairment, or the multimorbidity. Prospective cohort. North Carolina. Three thousand eight hundred seventy-eight participants in the North Carolina Established Populations for the Epidemiologic Studies of the Elderly with nonmissing visual status, cognitive status, and disability status data at baseline Short Portable Mental Status Questionnaire (cognitive impairment defined as > or =4 errors), self reported visual acuity (visual impairment defined as inability to see well enough to recognize a friend across the street or to read newspaper print), demographic and health-related variables, disability status (activities of daily living (ADLs), instrumental activities of daily living (IADLs), mobility), death, and time to nursing home placement. Participants with coexisting visual and cognitive impairment were at greater risk of IADL disability (odds ratio (OR)=6.50, 95% confidence interval (CI)=4.34-9.75), mobility disability (OR=4.04, 95% CI=2.49-6.54), ADL disability (OR=2.84, 95% CI=1.87-4.32), and incident ADL disability (OR=3.66, 95%, CI=2.36-5.65). In each case, the estimated OR associated with the multimorbidity was greater than the estimated OR associated with visual or cognitive impairment alone, a pattern that was not observed for other adverse outcomes assessed. No significant interactions were observed between cognitive impairment and visual impairment as predictors of disability status. Individuals with coexisting visual impairment and cognitive impairment are at high risk of disability, with each condition contributing additively to disability risk. Further study is needed to improve functional trajectories in patients with this prevalent multimorbidity. When visual or cognitive impairment is present, efforts to maximize the other function may be beneficial.

  15. Post-stroke cognitive impairment: epidemiology, mechanisms and management

    Science.gov (United States)

    Sun, Jia-Hao

    2014-01-01

    Post-stroke cognitive impairment occurs frequently in the patients with stroke. The prevalence of post-stroke cognitive impairment ranges from 20% to 80%, which varies for the difference between the countries, the races, and the diagnostic criteria. The risk of post-stroke cognitive impairment is related to both the demographic factors like age, education and occupation and vascular factors. The underlying mechanisms of post-stroke cognitive impairment are not known in detail. However, the neuroanatomical lesions caused by the stroke on strategic areas such as the hippocampus and the white matter lesions (WMLs), the cerebral microbleeds (CMBs) due to the small cerebrovascular diseases and the mixed AD with stroke, alone or in combination, contribute to the pathogenesis of post-stroke cognitive impairment. The treatment of post-stroke cognitive impairment may benefit not only from the anti-dementia drugs, but also the manage measures on cerebrovascular diseases. In this review, we will describe the epidemiological features and the mechanisms of post-stroke cognitive impairment, and discuss the promising management strategies for these patients. PMID:25333055

  16. Reduced prevalence of cognitive impairment in families with exceptional longevity

    DEFF Research Database (Denmark)

    Cosentino, Stephanie; Schupf, Nicole; Christensen, Kaare

    2013-01-01

    with exceptional longevity are protected against cognitive impairment consistent with Alzheimer disease. DESIGN Cross-sectional analysis. SETTING Multisite study in New York, Massachusetts, Pennsylvania, and Denmark. PARTICIPANTS A total of 1870 individuals (1510 family members and 360 spouse controls) recruited...... through the Long Life Family Study. MAIN OUTCOME AND MEASURE Prevalence of cognitive impairment based on a diagnostic algorithm validated using the National Alzheimer's Coordinating Center data set. RESULTS The cognitive algorithm classified 546 individuals (38.5%) as having cognitive impairment...... consistent with Alzheimer disease. Long Life Family Study probands had a slightly but not statistically significant reduced risk of cognitive impairment compared with spouse controls (121 of 232 for probands vs 45 of 103 for spouse controls; odds ratio = 0.7; 95% CI, 0.4-1.4), whereas Long Life Family Study...

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

    Science.gov (United States)

    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.

  18. Attention and inhibition in Mild Cognitive Impairment and Alzheimer's Disease

    Directory of Open Access Journals (Sweden)

    Clara Zancada-Menéndez

    2013-12-01

    Full Text Available Mild cognitive impairment is understood as a cognitive deficit of insufficient severity to fulfil the criteria for Alzheimer’s disease. Many studies have attempted to identify which cognitive functions are most affected by this type of impairment and which is the most sensitive neuropsychological test for early detection. This study investigated sustained and selective attention, processing speed, and the inhibition process using a sample of people divided into three groups mild cognitive impairment, Alzheimer disease and cognitively healthy controls selected and grouped based on their scores in the Mini Mental State Examination and Cambridge Cognitive Examination-revised. Three tests from the Cambridge Neuropsychological Test Automated Battery (Motor Screening Task, Stop Signal Task and Reaction time were used as well as the d2 attention test. The results show that that participants with mild cognitive impairment and Alzheimer disease showed lower levels of concentration compared with the cognitively healthy controls group in the d2 test and longer reaction times in the Cambridge Neuropsychological Test Automated Battery, although the differences were not marked in the latter test. The impairments in basic cognitive processes, such as reaction time and sustained attention, indicate the need to take these functions into account in the test protocols when discriminating between normal aging and early and preclinical dementia processes.

  19. Vascular cognitive impairment in Pemphigus vulgaris: a case report

    Directory of Open Access Journals (Sweden)

    José Ibiapina Siqueira- Neto

    Full Text Available ABSTRACT Pemphigus vulgaris is a systemic auto-immune medical condition that mainly manifests with changes in skin and vasculopathy. This is a case report of a 69-year-old male with confirmed histopathologic diagnosis of Pemphigus vulgaris presenting ulterior Cognitive Impairment, mostly in executive function. The patient was treated using steroids, immunomodulatory therapy, fluoxetine and galantamine. Neuropsychological testing and magnetic resonance (MRI were performed. This is the first report of correlational cognitive impairment with Pemphigus vulgaris in the literature. Physicians should be aware of vascular causes for cognitive impairment in patients presenting auto-immune conditions.

  20. Progress of assessment and rehabilitation therapy of cognitive impairment

    Directory of Open Access Journals (Sweden)

    Yuan-yuan TAO

    2017-07-01

    Full Text Available  Cognitive impairment is one of major disorders after brain injury. With the rapid development of rehabilitation medicine in China, more and more attention was focused on it. The methods of assessment and rehabilitation therapy of cognitive impairment are more widely used in clinic. Based on traditional methods of assessment and rehabilitation therapy, driven by the development of computer, Internet and Internet of Things, more and more new methods emerged. This article intends to review the commonly used assessment and rehabilitation therapy of cognitive impairment and their progress. DOI: 10.3969/j.issn.1672-6731.2017.05.002

  1. Cytokine Response, Tract-Specific Fractional Anisotropy, and Brain Morphometry in Post-Stroke Cognitive Impairment.

    Science.gov (United States)

    Kulesh, Aleksey; Drobakha, Viktor; Kuklina, Elena; Nekrasova, Irina; Shestakov, Vladimir

    2018-07-01

    Post-stroke cognitive impairment is a clinically heterogeneous condition and its types have a different course and prognosis. The aim of the present study is to address the roles of inflammation, white matter pathology, and brain atrophy in different neuropsychological types of cognitive impairment in the acute period of ischemic stroke. In 92 patients, we performed an assessment of the cognitive status and measured concentrations of cytokines (interleukin [IL]-1β, IL-6, tumor necrosis factor-alpha, IL-10) in liquor and serum, as well as a number of magnetic resonance imaging (MRI) morphometric parameters and fractional anisotropy. The control group consisted of 14 individuals without cerebrovascular disease. All patients had a higher level of IL-10 in serum than the control group. Patients with dysexecutive cognitive impairment had a higher concentration of IL-1β and IL-10 in liquor, IL-6 level in serum, and a lower fractional anisotropy of the ipsilateral thalamus than patients with normal cognition. Patients with mixed cognitive impairment were characterized by a lower fractional anisotropy of contralateral fronto-occipital fasciculus, compared with patients with dysexecutive cognitive impairment. Patients with both dysexecutive and mixed cognitive deficit had a wide area of leukoaraiosis and a reduced fractional anisotropy of the contralateral cingulum, compared with patients without cognitive impairment. Also, we found numerous correlations between cognitive status and levels of cytokines, MRI morphometric parameters, and fractional anisotropy of certain regions of the brain. The concentrations of cytokines in serum and cerebrospinal fluid studied in combination with MRI morphometric parameters and fractional anisotropy appear to be informative biomarkers of clinical types of post-stroke cognitive impairment. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  2. Feeling Older and the Development of Cognitive Impairment and Dementia.

    Science.gov (United States)

    Stephan, Yannick; Sutin, Angelina R; Luchetti, Martina; Terracciano, Antonio

    2017-10-01

    Subjective age is a biopsychosocial marker of aging associated with a range of outcomes in old age. In the domain of cognition, feeling older than one's chronological age is related to lower cognitive performance and steeper cognitive decline among older adults. The present study examines whether an older subjective age is associated with the risk of incident cognitive impairment and dementia. Participants were 5,748 individuals aged 65 years and older drawn from the Health and Retirement Study. Measures of subjective age, cognition, and covariates were obtained at baseline, and follow-up cognition was assessed over a 2- to 4-year period. Only participants without cognitive impairment were included at baseline. At follow-up, participants were classified into one of the three categories: normal functioning, cognitive impairment without dementia (CIND), and dementia. An older subjective age at baseline was associated with higher likelihood of CIND (odds ratio [OR] = 1.18; 1.09-1.28) and dementia (OR = 1.29; 1.02-1.63) at follow-up, controlling for chronological age, other demographic factors, and baseline cognition. Physical inactivity and depressive symptoms partly accounted for these associations. An older subjective age is a marker of individuals' risk of subsequent cognitive impairment and dementia. © 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.

  3. Positive Effects of Computer-Based Cognitive Training in Adults with Mild Cognitive Impairment

    Science.gov (United States)

    Herrera, C.; Chambon, C.; Michel, B. F.; Paban, V.; Alescio-Lautier, B.

    2012-01-01

    Considering the high risk for individuals with amnestic Mild Cognitive Impairment (A-MCI) to progress towards Alzheimer's disease (AD), we investigated the efficacy of a non-pharmacological intervention, that is, cognitive training that could reduce cognitive difficulties and delay the cognitive decline. For this, we evaluated the efficacy of a…

  4. Cognitive impairment and computer tomography image in patients with arterial hypertension -preliminary results

    International Nuclear Information System (INIS)

    Yaneva-Sirakova, T.; Tarnovska-Kadreva, R.; Traykov, L.; Zlatareva, D.

    2012-01-01

    Arterial hypertension is the leading risk factor for cognitive impairment, but it is developed only in some of the patients with pour control. On the other hand, not all of the patents with white matter changes have cognitive deficit. There may be a variety of reasons for this: the accuracy of methods for blood pressure measurement, the specific brain localization or some other reason. Here are the preliminary results of a study (or the potential correlation between self-measured, office-, ambulatory monitored blood pressure, central aortic blood pressure, minimal cognitive impairment and the specific brain image on contrast computer tomography. We expect to answer, the question whether central aortic or self-measured blood pressure have the leading role for the development of cognitive impairment in the presence of a specific neuroimaging finding, as well as what is the prerequisite for the clinical manifestation of cognitive dysfunction in patients with computer tomographic pathology. (authors)

  5. Memory complaints in subjective cognitive impairment, amnestic mild cognitive impairment and mild Alzheimer's disease.

    Science.gov (United States)

    Ryu, Seon Young; Lee, Sang Bong; Kim, Tae Woo; Lee, Taek Jun

    2016-12-01

    Memory complaints are a frequent phenomenon in elderly individuals and can lead to opportunistic help-seeking behavior. The aim of this study was to compare different aspects of memory complaints (i.e., prospective versus retrospective complaints) in individuals with subjective cognitive impairment (SCI), amnestic mild cognitive impairment (aMCI), and mild Alzheimer's disease (AD). The study included a total of 115 participants (mean age: 68.82 ± 8.83 years) with SCI (n = 34), aMCI (n = 46), and mild AD (n = 35). Memory complaints were assessed using the Prospective and Retrospective Memory Questionnaire (PRMQ), which consists of 16 items that describe everyday memory failure of both prospective memory (PM) and retrospective memory (RM). For aMCI and AD subjects, informants also completed an informant-rating of the PRMQ. All participants completed detailed neuropsychological tests. Results show that PM complaints were equivalent among the three groups. However, RM complaints differed. Specifically, RM complaints in aMCI were higher than SCI, but similar to AD. Informant-reported memory complaints were higher for AD than aMCI. Our study suggests that RM complaints of memory complaints may be helpful in discriminating between SCI and aMCI, but both PM and RM complaints are of limited value in differentiating aMCI from AD.

  6. Cognitive impairment in folate-deficient rats corresponds to depleted brain phosphatidylcholine and is prevented by methionine without lowering homocysteine

    Science.gov (United States)

    Poor folate status is associated with cognitive decline and dementia in older adults. Although impaired brain methylation activity and homocysteine toxicity are widely believed to account for this association, how folate deficiency impairs cognition is uncertain. To better define the role of folate ...

  7. The Vascular Impairment of Cognition Classification Consensus Study

    NARCIS (Netherlands)

    Skrobot, Olivia A.; Love, Seth; Kehoe, Patrick G.; O'Brien, John; Black, Sandra E.; Chen, Christopher; DeCarli, Charles; Erkinjuntti, Timo; Ford, Gary A.; Kalaria, Rajesh N.; Pantoni, Leonardo; Pasquier, Florence; Roman, Gustavo C.; Wallin, Anders; Sachdev, Perminder S.; Sachdev, Perminder S.; Skoog, Ingmar; Ben-Shlomo, Yoav; Passmore, Anthony P.; Engelborghs, S.; Lafosse, C.; Bertolucci, P. H.; Brucki, S.; Caramelli, P.; de Toledo Ferraz Alves, T. C.; Bocti, C.; Fulop, T.; Hogan, D. B.; Hsiung, G. R.; Kirk, A.; Leach, L.; Robillard, A.; Sahlas, D. J.; Guo, Q.; Tian, J.; Hokkanen, L.; Jokinen, H.; Benisty, S.; Deramecourt, V.; Hauw, J-J.; Lenoir, H.; Tsatali, M.; Tsolaki, Magda; Sundar, U.; Coen, R. F.; Korczyn, A.D.; Altieri, M.; Baldereschi, M.; Caltagirone, C.; Caravaglios, G.; Di Carlo, A.; DI Piero, V.; Gainotti, G.; Galluzzi, S.; Logroscino, G.; Mecocci, Patrizia; Moretti, D. V.; Padovani, Alessandro; Fukui, T.; Ihara, Masafumi; Mizuno, T.; Kim, Y.S.; Akinyemi, R.; Baiyewu, O.; Ogunniyi, Adesola; Szczudlik, A.; Bastos-Leite, António J.; Firmino, H.; Massano, J.; Verdelho, A.; Kruglov, L. S.; Ikram, M. K.; Kandiah, N.; Arana, E.; Barroso-Ribal, J.; Calatayud, T.; Cruz-Jentoft, A. J.; López-Pousa, S.; Martinez-Lage, P.; Mataro, M.; Börjesson-Hanson, A.; Englund, E.; Laukka, E. J.; Qiu, C.; Viitanen, M.; Biessels, G. J.; de Leeuw, F.E.; den Heijer, T.; Exalto, L. G.; Kappelle, L. J.; Prins, Niels D.; Richard, E.; Schmand, B.; van den Berg, E.; van der Flier, Wiesje M.; Bilgic, B.; Allan, L. M.; Archer, John A.; Attems, J.; Bayer, Thomas A.; Blackburn, D.; Brayne, C.; Bullock, M Ross; Connelly, P. J.; Farrant, A.; Fish, Margaret; Harkness, K.; Ince, Paul G; Langhorne, P.; Mann, J.J.; Matthews, F. E.; Mayer, P.; Pendlebury, S.T.; Perneczky, R.; Peters, R.; Smithard, D.; Stephan, B. C.; Swartz, J. E.; Todd, S.; Werring, D.J.; Wijayasiri, S. N.; Wilcock, G.; Zamboni, G.; Au, R.; Borson, S.; Bozoki, A.; Browndyke, J. N.; Corrada, M. M.; Crane, Paul K.; Diniz, B. S.; Etcher, L.; Fillit, H.; Greenberg, Steven M.; Grinberg, Lea T; Hurt, S. W.; Lamar, M.; Mielke, Martin; Ott, B. R.; Perry, G.; Powers, W. J.; Ramos-Estebanez, C.; Reed, B.; Roberts, R. O.; Romero Roldán, Javier; Saykin, Andrew J.; Seshadri, S.; Silbert, L.; Stern, Y.; Zarow, C.

    2017-01-01

    Introduction Numerous diagnostic criteria have tried to tackle the variability in clinical manifestations and problematic diagnosis of vascular cognitive impairment (VCI) but none have been universally accepted. These criteria have not been readily comparable, impacting on clinical diagnosis rates

  8. The Vascular Impairment of Cognition Classification Consensus Study.

    NARCIS (Netherlands)

    Skrobot, O.A.; O'Brien, J.; Black, S.; Chen, C; DeCarli, C.; Erkinjuntti, T.; Ford, G.A.; Kalaria, R.N.; Pantoni, L.; Pasquier, F.; Roman, G.C.; Wallin, A.; Sachdev, P.; Skoog, I.; Ben-Shlomo, Y.; Passmore, A.P.; Leeuw, F.E. de; Richard, E.; Love, S.; Kehoe, P.G.

    2017-01-01

    INTRODUCTION: Numerous diagnostic criteria have tried to tackle the variability in clinical manifestations and problematic diagnosis of vascular cognitive impairment (VCI) but none have been universally accepted. These criteria have not been readily comparable, impacting on clinical diagnosis rates

  9. PREVALENCE, MECHANISMS, AND MANAGEMENT OF CANCER-RELATED COGNITIVE IMPAIRMENT

    Science.gov (United States)

    Janelsins, Michelle C.; Kesler, Shelli R.; Ahles, Tim A.; Morrow, Gary R.

    2014-01-01

    This review summarizes the current literature on cancer-related cognitive impairment (CRCI) with a focus on prevalence, mechanisms, and possible interventions for CRCI in those who receive adjuvant chemotherapy for non-central nervous system tumors and is primarily focused on breast cancer. CRCI is characterized as deficits in areas of cognition including memory, attention, concentration, and executive function. Development of CRCI can impair quality of life and impact treatment decisions. CRCI is highly prevalent; these problems can be detected in up to 30% of patients prior to chemotherapy; up to 75% of patients report some form of CRCI during treatment, and CRCI is still present in up to 35% of patients many years following completion of treatment. While the trajectory of CRCI is becoming better understood, the mechanisms underlying the development of CRCI are still obscure; however, host characteristics, immune dysfunction, neural toxicity, and genetics may play key roles in the development and trajectory of CRCI. Intervention research is limited, though strategies to maintain function are being studied with promising preliminary findings. This review highlights key research being conducted in these areas, both in patient populations and in animals, which will ultimately result in better understanding and effective treatments for CRCI. PMID:24716504

  10. Sarcopenia and impairment in cognitive and physical performance

    Directory of Open Access Journals (Sweden)

    Tolea MI

    2015-03-01

    Full Text Available Magdalena I Tolea,1 James E Galvin1–3 1Alzheimer’s Disease Center, Department of Neurology, 2Department of Psychiatry, 3Department of Population Health, New York University School of Medicine, New York, NY, USA Background: Whether older adults with sarcopenia who underperform controls on tests of physical performance and cognition also have a higher likelihood of combined cognitive-physical impairment is not clear. We assessed the impact of sarcopenia on impairment in both aspects of functionality and the relative contribution of its components, muscle mass and strength.Methods: Two hundred and twenty-three community-dwelling adults aged 40 years and older (mean age =68.1±10.6 years; 65% female were recruited and underwent physical functionality, anthropometry, and cognitive testing. Participants with low muscle mass were categorized as pre-sarcopenic; those with low muscle mass and muscle strength as sarcopenic; those with higher muscle mass and low muscle strength only were categorized as non-sarcopenic and were compared on risk of cognitive impairment (Montreal Cognitive Assessment <26; Ascertaining Dementia 8 ≥2, physical impairment (Mini Physical Performance Test <12, both, or neither by ordinal logistic regression. Results: Compared to controls, those with sarcopenia were six times more likely to have combined cognitive impairment/physical impairment with a fully adjusted model showing a three-fold increased odds ratio. The results were consistent across different measures of global cognition (odds ratio =3.46, 95% confidence interval =1.07–11.45 for the Montreal Cognitive Assessment; odds ratio =3.61, 95% confidence interval =1.11–11.72 for Ascertaining Dementia 8. Pre-sarcopenic participants were not different from controls. The effect of sarcopenia on cognition is related to low muscle strength rather than low muscle mass. Conclusion: Individuals with sarcopenia are not only more likely to have single but also to have dual

  11. Molecular imaging of serotonin degeneration in mild cognitive impairment.

    Science.gov (United States)

    Smith, Gwenn S; Barrett, Frederick S; Joo, Jin Hui; Nassery, Najlla; Savonenko, Alena; Sodums, Devin J; Marano, Christopher M; Munro, Cynthia A; Brandt, Jason; Kraut, Michael A; Zhou, Yun; Wong, Dean F; Workman, Clifford I

    2017-09-01

    Neuropathological and neuroimaging studies have consistently demonstrated degeneration of monoamine systems, especially the serotonin system, in normal aging and Alzheimer's disease. The evidence for degeneration of the serotonin system in mild cognitive impairment is limited. Thus, the goal of the present study was to measure the serotonin transporter in vivo in mild cognitive impairment and healthy controls. The serotonin transporter is a selective marker of serotonin terminals and of the integrity of serotonin projections to cortical, subcortical and limbic regions and is found in high concentrations in the serotonergic cell bodies of origin of these projections (raphe nuclei). Twenty-eight participants with mild cognitive impairment (age 66.6±6.9, 16 males) and 28 healthy, cognitively normal, demographically matched controls (age 66.2±7.1, 15 males) underwent magnetic resonance imaging for measurement of grey matter volumes and high-resolution positron emission tomography with well-established radiotracers for the serotonin transporter and regional cerebral blood flow. Beta-amyloid imaging was performed to evaluate, in combination with the neuropsychological testing, the likelihood of subsequent cognitive decline in the participants with mild cognitive impairment. The following hypotheses were tested: 1) the serotonin transporter would be lower in mild cognitive impairment compared to controls in cortical and limbic regions, 2) in mild cognitive impairment relative to controls, the serotonin transporter would be lower to a greater extent and observed in a more widespread pattern than lower grey matter volumes or lower regional cerebral blood flow and 3) lower cortical and limbic serotonin transporters would be correlated with greater deficits in auditory-verbal and visual-spatial memory in mild cognitive impairment, not in controls. Reduced serotonin transporter availability was observed in mild cognitive impairment compared to controls in cortical and limbic

  12. Older drivers with cognitive impairments : issues of detection and assessment

    OpenAIRE

    Lundberg, Catarina

    2003-01-01

    Older drivers are often presented as a traffic safety problem . Age-related medical conditions such as dementias and stroke impair cognitive functions that are crucial for safe driving Uncertainty remains regarding the most appropriate clinical methods to assess driving fitness in these patient groups. Furthermore, preclinical dementia and cognitive impairment may affect driving performance and lead to an increased crash risk. The first general aim of the thesis was to inve...

  13. Progress of assessment and rehabilitation therapy of cognitive impairment

    OpenAIRE

    Yuan-yuan TAO; Rong SUN; Lu-ping SONG

    2017-01-01

     Cognitive impairment is one of major disorders after brain injury. With the rapid development of rehabilitation medicine in China, more and more attention was focused on it. The methods of assessment and rehabilitation therapy of cognitive impairment are more widely used in clinic. Based on traditional methods of assessment and rehabilitation therapy, driven by the development of computer, Internet and Internet of Things, more and more new methods emerged. This article intends to revie...

  14. The Precarity of Older Adults Living Alone With Cognitive Impairment.

    Science.gov (United States)

    Portacolone, Elena; Rubinstein, Robert L; Covinsky, Kenneth E; Halpern, Jodi; Johnson, Julene K

    2018-01-24

    To examine the lived experience of older adults living alone with cognitive impairment to better understand their needs and concerns. Based on our previous work suggesting that older adults living alone often experience a sense of precarity, we were interested in exploring this construct in older adults living alone with a diagnosis of cognitive impairment. The notion of precarity points to the uncertainty deriving from coping with cumulative pressures while trying to preserve a sense of independence. This is a qualitative study of 12 adults aged 65 and older living alone with cognitive impairment. Six participants had a diagnosis of Alzheimer's disease; 6 had a diagnosis of mild cognitive impairment. Participants' lived experiences were elicited through 40 ethnographic interviews and participant observation in their homes. Using a qualitative content analysis approach, interview transcripts and fieldnotes were analyzed to identify codes and themes. Qualitative analysis of transcripts revealed three themes. Theme 1 described the distress stemming from the uncertainty of having cognitive impairment that has an unpredictable course. Theme 2 drew attention to the tendency of participants to feel responsible for managing their cognitive impairment. Theme 3 described the pressures stemming from the lack of appropriate services to support independent living for persons with cognitive impairment. These 3 themes all pointed to facets of precarity. Findings also suggest the dearth of programs to support older adults living alone with cognitive impairment and the need to develop novel programs and interventions. © The Author(s) 2018. 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.

  15. Rule induction performance in amnestic mild cognitive impairment and Alzheimer's dementia: examining the role of simple and biconditional rule learning processes.

    Science.gov (United States)

    Oosterman, Joukje M; Heringa, Sophie M; Kessels, Roy P C; Biessels, Geert Jan; Koek, Huiberdina L; Maes, Joseph H R; van den Berg, Esther

    2017-04-01

    Rule induction tests such as the Wisconsin Card Sorting Test require executive control processes, but also the learning and memorization of simple stimulus-response rules. In this study, we examined the contribution of diminished learning and memorization of simple rules to complex rule induction test performance in patients with amnestic mild cognitive impairment (aMCI) or Alzheimer's dementia (AD). Twenty-six aMCI patients, 39 AD patients, and 32 control participants were included. A task was used in which the memory load and the complexity of the rules were independently manipulated. This task consisted of three conditions: a simple two-rule learning condition (Condition 1), a simple four-rule learning condition (inducing an increase in memory load, Condition 2), and a complex biconditional four-rule learning condition-inducing an increase in complexity and, hence, executive control load (Condition 3). Performance of AD patients declined disproportionately when the number of simple rules that had to be memorized increased (from Condition 1 to 2). An additional increment in complexity (from Condition 2 to 3) did not, however, disproportionately affect performance of the patients. Performance of the aMCI patients did not differ from that of the control participants. In the patient group, correlation analysis showed that memory performance correlated with Condition 1 performance, whereas executive task performance correlated with Condition 2 performance. These results indicate that the reduced learning and memorization of underlying task rules explains a significant part of the diminished complex rule induction performance commonly reported in AD, although results from the correlation analysis suggest involvement of executive control functions as well. Taken together, these findings suggest that care is needed when interpreting rule induction task performance in terms of executive function deficits in these patients.

  16. Association of neck circumference and cognitive impairment among Chinese elderly.

    Science.gov (United States)

    Chen, Jin-Mei; Li, Qing-Wei; Jiang, Guo-Xin; Zeng, Shu-Jun; Shen, Jun; Sun, Ji; Wu, Dan-Hong; Cheng, Qi

    2018-03-01

    To investigate the association between neck circumference (NC) and cognitive impairment and interactions between relevant variables to the risk of cognitive impairment. A population-based survey was conducted among elderly inhabitants aged 60 years and over from a community in Shanghai suburb. Multivariate logistic regression analyses were performed to evaluate associations and log likelihood ratio tests to examine interactions. Cognitive impairment was identified in 269 (10.8%) subjects from 2,500 participants. Higher BMI (OR = 1.55; 95% CI = 1.11-2.16), higher WHR (OR = 1.44; 95% CI = 1.07-1.95), and higher total cholesterol (TC) (OR = 1.52; 95% CI = 1.09-2.13) were significantly associated with the increased risk of cognitive impairment. Significant interactions were observed between TC and a few other relevant variables, respectively. NC was associated with the high risk of cognitive impairment. Additive effects of NC with TC on cognitive impairment were observed.

  17. Care mapping in clinical neuroscience settings: Cognitive impairment and dependency.

    Science.gov (United States)

    Leigh, Andrew James; O'Hanlon, Katie; Sheldrick, Russell; Surr, Claire; Hare, Dougal Julian

    2015-01-01

    Person-centred care can improve the well-being of patients and is therefore a key driver in healthcare developments in the UK. The current study aims to investigate the complex relationship between cognitive impairment, dependency and well-being in people with a wide range of acquired brain and spinal injuries. Sixty-five participants, with varied acquired brain and spinal injuries, were selected by convenience sampling from six inpatient clinical neuroscience settings. Participants were observed using Dementia Care Mapping - Neurorehabilitation (DCM-NR) and categorised based on severity of cognitive impairment. A significant difference in the behaviours participants engaged in, their well-being and dependency was found between the severe cognitive impairment group and the mild, moderate or no cognitive impairment groups. Dependency and cognitive impairment accounted for 23.9% of the variance in well-ill-being scores and 17.2% of the variance in potential for positive engagement. The current study highlights the impact of severe cognitive impairment and dependency on the behaviours patients engaged in and their well-being. It also affirms the utility of DCM-NR in providing insights into patient experience. Consideration is given to developing DCM-NR as a process that may improve person-centred care in neuroscience settings.

  18. Effectiveness of Compensatory Strategies applied to Cognitive impairment in Schizophrenia

    DEFF Research Database (Denmark)

    Hansen, Jens Peter; Østergaard, Birte; Nordentoft, Merete

      Background Between 75% and 85% of patients with schizophrenia have cognitive impairments. The impairments have a negative influence on the patient's ability to maintain work, maintain contact with friends, independent living and living in a social relationship. Compared to treatment as usual, s...

  19. Cognitive impairment, clinical severity and MRI changes in MELAS syndrome.

    Science.gov (United States)

    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.

  20. Dutch family physicians' awareness of cognitive impairment among the elderly

    NARCIS (Netherlands)

    van den Dungen, Pim; Moll van Charante, Eric P.; van de Ven, Peter M.; Foppes, Gerbrand; van Campen, Jos P. C. M.; van Marwijk, Harm W. J.; van der Horst, Henriëtte E.; van Hout, Hein P. J.

    2015-01-01

    Dementia is often not formally diagnosed in primary care. To what extent this is due to family physicians' (FPs) watchful waiting, reluctance to diagnose or to their unawareness of the presence of cognitive impairment is unclear. The objective of this study was to assess FPs' awareness of cognitive

  1. Interacting with women can impair men's cognitive functioning

    NARCIS (Netherlands)

    Karremans, J.C.T.M.; Verwijmeren, T.; Pronk, T.M.; Reitsma, M.

    2009-01-01

    The present research tested the prediction that mixed-sex interactions may temporarily impair cognitive functioning. Two studies, in which participants interacted either with a same-sex or opposite-sex other, demonstrated that men's (but not women's) cognitive performance declined following a

  2. [Effect of anticholinergic drugs on cognitive impairment in the elderly].

    Science.gov (United States)

    López-Álvarez, Jorge; Zea Sevilla, María Ascensión; Agüera Ortiz, Luis; Fernández Blázquez, Miguel Ángel; Valentí Soler, Meritxell; Martínez-Martín, Pablo

    2015-01-01

    The use of anticholinergic drugs is common in the elderly, even in people with cognitive impairment. A systematic search was conducted in PubMed (anticholinergic effects, anticholinergic and dementia) to define the effects of anticholinergic drugs in the elderly. We emphasized the search in patterns of use, the combined use with AChEIs, the measurement of the Serum Anticholinergic Activity, and the short-term and long-term cognitive effects. The conclusions are that the use of anticholinergic drugs is common in the elderly, even more so than the medical prescription of AChEIs in Alzheimer's disease. The use of anticholinergic drugs may result in cognitive impairment. In long-term use it may generate a worsening of cognitive functions. It can lead to a wrong diagnosis of mild cognitive impairment or dementia, and they can also initiate signs of dementia. Greater cognitive effects appear when there is a previous deficit, but cognitive effects from anticholinergic drugs disappear in severe dementia. The presence of ApoEɛ4 increases the vulnerability for cognitive impairment when these drugs are employed. Copyright © 2013 SEP y SEPB. Published by Elsevier España. All rights reserved.

  3. Mild cognitive impairment: coping with an uncertain label.

    NARCIS (Netherlands)

    Joosten-Weyn Banningh, E.W.A.; Vernooy-Dassen, M.J.F.J.; Olde Rikkert, M.G.M.; Teunisse, J.P.W.M.

    2008-01-01

    BACKGROUND: The recently introduced diagnostic label of Mild Cognitive Impairment (MCI) identifies patients with a cognitive decline that is more pronounced than is usual for a person's age and educational level but does not notably interfere with activities of daily living (ADL). The natural course

  4. Advanced Asymptomatic Carotid Disease and Cognitive Impairment: An Understated Link?

    Directory of Open Access Journals (Sweden)

    Irena Martinić-Popović

    2012-01-01

    Full Text Available Advanced carotid disease is known to be associated with symptomatic cerebrovascular diseases, such as stroke or transient ischemic attack (TIA, as well as with poststroke cognitive impairment. However, cognitive decline often occurs in patients with advanced carotid stenosis without clinically evident stroke or TIA, so it is also suspected to be an independent risk factor for dementia. Neurosonological methods enable simple and noninvasive assessment of carotid stenosis in patients at risk of advanced atherosclerosis. Cognitive status in patients diagnosed with advanced carotid stenosis is routinely not taken into consideration, although if cognitive impairment is present, such patients should probably be called symptomatic. In this paper, we discuss results of some most important studies that investigated cognitive status of patients with asymptomatic advanced carotid disease and possible mechanisms involved in the causal relationship between asymptomatic advanced carotid disease and cognitive decline.

  5. Cognitive impairment and self-care in heart failure

    Directory of Open Access Journals (Sweden)

    Hajduk AM

    2013-10-01

    Full Text Available Alexandra M Hajduk,1,2 Stephenie C Lemon,3 David D McManus,1,2,4 Darleen M Lessard,1 Jerry H Gurwitz,1,2,4 Frederick A Spencer,5 Robert J Goldberg,1,2 Jane S Saczynski1,2,4 1Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA; 2Meyers Primary Care Institute, University of Massachusetts Medical School, Worcester, MA, USA; 3Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA; 4Division of Geriatric Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA; 5Department of Medicine, McMaster University, Hamilton, ON, Canada Background: Heart failure (HF is a prevalent chronic disease in older adults that requires extensive self-care to prevent decompensation and hospitalization. Cognitive impairment may impact the ability to perform HF self-care activities. We examined the association between cognitive impairment and adherence to self-care in patients hospitalized for acute HF. Design: Prospective cohort study. Setting and participants: A total of 577 patients (mean age = 71 years, 44% female hospitalized for HF at five medical centers in the United States and Canada. Measurements and methods: Participants were interviewed for information on self-reported adherence to self-care using the European Heart Failure Self-care Behaviour Scale. We assessed cognitive impairment in three domains (memory, processing speed, and executive function using standardized measures. Patients' demographic and clinical characteristics were obtained through medical record review. Multivariable linear regression was used to examine the association between cognitive impairment and self-care practices adjusting for demographic and clinical factors. Results: A total of 453 patients (79% were impaired in at least one cognitive

  6. [Impaired cognitive function in hepatitis C - a review.

    DEFF Research Database (Denmark)

    Renvillard, Signe Groth; Leutscher, Peter; Hjerrild, Simon

    2010-01-01

    Impaired cognitive function is commonly seen in patients with hepatitis C-virus (HCV). This might be due to a toxic effect of the virus itself or to neuroinflammatory processes with a direct damaging cerebral effect. The symptoms appear in the pre-cirrhotic stage and impair the patient's level...... of functioning. Therefore, doctors in contact with HCV patients should be up to date on the existing knowledge in the field to be able to inform patients about their cognitive deficits and take them into consideration. It is unknown if the cognitive deficits decline when the virus is eradicated. Udgivelsesdato...

  7. Mild cognitive impairment. Diagnostic value of different MR techniques

    International Nuclear Information System (INIS)

    Hauser, T.; Stieltjes, B.; Essig, M.; Thomann, P.A.

    2011-01-01

    In view of an increasingly aging population the prevalence of dementia is also expected to increase rapidly. As well as clinical, neuropsychological and laboratory procedures magnetic resonance imaging (MRI) plays an important role in the early diagnosis of dementia which is important in the precursor stage of mild cognitive impairment (MCI). On the one hand this stage is associated with an increased risk of dementia and on the other hand an early treatment in this stage could attenuate development of the disease. In addition to morphological changes different functional MRI techniques can help in the early diagnosis of dementia and the precursor stages. Moreover, it is important to detect those MCI patients who are at particularly risk for developing dementia. In the differentiation of converters to non-converters initial studies suggest that particularly voxel-based morphometry, MR spectroscopy and diffusion tensor imaging can provide important additional information. (orig.) [de

  8. High blood pressure in older subjects with cognitive impairment.

    Science.gov (United States)

    Mossello, Enrico; Simoni, David

    2016-06-22

    High blood pressure and cognitive impairment often coexist in old age, but their pathophysiological association is complex. Several longitudinal studies have shown that high blood pressure at midlife is a risk factor for cognitive impairment and dementia, although this association is much less clear in old age. The effect of blood pressure lowering in reducing the risk of dementia is only borderline significant in clinical trials of older subjects, partly due to the insufficient follow-up time. Conversely, dementia onset is associated with a decrease of blood pressure values, probably secondary to neurodegeneration. Prognostic effect of blood pressure values in cognitively impaired older subjects is still unclear, with aggressive blood pressure lowering being potentially harmful in this patients category. Brief cognitive screening, coupled with simple motor assessment, are warranted to identify frail older subjects who need a more cautious approach to antihypertensive treatment. Values obtained with ambulatory blood pressure monitoring seem more useful than clinical ones to predict the outcome of cognitively impaired older subjects. Future studies should identify the most appropriate blood pressure targets in older subjects with cognitive impairment.

  9. Interventions to reduce cognitive impairments following critical illness

    DEFF Research Database (Denmark)

    Nedergaard, H K; Jensen, H I; Toft, P

    2017-01-01

    and sleep quality improvement. Data were synthesized to provide an overview of interventions, quality, follow-up assessments and neuropsychological outcomes. CONCLUSION: None of the interventions had significant positive effects on cognitive impairments following critical illness. Quality was negatively......BACKGROUND: Critical illness is associated with cognitive impairments. Effective treatment or prevention has not been established. The aim of this review was to create a systematic summary of the current evidence concerning clinical interventions during intensive care admission to reduce cognitive...... impairments after discharge. METHODS: Medline, Embase, Cochrane Central, PsycInfo and Cinahl were searched. Inclusion criteria were studies assessing the effect of interventions during intensive care admission on cognitive function in adult patients. Studies were excluded if they were reviews or reported...

  10. Cognitive Impairment in Bipolar Disorder: Treatment and Prevention Strategies.

    Science.gov (United States)

    Solé, Brisa; Jiménez, Esther; Torrent, Carla; Reinares, Maria; Bonnin, Caterina Del Mar; Torres, Imma; Varo, Cristina; Grande, Iria; Valls, Elia; Salagre, Estela; Sanchez-Moreno, Jose; Martinez-Aran, Anabel; Carvalho, André F; Vieta, Eduard

    2017-08-01

    Over the last decade, there has been a growing appreciation of the importance of identifying and treating cognitive impairment associated with bipolar disorder, since it persists in remission periods. Evidence indicates that neurocognitive dysfunction may significantly influence patients' psychosocial outcomes. An ever-increasing body of research seeks to achieve a better understanding of potential moderators contributing to cognitive impairment in bipolar disorder in order to develop prevention strategies and effective treatments. This review provides an overview of the available data from studies examining treatments for cognitive dysfunction in bipolar disorder as well as potential novel treatments, from both pharmacological and psychological perspectives. All these data encourage the development of further studies to find effective strategies to prevent and treat cognitive impairment associated with bipolar disorder. These efforts may ultimately lead to an improvement of psychosocial functioning in these patients. © The Author 2017. Published by Oxford University Press on behalf of CINP.

  11. Cognitive Impairment in Bipolar Disorder: Treatment and Prevention Strategies

    Science.gov (United States)

    Solé, Brisa; Jiménez, Esther; Torrent, Carla; Reinares, Maria; Bonnin, Caterina del Mar; Torres, Imma; Varo, Cristina; Grande, Iria; Valls, Elia; Salagre, Estela; Sanchez-Moreno, Jose; Martinez-Aran, Anabel; Carvalho, André F

    2017-01-01

    Abstract Over the last decade, there has been a growing appreciation of the importance of identifying and treating cognitive impairment associated with bipolar disorder, since it persists in remission periods. Evidence indicates that neurocognitive dysfunction may significantly influence patients’ psychosocial outcomes. An ever-increasing body of research seeks to achieve a better understanding of potential moderators contributing to cognitive impairment in bipolar disorder in order to develop prevention strategies and effective treatments. This review provides an overview of the available data from studies examining treatments for cognitive dysfunction in bipolar disorder as well as potential novel treatments, from both pharmacological and psychological perspectives. All these data encourage the development of further studies to find effective strategies to prevent and treat cognitive impairment associated with bipolar disorder. These efforts may ultimately lead to an improvement of psychosocial functioning in these patients. PMID:28498954

  12. Awareness of deficits in mild cognitive impairment and Alzheimer's disease: do MCI patients have impaired insight

    DEFF Research Database (Denmark)

    Vogel, Asmus; Stokholm, Jette; Gade, Anders

    2004-01-01

    In this study we investigated impaired awareness of cognitive deficits in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). Very few studies have addressed this topic, and methodological inconsistencies make the comparison of previous studies difficult. From a prospective...... heterogeneity in the clinical presentation of awareness. The results demonstrate that subjective memory problems should not be a mandatory prerequisite in suspected dementia or MCI, which makes reports from informants together with thorough clinical interview and observation central when assessing suspected...

  13. Hemostasis biomarkers and incident cognitive impairment: the REGARDS study.

    Science.gov (United States)

    Gillett, S R; McClure, L A; Callas, P W; Thacker, E L; Unverzagt, F W; Wadley, V G; Letter, A J; Cushman, M

    2018-05-07

    Vascular risk factors are associated with cognitive impairment, a condition with substantial public health burden. We hypothesized that hemostasis biomarkers related to vascular disease would be associated with risk of incident cognitive impairment. We performed a nested case control study including 1,082 participants with 3.5 years of follow-up in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a longitudinal cohort study of 30,239 black and white Americans ≥45 years old. Participants were free of stroke or cognitive impairment at baseline. Baseline D-dimer, fibrinogen, factor VIII, and protein C were measured in 495 cases who developed cognitive impairment during follow-up (based on abnormal scores on ≥2 of 3 cognitive tests) and 587 controls. Unadjusted ORs for incident cognitive impairment were 1.32 (95% CI 1.02, 1.70) for D-dimer >0.50 μg/mL, 1.83 (CI 1.24, 2.71) for fibrinogen >90 th percentile, 1.63 (CI 1.11, 2.38) for factor VIII >90 th percentile and 1.10 (CI 0.73, 1.65) for protein C impairment, with an adjusted OR 1.73 (CI 1.10, 2.69). Elevated D-dimer, fibrinogen, and factor VIII were not associated with occurrence of cognitive impairment after multivariable adjustment; however, having at least 2 abnormal biomarkers was associated, suggesting the burden of these biomarkers is relevant. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  14. Early Detection of Cognitive-Linguistic Change Associated with Mild Cognitive Impairment

    Science.gov (United States)

    Fleming, Valarie B.

    2014-01-01

    Individuals with mild cognitive impairment (MCI) may present with subtle declines in linguistic ability that go undetected by tasks not challenging enough to tax a relatively intact cognitive-linguistic system. This study was designed to replicate and extend a previous study of cognitive-linguistic ability in MCI using a complex discourse…

  15. Temporal Evolution of Poststroke Cognitive Impairment Using the Montreal Cognitive Assessment

    NARCIS (Netherlands)

    Nijsse, Britta; Visser-Meily, Johanna M A; van Mierlo, Maria L; Post, Marcel W M; de Kort, Paul L M; van Heugten, Caroline M

    BACKGROUND AND PURPOSE: The Montreal Cognitive Assessment (MoCA) is nowadays recommended for the screening of poststroke cognitive impairment. However, little is known about the temporal evolution of MoCA-assessed cognition after stroke. The objective of this study was to examine the temporal

  16. Temporal Evolution of Poststroke Cognitive Impairment Using the Montreal Cognitive Assessment

    NARCIS (Netherlands)

    Nijsse, Britta; Visser-Meily, Johanna M.A.; van Mierlo, Maria L.; Post, Marcel W. M.; de Kort, Paul. L. M.; van Heugten, Caroline M.

    Background and Purpose-The Montreal Cognitive Assessment (MoCA) is nowadays recommended for the screening of poststroke cognitive impairment. However, little is known about the temporal evolution of MoCA-assessed cognition after stroke. The objective of this study was to examine the temporal pattern

  17. The relationship between C-type natriuretic peptide and cognitive impairment in older patients with Type 2 diabetes

    International Nuclear Information System (INIS)

    Li Xinling; Zhu Xiangyang; Huang Huaiyu; Jin Yan

    2011-01-01

    Objective: To investigate the relationship between C-type natriuretic peptide and cognitive impairment in older patients with type 2 diabetes, and to explore the pathogenesis of diabetic cognitive impairment. Methods: According to the Montreal Cognitive Assessment (MoCA) scores, 80 type 2 diabetic patients over the age of 60 years were divided into two groups, one group including 31 cases with cognitive impairment, the other 49 patients with non-cognitive impairment. And 80 normal participants were selected as the control group. Plasma level of C-type natriuretic peptide was measured by radio-immunity assay in all subjects. The changes and associations of the plasma C-type natriuretic peptide level among three groups was analyzed. Result: In the non-cognitive impairment group, plasma level of C-type natriuretic peptide was higher than that in the control group (P<0.01). But the plasma level of C-type natriuretic peptide in the cognitive impairment group was degraded, significantly deferent with those in the control group and the non-cognitive impairment group (P<0.01). MoCA scores of the cognitive impairment group positively correlated with plasma level of C-type natriuretic peptide (r=0.513, P<0.01). Conclusion: In the early period of type 2 diabetes,the secretion of C-type natriuretic peptide was increased. When diabetic cognitive impairment complicated,the secretion of C-type natriuretic peptide was decompensated. Then plasma level of C-type natriuretic peptide become low. The level of C-type natriuretic peptide closely correlated with diabetic cognitive impairment. It was suggested that diabetic angiopathies may act an important role in the pathogenesis of diabetic cognitive impairment. (authors)

  18. REM Sleep Behavior Disorder and Cognitive Impairment in Parkinson's Disease.

    Science.gov (United States)

    Jozwiak, Natalia; Postuma, Ronald B; Montplaisir, Jacques; Latreille, Véronique; Panisset, Michel; Chouinard, Sylvain; Bourgouin, Pierre-Alexandre; Gagnon, Jean-François

    2017-08-01

    REM sleep behavior disorder (RBD) is a parasomnia affecting 33% to 46% of patients with Parkinson's disease (PD). The existence of a unique and specific impaired cognitive profile in PD patients with RBD is still controversial. We extensively assessed cognitive functions to identify whether RBD is associated with more severe cognitive deficits in nondemented patients with PD. One hundred sixty-two participants, including 53 PD patients with RBD, 40 PD patients without RBD, and 69 healthy subjects, underwent polysomnography, a neurological assessment and an extensive neuropsychological exam to assess attention, executive functions, episodic learning and memory, visuospatial abilities, and language. PD patients with RBD had poorer and clinically impaired performance in several cognitive tests compared to PD patients without RBD and healthy subjects. These two latter groups were similar on all cognitive measures. Mild cognitive impairment (MCI) diagnosis frequency was almost threefold higher in PD patients with RBD compared to PD patients without RBD (66% vs. 23%, p < .001). Moreover, subjective cognitive decline was reported in 89% of PD patients with RBD compared to 58% of PD patients without RBD (p = .024). RBD in PD is associated with a more impaired cognitive profile and higher MCI diagnosis frequency, suggesting more severe and widespread neurodegeneration. This patient subgroup and their caregivers should receive targeted medical attention to better detect and monitor impairment and to enable the development of management interventions for cognitive decline and its consequences. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  19. Gray and white matter changes in subjective cognitive impairment, amnestic mild cognitive impairment and Alzheimer's disease: a voxel-based analysis study.

    Directory of Open Access Journals (Sweden)

    Kuniaki Kiuchi

    Full Text Available Subjective cognitive impairment may be a very early at-risk period of the continuum of dementia. However, it is difficult to discriminate at-risk states from normal aging. Thus, detection of the early pathological changes in the subjective cognitive impairment period is needed. To elucidate these changes, we employed diffusion tensor imaging and volumetry analysis, and compared subjective cognitive impairment with normal, mild cognitive impairment and Alzheimer's disease. The subjects in this study were 39 Alzheimer's disease, 43 mild cognitive impairment, 28 subjective cognitive impairment and 41 normal controls. There were no statistically significant differences between the normal control and subjective cognitive impairment groups in all measures. Alzheimer's disease and mild cognitive impairment had the same extent of brain atrophy and diffusion changes. These results are consistent with the hypothetical model of the dynamic biomarkers of Alzheimer's disease.

  20. Screening for Cognitive Impairment in Older Adults

    Science.gov (United States)

    ... perform several tasks that measure memory, language skills, attention, decision-making, and other mental functions. Potential Benefits and Harms ... person is doing with other mental functions like attention, decision- making, and language. Talking to Your Doctor about Cognitive ...

  1. Impaired cognition and attention in adults: pharmacological management strategies.

    Science.gov (United States)

    Allain, Hervé; Akwa, Yvette; Lacomblez, Lucette; Lieury, Alain; Bentué-Ferrer, Danièle

    2007-02-01

    Cognitive psychology has provided clinicians with specific tools for analyzing the processes of cognition (memory, language) and executive functions (attention-concentration, abstract reasoning, planning). Neuropsychology, coupled with the neurosciences (including neuroimaging techniques), has authenticated the existence of early disorders affecting the "superior or intellectual" functions of the human brain. The prevalence of cognitive and attention disorders is high in adults because all the diseases implicating the central nervous system are associated with cognitive correlates of variable intensity depending on the disease process and the age of the patient. In some pathologies, cognitive impairment can be a leading symptom such as in schizophrenia, posttraumatic stress disorder or an emblematic stigmata as in dementia including Alzheimer's disease. Paradoxically, public health authorities have only recognized as medications for improving cognitive symptoms those with proven efficacy in the symptomatic treatment of patients with Alzheimer's disease; the other cognitive impairments are relegated to the orphanage of syndromes and symptoms dispossessed of medication. The purpose of this review is to promote a true "pharmacology of cognition" based on the recent knowledge in neurosciences. Data from adult human beings, mainly concerning memory, language, and attention processes, will be reported. "Drug therapeutic strategies" for improving cognition (except for memory function) are currently rather scarce, but promising perspectives for a new neurobiological approach to cognitive pharmacology will be highlighted.

  2. Subtle cognitive impairments in patients with long-term cure of Cushing's disease

    NARCIS (Netherlands)

    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.

    2010-01-01

    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

  3. Cognitive and psychosocial impairment in remitted bipolar patients

    Directory of Open Access Journals (Sweden)

    Flávia Moreira Lima

    2015-07-01

    Full Text Available There is growing evidence showing that bipolar disorder is associated with persistent cognitive deficits. However, the exact meaning and impact of cognitive deficits in bipolar disorder is still not entirely known, even though they have been associated with poor psychosocial functioning. This study aims to summarize cognitive and psychosocial functioning findings of remitted bipolar patients. We conducted an extensive Medline search of the published English literature for the period January 2000– March 2014 using a variety of search terms to find relevant articles. Bibliographies of retrieved papers were further analysed for publications of interest. Our results showed that: (1 all mood states of bipolar disorder are associated with cognitive impairment. However, the euthymic state is associated with less impairment than the other states; (2 there is a strong association between clinical factors (i.e, duration of illness, number of episodes, residual mood symptoms, comorbidities and cognitive impairment in euthymic bipolar patients, although these factors do not account fully for these deficits; (3 cognitive deficits, in particular, verbal learning and executive dysfunctions may contribute to poor functioning. In conclusion, our review suggests that cognitive deficits are strongly associated with mood episodes; such deficits persist, in lower degree, during remission. Impairment on cognitive performance may explain, in part, poor long–term functioning in remitted bipolar patients. It highlights that psychosocial interventions in combination with pharmacotherapy should be considered to improve cognition and enhance the level of functioning. Therefore, studies assessing the efficacy of novel strategies focused on cognitive and functional status are an important area of future investigation in bipolar disorder.

  4. Different MK-801 administration schedules induce mild to severe learning impairments in an operant conditioning task: role of buspirone and risperidone in ameliorating these cognitive deficits.

    Science.gov (United States)

    Rapanelli, Maximiliano; Frick, Luciana Romina; Bernardez-Vidal, Micaela; Zanutto, Bonifacio Silvano

    2013-11-15

    Blockade of N-methyl-d-aspartate receptor (NMDA) by the noncompetitive NMDA receptor (NMDAR) antagonist MK-801 produces behavioral abnormalities and alterations in prefrontal cortex (PFC) functioning. Due to the critical role of the PFC in operant conditioning task learning, we evaluated the effects of acute, repeated postnatal injections of MK-801 (0.1mg/kg) on learning performance. We injected Long-Evans rats i.p. with MK-801 (0.1mg/kg) using three different administration schedules: injection 40 min before beginning the task (during) (n=12); injection twice daily for six consecutive days prior to beginning the experimental procedures (prior) (n=12); or twice daily subcutaneous injections from postnatal day 7 to 11 (postnatal) (n=12). Next, we orally administered risperidone (serotonin receptor 2A and dopamine receptor 2 antagonist, 1mg/kg) or buspirone (serotonin receptor 1A partial agonist, 10mg/kg) to animals treated with the MK-801 schedule described above. The postnatal and prior administration schedules produced severe learning deficits, whereas injection of MK-801 just before training sessions had only mild effects on acquisition of an operant conditioning. Risperidone was able to reverse the detrimental effect of MK-801 in the animals that were treated with MK-801 during and prior training sessions. In contrast, buspirone was only effective at mitigating the cognitive deficits induced by MK-801 when administered during the training procedures. The data demonstrates that NMDA antagonism disrupts basic mechanisms of learning in a simple PFC-mediated operant conditioning task, and that buspirone and risperidone failed to attenuate the learning deficits when NMDA neurotransmission was blocked in the early stages of the postnatal period. Copyright © 2013 Elsevier B.V. All rights reserved.

  5. Cognitive impairment in rural elderly population in ecuador

    Directory of Open Access Journals (Sweden)

    Xavier Wong-Achi

    2017-01-01

    Full Text Available Introduction: The Mini-Cog is a simple and short test that identifies cognitive impairment. Its detection helps provide an early dementia diagnosis, rapid access to treatments, and even delay or reversion. Materials and Methods: This multicenter, observational, descriptive, and cross-sectional study included 214 patients. Patients enrolled in this study were community dwellers aged ≥55-year-old, without prior diagnosis of cognitive impairment or dementia, with adequate hearing and vision functions. It was conducted in primary care health centers localized in rural communities of Ecuador. Results: Ages ranged from 50 to 98 years and there was predominance of female gender: 66% versus 33%. The percentage of illiteracy was 26.4% (CI: 25.32–27.48, and 63% (CI: 62.1–63.94 of patients had complete primary educational level. The overall prevalence of cognitive impairment was 50.9% (95% CI: 48.5–53.3 and 47.2% (95% CI: 45.2–49.2 in patients with risk factors. We found several established risk factors associated with cognitive impairment onset, including social factors, physiological factors, and comorbidities. Conclusion: This is the first epidemiological research of CI in rural populations in this country using the Mini-Cog as a screening tool. Adopting public health measures for the prevention and control of those modifiable risk factors could reduce the prevalence of cognitive impairment and even its progression to dementia.

  6. Selective cognitive impairments associated with NMDA receptor blockade in humans.

    Science.gov (United States)

    Rowland, Laura M; Astur, Robert S; Jung, Rex E; Bustillo, Juan R; Lauriello, John; Yeo, Ronald A

    2005-03-01

    Hypofunction of the N-methyl-D-aspartate receptor (NMDAR) may be involved in the pathophysiology of schizophrenia. NMDAR antagonists like ketamine induce schizophrenia-like features in humans. In rodent studies, NMDAR antagonism impairs learning by disrupting long-term potentiation (LTP) in the hippocampus. This study investigated the effects of ketamine on spatial learning (acquisition) vs retrieval in a virtual Morris water task in humans. Verbal fluency, working memory, and learning and memory of verbal information were also assessed. Healthy human subjects participated in this double-blinded, placebo-controlled study. On two separate occasions, ketamine/placebo was administered and cognitive tasks were assessed in association with behavioral ratings. Ketamine impaired learning of spatial and verbal information but retrieval of information learned prior to drug administration was preserved. Schizophrenia-like symptoms were significantly related to spatial and verbal learning performance. Ketamine did not significantly impair attention, verbal fluency, or verbal working memory task performance. Spatial working memory was slightly impaired. In conclusion, these results provide evidence for ketamine's differential impairment of verbal and spatial learning vs retrieval. By using the Morris water task, which is hippocampal-dependent, this study helps bridge the gap between nonhuman animal and human NMDAR antagonism research. Impaired cognition is a core feature of schizophrenia. A better understanding of NMDA antagonism, its physiological and cognitive consequences, may provide improved models of psychosis and cognitive therapeutics.

  7. Smoking and cognitive impairment among older persons in Malaysia.

    Science.gov (United States)

    Momtaz, Yadollah Abolfathi; Ibrahim, Rahimah; Hamid, Tengku Aizan; Chai, Sen Tyng

    2015-06-01

    Previous studies have shown conflicting results on the association between smoking and cognitive function. This study aims to examine the relationship of smoking with cognitive function. Data for the study, consisting of 2553 older adults aged 60 years and older, were drawn from a nationwide household survey entitled "Determinants of Wellness among Older Malaysians: A Health Promotion Perspective" conducted in 2010. Current smokers had lower rates of cognitive impairment compared to never smokers (17.4% vs 25.9%), while cognitive function in former or ex-smokers was almost similar to that of the never smokers. Findings from multiple logistic regression analysis showed that current smokers were 37% less likely to be cognitively impaired, compared to the never smokers (odds ratio [OR] = .63; 95% confidence interval [CI]: .46-.86) while controlling for potential confounders. No difference in cognitive function was observed between former smokers and never smokers (OR = .94; 95% CI: .71-1.25). Although the findings indicated a negative association between cigarette smoking and cognitive impairment, we are unable to conclude whether this relationship is causal or affected by other unmeasured confounding factors, especially survival bias. © The Author(s) 2014.

  8. Type 1 Diabetes Mellitus and Cognitive Impairments: A Systematic Review.

    Science.gov (United States)

    Li, Wei; Huang, Edgar; Gao, Sujuan

    2017-01-01

    Type 1 diabetes mellitus (T1DM) is a major subtype of diabetes and is usually diagnosed at a young age with insulin deficiency. The life expectancy of T1DM patients has increased substantially in comparison with that three decades ago due to the availability of exogenous insulin, though it is still shorter than that of healthy people. However, the relation remains unclear between T1DM and dementia as an aging-related disease. We conducted a systematic review of existing literature on T1DM and cognition impairments by carrying out searches in electronic databases Medline, EMBASE, and Google Scholar. We restricted our review to studies involving only human subjects and excluded studies on type 2 diabetes mellitus or non-classified diabetes. A meta-analysis was first performed on the relationship between T1DM and cognitive changes in youths and adults respectively. Then the review focused on the cognitive complications of T1DM and their relation with the characteristics of T1DM, glycemic control, diabetic complications, comorbidities, and others. First, age at onset, disease duration, and glycemic dysregulation were delineated for their association with cognitive changes. Then diabetic ketoacidosis, angiopathy, and neuropathy were examined as diabetic complications for their involvement in cognitive impairments. Lastly, body mass index and blood pressure were discussed for their relations with the cognitive changes. Future studies are needed to elucidate the pathogenesis of T1DM-related cognitive impairments or dementia.

  9. Association of social and cognitive impairment and biomarkers in autism spectrum disorders

    OpenAIRE

    Alabdali, Altaf; Al-Ayadhi, Laila; El-Ansary, Afaf

    2014-01-01

    Objectives The neurological basis for autism is still not fully understood, and the role of the interaction between neuro-inflammation and neurotransmission impairment needs to be clearer. This study aims to test the possible association between impaired levels of gamma aminobutyric acid (GABA), serotonin, dopamine, oxytocin, and interferon-γ-induced protein-16 (IFI16) and the severity of social and cognitive dysfunctions in individuals with autism spectrum disorders. Materials and methods GA...

  10. Evidence for cognitive vestibular integration impairment in idiopathic scoliosis patients

    Directory of Open Access Journals (Sweden)

    Mercier Pierre

    2009-08-01

    Full Text Available Abstract Background Adolescent idiopathic scoliosis is characterized by a three-dimensional deviation of the vertebral column and its etiopathogenesis is unknown. Various factors cause idiopathic scoliosis, and among these a prominent role has been attributed to the vestibular system. While the deficits in sensorimotor transformations have been documented in idiopathic scoliosis patients, little attention has been devoted to their capacity to integrate vestibular information for cognitive processing for space perception. Seated idiopathic scoliosis patients and control subjects experienced rotations of different directions and amplitudes in the dark and produced saccades that would reproduce their perceived spatial characteristics of the rotations (vestibular condition. We also controlled for possible alteration of the oculomotor and vestibular systems by measuring the subject's accuracy in producing saccades towards memorized peripheral targets in absence of body rotation and the gain of their vestibulo-ocular reflex. Results Compared to healthy controls, the idiopathic scoliosis patients underestimated the amplitude of their rotations. Moreover, the results revealed that idiopathic scoliosis patients produced accurate saccades to memorized peripheral targets in absence of body rotation and that their vestibulo-ocular reflex gain did not differ from that of control participants. Conclusion Overall, results of the present study demonstrate that idiopathic scoliosis patients have an alteration in cognitive integration of vestibular signals. It is possible that severe spine deformity developed partly due to impaired vestibular information travelling from the cerebellum to the vestibular cortical network or alteration in the cortical mechanisms processing the vestibular signals.

  11. Perceptual and Cognitive Impairments and Driving

    Science.gov (United States)

    Korner-Bitensky, Nicol; Coopersmith, Henry; Mayo, Nancy; Leblanc, Ginette; Kaizer, Franceen

    1990-01-01

    Perceptual and cognitive disorders that frequently accompany stroke and head injury influence an individual's ability to drive a motor vehicle. Canadian physicians are legally responsible for identifying patients who are potentially unsafe to drive and, if they fail to do so, may be held liable in a civil action suit. The authors review the guidelines for physicians evaluating a patient's fitness to drive after brain injury. They also examine the actions a physician should take when a patient with perceptual and cognitive problems wants to drive. Ultimately, by taking these actions, physicians will help to prevent driving accidents. PMID:21234047

  12. Physical Activity Prevents Progression for Cognitive Impairment and Vascular Dementia

    DEFF Research Database (Denmark)

    Verdelho, Ana; Madureira, Sofia; Ferro, José M

    2012-01-01

    BACKGROUND AND PURPOSE: We aimed to study if physical activity could interfere with progression for cognitive impairment and dementia in older people with white matter changes living independently. METHODS: The LADIS (Leukoaraiosis and Disability) prospective multinational European study evaluates....... Physical activity was recorded during the clinical interview. MRI was performed at entry and at the end of the study. RESULTS: Six hundred thirty-nine subjects were included (74.1±5 years old, 55% women, 9.6±3.8 years of schooling, 64% physically active). At the end of follow-up, 90 patients had dementia...... (vascular dementia, 54; Alzheimer disease with vascular component, 34; frontotemporal dementia, 2), and 147 had cognitive impairment not dementia. Using Cox regression analysis, physical activity reduced the risk of cognitive impairment (dementia and not dementia: β=-0.45, P=0.002; hazard ratio, 0.64; 95...

  13. Identifying Dietary Patterns Associated with Mild Cognitive Impairment in Older Korean Adults Using Reduced Rank Regression

    Directory of Open Access Journals (Sweden)

    Dayeon Shin

    2018-01-01

    Full Text Available Diet plays a crucial role in cognitive function. Few studies have examined the relationship between dietary patterns and cognitive functions of older adults in the Korean population. This study aimed to identify the effect of dietary patterns on the risk of mild cognitive impairment. A total of 239 participants, including 88 men and 151 women, aged 65 years and older were selected from health centers in the district of Seoul, Gyeonggi province, and Incheon, in Korea. Dietary patterns were determined using Reduced Rank Regression (RRR methods with responses regarding vitamin B6, vitamin C, and iron intakes, based on both a one-day 24-h recall and a food frequency questionnaire. Cognitive function was assessed using the Korean-Mini Mental State Examination (K-MMSE. Multivariable logistic regression models were used to estimate the association between dietary pattern score and the risk of mild cognitive impairment. A total of 20 (8% out of the 239 participants had mild cognitive impairment. Three dietary patterns were identified: seafood and vegetables, high meat, and bread, ham, and alcohol. Among the three dietary patterns, the older adult population who adhered to the seafood and vegetables pattern, characterized by high intake of seafood, vegetables, fruits, bread, snacks, soy products, beans, chicken, pork, ham, egg, and milk had a decreased risk of mild cognitive impairment compared to those who did not (adjusted odds ratios 0.06, 95% confidence interval 0.01–0.72 after controlling for gender, supplementation, education, history of dementia, physical activity, body mass index (BMI, and duration of sleep. The other two dietary patterns were not significantly associated with the risk of mild cognitive impairment. In conclusion, high consumption of fruits, vegetables, seafood, and protein foods was significantly associated with reduced mild cognitive impairment in older Korean adults. These results can contribute to the establishment of

  14. Do subjective cognitive complaints correlate with cognitive impairment in systemic lupus erythematosus? A Danish outpatient study

    DEFF Research Database (Denmark)

    Vogel, A; Bhattacharya, S; Larsen, J L

    2011-01-01

    This study examined the prevalence of cognitive impairment and its association with depressive symptoms and self-reported cognitive complaints in Danish outpatients with systemic lupus erythematosus (SLE). Fifty-seven consecutive female SLE-outpatients were examined with a comprehensive neuropsyc......This study examined the prevalence of cognitive impairment and its association with depressive symptoms and self-reported cognitive complaints in Danish outpatients with systemic lupus erythematosus (SLE). Fifty-seven consecutive female SLE-outpatients were examined with a comprehensive...

  15. [User friendliness of computer-based cognitive training for psychogeriatric patients with mild to moderate cognitive impairments].

    Science.gov (United States)

    van der Ploeg, Eva S; Hoorweg, Angela; van der Lee, Jacqueline

    2016-04-01

    Cognitive impairment associated with dementia is characterized by a continuous decline. Cognitive training is a method to train specific brain functions such as memory and attention to prevent or slow down cognitive decline. A small number of studies has shown that cognitive training on a computer has a positive effect on both cognition and mood in people with cognitive impairment. This pilot study tested if serious games could be integrated in a psychogeriatric rehabilitation center. Fourteen psychogeriatric patients participated twice weekly in cognitive training sessions on a computer. Both the participants and the facilitator reported positive interactions and outcomes. However, after five weeks only half of the sample still participated in the training. This was partly because of patient turn-over as well as incorporating this new task in the facilitators' daily work. Fear of failure, physical limitations and rapidly decreasing cognitive function led to drop out according to the facilitator. The engagement of patients in the games and the role of the facilitator seemed essential for success, especially monitoring (and adjusting) the difficulty level of the program for every individual participant.

  16. Benign multiple sclerosis: physical and cognitive impairment follow distinct evolutions.

    Science.gov (United States)

    Gajofatto, A; Turatti, M; Bianchi, M R; Forlivesi, S; Gobbin, F; Azzarà, A; Monaco, S; Benedetti, M D

    2016-03-01

    Benign multiple sclerosis (BMS) definitions rely on physical disability level but do not account sufficiently for cognitive impairment which, however, is not rare. To study the evolution of physical disability and cognitive performance of a group of patients with BMS followed at an University Hospital Multiple Sclerosis Center. A consecutive sample of 24 BMS cases (diagnosis according to 2005 McDonald's criteria, relapsing-remitting course, disease duration ≥ 10 years, and expanded disability status scale [EDSS] score ≤ 2.0) and 13 sex- and age-matched non-BMS patients differing from BMS cases for having EDSS score 2.5-5.5 were included. Main outcome measures were as follows: (i) baseline and 5-year follow-up cognitive impairment defined as failure of at least two tests of the administered neuropsychological battery; (ii) EDSS score worsening defined as confirmed increase ≥ 1 point (or 0.5 point if baseline EDSS score = 5.5). At inclusion, BMS subjects were 41 ± 8 years old and had median EDSS score 1.5 (range 0-2), while non-BMS patients were 46 ± 8 years old and had median EDSS score 3.0 (2.5-5.5). At baseline 16% of patients in both groups were cognitively impaired. After 5 years, EDSS score worsened in 8% of BMS and 46% of non-BMS patients (P = 0.008), while the proportion of cognitively impaired subjects increased to 25% in both groups. Patients with BMS had better physical disability outcome at 5 years compared to non-BMS cases. However, cognitive impairment frequency and decline over time appeared similar. Neuropsychological assessment is essential in patients with BMS given the distinct pathways followed by disease progression in cognitive and physical domains. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Higher incidence of mild cognitive impairment in familial hypercholesterolemia

    Science.gov (United States)

    Zambón, D.; Quintana, M.; Mata, P.; Alonso, R.; Benavent, J.; Cruz-Sánchez, F.; Gich, J.; Pocoví, M.; Civeira, F.; Capurro, S.; Bachman, D.; Sambamurti, K.; Nicholas, J.; Pappolla, M. A.

    2010-01-01

    Objective Hypercholesterolemia is an early risk factor for Alzheimer’s disease. Low density lipoprotein (LDL) receptors may be involved in this disorder. Our objective was to determine the risk of mild cognitive impairment in a population of patients with heterozygous familial hypercholesterolemia, a condition involving LDL receptors dysfunction and life long hypercholesterolemia. Methods Using a cohort study design, patients with (N=47) meeting inclusion criteria and comparison patients without familial hypercholesterolemia (N=70) were consecutively selected from academic specialty and primary care clinics respectively. All patients were older than 50 years. Those with disorders which could impact cognition, including history of stroke or transient ischemic attacks, were excluded from both groups. Thirteen standardized neuropsychological tests were performed in all subjects. Mutational analysis was performed in patients with familial hypercholesterolemia and brain imaging was obtained in those with familial hypercholesterolemia and mild cognitive impairment. Results Patients with familial hypercholesterolemia showed a very high incidence of mild cognitive impairment compared to those without familial hypercholesterolemia (21.3% vs. 2.9%; p = 0.00). This diagnosis was unrelated to structural pathology or white matter disease. There were significant differences between the familial hypercholesterolemia and the no-familial hypercholesterolemia groups in several cognitive measures, all in the direction of worse performance for familial hypercholesterolemia patients, independent of apoE4 or apoE2 status. Conclusions Because prior studies have shown that older patients with sporadic hypercholesterolemia do not show higher incidence of mild cognitive impairment, the findings presented here suggest that early exposure to elevated cholesterol or LDL receptors dysfunction may be risk factors for mild cognitive impairment. PMID:20193836

  18. Mild Cognitive Impairment: Diagnosis, Longitudinal Course, and Emerging Treatments

    Science.gov (United States)

    Vega, Jennifer N.; Newhouse, Paul A.

    2014-01-01

    Mild cognitive impairment (MCI) is widely regarded as the intermediate stage of cognitive impairment between the changes seen in normal cognitive aging and those associated with dementia. Elderly patients with MCI constitute a high-risk population for developing dementia, in particular Alzheimer’s disease (AD). Although the core clinical criteria for MCI have remained largely unchanged, the operational definition of MCI has undergone several revisions over the course of the last decade and remains an evolving diagnosis. Prognostic implications of this diagnosis are becoming clearer with regard to the risk of progressive cognitive deterioration. Although patients with MCI may represent an optimal target population for pharmacological and non-pharmacological interventions, results from clinical trials have been mixed and a definitive effective treatment remains elusive. This article provides a brief overview of the evolution of the concept of MCI and reviews current diagnostic criteria, the longitudinal course of the disorder, and current and emerging treatments for MCI. PMID:25160795

  19. Pain in cognitively impaired, non-communicating children

    OpenAIRE

    Stallard, P; Williams, L; Lenton, S; Velleman, R

    2001-01-01

    AIM—To detail the everyday occurrence of pain in non-communicating children with cognitive impairment.
METHODS—Thirty four parents of cognitively impaired verbally non-communicating children completed pain diaries over a two week period. Each day, for five defined periods, parents rated whether their child had been in pain, and if so, its severity and duration.
RESULTS—Twenty five (73.5%) children experienced pain on at least one day, with moderate or severe levels of pai...

  20. Effects of Social Cognitive Impairment on Speech Disorder in Schizophrenia

    OpenAIRE

    Docherty, Nancy M.; McCleery, Amanda; Divilbiss, Marielle; Schumann, Emily B.; Moe, Aubrey; Shakeel, Mohammed K.

    2012-01-01

    Disordered speech in schizophrenia impairs social functioning because it impedes communication with others. Treatment approaches targeting this symptom have been limited by an incomplete understanding of its causes. This study examined the process underpinnings of speech disorder, assessed in terms of communication failure. Contributions of impairments in 2 social cognitive abilities, emotion perception and theory of mind (ToM), to speech disorder were assessed in 63 patients with schizophren...

  1. Metabolic Profiling of Impaired Cognitive Function in Patients Receiving Dialysis

    OpenAIRE

    Kurella Tamura, Manjula; Chertow, Glenn M.; Depner, Thomas A.; Nissenson, Allen R.; Schiller, Brigitte; Mehta, Ravindra L.; Liu, Sai; Sirich, Tammy L.

    2016-01-01

    Retention of uremic metabolites is a proposed cause of cognitive impairment in patients with ESRD. We used metabolic profiling to identify and validate uremic metabolites associated with impairment in executive function in two cohorts of patients receiving maintenance dialysis. We performed metabolic profiling using liquid chromatography/mass spectrometry applied to predialysis plasma samples from a discovery cohort of 141 patients and an independent replication cohort of 180 patients partici...

  2. Electroacupuncture for older adults with mild cognitive impairment: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Leung, Albert Wing Nang; Lam, Linda Chiu Wa; Kwan, Andrew Ka Lun; Tsang, Celia Lai Lin; Zhang, Hong Wei; Guo, Yuan Qi; Xu, Chuan Shan

    2015-05-27

    Mild cognitive impairment is an intermediary state between normal aging and clinical Alzheimer's disease. Early intervention of mild cognitive impairment may be an important strategy in the management of Alzheimer's disease. The proposal aims to evaluate if electroacupuncture would optimize cognitive function in subjects with mild cognitive impairment and understand the role of electroacupuncture in the treatment of Alzheimer's disease. A randomised patient- and assessor-blind sham-controlled trial is designed to assess whether electroacupuncture intervention decreases the rate of cognitive decline amongst older adults with mild cognitive impairment. One hundred and fifty subjects aged 65 years of age or over with a diagnosis of mild cognitive impairment are recruited from the community and elderly centre in Hong Kong. All subjects are randomly allocated into two groups (75 subjects each group): the electroacupuncture group and sham control. Participants in the electroacupuncture group receive electroacupuncture stimulation by sterile, disposable acupuncture needles inserted to the acupoints with a depth of 1 to 3 cm. The acupuncture needles are subjected to 2 Hz electroacupuncture with an intensity of 5 to 10 mA. Each participant receives electroacupuncture for 8 weeks (once a day, 3 days a week) and the treatment lasts for 30 minutes each time. For sham electroacupuncture, needles are inserted to a depth of 1 to 2 mm, and connected to the electroacupuncture device without any current passing through. Outcome measures (including primary and secondary outcome measures) are collected at baseline, at the end day of intervention, and months 4 and 6 after intervention. The primary outcome is measured by the Alzheimer Disease Assessment Scale-Cognitive subscale. Secondary outcomes are measured by the mini-mental state examination, category fluency text and the Short Form 12. The study will provide evidence for evaluating and understanding the role of electroacupuncture

  3. Beyond Thiamine: Treatment for Cognitive Impairment in Korsakoff's Syndrome.

    Science.gov (United States)

    Johnson, Justin M; Fox, Valerie

    2018-03-27

    Wernicke's encephalopathy is a condition whose treatment many consultation-liaison psychiatrists know quite well. Less clear, however, is the treatment of its dementia disorder descendent, the Korsakoff's syndrome (KS). This article seeks to review treatment options and provide recommendations for consultation-liaison psychiatrists treating cognitive impairment in KS. In this nonsystematic review, we reviewed PubMed, CINAHL Plus, and Google Scholar for published reports and studies regarding treatment of KS. The literature revealed case reports and placebo-controlled trials of various medications for treatment of KS, though the samples sizes were small and were mostly case reports. There is more attention devoted toward medications used in other dementia disorders, such as donepezil and memantine. The literature revealed more studies around behavioral interventions recommended for treatment of memory impairment in KS and they focused on cognitive remediation and environmental adaptation, such as the use of PDAs or alarms. There is no single, well-studied intervention proven effective as a primary treatment for cognitive impairment in KS. An approach of using environmental modifications in a well-structured living environment, combined with various cognitive interventions, such as pictorial associations, and perhaps a trial of donepezil or memantine, likely represents the best strategy for treating long-term cognitive impairment in KS. Published by Elsevier Inc.

  4. Including persistency of impairment in mild cognitive impairment classification enhances prediction of 5-year decline.

    Science.gov (United States)

    Vandermorris, Susan; Hultsch, David F; Hunter, Michael A; MacDonald, Stuart W S; Strauss, Esther

    2011-02-01

    Although older adults with Mild Cognitive Impairment (MCI) show elevated rates of conversion to dementia as a group, heterogeneity of outcomes is common at the individual level. Using data from a prospective 5-year longitudinal investigation of cognitive change in healthy older adults (N = 262, aged 64-92 years), this study addressed limitations in contemporary MCI identification procedures which rely on single occasion assessment ("Single-Assessment [SA] MCI") by evaluating an alternate operational definition of MCI requiring evidence of persistent cognitive impairment over multiple-testing sessions ("Multiple-Assessment [MA] MCI"). As hypothesized, prevalence of SA-MCI exceeded that of MA-MCI. Further, the MA-MCI groups showed lower baseline cognitive and functional performance and steeper cognitive decline compared with Control and SA-MCI group. Results are discussed with reference to retest effects and clinical implications.

  5. Behavioral symptoms in community-dwelling elderly Nigerians with dementia, mild cognitive impairment, and normal cognition.

    Science.gov (United States)

    Baiyewu, Olusegun; Unverzagt, Fred W; Ogunniyi, Adesola; Smith-Gamble, Valerie; Gureje, Oye; Lane, Kathleen A; Gao, Sujuan; Hall, Kathleen S; Hendrie, Hugh C

    2012-09-01

    Few studies have examined the neuropsychiatric status of patients with dementia and cognitive impairment in the developing world despite the fact that current demographic trends suggest an urgent need for such studies. To assess the level of neuropsychiatric symptoms in community-dwelling individuals with dementia, cognitive impairment no dementia and normal cognition. Subjects were from the Ibadan site of Indianapolis-Ibadan Dementia Project with stable diagnoses of normal cognition, cognitive impairment, no dementia/mild cognitive impairment (CIND/MCI), and dementia. Informants of subjects made ratings on the neuropsychiatric inventory and blessed dementia scale; subjects were tested with the mini mental state examination. One hundred and eight subjects were included in the analytic sample, 21 were cognitively normal, 34 were demented, and 53 were CIND/MCI. The diagnostic groups did not differ in age, per cent female, or per cent with any formal education. The most frequent symptoms among subjects with CIND/MCI were depression (45.3%), apathy (37.7%), night time behavior (28.3%), appetite change (24.5%), irritability (22.6%), delusions (22.6%), anxiety (18.9%), and agitation (17.0%). Depression was significantly more frequent among the CIND/MCI and dementia (44.1%) groups compared with the normal cognition group (9.5%). Distress scores were highest for the dementia group, lowest for the normal cognition group, and intermediate for the CIND/MCI group. Significant neuropsychiatric symptomatology and distress are present among cognitively impaired persons in this community-based study of older adults in this sub-Saharan African country. Programs to assist family members of cognitively impaired and demented persons should be created or adapted for use in developing countries. Copyright © 2012 John Wiley & Sons, Ltd.

  6. Brain insulin signaling: a key component of cognitive processes and a potential basis for cognitive impairment in type 2 diabetes

    Science.gov (United States)

    McNay, Ewan C.; Recknagel, Andrew K.

    2011-01-01

    Understanding of the role of insulin in the brain has gradually expanded, from initial conceptions of the brain as insulin-insensitive through identification of a role in regulation of feeding to recent demonstration of insulin as a key component of hippocampal memory processes. Conversely, systemic insulin resistance such as that seen in type 2 diabetes is associated with a range of cogntive and neural deficits. Here we review the evidence for insulin as a cognitive and neural modulator, including potential effector mechanisms, and examine the impact that type 2 diabetes has on these mechanisms in order to identify likely bases for the cognitive impairments seen in type 2 diabetic patients. PMID:21907815

  7. Impact of Cognitive Impairment on Functional Outcome in Stroke

    Directory of Open Access Journals (Sweden)

    Nurdan Paker

    2010-01-01

    Full Text Available The aim of this study was to investigate the effect of the cognitive impairment on functional status in patients with subacute stroke. Fifty-two patients with subacute stroke were included in the study. Mini mental state examination (MMSE test was used for the evaluation of cognitive status. Patients were separated into two groups according to their cognitive functions. Functional follow-up parameters were activities of daily living (ADL, global recovery and ambulation status. All patients were evaluated on admission to rehabilitation unit, at discharge and 6 months after discharge. Forty-four patients were completed the study. Mean age was 66 and 57 years; disease duration on admission was 4,8 and 3,5 months in the cognitively impaired and normal groups, respectively. Significant improvement was found in terms of functional follow-up parameters in both groups at discharge (<.05. Functional follow-up parameters did not show statistically significant difference between the groups. But community ambulation rate was higher in cognitively normal group at the sixth month visit. As a result of this study, inpatient rehabilitation was effective both cognitively normal and impaired subacute stroke patients.

  8. Cognitive and functional neuroimaging correlate for anosognosia in mild cognitive impairment and Alzheimer's disease

    DEFF Research Database (Denmark)

    Vogel, Asmus; Hasselbalch, Steen G; Gade, Anders

    2005-01-01

    To investigate the correlation between anosognosia and behavioural symptoms, performance on executive tests, and frontal cortex regional cerebral blood flow (rCBF) in patients with 'amnestic mild cognitive impairment' (MCI) and mild Alzheimer's disease (AD).......To investigate the correlation between anosognosia and behavioural symptoms, performance on executive tests, and frontal cortex regional cerebral blood flow (rCBF) in patients with 'amnestic mild cognitive impairment' (MCI) and mild Alzheimer's disease (AD)....

  9. Physical Performance Is Associated with Working Memory in Older People with Mild to Severe Cognitive Impairment

    NARCIS (Netherlands)

    Volkers, K. M.; Scherder, E. J. A.

    2014-01-01

    Background. Physical performances and cognition are positively related in cognitively healthy people. The aim of this study was to examine whether physical performances are related to specific cognitive functioning in older people with mild to severe cognitive impairment. Methods. This

  10. Cognitive Blackouts in Mild Cognitive Impairment and Alzheimer’s Dementia

    Directory of Open Access Journals (Sweden)

    Georg Adler

    2018-02-01

    Full Text Available Background: Cognitive blackouts, e.g. moments of amnesia, disorientation, or perplexity may be an early sign of incipient Alzheimer’s dementia (AD. A short questionnaire, the checklist for cognitive blackouts (CCB, was evaluated cross-sectionally in users of a memory clinic. Methods: The CCB was performed in 130 subjects, who further underwent a neuropsychological and clinical examination. Subjective memory impairment and depressive symptoms were assessed. Differences in the CCB score between diagnostic groups and relationships with cognitive performance, depression, and subjective memory impairment were analyzed. Results: The CCB score was increased in mild cognitive impairment of the amnestic type or mild AD and correctly predicted 69.2% of the respective subjects. It was negatively correlated with cognitive performance, positively correlated with depressive symptoms, and substantially increased in subjects who estimated their memory poorer than that of other persons of their age. Discussion: The CCB may be a helpful screening tool for the early recognition of AD.

  11. Edaravone attenuates intracerebroventricular streptozotocin-induced cognitive impairment in rats.

    Science.gov (United States)

    Reeta, K H; Singh, Devendra; Gupta, Yogendra K

    2017-04-01

    Alzheimer's disease is a major cause of dementia worldwide. Edaravone, a potent free radical scavenger, is reported to be neuroprotective. The present study was designed to investigate the effect of chronic edaravone administration on intracerebroventricular-streptozotocin (ICV-STZ) induced cognitive impairment in male Wistar rats. Cognitive impairment was developed by single ICV-STZ (3 mg/kg) injection bilaterally on day 1. Edaravone (1, 3 and 10 mg/kg, orally, once daily) was administered for 28 days. Morris water maze and passive avoidance tests were used to assess cognitive functions at baseline and on days 14 and 28. ICV-STZ caused cognitive impairment as evidenced by increased escape latency and decreased time spent in target quadrant in the Morris water maze test and reduced retention latency in the passive avoidance test. STZ caused increase in oxidative stress, cholinesterases, inflammatory cytokines and protein expression of ROCK-II and decrease in protein expression of ChAT. Edaravone ameliorated the STZ-induced cognitive impairment. STZ-induced increase in oxidative stress and increased levels of pro-inflammatory cytokines (TNF-α, IL-1β) were mitigated by edaravone. Edaravone also prevented STZ-induced increased protein expression of ROCK-II. Moreover, edaravone significantly prevented STZ-induced increased activity of cholinesterases in the cortex and hippocampus. The decreased expression of ChAT caused by STZ was brought towards normal by edaravone in the hippocampus. The results thus show that edaravone is protective against STZ-induced cognitive impairment, oxidative stress, cholinergic dysfunction and altered protein expressions. This study thus suggests the potential of edaravone as an adjuvant in the treatment of Alzheimer's disease. © 2017 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

  12. Different Patterns of Theory of Mind Impairment in Mild Cognitive Impairment.

    Science.gov (United States)

    Moreau, Noémie; Rauzy, Stéphane; Bonnefoi, Bernadette; Renié, Laurent; Martinez-Almoyna, Laurent; Viallet, François; Champagne-Lavau, Maud

    2015-01-01

    Theory of Mind refers to the ability to infer other’s mental states, their beliefs, intentions, or knowledge. To date, only two studies have reported the presence of Theory of Mind impairment in mild cognitive impairment (MCI). In the present study,we evaluated 20 MCI patients and compared them with 25 healthy control participants using two Theory of Mind tasks. The first task was a false belief paradigm as frequently used in the literature, and the second one was a referential communication task,assessing Theory of Mind in a real situation of interaction and which had never been used before in this population. The results showed that MCI patients presented difficulties inferring another person’s beliefs about reality and attributing knowledge to them in a situation of real-life interaction. Two different patterns of Theory of Mind emerged among the patients. In comparison with the control group, some MCI patients demonstrated impairment only in the interaction task and presented isolated episodicmemory impairment, while others were impaired in both Theory of Mind tasks and presented cognitive impairment impacting both episodic memory and executive functioning. Theory of Mind is thus altered in the very early stages of cognitive impairment even in real social interaction, which could impact precociously relationships in daily life.

  13. A methodology for the characterization and diagnosis of cognitive impairments-Application to specific language impairment.

    Science.gov (United States)

    Oliva, Jesús; Serrano, J Ignacio; del Castillo, M Dolores; Iglesias, Angel

    2014-06-01

    The diagnosis of mental disorders is in most cases very difficult because of the high heterogeneity and overlap between associated cognitive impairments. Furthermore, early and individualized diagnosis is crucial. In this paper, we propose a methodology to support the individualized characterization and diagnosis of cognitive impairments. The methodology can also be used as a test platform for existing theories on the causes of the impairments. We use computational cognitive modeling to gather information on the cognitive mechanisms underlying normal and impaired behavior. We then use this information to feed machine-learning algorithms to individually characterize the impairment and to differentiate between normal and impaired behavior. We apply the methodology to the particular case of specific language impairment (SLI) in Spanish-speaking children. The proposed methodology begins by defining a task in which normal and individuals with impairment present behavioral differences. Next we build a computational cognitive model of that task and individualize it: we build a cognitive model for each participant and optimize its parameter values to fit the behavior of each participant. Finally, we use the optimized parameter values to feed different machine learning algorithms. The methodology was applied to an existing database of 48 Spanish-speaking children (24 normal and 24 SLI children) using clustering techniques for the characterization, and different classifier techniques for the diagnosis. The characterization results show three well-differentiated groups that can be associated with the three main theories on SLI. Using a leave-one-subject-out testing methodology, all the classifiers except the DT produced sensitivity, specificity and area under curve values above 90%, reaching 100% in some cases. The results show that our methodology is able to find relevant information on the underlying cognitive mechanisms and to use it appropriately to provide better

  14. Impaired quality and efficiency of sleep impairs cognitive functioning in Addison's disease.

    Science.gov (United States)

    Henry, Michelle; Ross, Ian Louis; Wolf, Pedro Sofio Abril; Thomas, Kevin Garth Flusk

    2017-04-01

    Standard replacement therapy for Addison's disease (AD) does not restore a normal circadian rhythm. Periods of sub- and supra- physiological cortisol levels experienced by patients with AD likely induce disrupted sleep. Given that healthy sleep plays an important role in memory consolidation, the novelty of the current study was to characterise, using objective measures, the relationship between sleep and memory in patients with AD, and to examine the hypothesis that poor sleep is a biological mechanism underlying memory impairment in those patients. We used a within-subjects design. Ten patients with AD and 10 matched healthy controls completed standardised neuropsychological tests assessing declarative memory (Rey Auditory Verbal Learning Test) and procedural memory (Finger Tapping Task) before and after a period of actigraphy-measured sleep, and before and after a period of waking. Relative to healthy controls, patients with AD experienced disrupted sleep characterised by poorer sleep efficiency and more time spent awake. Patients also showed impaired verbal learning and memory relative to healthy controls (p=0.007). Furthermore, whereas healthy controls' declarative memory performance benefited from a period of sleep compared to waking (p=0.032), patients with AD derived no such benefit from sleep (p=0.448). Regarding the procedural memory task, analyses detected no significant between-group differences (all p's<0.065), and neither group showed significant sleep-enhanced performance. We demonstrated, using actigraphy and standardized measures of memory performance, an association between sleep disturbances and cognitive deficits in patients with AD. These results suggest that, in patients with AD, the source of memory deficits is, at least to some extent, disrupted sleep patterns that interfere with optimal consolidation of previously-learned declarative information. Hence, treating the sleep disturbances that are frequently experienced by patients with AD may

  15. Isoflurane induced cognitive impairment in aged rats through hippocampal calcineurin/NFAT signaling

    Energy Technology Data Exchange (ETDEWEB)

    Ni, Cheng; Li, Zhengqian; Qian, Min; Zhou, Yang; Wang, Jun; Guo, Xiangyang, E-mail: puthmzk@163.com

    2015-05-15

    Calcineurin (CaN) over-activation constrains synaptic plasticity and memory formation. Upon CaN activation, NFAT imports into the nucleus and guides its downstream genes, which also affect neuronal and synaptic function. Aberrant CaN/NFAT signaling involves in neurotoxicity and cognitive impairment in neurological disorders such as Alzheimer's disease, but its role in postoperative cognitive dysfunction (POCD) remains uninvestigated. Inhaled anesthetic isoflurane facilitates the development of POCD, and the present study investigated the role of CaN/NFAT signaling in isoflurane induced cognitive impairment of aged rats, and the therapeutic effects of CaN inhibitor cyclosporine A (CsA). The results indicated that hippocampal CaN activity increased and peaked at 6 h after isoflurane exposure, and NFAT, especially NFATc4, imported into the nucleus following CaN activation. Furthermore, phamacological inhibition of CaN by CsA markedly attenuated isoflurane induced aberrant CaN/NFATc4 signaling in the hippocampus, and rescued relevant spatial learning and memory impairment of aged rats. Overall, the study suggests hippocampal CaN/NFAT signaling as the upstream mechanism of isoflurane induced cognitive impairment, and provides potential therapeutic target and possible treatment methods for POCD. - Highlights: • Isoflurane induces hippocampal calcineurin activation. • Isoflurane induces hippocampal NFAT, especially NFATc4, nuclear import. • Cyclosporine A attenuates isoflurane induced aberrant calcineurin/NFAT signaling. • Cyclosporine A rescues isoflurane induced cognitive impairment. • Calcineurin/NFAT signaling is the upstream mechanism of isoflurane induced synaptic dysfunction and cognitive impairment.

  16. Isoflurane induced cognitive impairment in aged rats through hippocampal calcineurin/NFAT signaling

    International Nuclear Information System (INIS)

    Ni, Cheng; Li, Zhengqian; Qian, Min; Zhou, Yang; Wang, Jun; Guo, Xiangyang

    2015-01-01

    Calcineurin (CaN) over-activation constrains synaptic plasticity and memory formation. Upon CaN activation, NFAT imports into the nucleus and guides its downstream genes, which also affect neuronal and synaptic function. Aberrant CaN/NFAT signaling involves in neurotoxicity and cognitive impairment in neurological disorders such as Alzheimer's disease, but its role in postoperative cognitive dysfunction (POCD) remains uninvestigated. Inhaled anesthetic isoflurane facilitates the development of POCD, and the present study investigated the role of CaN/NFAT signaling in isoflurane induced cognitive impairment of aged rats, and the therapeutic effects of CaN inhibitor cyclosporine A (CsA). The results indicated that hippocampal CaN activity increased and peaked at 6 h after isoflurane exposure, and NFAT, especially NFATc4, imported into the nucleus following CaN activation. Furthermore, phamacological inhibition of CaN by CsA markedly attenuated isoflurane induced aberrant CaN/NFATc4 signaling in the hippocampus, and rescued relevant spatial learning and memory impairment of aged rats. Overall, the study suggests hippocampal CaN/NFAT signaling as the upstream mechanism of isoflurane induced cognitive impairment, and provides potential therapeutic target and possible treatment methods for POCD. - Highlights: • Isoflurane induces hippocampal calcineurin activation. • Isoflurane induces hippocampal NFAT, especially NFATc4, nuclear import. • Cyclosporine A attenuates isoflurane induced aberrant calcineurin/NFAT signaling. • Cyclosporine A rescues isoflurane induced cognitive impairment. • Calcineurin/NFAT signaling is the upstream mechanism of isoflurane induced synaptic dysfunction and cognitive impairment

  17. Neural correlates of true and false memory in mild cognitive impairment.

    Science.gov (United States)

    Sweeney-Reed, Catherine M; Riddell, Patricia M; Ellis, Judi A; Freeman, Jayne E; Nasuto, Slawomir J

    2012-01-01

    The goal of this research was to investigate the changes in neural processing in mild cognitive impairment. We measured phase synchrony, amplitudes, and event-related potentials in veridical and false memory to determine whether these differed in participants with mild cognitive impairment compared with typical, age-matched controls. Empirical mode decomposition phase locking analysis was used to assess synchrony, which is the first time this analysis technique has been applied in a complex cognitive task such as memory processing. The technique allowed assessment of changes in frontal and parietal cortex connectivity over time during a memory task, without a priori selection of frequency ranges, which has been shown previously to influence synchrony detection. Phase synchrony differed significantly in its timing and degree between participant groups in the theta and alpha frequency ranges. Timing differences suggested greater dependence on gist memory in the presence of mild cognitive impairment. The group with mild cognitive impairment had significantly more frontal theta phase locking than the controls in the absence of a significant behavioural difference in the task, providing new evidence for compensatory processing in the former group. Both groups showed greater frontal phase locking during false than true memory, suggesting increased searching when no actual memory trace was found. Significant inter-group differences in frontal alpha phase locking provided support for a role for lower and upper alpha oscillations in memory processing. Finally, fronto-parietal interaction was significantly reduced in the group with mild cognitive impairment, supporting the notion that mild cognitive impairment could represent an early stage in Alzheimer's disease, which has been described as a 'disconnection syndrome'.

  18. Presence and significant determinants of cognitive impairment in a large sample of patients with multiple sclerosis.

    Directory of Open Access Journals (Sweden)

    Martina Borghi

    Full Text Available OBJECTIVES: To investigate the presence and the nature of cognitive impairment in a large sample of patients with Multiple Sclerosis (MS, and to identify clinical and demographic determinants of cognitive impairment in MS. METHODS: 303 patients with MS and 279 healthy controls were administered the Brief Repeatable Battery of Neuropsychological tests (BRB-N; measures of pre-morbid verbal competence and neuropsychiatric measures were also administered. RESULTS: Patients and healthy controls were matched for age, gender, education and pre-morbid verbal Intelligence Quotient. Patients presenting with cognitive impairment were 108/303 (35.6%. In the overall group of participants, the significant predictors of the most sensitive BRB-N scores were: presence of MS, age, education, and Vocabulary. The significant predictors when considering MS patients only were: course of MS, age, education, vocabulary, and depression. Using logistic regression analyses, significant determinants of the presence of cognitive impairment in relapsing-remitting MS patients were: duration of illness (OR = 1.053, 95% CI = 1.010-1.097, p = 0.015, Expanded Disability Status Scale score (OR = 1.247, 95% CI = 1.024-1.517, p = 0.028, and vocabulary (OR = 0.960, 95% CI = 0.936-0.984, p = 0.001, while in the smaller group of progressive MS patients these predictors did not play a significant role in determining the cognitive outcome. CONCLUSIONS: Our results corroborate the evidence about the presence and the nature of cognitive impairment in a large sample of patients with MS. Furthermore, our findings identify significant clinical and demographic determinants of cognitive impairment in a large sample of MS patients for the first time. Implications for further research and clinical practice were discussed.

  19. Neural Correlates of True and False Memory in Mild Cognitive Impairment

    Science.gov (United States)

    Sweeney-Reed, Catherine M.; Riddell, Patricia M.; Ellis, Judi A.; Freeman, Jayne E.; Nasuto, Slawomir J.

    2012-01-01

    The goal of this research was to investigate the changes in neural processing in mild cognitive impairment. We measured phase synchrony, amplitudes, and event-related potentials in veridical and false memory to determine whether these differed in participants with mild cognitive impairment compared with typical, age-matched controls. Empirical mode decomposition phase locking analysis was used to assess synchrony, which is the first time this analysis technique has been applied in a complex cognitive task such as memory processing. The technique allowed assessment of changes in frontal and parietal cortex connectivity over time during a memory task, without a priori selection of frequency ranges, which has been shown previously to influence synchrony detection. Phase synchrony differed significantly in its timing and degree between participant groups in the theta and alpha frequency ranges. Timing differences suggested greater dependence on gist memory in the presence of mild cognitive impairment. The group with mild cognitive impairment had significantly more frontal theta phase locking than the controls in the absence of a significant behavioural difference in the task, providing new evidence for compensatory processing in the former group. Both groups showed greater frontal phase locking during false than true memory, suggesting increased searching when no actual memory trace was found. Significant inter-group differences in frontal alpha phase locking provided support for a role for lower and upper alpha oscillations in memory processing. Finally, fronto-parietal interaction was significantly reduced in the group with mild cognitive impairment, supporting the notion that mild cognitive impairment could represent an early stage in Alzheimer’s disease, which has been described as a ‘disconnection syndrome’. PMID:23118992

  20. Ixeris dentata (Thunb) Nakai attenuates cognitive impairment in ...

    African Journals Online (AJOL)

    Ixeris dentata (Thunb) Nakai attenuates cognitive impairment in MPTP-treated mouse model of Parkinson's disease. ... Conclusion: IDE exhibits good protection against MPTP-induced behavioral deficits via potential antioxidant defense mechanisms. Therefore, IDE could potentially be developed as a therapeutic approach ...

  1. Late-Life Depression, Mild Cognitive Impairment, and Dementia

    NARCIS (Netherlands)

    Richard, Edo; Reitz, Christiane; Honig, Lawrence H.; Schupf, Nicole; Tang, Ming X.; Manly, Jennifer J.; Mayeux, Richard; Devanand, Devangere; Luchsinger, José A.

    2013-01-01

    Objective: To evaluate the association of late-life depression with mild cognitive impairment (MCI) and dementia in a multiethnic community cohort. Design and Setting: A cohort study was conducted in Northern Manhattan, New York, New York. Participants: A total of 2160 community-dwelling Medicare

  2. Does early ischemic lesion induce cognitive impairment and epilepsy?

    Czech Academy of Sciences Publication Activity Database

    Kubová, Hana; Máttéffyová, Adéla; Tsenov, Grygoriy; Otáhal, Jakub

    -, - (2005), s. 30-30 [Conference of the Czech Neuroscience Society /5./, The Annual Meeting of the Network of European Neuroscience Institutes. 19.11.2005-21.11.2005, Prague] R&D Projects: GA MŠk(CZ) LC554 Institutional research plan: CEZ:AV0Z50110509 Keywords : focal ischemia * cognitive impairment * development of epilepsy Subject RIV: ED - Physiology

  3. Dutch family physicians' awareness of cognitive impairment among the elderly

    NARCIS (Netherlands)

    van den Dungen, P.; van Charante, E.P.M.; van de Ven, P.M.; Foppes, G.; van Campen, J.P.C.M.; van Marwijk, H.W.J.; van der Horst, H.E.; van Hout, H.P.J.

    2015-01-01

    Background: Dementia is often not formally diagnosed in primary care. To what extent this is due to family physicians' (FPs) watchful waiting, reluctance to diagnose or to their unawareness of the presence of cognitive impairment is unclear. The objective of this study was to assess FPs' awareness

  4. Care Partner Responses to the Onset of Mild Cognitive Impairment

    Science.gov (United States)

    Blieszner, Rosemary; Roberto, Karen A.

    2010-01-01

    Purpose: We examined characteristics, responses, and psychological well-being of care partners who support and assist older adults recently diagnosed with mild cognitive impairment (MCI). Design and Methods: Based on a sample of 106 care partners of community residents diagnosed with MCI at memory clinics, we conducted face-to-face interviews…

  5. Co-designing Social Robots With Cognitively Impaired Citizens

    DEFF Research Database (Denmark)

    Rodil, Kasper; Rehm, Matthias; Krummheuer, Antonia Lina

    2018-01-01

    This Work-in-Progress paper describes current work and future challenges of co-designing social robots with cognitively impaired residents. The project has in time of writing ran more than two years, which allows the reporting of both technical outcomes and methodological challenges....

  6. Assessment of Mild Cognitive Impairment with Mini Mental State ...

    African Journals Online (AJOL)

    Background: Mild cognitive impairment is a recently described neuropsychiatric entity with the possibility of evolving into overt dementia. It has been found to respond to therapeutic intervention, thus halting or significantly retarding the progression to dementia. Resource.poor countries like Nigeria can hardly afford to ...

  7. Structural MRI substrates of cognitive impairment in neuromyelitis optica

    NARCIS (Netherlands)

    Liu, Y.; Fu, Y.; Schoonheim, M.M.; Zhang, N.; Fan, M.L.; Su, L.; Shen, Y.; Yan, Y.P.; Yang, L.; Wang, Q.H.; Zhang, N.N.N.; Yu, C.S.; Barkhof, F.; Shi, F.D.

    2015-01-01

    Objective: To identify the clinical and structural MRI markers for predicting cognitive impairment (CI) in patients with neuromyelitis optica (NMO). Methods: Fifty-four patients with NMO and 27 healthy controls underwent extensive neuropsychological testing and multimodal 3.0T MRI. The patient group

  8. [Alcohol-related cognitive impairment and the DSM-5

    NARCIS (Netherlands)

    Walvoort, S.J.; Wester, A.J.; Doorakkers, M.C.; Kessels, R.P.C.; Egger, J.I.

    2016-01-01

    BACKGROUND: It is evident from the dsm-iv-tr that alcohol-related impairment is extremely difficult to classify accurately. As a result, cognitive deficits can easily be overlooked. The dsm-5, however, incorporates a new category, namely 'neurocognitive disorders', which may lead to significant

  9. A Clinical Research Study of Cognitive Dysfunction and Affective Impairment after Isolated Brainstem Stroke

    Directory of Open Access Journals (Sweden)

    Xiujuan Fu

    2017-12-01

    Full Text Available Although the function of the cerebellum in neurocognition has been well-documented, the similar role of the brainstem has yet to be fully elucidated. This clinical research study aimed to combine data relating to neuropsychological assessments and P300 to explore cognitive dysfunction and affective impairment following brainstem stroke. Thirty-four patients with isolated brainstem stroke and twenty-six healthy controls were recruited; for each patient, we collated data pertaining to the P300, Addenbrooke's Cognitive Examination III (ACE-III, Montreal Cognitive Assessment Chinese version (MoCA, trail-making test (TMT, Symbol Digit Modalities Test (SDMT, Wechsler Adult Intelligence Scale-Digit Spans (DS, Stroop test, Self Rating Depression Scale (SDS, and Self Rating Anxiety Scale (SAS. Significance was analyzed using an independent T-test or the Mann-Whitney U-test. Correlation was analyzed using Pearson's correlation analysis or Spearman's correlation analysis. Collectively, data revealed that brainstem stroke caused mild cognitive impairment (MCI, and that visuospatial, attention, linguistic, and emotional disturbances may occur after isolated brainstem stroke. Cognitive decline was linked to P300 latency, ACE-III, and MoCA; P300 latency was correlated with ACE-III. Patients with right brainstem lesions were more likely to suffer memory decline. The present study provides initial data relating to the role of the brainstem in neurocognition, and will be useful for further understanding of vascular cognitive and affective impairment.

  10. A Clinical Research Study of Cognitive Dysfunction and Affective Impairment after Isolated Brainstem Stroke

    Science.gov (United States)

    Fu, Xiujuan; Lu, Zuneng; Wang, Yan; Huang, Lifang; Wang, Xi; Zhang, Hong; Xiao, Zheman

    2017-01-01

    Although the function of the cerebellum in neurocognition has been well-documented, the similar role of the brainstem has yet to be fully elucidated. This clinical research study aimed to combine data relating to neuropsychological assessments and P300 to explore cognitive dysfunction and affective impairment following brainstem stroke. Thirty-four patients with isolated brainstem stroke and twenty-six healthy controls were recruited; for each patient, we collated data pertaining to the P300, Addenbrooke's Cognitive Examination III (ACE-III), Montreal Cognitive Assessment Chinese version (MoCA), trail-making test (TMT), Symbol Digit Modalities Test (SDMT), Wechsler Adult Intelligence Scale-Digit Spans (DS), Stroop test, Self Rating Depression Scale (SDS), and Self Rating Anxiety Scale (SAS). Significance was analyzed using an independent T-test or the Mann-Whitney U-test. Correlation was analyzed using Pearson's correlation analysis or Spearman's correlation analysis. Collectively, data revealed that brainstem stroke caused mild cognitive impairment (MCI), and that visuospatial, attention, linguistic, and emotional disturbances may occur after isolated brainstem stroke. Cognitive decline was linked to P300 latency, ACE-III, and MoCA; P300 latency was correlated with ACE-III. Patients with right brainstem lesions were more likely to suffer memory decline. The present study provides initial data relating to the role of the brainstem in neurocognition, and will be useful for further understanding of vascular cognitive and affective impairment. PMID:29311895

  11. Lower-Extremity Function in Cognitively Healthy Aging, Mild Cognitive Impairment, and Alzheimer's Disease

    NARCIS (Netherlands)

    Eggermont, Laura H.; Gavett, Brandon E.; Volkers, Karin M.; Blankevoort, Christiaan G.; Scherder, Erik J.; Jefferson, Angela L.; Steinberg, Eric; Nair, Anil; Green, Robert C.; Stern, Robert A.

    Eggermont LH, Gavett BE, Volkers KM, Blankevoort CG, Scherder EJ, Jefferson AL, Steinberg E, Nair A, Green RC, Stern RA. Lower-extremity function in cognitively healthy aging, mild cognitive impairment, and Alzheimer's disease. Arch Phys Med Rehabil 2010;91:584-8. Objective: To examine differences

  12. Lower extremity function in normal cognitive aging, mild cognitive impairment, and Alzheimer’s disease

    NARCIS (Netherlands)

    Eggermont, L.H.P.; Gavett, B.E.; Volkers, K.M.; Blankevoort, C.G.; Scherder, E.J.A.; Jefferson, A.L.; Steinberg, E.; Nair, A.; Green, R.C.; Stern, R.A.

    2010-01-01

    Eggermont LH, Gavett BE, Volkers KM, Blankevoort CG, Scherder EJ, Jefferson AL, Steinberg E, Nair A, Green RC, Stern RA. Lower-extremity function in cognitively healthy aging, mild cognitive impairment, and Alzheimer's disease. Objective: To examine differences in lower-extremity function in

  13. Stroke occurring in patients with cognitive impairment or dementia

    Directory of Open Access Journals (Sweden)

    Solène Moulin

    Full Text Available ABSTRACT One in six patients admitted for stroke was previously demented. These patients have less access to appropriate stroke care, although little is known about their optimal management. Objective To determine how pre-stroke cognitive impairment can be detected, its mechanism, and influence on outcome and management. Methods Literature search. Results (i A systematic approach with the Informant Questionnaire of Cognitive Decline in the Elderly is recommended; (ii Pre-stroke cognitive impairment may be due to brain lesions of vascular, degenerative, or mixed origin; (iii Patients with pre-stroke dementia, have worse outcomes, more seizures, delirium, and depression, and higher mortality rates; they often need to be institutionalised after their stroke; (iv Although the safety profile of treatment is not as good as that of cognitively normal patients, the risk:benefit ratio is in favour of treating these patients like others. Conclusion Patients with cognitive impairment who develop a stroke have worse outcomes, but should be treated like others.

  14. [Cognitive impairments in alcohol dependence: From screening to treatment improvements].

    Science.gov (United States)

    Cabé, N; Laniepce, A; Ritz, L; Lannuzel, C; Boudehent, C; Vabret, F; Eustache, F; Beaunieux, H; Pitel, A-L

    2016-02-01

    Alcohol-related cognitive impairments are largely underestimated in clinical practice, even though they could limit the benefit of alcohol treatment and hamper the patient's ability to remain abstinent or to respect his/her therapeutic contract. These neuropsychological deficits can impact the management of patients well before the development of the well-known Korsakoff's syndrome. Indeed, even in the absence of ostensible neurological complications, excessive and chronic alcohol consumption results in damage of brain structure and function. The frontocerebellar circuit and the circuit of Papez, respectively involved in motor and executive abilities and episodic memory, are mainly affected. Those brain dysfunctions are associated with neuropsychological deficits, including deficits of executive functions, episodic memory, social cognition, as well as visuospatial and motor abilities. Such cognitive disorders can interfere with the motivation process to abandon maladjusted drinking behavior in favor of a healthier lifestyle (such as abstinence or controlled alcohol consumption). They can also limit the patient's capacity to fully benefit from treatment (notably psychoeducation and cognitive-behavioural treatments) currently widely proposed in French Addiction departments. In addition, they may contribute to relapse which is multi-determinated. A neuropsychological assessment appears therefore crucial to take relevant clinical decisions. However, very few addiction departments have the human and financial resources to conduct an extensive neuropsychological examination of all patients with alcohol dependence. Some brief screening tools can be used, notably the MOntreal Cognitive Assessment and the Brief Evaluation of Alcohol-Related Neuropsychological Impairments, which has been especially designed to assess cognitive and motor deficits in alcoholism. These tools can be used by non-psychologist clinicians to detect alcohol-related cognitive deficits, which require

  15. Neuroanatomic changes and their association with cognitive decline in mild cognitive impairment: a meta-analysis

    OpenAIRE

    Nickl-Jockschat, Thomas; Kleiman, Alexandra; Schulz, Jörg B.; Schneider, Frank; Laird, Angela R.; Fox, Peter T.; Eickhoff, Simon B.; Reetz, Kathrin

    2011-01-01

    Mild cognitive impairment (MCI) is an acquired syndrome characterised by cognitive decline not affecting activities of daily living. Using a quantitative meta-analytic approach, we aimed to identify consistent neuroanatomic correlates of MCI and how they are related to cognitive dysfunction. The meta-analysis enrols 22 studies, involving 917 MCI (848 amnestic MCI) patients and 809 healthy controls. Only studies investigating local changes in grey matter and reporting whole-brain results in st...

  16. Detecting cognitive impairment in patients with Parkinson's disease using a brief cognitive screening tool: Addenbrooke's Cognitive Examination (ACE

    Directory of Open Access Journals (Sweden)

    Anabel Chade

    Full Text Available Abstract Detecting cognitive impairment in patients with Parkinson's disease is crucial for good clinical practice given the new therapeutic possibilities available. When full neuropsychological evaluations are not available, screening tools capable of detecting cognitive difficulties become crucial. Objective: The goal of this study was to investigate whether the Spanish version of the Addenbrooke's Cognitive Examination (ACE is capable of detecting cognitive difficulties in patients with Parkinson's disease and discriminating their cognitive profile from patients with dementia. Methods: 77 early dementia patients (53 with Alzheimer's Disease and 24 with Frontotemporal Dementia, 22 patients with Parkinson's disease, and 53 healthy controls were evaluated with the ACE. Results: Parkinson's disease patients significantly differed from both healthy controls and dementia patients on ACE total score. Conclusions: This study shows that the Spanish version of the ACE is capable of detecting patients with cognitive impairment in Parkinson's disease and is able to differentiate them from patients with dementia based on their general cognitive status.

  17. Detecting cognitive impairment in patients with Parkinson's disease with a brief cognitive screening tool: the Addenbrooke's Cognitive Examination (ACE).

    Science.gov (United States)

    Chade, Anabel; Roca, María; Torralva, Teresa; Gleichgerrcht, Ezequiel; Fabbro, Nicolás; Arévalo, Gonzalo Gómez; Gershanik, Oscar; Manes, Facundo

    2008-01-01

    Detecting cognitive impairment in patients with Parkinson's disease is crucial for good clinical practice given the new therapeutic possibilities available. When full neuropsychological evaluations are not available, screening tools capable of detecting cognitive difficulties become crucial. The goal of this study was to investigate whether the Spanish version of the Addenbrooke's Cognitive Examination (ACE) is capable of detecting cognitive difficulties in patients with Parkinson's disease and discriminating their cognitive profile from patients with dementia. 77 early dementia patients (53 with Alzheimer's Disease and 24 with Frontotemporal Dementia), 22 patients with Parkinson's disease, and 53 healthy controls were evaluated with the ACE. Parkinson's disease patients significantly differed from both healthy controls and dementia patients on ACE total score. This study shows that the Spanish version of the ACE is capable of detecting patients with cognitive impairment in Parkinson's disease and is able to differentiate them from patients with dementia based on their general cognitive status.

  18. Cognitive Activities and Instrumental Activity of Daily Living in Older Adults with Mild Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Takehiko Doi

    2013-10-01

    Full Text Available Aims: This study aimed to identify differences in the implementation of cognitive activities and instrumental activities of daily living (IADLs between healthy individuals and subjects with mild cognitive impairment (MCI. Methods: The study included 2,498 cognitively healthy subjects (mean age, 71.2 ± 5.1 years and 809 MCI subjects (mean age, 71.8 ± 5.4 years. The subjects were interviewed regarding their participation in cognitive activities and the implementation of IADLs. Results: We found a significant association between participation in any cognitive activities (p Conclusions: Our study revealed that greater participation in cognitive activity was associated with lower odds of MCI. Participation in cognitive activities may reflect differences between healthy and MCI subjects. To clarify the causal relationship between cognitive activities and MCI, further studies are required.

  19. The Efficacy of Cognitive Stimulation on Depression and Cognition in Elderly Patients with Cognitive Impairment: A Retrospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Federerico Filipin

    2015-12-01

    Full Text Available Cognitive decline due to neurodegenerative diseases is a prevalent worldwide problem. Both pharmacological and non-pharmacological treatments to improve, delay or stop disease progression are of vital importance. Cognitive stimulation is frequently used in clinical practice; however, there are few studies that demonstrate its efficacy. Aim: To evaluate the efficacy of cognitive stimulation in patients with mild cognitive impairment (CDR = 0.5 and dementia (CDR = 1. Methods: A retrospective cohort study was performed. Patients with cognitive impairment receiving weekly cognitive stimulation (16 or 24 sessions were evaluated with a complete neuropsychological battery before and after the stimulation program. Each stimulation session was carried out by a trained neuropsychologist. Results: Forty two patients receiving cognitive stimulation were evaluated over a period of 12.53 months (SD 5.5. Patients were grouped as 11 amnesic mild cognitive impairment (aMCI, 23 multi domain mild cognitive impairment (mMCI and 8 Mild Alzheimer's Dementia (CDR 1. None of the groups improved their cognitive functions after the cognitive stimulation program. MCI group was also divided according to their global intelligence quotient (IQ into two groups: low (IQ < 98.5 and high (IQ > 98.5. Each group was compared before and after the stimulation program and no significant difference was found (p ≥ 0.05. Moreover, MCI group was also analyzed according to the duration of the stimulation program: less than 9, between 9 and 13 and more than 13 months. Different duration groups were compared before and after the cognitive stimulation program and no significant differences were found. Depression, anxiety and subjective memory symptoms were also analysed and neither improvement nor worsening could be demonstrated. Conclusions: Patients remained stable, both in cognitive and behavioural domains, for more than 18 months. However, no significant cognitive or behavioural

  20. Mitochondria, cognitive impairment, and Alzheimer's disease.

    Science.gov (United States)

    Mancuso, M; Calsolaro, V; Orsucci, D; Carlesi, C; Choub, A; Piazza, S; Siciliano, G

    2009-07-06

    To date, the beta amyloid (Abeta) cascade hypothesis remains the main pathogenetic model of Alzheimer's disease (AD), but its role in the majority of sporadic AD cases is unclear. The "mitochondrial cascade hypothesis" could explain many of the biochemical, genetic, and pathological features of sporadic AD. Somatic mutations in mitochondrial DNA (mtDNA) could cause energy failure, increased oxidative stress, and accumulation of Abeta, which in a vicious cycle reinforce the mtDNA damage and the oxidative stress. Despite the evidence of mitochondrial dysfunction in AD, no causative mutations in the mtDNA have been detected so far. Indeed, results of studies on the role of mtDNA haplogroups in AD are controversial. In this review we discuss the role of the mitochondria, and especially of the mtDNA, in the cascade of events leading to neurodegeneration, dementia, and AD.

  1. The Cognitive and Neural Expression of Semantic Memory Impairment in Mild Cognitive Impairment and Early Alzheimer's Disease

    Science.gov (United States)

    Joubert, Sven; Brambati, Simona M.; Ansado, Jennyfer; Barbeau, Emmanuel J.; Felician, Olivier; Didic, Mira; Lacombe, Jacinthe; Goldstein, Rachel; Chayer, Celine; Kergoat, Marie-Jeanne

    2010-01-01

    Semantic deficits in Alzheimer's disease have been widely documented, but little is known about the integrity of semantic memory in the prodromal stage of the illness. The aims of the present study were to: (i) investigate naming abilities and semantic memory in amnestic mild cognitive impairment (aMCI), early Alzheimer's disease (AD) compared to…

  2. Addenbrooke's Cognitive Examination-Revised for mild cognitive impairment in Parkinson's disease.

    Science.gov (United States)

    McColgan, Peter; Evans, Jonathan R; Breen, David P; Mason, Sarah L; Barker, Roger A; Williams-Gray, Caroline H

    2012-08-01

    Cognitive impairment is common in Parkinson's disease (PD), even in the early stages, and appropriate screening tools are needed. We investigated the utility of the Addenbrooke's Cognitive Examination-Revised for detecting mild cognitive impairment (MCI) in PD in an incident population-representative cohort (n = 132) and investigated the relationship between performance on this instrument and behavior and quality of life (n = 219). Twenty-two percent met criteria for MCI. Receiver operating curve analysis revealed an area under the curve of 0.81. A cutoff Cognitive Rating Scale, and there were significant correlations with the Cambridge Behavioral Inventory-Revised and Parkinson's Disease Questionnaire 39. This instrument is a useful screening tool for PD-MCI, and poor performance is significantly related to impaired behavior and quality of life. Copyright © 2012 Movement Disorder Society.

  3. Association Between Nutrition Status and Cognitive Impairment Among Chinese Nonagenarians and Centenarians

    Directory of Open Access Journals (Sweden)

    Shan Hai

    2017-12-01

    Conclusion: Among Chinese nonagenarians and centenarians, there were significant associations between nutrition status and cognitive impairment. Further studies should evaluation if maintaining a good nutritional status or nutritional intervention may be effective in the management and prevention of cognitive impairment.

  4. Evident cognitive impairments in seemingly recovered patients after midazolam-based light sedation during diagnostic endoscopy

    Directory of Open Access Journals (Sweden)

    Yen-Hsuan Hsu

    2015-06-01

    Conclusion: Midazolam-based light sedation induced selective cognitive impairments and prolonged cognitive impairments occurred in patients with advanced age. A longer observation time and further screening were recommended for patients due to their at risk state.

  5. Cognitive Impairment in Adults with Non-CNS Cancers (PDQ®)—Patient Version

    Science.gov (United States)

    Cognitive impairment (problems with memory and thinking) is often reported by cancer patients and survivors and is sometimes called "chemobrain" or "chemofog.” Get detailed information about cognitive impairment and treatment in this expert-reviewed summary.

  6. The efficacy of SMS text messages to compensate for the effects of cognitive impairments in schizophrenia

    NARCIS (Netherlands)

    Pijnenborg, G. H. M.; Withaar, F. K.; Brouwer, W. H.; Timmerman, M. E.; van den Bosch, R. J.; Evans, J. J.

    Background and aims. Many people with schizophrenia have severe cognitive impairments that hamper their activities. The effect of pharmacological and behavioural interventions on cognitive functioning has been demonstrated, but even after successful intervention considerable impairments can remain.

  7. White Matter Hyperintensities and Cognitive Impairment During Electroconvulsive Therapy in Severely Depressed Elderly Patients

    NARCIS (Netherlands)

    Oudega, M.L.; van Exel, E.; Wattjes, M.P.; Comijs, H.C.; Scheltens, P.; Barkhof, F.; Eikelenboom, P.; Craen, A.J.M.; Beekman, A.T.F.; Stek, M.L.

    2014-01-01

    Objective: Transient cognitive impairment during electroconvulsive therapy (ECT) can be a reason to discontinue ECT in depressed elderly patients. We hypothesized that both white matter hyperintensities and medial temporal lobe atrophy contribute to transient cognitive impairment during ECT.

  8. Apelin-13 ameliorates cognitive impairments in 6-hydroxydopamine-induced substantia nigra lesion in rats.

    Science.gov (United States)

    Haghparast, Elham; Esmaeili-Mahani, Saeed; Abbasnejad, Mehdi; Sheibani, Vahid

    2018-04-01

    Although Parkinson's disease (PD) is well known with its motor deficits, the patients often suffer from cognitive dysfunction. Apelin, as the endogenous ligand of the APJ receptor, is found in several brain regions such as substantia nigra and mesolimbic pathway. However, the role of apelin in cognition and cognitive disorders has not been fully clarified. In this study the effects of apelin-13 were investigated on cognitive disorders in rat Parkinsonism experimental model. 6-hydroxydopamine (6-OHDA) was administrated into the substantia nigra. Apelin-13 (1, 2 and 3μg/rat) was administered into the substantia nigra one week after the 6-OHDA injection. Morris water maze (MWM), object location and novel object recognition tests were performed one month after the apelin injection. 6-OHDA-treated animals showed a significant impairment in cognitive functions which was revealed by the increased in the escape latency and traveled distance in MWM test and decreased in the exploration index in novel object recognition and object location tasks. Apelin-13 (3μg/rat) significantly attenuates the mentioned cognitive impairments in 6-OHDA-treated animals. In conclusion, the data support the pro-cognitive property of apelin-13 in 6-OHDA-induced cognitive deficit and provided a new pharmacological aspect of the neuropeptide apelin. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. Various MRS application tools for Alzheimer disease and mild cognitive impairment.

    Science.gov (United States)

    Gao, F; Barker, P B

    2014-06-01

    MR spectroscopy is a noninvasive technique that allows the detection of several naturally occurring compounds (metabolites) from well-defined regions of interest within the human brain. Alzheimer disease, a progressive neurodegenerative disorder, is the most common cause of dementia in the elderly. During the past 20 years, multiple studies have been performed on MR spectroscopy in patients with both mild cognitive impairment and Alzheimer disease. Generally, MR spectroscopy studies have found decreased N-acetylaspartate and increased myo-inositol in both patients with mild cognitive impairment and Alzheimer disease, with greater changes in Alzheimer disease than in mild cognitive impairment. This review summarizes the information content of proton brain MR spectroscopy and its related technical aspects, as well as applications of MR spectroscopy to mild cognitive impairment and Alzheimer disease. While MR spectroscopy may have some value in the differential diagnosis of dementias and assessing prognosis, more likely its role in the near future will be predominantly as a tool for monitoring disease response or progression in treatment trials. More work is needed to evaluate the role of MR spectroscopy as a biomarker in Alzheimer disease and its relationship to other imaging modalities. © 2014 by American Journal of Neuroradiology.

  10. Effects of social cognitive impairment on speech disorder in schizophrenia.

    Science.gov (United States)

    Docherty, Nancy M; McCleery, Amanda; Divilbiss, Marielle; Schumann, Emily B; Moe, Aubrey; Shakeel, Mohammed K

    2013-05-01

    Disordered speech in schizophrenia impairs social functioning because it impedes communication with others. Treatment approaches targeting this symptom have been limited by an incomplete understanding of its causes. This study examined the process underpinnings of speech disorder, assessed in terms of communication failure. Contributions of impairments in 2 social cognitive abilities, emotion perception and theory of mind (ToM), to speech disorder were assessed in 63 patients with schizophrenia or schizoaffective disorder and 21 nonpsychiatric participants, after controlling for the effects of verbal intelligence and impairments in basic language-related neurocognitive abilities. After removal of the effects of the neurocognitive variables, impairments in emotion perception and ToM each explained additional variance in speech disorder in the patients but not the controls. The neurocognitive and social cognitive variables, taken together, explained 51% of the variance in speech disorder in the patients. Schizophrenic disordered speech may be less a concomitant of "positive" psychotic process than of illness-related limitations in neurocognitive and social cognitive functioning.

  11. Self-Reported Chemotherapy-Related Cognitive Impairment Compared with Cognitive Complaints following Menopause.

    Science.gov (United States)

    Vega, Jennifer N; Dumas, Julie; Newhouse, Paul

    2018-06-15

    Cancer-related cognitive impairment (CRCI) is commonly reported following the administration of cancer treatment. Current longitudinal studies, primarily in women with breast cancer, suggest that up to 35%-60% of patients exhibit persistent CRCI (pCRCI) following completion of chemotherapy. Complaints of subjective cognitive decline (SCD) are also commonly reported by women during and following the menopause transition in non-cancer patients. Although the majority of evidence for cognitive difficulties in cancer patients and survivors is attributed to chemotherapy, there is growing evidence to suggest that menopausal status can also influence cognitive function in cancer patients. Given that menopausal status may be contributing to pCRCI, we compared a group of primarily post-menopausal women with pCRCI to two groups of post-menopausal women: women who endorse menopause-associated SCD (maSCD+) and women who do not (maSCD-) to explore the similarities/differences between maSCD and pCRCI and the potential role of menopause in pCRCI. pCRCI participants report more severe SCD symptoms than women after natural menopause, despite being on average 2.5-years post-chemotherapy, supporting previous findings that CRCI can persist for months to years after completing treatment. pCRCI participants not only endorsed greater SCD, but also exhibited objective performance differences. In addition, pCRCI participants endorsed significantly greater menopausal symptoms compared to either maSCD group. Results were not related to menopausal status prior to chemotherapy or current endocrine therapy use. These results suggest that while menopausal symptoms may contribute to SCD experienced by cancer patients after chemotherapy, they do not fully account for pCRCI. This article is protected by copyright. All rights reserved.

  12. High prevalence of cognitive impairment after intracerebral hemorrhage.

    Directory of Open Access Journals (Sweden)

    Mélanie Planton

    Full Text Available Cognitive impairment seems to be frequent in intracerebral hemorrhage (ICH survivors, but remains widely understudied. In this study, we investigated the frequency and patterns of vascular cognitive disorders (VCDs in patients with cerebral amyloid angiopathy (CAA-related and deep ICH compared to patients with mild cognitive impairment due to Alzheimer's disease (MCI-AD and healthy controls.We prospectively recruited 20 patients with CAA-related lobar ICH, 20 with deep ICH, 20 with MCI-AD and 17 healthy controls. Patients with cognitive decline pre-ICH were excluded from the analysis. Each participant underwent a comprehensive neuropsychological assessment and a structural brain MRI. Cognitive assessment was performed at a median delay of 4 months after the acute phase in ICH patients, and more than 6 months after the first complaint in MCI-AD patients. Cognitive profiles were compared between groups. The prevalence of VCDs in the ICH groups was estimated using the recent VASCOG criteria."Mild" and "major VCDs" were respectively observed in 87.5% and 2.5% of all ICH patients. Every patient in the CAA group had mild VCDs. No significant difference was observed in cognitive functioning between CAA-related and deep ICH patients. The most impaired process in the CAA group was naming, with a mean (±standard deviation z-score of -5.2 ±5.5, followed by processing speed (-4.1±3.3, executive functioning (-2.6 ±2.5, memory (-2.4 ±3.5 and attention (-0.9 ±1.3. This cognitive pattern was different from the MCI-AD patients, but the groups were only different in gestural praxis, and by construction, in memory processes.VCDs are frequent after ICH. Cognitive patterns of patients with deep or CAA-related ICH did not differ, but there was impaired performance in specific domains distinct from the effects of Alzheimer's disease.URL: http://www.clinicaltrials.gov. Unique identifier: NCT01619709.

  13. Relationship between cognitive impairment and nutritional assessment on functional status in Calabrian long-term-care.

    Science.gov (United States)

    Malara, Alba; Sgrò, Giovanni; Caruso, Chiara; Ceravolo, Francesco; Curinga, Giuseppe; Renda, Grazia Francesca; Spadea, Fausto; Garo, Michele; Rispoli, Vincenzo

    2014-01-01

    The interaction between dementia and nutritional state is very complex and not yet fully understood. The aim of the present study was to assess the interaction between cognitive impairment and nutritional state in a cohort of residential elderly in relationship with functional condition of patients and their load of assistance in long-term-care facilities of the National Association of Third Age Structures (ANASTE) Calabria. One hundred seventy-four subjects (122 female and 52 male) were admitted to the long-term-care ANASTE Calabria study. All patients underwent multidimensional geriatric assessment. Nutritional state was assessed with the Mini Nutritional Assessment (MNA), whereas cognitive performance was evaluated by the Mini-Mental State Examination (MMSE). The functional state was assessed by Barthel Index (BI) and Activity Daily Living (ADL). The following nutritional biochemical parameters were also evaluated: albumin, cholesterol, iron, and hemoglobin. All patients were reassessed 180 days later. A severe cognitive impairment in MMSE performance was displayed in 49.7% patients, while 39.8% showed a moderate deficit; 6.9% had a slight deficit; and 3.4% evidenced no cognitive impairment. In MNA, 30% of patients exhibited an impairment of nutritional state; 56% were at risk of malnutrition; and 14% showed no nutritional problems. Malnutrition was present in 42% of patients with severe cognitive impairment, but only 4% of malnourished patients showed moderate cognitive deficit. The statistical analysis displayed a significant correlation between MNA and MMSE (Pnutritional state (P<0.005) as well as with the functional state (P<0.05) and mortality (P<0.01). The present study clearly shows that malnutrition may play an important role in the progression of cognitive loss.

  14. Cerebral Metabolic Differences Associated with Cognitive Impairment in Parkinson's Disease.

    Directory of Open Access Journals (Sweden)

    Yilin Tang

    Full Text Available To characterize cerebral glucose metabolism associated with different cognitive states in Parkinson's disease (PD using 18F-fluorodeoxyglucose (FDG and Positron Emission Tomography (PET.Three groups of patients were recruited in this study including PD patients with dementia (PDD; n = 10, with mild cognitive impairment (PD-MCI; n = 20, and with no cognitive impairment (PD-NC; n = 30. The groups were matched for age, sex, education, disease duration, motor disability, levodopa equivalent dose and Geriatric Depression Rating Scale (GDS score. All subjects underwent a FDG-PET study. Maps of regional metabolism in the three groups were compared using statistical parametric mapping (SPM5.PD-MCI patients exhibited limited areas of hypometabolism in the frontal, temporal and parahippocampal gyrus compared with the PD-NC patients (p < 0.01. PDD patients had bilateral areas of hypometabolism in the frontal and posterior parietal-occipital lobes compared with PD-MCI patients (p < 0.01, and exhibited greater metabolic reductions in comparison with PD-NC patients (p < 0.01.Compared with PD-NC patients, hypometabolism was much higher in the PDD patients than in PD-MCI patients, mainly in the posterior cortical areas. The result might suggest an association between posterior cortical hypometabolism and more severe cognitive impairment. PD-MCI might be important for early targeted therapeutic intervention and disease modification.

  15. Measuring hope among families impacted by cognitive impairment.

    Science.gov (United States)

    Hunsaker, Amanda E; Terhorst, Lauren; Gentry, Amanda; Lingler, Jennifer H

    2016-07-01

    The current exploratory investigation aims to establish the reliability and validity of a hope measure, the Herth Hope Index, among families impacted by early cognitive impairment (N = 96). Exploratory factor analysis was used to examine the dimensionality of the measure. Bivariate analyses were used to examine construct validity. The sample had moderately high hope scores. A two-factor structure emerged from the factor analysis, explaining 51.44% of the variance. Both factors exhibited strong internal consistency (Cronbach's alphas ranged from .83 to .86). Satisfaction with social support was positively associated with hope, supporting convergent validity. Neurocognitive status, illness insight, and depression were not associated with hope, indicating discriminant validity. Families impacted by cognitive impairment may maintain hope in the face of a potentially progressive illness, regardless of cognitive status. The Herth Hope Index can be utilized as a reliable and valid measure of hope by practitioners providing support to families impacted by cognitive impairment. © The Author(s) 2014.

  16. High body mass index is associated with impaired cognitive control.

    Science.gov (United States)

    Sellaro, Roberta; Colzato, Lorenza S

    2017-06-01

    The prevalence of weight problems is increasing worldwide. There is growing evidence that high body mass index (BMI) is associated with frontal lobe dysfunction and cognitive deficits concerning mental flexibility and inhibitory control efficiency. The present study aims at replicating and extending these observations. We compared cognitive control performance of normal weight (BMI task tapping either inhibitory control (Experiment 1) or interference control (Experiment 2). Experiment 1 replicated previous findings that found less efficient inhibitory control in overweight individuals. Experiment 2 complemented these findings by showing that cognitive control impairments associated with high BMI also extend to the ability to resolve stimulus-induced response conflict and to engage in conflict-driven control adaptation. The present results are consistent with and extend previous literature showing that high BMI in young, otherwise healthy individuals is associated with less efficient cognitive control functioning. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Real-space path integration is impaired in Alzheimer’s disease and mild cognitive impairment

    Czech Academy of Sciences Publication Activity Database

    Mokrišová, I.; Laczó, J.; Andel, R.; Gažová, I.; Vyhnálek, M.; Nedělská, Z.; Levčík, David; Cerman, J.; Vlček, Kamil; Hort, J.

    2016-01-01

    Roč. 307, Jul 1 (2016), s. 150-158 ISSN 0166-4328 Institutional support: RVO:67985823 Keywords : Alzheimer disease * mild cognitive impairment * spatial navigation * hippocampus * path integration Subject RIV: FH - Neurology Impact factor: 3.002, year: 2016

  18. Aerobic exercise effects upon cognition in Mild Cognitive Impairment: A systematic review of randomized controlled trials.

    Science.gov (United States)

    Cammisuli, D M; Innocenti, A; Franzoni, F; Pruneti, C

    2017-07-01

    Several studies have shown that physical activity has positive effects on cognition in healthy older adults without cognitive complains but lesser is known about the effectiveness of aerobic exercise in patients suffering from Mild Cognitive Impairment (MCI). The aim of the present study was to systematically review the evidence from randomized controlled trials (RCTs) about the effects of aerobic exercise upon cognition in MCI patients. To this end, PubMed, Cochrane and Web of Science databases were analytically searched for RCTs including aerobic exercise interventions for MCI patients. There is evidence that aerobic exercise improves cognition in MCI patients. Overall research reported moderate effects for global cognition, logical memory, inhibitory control and divided attention. Due to methodological limitations of the investigated studies, findings should be interpreted with caution. Standardized training protocols, larger scale interventions and follow-ups may also provide better insight into the preventive effects of aerobic exercise on cognitive deterioration in MCI and its conversion into dementia.

  19. Personality traits and risk of cognitive impairment and dementia.

    Science.gov (United States)

    Terracciano, Antonio; Stephan, Yannick; Luchetti, Martina; Albanese, Emiliano; Sutin, Angelina R

    2017-06-01

    We investigated the association between five factor model personality traits (neuroticism, extraversion, openness, agreeableness, and conscientiousness) and risk of dementia, cognitive impairment not dementia (CIND), and conversion from CIND to dementia in a large national cohort. Participants from the Health and Retirement Study (N > 10,000) completed a personality scale in 2006-2008 and their cognitive status was tracked for up to 8 years using the modified Telephone Interview for Cognitive Status (TICSm). Adjusting for age, sex, education, race, and ethnicity, lower conscientiousness and agreeableness and higher neuroticism were independently associated with increased risk of dementia. These associations remained significant after adjusting for other risk factors for dementia, including income, wealth, smoking, physical inactivity, obesity, diabetes, hypertension, and blood biomarkers. These associations were not modified by age, sex, race, ethnicity, and education, suggesting that the associations of personality with risk of dementia were similar across demographic groups. Neuroticism and conscientiousness were also associated with risk of CIND. Low conscientiousness predicted conversion from CIND to dementia. Using brief assessments of personality and cognition, we found robust evidence that personality is associated with risk of cognitive impairment and dementia in a large national sample. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Cognitive Correlates of Perseverations in Individuals with Memory Impairment.

    Science.gov (United States)

    Kavé, Gitit; Heinik, Jeremia

    2017-02-01

    This study examines which cognitive measure best accounts for perseverations in individuals with memory impairment. The sample included 85 individuals, of whom 21 had subjective memory concerns, 27 had mild cognitive impairment, and 37 had Alzheimer's disease. Participants produced responses on a semantic category fluency task and on the ideational fluency (IF) task from the Cambridge Cognitive Examination-Revised. Measures of word finding, working memory, and abstract thinking were also assessed. Significant group differences in percentage of perseverations emerged on both tasks. No cognitive measure accounted for the percentage of perseverations on the semantic fluency task. A measure of abstract thinking was the best predictor of the percentage of perseverations on the IF task, followed by a measure of working memory. The underlying cognitive mechanisms that lead to perseverations differ across tasks, with perseverations on the IF task reflecting both conceptual deficits and working memory limitations. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  1. Incidental MRI Findings in Patients with Impaired Cognitive Function

    International Nuclear Information System (INIS)

    Hwang, Yoon Joon

    2013-01-01

    This study aims to evaluate the incidental findings on brain MRI of patients with cognitive function impairments. We analyzed magnetic resonance (MR) findings of 236 patients with decreased cognitive function. MR protocols include conventional T2 weighted axial images, fluid attenuated inversion recovery axial images, T1 weighted coronal 3-dimensional magnetization-prepared rapid acquisition of gradient echo and diffusion tensor images. We retrospectively evaluated the signal changes that suggest acute/subacute infarction and space occupying lesions which show mass effect. Incidental MR findings were seen in 16 patients. Nine patients (3.8%) showed increased signal intensity on trace map of diffusion tensor images suggesting acute/subacute infarctions. Space occupying lesions were detected in 7 patients, and 3 lesions (1.27%) had mass effect and edema and were considered clinically significant lesions that diminish cognitive functions. Several incidental MR findings were detected in patients with decreased cognitive function, and the incidence of aucte/subacute infarctions were higher. Proper evaluations of MRI in patients with impaired cognitive functions will be helpful in early detection and management of ischemic lesions and space occupying lesions.

  2. Cognitive Impairments and Subjective Cognitive Complaints in Fabry Disease

    DEFF Research Database (Denmark)

    Loeb, Josefine; Feldt-Rasmussen, Ulla; Madsen, Christoffer Valdorff

    2018-01-01

    Fabry disease is a rare progressive X-linked lysosomal storage disorder which leads to neuropathic pain, organ dysfunction and cerebral pathology. Few studies have investigated cognitive impairment in Fabry disease and these previous studies are difficult to compare due to heterogeneous methodolo......Fabry disease is a rare progressive X-linked lysosomal storage disorder which leads to neuropathic pain, organ dysfunction and cerebral pathology. Few studies have investigated cognitive impairment in Fabry disease and these previous studies are difficult to compare due to heterogeneous...... methodological designs and small cohorts. The objective was to investigate the frequency of cognitive impairment in the Danish nationwide cohort of Fabry patients. Further, we examined if subjective cognitive complaints were associated with objective cognitive performances in this patient group....... Neuropsychological tests (17 measures) and evaluation of subjective complaints with the Perceived Deficits Questionnaire (PDQ) were applied in 41 of 63 patients. According to an a priori definition, 12 patients (29.3%) were cognitively impaired. Tests tapping psychomotor speed, attention and executive functions had...

  3. Prevalence and patterns of cognitive impairment in adult hemodialysis patients: the COGNITIVE-HD study.

    Science.gov (United States)

    van Zwieten, Anita; Wong, Germaine; Ruospo, Marinella; Palmer, Suetonia C; Barulli, Maria Rosaria; Iurillo, Annalisa; Saglimbene, Valeria; Natale, Patrizia; Gargano, Letizia; Murgo, Marco; Loy, Clement T; Tortelli, Rosanna; Craig, Jonathan C; Johnson, David W; Tonelli, Marcello; Hegbrant, Jörgen; Wollheim, Charlotta; Logroscino, Giancarlo; Strippoli, Giovanni F M

    2017-11-22

    Mounting evidence indicates an increased risk of cognitive impairment in adults with end-stage kidney disease on dialysis, but the extent and pattern of deficits across the spectrum of cognitive domains are uncertain. We conducted a cross-sectional study of 676 adult hemodialysis patients from 20 centers in Italy, aiming to evaluate the prevalence and patterns of cognitive impairment across five domains of learning and memory, complex attention, executive function, language and perceptual-motor function. We assessed cognitive function using a neuropsychological battery of 10 tests and calculated test and domain z-scores using population norms (age or age/education). We defined cognitive impairment as a z-score  ≤ -1.5. Participants' median age was 70.9 years (range 21.6-94.1) and 262 (38.8%) were women. Proportions of impairment on each domain were as follows: perceptual-motor function 31.5% (150/476), language 41.2% (273/662), executive function 41.7% (281/674), learning and memory 42.2% (269/638), complex attention 48.8% (329/674). Among 474 participants with data for all domains, only 28.9% (n  =  137) were not impaired on any domain, with 25.9% impaired on a single domain (n  =  123), 17.3% on two (n  =  82), 13.9% on three (n  =  66), 9.1% on four (n  =  43) and 4.9% (n  =  23) on all five. Across patients, patterns of impairment combinations were diverse. In conclusion, cognitive impairment is extremely common in hemodialysis patients, across numerous domains, and patients often experience multiple deficits simultaneously. Clinical care should be tailored to meet the needs of patients with different types of cognitive impairment and future research should focus on identifying risk factors for cognitive decline. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  4. Association of Source of Memory Complaints and Increased Risk of Cognitive Impairment and Cognitive Decline: A Community-Based Study.

    Science.gov (United States)

    Qi, Xue-Mei; Gu, Lin; Tang, Hui-Dong; Chen, Sheng-Di; Ma, Jian-Fang

    2018-04-20

    Memory complaint is common in the elderly. Recently, it was shown that self-report memory complaint was predictive of cognitive decline. This study aimed to investigate the predictive value of the source of memory complaints on the risk of cognitive impairment and cognitive decline in a community-based cohort. Data on memory complaints and cognitive function were collected among 1840 Chinese participants (aged ≥55 years old) in an urban community at baseline interview and 5-year follow-up. Incident cognitive impairment was identified based on education-adjusted Mini-Mental State Examination score. Logistic regression model was used to estimate the association between the source of memory complaints and risk of cognitive impairment conversion and cognitive decline, after adjusting for covariates. A total of 1840 participants were included into this study including 1713 normal participants and 127 cognitive impairment participants in 2009. Among 1713 normal participants in 2009, 130 participants were converted to cognitive impairment after 5 years of follow-up. In 2014, 606 participants were identified as cognitive decline. Both self- and informant-reported memory complaints were associated with an increased risk of cognitive impairment (odds ratio [OR] = 1.60, 95% confidence interval [CI]: 1.04-2.48) and cognitive decline (OR = 1.30, 95% CI: 1.01-1.68). Furthermore, this association was more significant in males (OR = 2.10, 95% CI: 1.04-4.24 for cognitive impairment and OR = 1.87, 95% CI: 1.20-2.99 for cognitive decline) and in higher education level (OR = 1.79, 95% CI: 1.02-3.15 for cognitive impairment and OR = 1.40, 95% CI: 1.02-1.91 for cognitive decline). Both self- and informant-reported memory complaints were associated with an increased risk of cognitive impairment conversion and cognitive decline, especially in persons with male gender and high educational background.

  5. Functional abilities in older adults with mild cognitive impairment.

    Science.gov (United States)

    Burton, Catherine L; Strauss, Esther; Bunce, David; Hunter, Michael A; Hultsch, David F

    2009-01-01

    A classification scheme and general set of criteria for diagnosing mild cognitive impairment (MCI) were recently proposed by a multidisciplinary group of experts who met at an international symposium on MCI. One of the proposed criteria included preserved basic activities of daily living and minimal impairment in complex instrumental activities of daily living (IADLs). To investigate whether older adults with MCI classified according to the subtypes identified by the Working Group (i.e. amnestic, single non-memory domain, and multiple domain with or without a memory component) differed from cognitively intact older adults on a variety of measures indexing IADLs and to examine how well measures of IADL predict concurrent MCI status. Two hundred and fifty community-dwelling older adults, ranging in age from 66 to 92, completed self-report measures of IADLs (Lawton and Brody IADL Scale, Scales of Independent Behaviour-Revised--SIB-R) and a measure of everyday problem solving indexing IADLs (Everyday Problems Test--EPT). Ratings of participants' IADL functioning were also obtained from informants (e.g. spouse, adult child and friend). Older adults with multiple-domain MCI demonstrated poorer IADL functioning than older adults with no cognitive impairment on the EPT and the SIB-R (both self- and informant-report versions). The multiple-domain MCI participants also demonstrated poorer IADLs than MCI participants with impairments in a single cognitive domain on the self-reported SIB-R and EPT. The single-domain MCI groups demonstrated poorer IADLs than older adults without cognitive impairment on the informant-reported SIB-R and EPT. No significant group differences were found on the Lawton and Brody IADL Scale. Using the EPT and SIB-R as predictors in a multinomial regression analysis, MCI group status was reliably predicted, but the classification rate was poor. Individuals with MCI demonstrated poorer IADL functioning compared to cognitively intact older adults

  6. Spatial navigation deficit in amnestic mild cognitive impairment

    Czech Academy of Sciences Publication Activity Database

    Hort, J.; Laczó, J.; Vyhnálek, M.; Bojar, M.; Bureš, Jan; Vlček, Kamil

    2007-01-01

    Roč. 104, č. 10 (2007), s. 4042-4047 ISSN 0027-8424 R&D Projects: GA ČR(CZ) GA309/06/1231; GA MŠk(CZ) 1M0517; GA ČR(CZ) GA309/05/0693 Institutional research plan: CEZ:AV0Z50110509 Keywords : Mild cognitive impairment * spatial navigation * Alzheimer’s Disease Subject RIV: FH - Neuro logy Impact factor: 9.598, year: 2007

  7. Spatial Navigation and APOE in Amnestic Mild Cognitive Impairment

    Czech Academy of Sciences Publication Activity Database

    Laczó, J.; Andel, R.; Vlček, Kamil; Maťoška, V.; Vyhnálek, M.; Tolar, M.; Bojar, M.; Hort, J.

    2011-01-01

    Roč. 8, č. 4 (2011), s. 169-177 ISSN 1660-2854 R&D Projects: GA ČR(CZ) GA309/09/0286; GA ČR(CZ) GA309/09/1053; GA MŠk(CZ) 1M0517; GA MŠk(CZ) LC554 Institutional research plan: CEZ:AV0Z50110509 Keywords : mild cognitive impairment * spatial navigation * Alzheimer's disease Subject RIV: FH - Neurology Impact factor: 3.056, year: 2011

  8. Clinical-pathologic correlations in vascular cognitive impairment and dementia.

    Science.gov (United States)

    Flanagan, Margaret; Larson, Eric B; Latimer, Caitlin S; Cholerton, Brenna; Crane, Paul K; Montine, Kathleen S; White, Lon R; Keene, C Dirk; Montine, Thomas J

    2016-05-01

    The most common causes of cognitive impairment and dementia are Alzheimer's disease (AD) and vascular brain injury (VBI), either independently, in combination, or in conjunction with other neurodegenerative disorders. The contribution of VBI to cognitive impairment and dementia, particularly in the context of AD pathology, has been examined extensively yet remains difficult to characterize due to conflicting results. Describing the relative contribution and mechanisms of VBI in dementia is important because of the profound impact of dementia on individuals, caregivers, families, and society, particularly the stability of health care systems with the rapidly increasing age of our population. Here we discuss relationships between pathologic processes of VBI and clinical expression of dementia, specific subtypes of VBI including microvascular brain injury, and what is currently known regarding contributions of VBI to the development and pathogenesis of the dementia syndrome. This article is part of a Special Issue entitled: Vascular Contributions to Cognitive Impairment and Dementia edited by M. Paul Murphy, Roderick A. Corriveau and Donna M. Wilcock. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Awareness of memory failures and motivation for cognitive training in mild cognitive impairment.

    Science.gov (United States)

    Werheid, Katja; Ziegler, Matthias; Klapper, Annina; Kühl, Klaus-Peter

    2010-01-01

    Awareness of cognitive deficits is considered to be decisive for the effectiveness of cognitive training in mild cognitive impairment (MCI). However, it is unclear in what way awareness influences motivation to participate in cognitive training. Thirty-two elderly adults with MCI and 72 controls completed the 5-scale Memory Functioning Questionnaire (MFQ) and a motivation questionnaire. The predictive value of the MFQ scales on motivation was analyzed using regression analysis. In the MCI group, but not in controls, higher perceived frequency of memory failures was associated with a lower motivation score. Our findings indicate that, in MCI, greater awareness of cognitive deficits does not necessarily increase motivation to participate in cognitive trainings, and suggest that success expectancy may be a moderating factor. Copyright © 2010 S. Karger AG, Basel.

  10. Subclinical naming errors in mild cognitive impairment: A semantic deficit?

    Directory of Open Access Journals (Sweden)

    Indra F. Willers

    Full Text Available Abstract Mild cognitive impairment (MCI is the transitional stage between normal aging and Alzheimer's disease (AD. Impairments in semantic memory have been demonstrated to be a critical factor in early AD. The Boston Naming Test (BNT is a straightforward method of examining semantic or visuo-perceptual processing and therefore represents a potential diagnostic tool. The objective of this study was to examine naming ability and identify error types in patients with amnestic mild cognitive impairment (aMCI. Methods: Twenty aMCI patients, twenty AD patients and twenty-one normal controls, matched by age, sex and education level were evaluated. As part of a further neuropsychological evaluation, all subjects performed the BNT. A comprehensive classification of error types was devised in order to compare performance and ascertain semantic or perceptual origin of errors. Results: AD patients obtained significantly lower total scores on the BNT than aMCI patients and controls. aMCI patients did not obtain significant differences in total scores, but showed significantly higher semantic errors compared to controls. Conclusion: This study reveals that semantic processing is impaired during confrontation naming in aMCI.

  11. Working memory span in mild cognitive impairment. Influence of processing speed and cognitive reserve.

    Science.gov (United States)

    Facal, David; Juncos-Rabadán, Onésimo; Pereiro, Arturo X; Lojo-Seoane, Cristina

    2014-04-01

    Mild cognitive impairment (MCI) often includes episodic memory impairment, but can also involve other types of cognitive decline. Although previous studies have shown poorer performance of MCI patients in working memory (WM) span tasks, different MCI subgroups were not studied. In the present exploratory study, 145 participants underwent extensive cognitive evaluation, which included three different WM span tasks, and were classified into the following groups: multiple-domain amnestic MCI (mda-MCI), single-domain amnestic MCI (sda-MCI), and controls. General linear model was conducted by considering the WM span tasks as the within-subject factor; the group (mda-MCI, sda-MCI, and controls) as the inter-subject factor; and processing speed, vocabulary and age as covariates. Multiple linear regression models were also used to test the influence of processing speed, vocabulary, and other cognitive reserve (CR) proxies. Results indicate different levels of impairment of WM, with more severe impairment in mda-MCI patients. The differences were still present when processing resources and CR were controlled. Between-group differences can be understood as a manifestation of the greater severity and widespread memory impairment in mda-MCI patients and may contribute to a better understanding of continuum from normal controls to mda-MCI patients. Processing speed and CR have a limited influence on WM scores, reducing but not removing differences between groups.

  12. Anosognosia and Anosodiaphoria in Mild Cognitive Impairment and Alzheimer's Disease

    Directory of Open Access Journals (Sweden)

    Maria Lindau

    2014-12-01

    Full Text Available Aims: To evaluate the occurrence of anosognosia (lack of awareness and anosodiaphoria (insouciance in mild cognitive impairment (MCI and Alzheimer's disease (AD and to evaluate the influence of a worsening of dementia on these phenomena. Methods: A self-evaluation scale was used assessing degrees of anosognosia and anosodiaphoria; furthermore, a neuropsychological assessment and statistical analyses with nonparametric tests which could cope with data on an ordinal scale level and small samples were employed. Results: Cognitive ability was lower in AD (n = 9 than in MCI patients (n = 12, but AD patients self-rated lower cognitive disabilities, which is interpreted as one relative sign of anosognosia in AD. Awareness of the reasons for cognitive problems was also lower in AD, which is considered as another sign of anosognosia. The main pattern in MCI found that the higher the awareness, the lower the cognitive ability. In AD low awareness paralleled low cognitive functioning. Anosodiaphoria was present in AD but not in MCI. Conclusion: According to the literature anosognosia and anosodiaphoria seem to increase with progression of dementia from MCI as a result of right hemispheric alterations.

  13. Metabolic Profiling of Impaired Cognitive Function in Patients Receiving Dialysis.

    Science.gov (United States)

    Kurella Tamura, Manjula; Chertow, Glenn M; Depner, Thomas A; Nissenson, Allen R; Schiller, Brigitte; Mehta, Ravindra L; Liu, Sai; Sirich, Tammy L

    2016-12-01

    Retention of uremic metabolites is a proposed cause of cognitive impairment in patients with ESRD. We used metabolic profiling to identify and validate uremic metabolites associated with impairment in executive function in two cohorts of patients receiving maintenance dialysis. We performed metabolic profiling using liquid chromatography/mass spectrometry applied to predialysis plasma samples from a discovery cohort of 141 patients and an independent replication cohort of 180 patients participating in a trial of frequent hemodialysis. We assessed executive function with the Trail Making Test Part B and the Digit Symbol Substitution test. Impaired executive function was defined as a score ≥2 SDs below normative values. Four metabolites-4-hydroxyphenylacetate, phenylacetylglutamine, hippurate, and prolyl-hydroxyproline-were associated with impaired executive function at the false-detection rate significance threshold. After adjustment for demographic and clinical characteristics, the associations remained statistically significant: relative risk 1.16 (95% confidence interval [95% CI], 1.03 to 1.32), 1.39 (95% CI, 1.13 to 1.71), 1.24 (95% CI, 1.03 to 1.50), and 1.20 (95% CI, 1.05 to 1.38) for each SD increase in 4-hydroxyphenylacetate, phenylacetylglutamine, hippurate, and prolyl-hydroxyproline, respectively. The association between 4-hydroxyphenylacetate and impaired executive function was replicated in the second cohort (relative risk 1.12; 95% CI, 1.02 to 1.23), whereas the associations for phenylacetylglutamine, hippurate, and prolyl-hydroxyproline did not reach statistical significance in this cohort. In summary, four metabolites related to phenylalanine, benzoate, and glutamate metabolism may be markers of cognitive impairment in patients receiving maintenance dialysis. Copyright © 2016 by the American Society of Nephrology.

  14. Tocopherols and tocotrienols plasma levels are associated with cognitive impairment.

    Science.gov (United States)

    Mangialasche, Francesca; Xu, Weili; Kivipelto, Miia; Costanzi, Emanuela; Ercolani, Sara; Pigliautile, Martina; Cecchetti, Roberta; Baglioni, Mauro; Simmons, Andrew; Soininen, Hilkka; Tsolaki, Magda; Kloszewska, Iwona; Vellas, Bruno; Lovestone, Simon; Mecocci, Patrizia

    2012-10-01

    Vitamin E includes 8 natural compounds (4 tocopherols, 4 tocotrienols) with potential neuroprotective activity. α-Tocopherol has mainly been investigated in relation to cognitive impairment. We examined the relation of all plasma vitamin E forms and markers of vitamin E damage (α-tocopherylquinone, 5-nitro-γ-tocopherol) to mild cognitive impairment (MCI) and Alzheimer's disease (AD). Within the AddNeuroMed-Project, plasma tocopherols, tocotrienols, α-tocopherylquinone, and 5-nitro-γ-tocopherol were assessed in 168 AD cases, 166 MCI, and 187 cognitively normal (CN) people. Compared with cognitively normal subjects, AD and MCI had lower levels of total tocopherols, total tocotrienols, and total vitamin E. In multivariable-polytomous-logistic regression analysis, both MCI and AD cases had 85% lower odds to be in the highest tertile of total tocopherols and total vitamin E, and they were, respectively, 92% and 94% less likely to be in the highest tertile of total tocotrienols than the lowest tertile. Further, both disorders were associated with increased vitamin E damage. Low plasma tocopherols and tocotrienols levels are associated with increased odds of MCI and AD. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. Cognitive impairments in poly-drug ketamine users.

    Science.gov (United States)

    Liang, H J; Lau, C G; Tang, A; Chan, F; Ungvari, G S; Tang, W K

    2013-11-01

    Cognitive impairment has been found to be reversible in people with substance abuse, particularly those using ketamine. Ketamine users are often poly-substance users. This study compared the cognitive functions of current and former ketamine users who were also abusing other psychoactive substances with those of non-users of illicit drugs as controls. One hundred ketamine poly-drug users and 100 controls were recruited. Drug users were divided into current (n = 32) and ex-users (n = 64) according to the duration of abstinence from ketamine (>30 days). The Beck Depression Inventory (BDI), the Hospital Anxiety Depression Scale (HADSA) and the Severity of Dependence Scale (SDS) were used to evaluate depression and anxiety symptoms and the severity of drug use, respectively. The cognitive test battery comprised verbal memory (Wechsler Memory Scale III: Logic Memory and Word List), visual memory (Rey-Osterrieth Complex Figure, ROCF), executive function (Stroop, Wisconsin Card Sorting Test, and Modified Verbal Fluency Test), working memory (Digit Span Backward), and general intelligence (Information, Arithmetic and Digit-Symbol Coding) tests. Current users had higher BDI and HADSA scores than ex-users (p recognition than controls (p = 0.002). No difference was found between the cognitive functions of current and ex-users. Ketamine poly-drug users displayed predominantly verbal and visual memory impairments, which persisted in ex-users. The interactive effect of ketamine and poly-drug use on memory needs further investigation. © 2013 Elsevier Ltd. All rights reserved.

  16. Geriatric depression and its relation with cognitive impairment and dementia.

    Science.gov (United States)

    Dillon, Carol; Tartaglini, María Florencia; Stefani, Dorina; Salgado, Pablo; Taragano, Fernando E; Allegri, Ricardo F

    2014-01-01

    Different subtypes of depressive syndromes exist in late life; many of them have cognitive impairment and sometimes it is difficult to differentiate them from dementia. This research aimed to investigate subtypes of geriatric depression associated with cognitive impairment, searched for differential variables and tried to propose a study model. A hundred and eighteen depressive patients and forty normal subjects matched by age and educational level were evaluated with an extensive neuropsychological battery, scales to evaluate neuropsychiatric symptoms and daily life activities (DLA). Depressive patients were classified in groups by SCAN 2.1: Major Depression Disorder (MDD) (n: 31), Dysthymia Disorder (DD) (n: 31), Subsyndromal Depression Disorder (SSD) (n: 29), Depression due to Dementia (n: 27) (DdD). Neuropsychological significant differences (pdepressive groups, demonstrating distinctive cognitive profiles. Moreover, significant differences (pdepression. Beck Depression Inventory (BDI) and Mini Mental State Examination (MMSE) were significant variables that helped to differentiate depressive groups. Significant correlations between BDI and Neuropsychological tests were found in MDD and DD groups. Depressive symptoms and its relation with neuropsychological variables, MMSE, cognitive profiles, DLA and age of onset of depression should be taken into consideration for the study of subtypes of geriatric depression. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. Obstructive sleep apnea syndrome and cognitive impairment: effects of CPAP

    Directory of Open Access Journals (Sweden)

    Alessandra Giordano

    2011-10-01

    Full Text Available Obstructive Sleep Apnea Syndrome (OSAS is a sleep disorder characterised by repetitive episodes of upper airway obstruction (apnea or reduced airflow (hypopnoea despite persistent respiratory effort. Apnea is defined as the cessation of breathing for at least 10 seconds during sleep, while hypopnoea is defined as at least 30% reduction in airflow for 10 seconds associated with oxygen desaturation and sleep fragmentation. The presence in the general population is about 4%. The principal symptoms are: excessive daytime sleepiness (EDS, snoring, dry throat, morning headache, night sweats, gastro-esophageal reflux, and increased blood pressure.Long term complications can be: increased cardio-cerebrovascular risk and cognitive impairment such as deficiency in attention, vigilance, visual abilities, thought, speech, perception and short term memory.Continuous Positive Airway Pressure (CPAP is currently the best non-invasive therapy for OSAS.CPAP guarantees the opening of upper airways using pulmonary reflexive mechanisms increasing lung volume during exhalation and resistance reduction, decreasing electromyografical muscular activity around airways.The causes of cognitive impairments and their possible reversibility after CPAP treatment have been analysed in numerous studies. The findings, albeit controversial, show that memory, attention and executive functions are the most compromised cognitive functions.The necessity of increasing the patient compliance with ventilotherapy is evident, in order to prevent cognitive deterioration and, when possible, rehabilitate the compromised functions, a difficult task for executive functions.

  18. Computer-Based Cognitive Training for Mild Cognitive Impairment: Results from a Pilot Randomized, Controlled Trial

    OpenAIRE

    Barnes, Deborah E.; Yaffe, Kristine; Belfor, Nataliya; Jagust, William J.; DeCarli, Charles; Reed, Bruce R.; Kramer, Joel H.

    2009-01-01

    We performed a pilot randomized, controlled trial of intensive, computer-based cognitive training in 47 subjects with mild cognitive impairment (MCI). The intervention group performed exercises specifically designed to improve auditory processing speed and accuracy for 100 minutes/day, 5 days/week for 6 weeks; the control group performed more passive computer activities (reading, listening, visuospatial game) for similar amounts of time. Subjects had a mean age of 74 years and 60% were men; 7...

  19. Older drivers with cognitive impairment: Perceived changes in driving skills, driving-related discomfort and self-regulation of driving

    DEFF Research Database (Denmark)

    Meng, A.; Siren, A.; Teasdale, Thomas William

    2013-01-01

    The results of a previous study indicate that in general, older drivers who recognise cognitive problems show realistic self-assessment of changes in their driving skills and that driving-related discomfort may function as an indirect monitoring of driving ability, contributing to their safe...... drivers may recognise cognitive problems, they tend not to recognise changes to their driving, which may reflect reluctance to acknowledge the impact of cognitive impairment on their driving. Furthermore, the results suggest that driving-related discomfort plays an important role in the self......-regulation of driving among cognitively impaired older drivers. However, it is less clear what triggers driving-related discomfort among cognitively impaired older drivers indicating that it may be a less reliable aspect of their self-monitoring of driving ability....

  20. Cognitive impairment after traumatic brain injury: a functional magnetic resonance imaging study using the Stroop task

    Energy Technology Data Exchange (ETDEWEB)

    Soeda, Akio; Iwama, Toru [Gifu University School of Medicine, Department of Neurosurgery, Gifu City (Japan); Nakashima, Toshihiko; Okumura, Ayumi; Shinoda, Jun [Kizawa Memorial Hospital, Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Department of Neurosurgery, Minokamo (Japan); Kuwata, Kazuo [Gifu University School of Medicine, Department of Biochemistry and Biophysics, Gifu (Japan)

    2005-07-01

    The anterior cingulate cortex (ACC) plays a key role in cognition, motor function, and emotion processing. However, little is known about how traumatic brain injury (TBI) affects the ACC system. Our purpose was to compare, by functional magnetic resonance imaging (fMRI) studies, the patterns of cortical activation in patients with cognitive impairment after TBI and those of normal subjects. Cortical activation maps of 11 right-handed healthy control subjects and five TBI patients with cognitive impairment were recorded in response to a Stroop task during a block-designed fMRI experiment. Statistical parametric mapping (SPM99) was used for individual subjects and group analysis. In TBI patients and controls, cortical activation, found in similar regions of the frontal, occipital, and parietal lobes, resembled patterns of activation documented in previous neuroimaging studies of the Stroop task in healthy controls. However, the TBI patients showed a relative decrease in ACC activity compared with the controls. Cognitive impairment in TBI patients seems to be associated with alterations in functional cerebral activity, especially less activation of the ACC. These changes are probably the result of destruction of neural networks after diffuse axonal injury and may reflect cortical disinhibition attributable to disconnection or compensation for an inefficient cognitive process. (orig.)

  1. Hippocampal infusions of apolipoprotein E peptides induce long-lasting cognitive impairment.

    Science.gov (United States)

    Eddins, Donnie; Klein, Rebecca C; Yakel, Jerrel L; Levin, Edward D

    2009-04-29

    The inheritance of the varepsilon4 allele of apolipoprotein E (ApoE4) and cholinergic system dysfunction have long been associated with the pathology of Alzheimer's disease (AD). Recently, in vitro studies have established a direct link between ApoE and cholinergic function in that synthetic peptides containing segments of the ApoE protein (ApoE(133-149) and ApoE(141-148)) interact with alpha7 nicotinic acetylcholine receptors (nAChRs) in the hippocampus. This raises the possibility that ApoE peptides may contribute to cognitive impairment in AD in that the hippocampus plays a key role in cognitive functioning. To test this, we acutely infused ApoE peptides into the ventral hippocampus of female Sprague-Dawley rats and assessed the resultant effects on radial-arm maze choice accuracy over a period of weeks after the infusion. Local ventral hippocampal infusion of ApoE peptides caused significant cognitive impairment in radial-arm maze learning that persisted several weeks after the acute infusion. This persisting deficit may be an important model for understanding the relationship between ApoE protein-induced neurotoxicity and cognitive impairment as well as serve as a platform for the development of new therapies to avoid neurotoxicity and cognitive decline.

  2. Cognitive impairment after traumatic brain injury: a functional magnetic resonance imaging study using the Stroop task

    International Nuclear Information System (INIS)

    Soeda, Akio; Iwama, Toru; Nakashima, Toshihiko; Okumura, Ayumi; Shinoda, Jun; Kuwata, Kazuo

    2005-01-01

    The anterior cingulate cortex (ACC) plays a key role in cognition, motor function, and emotion processing. However, little is known about how traumatic brain injury (TBI) affects the ACC system. Our purpose was to compare, by functional magnetic resonance imaging (fMRI) studies, the patterns of cortical activation in patients with cognitive impairment after TBI and those of normal subjects. Cortical activation maps of 11 right-handed healthy control subjects and five TBI patients with cognitive impairment were recorded in response to a Stroop task during a block-designed fMRI experiment. Statistical parametric mapping (SPM99) was used for individual subjects and group analysis. In TBI patients and controls, cortical activation, found in similar regions of the frontal, occipital, and parietal lobes, resembled patterns of activation documented in previous neuroimaging studies of the Stroop task in healthy controls. However, the TBI patients showed a relative decrease in ACC activity compared with the controls. Cognitive impairment in TBI patients seems to be associated with alterations in functional cerebral activity, especially less activation of the ACC. These changes are probably the result of destruction of neural networks after diffuse axonal injury and may reflect cortical disinhibition attributable to disconnection or compensation for an inefficient cognitive process. (orig.)

  3. Cognitive Impairment among Older Adults in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Hirschman, Karen

    2011-02-01

    Full Text Available Background: Within the next 30 years, the number of visits older adults will make to emergency departments (EDs is expected to double from 16 million, or 14% of all visits, to 34 million and comprise nearly a quarter of all visits.Objective: The objectives of this study were to determine prevalence rates of cognitive impairment among older adults in the ED and to identify associations, if any, between environmental factors unique to the ED and rates of cognitive impairment.Methods: A cross-sectional observational study of adults 65 and older admitted to the ED of a large, urban, tertiary academic health center was conducted between September 2007 and May 2008. Patients were screened for cognitive impairment in orientation, recall and executive function using the Six-Item Screen (SIS and the CLOX1, clock drawing task. Cognitive impairment among this ED population was assessed and both patient demographics and ED characteristics (crowding, triage time, location of assessment, triage class were compared through adjusted generalized linear models.Results: Forty-two percent (350/829 of elderly patients presented with deficits in orientation and recall as assessed by the SIS. An additional 36% of elderly patients with no impairment in orientation or recall had deficits in executive function as assessed by the CLOX1. In full model adjusted analyses patients were more likely to screen deficits in orientation and recall (SIS if they were 85 years or older (Relative Risk [RR]=1.63, 95% Confidence Interval [95% CI]=1.3-2.07, black (RR=1.85, 95% CI=1.5-2.4 and male (RR=1.42, 95% CI=1.2-1.7. Only age was significantly associated with executive functioning deficits in the ED screened using the clock drawing task (CLOX1 (75-84 years: RR=1.35, 95% CI= 1.2-1.6; 85+ years: RR=1.69, 95% CI= 1.5-2.0.Conclusion: These findings have several implications for patients seen in the ED. The SIS coupled with a clock drawing task (CLOX1 provide a rapid and simple method for

  4. Perceptions of a cognitive rehabilitation group by older people living with cognitive impairment and their caregivers: A qualitative interview study.

    Science.gov (United States)

    Moebs, Isabelle; Gee, Susan; Miyahara, Motohide; Paton, Helen; Croucher, Matthew

    2017-05-01

    Cognitive rehabilitation has been developed to improve quality of life, activities of daily living and mood for people with cognitive impairment, but the voice of people with cognitive impairment has been underrepresented. This study aimed to understand the experience of people living with cognitive impairment, as well as their caregivers who took part in a cognitive rehabilitation intervention programme. Twelve individuals with cognitive impairment and 15 caregivers participated in individual qualitative interviews. The interview data were analysed in three steps: 1) familiarisation of the transcripts; 2) identification of themes; 3) re-interpretation, refinement and integration of themes with methodological auditors. Both participants living with cognitive impairment and caregivers valued the comfortable environment with friendly, caring and supportive group leaders who taught practical tips and strategies. The participants living with cognitive impairment enjoyed socialising with like others. Caregivers benefited from learning about memory problems and sharing their challenges with other caregivers. The participants living with cognitive impairment emphasised the benefits of relational and practical aspects, whereas the caregivers valued the informational and emotional support. In conclusion, both participants living with cognitive impairment and caregivers found the cognitive rehabilitation group useful.

  5. Physical activity and depression in older adults with and without cognitive impairment.

    Science.gov (United States)

    Yuenyongchaiwat, Kornanong; Pongpanit, Khajonsak; Hanmanop, Somrudee

    2018-01-01

    Low physical activity and depression may be related to cognitive impairment in the elderly. To determine depression and physical activity (PA) among older adults with and without cognitive impairment. 156 older adults, both males and females, aged ≥60 years, were asked to complete the Thai Mini-Mental State Examination (Thai-MMSE), a global cognitive impairment screening tool. Seventy-eight older adults with cognitive impairment and 78 older adults without cognitive impairment were then separately administered two questionnaires (i.e., the Thai Geriatric Depression Scale; TGDS and Global Physical Activity Questionnaire; GPAQ). Logistic regression analysis was used to determine the risk of developing cognitive impairment in the groups of older individuals with and without cognitive impairment. A cross-sectional study of elderly with a mean age of 74.47 ± 8.14 years was conducted. There were significant differences on the depression scale and in PA between older adults with and without cognitive impairment. Further, participants with low PA and high level of depressive symptoms had an increased risk of cognitive impairment (Odds ratio = 4.808 and 3.298, respectively). Significant differences were noted in PA and on depression scales between older adults with and without cognitive impairment. Therefore, increased PA and decreased depressive symptoms (i.e., having psychological support) are suggested to reduce the risks of cognitive impairment in older adults.

  6. Nucleus basalis of Meynert degeneration precedes and predicts cognitive impairment in Parkinson's disease.

    Science.gov (United States)

    Schulz, Jonathan; Pagano, Gennaro; Fernández Bonfante, Juan Alberto; Wilson, Heather; Politis, Marios

    2018-05-01

    Currently, no reliable predictors of cognitive impairment in Parkinson's disease exist. We hypothesized that microstructural changes at grey matter T1-weighted MRI and diffusion tensor imaging in the cholinergic system nuclei and associated limbic pathways underlie cognitive impairment in Parkinson's disease. We performed a cross-sectional comparison between patients with Parkinson's disease with and without cognitive impairment. We also performed a longitudinal 36-month follow-up study of cognitively intact Parkinson's disease patients, comparing patients who remained cognitively intact to those who developed cognitive impairment. Patients with Parkinson's disease with cognitive impairment showed lower grey matter volume and increased mean diffusivity in the nucleus basalis of Meynert, compared to patients with Parkinson's disease without cognitive impairment. These results were confirmed both with region of interest and voxel-based analyses, and after partial volume correction. Lower grey matter volume and increased mean diffusivity in the nucleus basalis of Meynert was predictive for developing cognitive impairment in cognitively intact patients with Parkinson's disease, independent of other clinical and non-clinical markers of the disease. Structural and microstructural alterations in entorhinal cortex, amygdala, hippocampus, insula, and thalamus were not predictive for developing cognitive impairment in Parkinson's disease. Our findings provide evidence that degeneration of the nucleus basalis of Meynert precedes and predicts the onset of cognitive impairment, and might be used in a clinical setting as a reliable biomarker to stratify patients at higher risk of cognitive decline.

  7. Connectivity features for identifying cognitive impairment in presymptomatic carotid stenosis.

    Directory of Open Access Journals (Sweden)

    Chun-Jen Lin

    Full Text Available Severe asymptomatic stenosis of the internal carotid artery (ICA leads to increased incidence of mild cognitive impairment (MCI likely through silent embolic infarcts and/or chronic hypoperfusion, but the brain dysfunction is poorly understood and difficult to diagnose. Thirty cognitively intact subjects with asymptomatic, severe (≥ 70%, unilateral stenosis of the ICA were compared with 30 healthy controls, matched for age, sex, cardiovascular risk factors and education level, on a battery of neuropsychiatric tests, voxel-based morphometry of magnetic resonance imaging (MRI, diffusion tensor imaging and brain-wise, seed-based analysis of resting-state functional MRI. Multivariate regression models and multivariate pattern classification (support vector machines were computed to assess the relationship between connectivity measures and neurocognitive performance. The patients had worse dizziness scores and poorer verbal memory, executive function and complex visuo-spatial performance than controls. Twelve out of the 30 patients (40% were considered to have MCI. Nonetheless, the leukoaraiosis Sheltens scores, hippocampal and brain volumes were not different between groups. Their whole-brain mean fractional anisotropy (FA was significantly reduced and regional functional connectivity (Fc was significantly impaired in the dorsal attention network (DAN, frontoparietal network, sensorimotor network and default mode network. In particular, the Fc strength at the insula of the DAN and the mean FA were linearly related with attention performance and dizziness severity, respectively. The multivariate pattern classification gave over 90% predictive accuracy of individuals with MCI or severe dizziness. Cognitive decline in stroke-free individuals with severe carotid stenosis may arise from nonselective widespread disconnections of long-range, predominantly interhemispheric non-hippocampal pathways. Connectivity measures may serve as both predictors for

  8. Characterisation of Physical Frailty and Associated Physical and Functional Impairments in Mild Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Ma Shwe Zin Nyunt

    2017-12-01

    Full Text Available ObjectiveTo characterize the physical frailty phenotype and its associated physical and functional impairments in mild cognitive impairment (MCI.MethodParticipants with MCI (N = 119, normal low cognition (NLC, N = 138, and normal high cognition (NHC, N = 1,681 in the Singapore Longitudinal Ageing Studies (SLAS-2 were compared on the prevalence of physical frailty, low lean body mass, weakness, slow gait, exhaustion and low physical activity, and POMA balance and gait impairment and fall risk.ResultsThere were significantly higher prevalence of frailty in MCI (18.5%, than in NLC (8.0% and NHC (3.9%, and pre-frailty in MCI (54.6%, NLC (52.9% than in NHC (48.0%. Age, sex, and ethnicity-adjusted OR (95% CI of association with MCI (versus NHC for frailty were 4.65 (2.40–9.04 and for pre-frailty, 1.67 (1.07–2.61. Similar significantly elevated prevalence and adjusted ORs of association with MCI were observed for frailty-associated physical and functional impairments. Further adjustment for education, marital status, living status, comorbidities, and GDS significantly reduced the OR estimates. However, the OR estimates remained elevated for frailty: 3.86 (1.83–8.17, low body mass: 1.70 (1.08–2.67, slow gait: 1.84 (1.17–2.89, impaired gait: 4.17 (1.98–8.81, and elevated fall risk 3.42 (1.22–9.53.ConclusionTwo-thirds of MCI were physically frail or pre-frail, most uniquely due to low lean muscle mass, slow gait speed, or balance and gait impairment. The close associations of frailty and physical and functional impairment with MCI have important implications for improving diagnostic acuity of MCI and targetting interventions among cognitively frail individuals to prevent dementia and disability.

  9. Cognitive Profiles of Patients with Mild Cognitive Impairment or Dementia in Alzheimer's or Parkinson's Disease

    Directory of Open Access Journals (Sweden)

    Helmut Hildebrandt

    2013-04-01

    Full Text Available Background: Alzheimer's disease (AD and Parkinson's disease (PD are associated with severe cognitive decline, but it is still unclear to what extent they become functionally more similar over time. Methods: We compared amnestic mild cognitively impaired (aMCI; n = 29 patients to mild cognitively impaired (MCI PD patients (n = 25, and patients with AD (n = 34 to patients with PD dementia (PDD; n = 15 with respect to cognitive functioning and mood. Results: aMCI patients were impaired in episodic memory, while MCI PD patients showed deficits in visuoconstruction and attention. AD and PDD patients showed comparable deficits on tests for language, attention and visuoconstruction. However, unlike PDD patients but similar to aMCI patients, AD patients showed a characteristic memory impairment, especially commission errors on recognition tasks, whereas PDD patients scored higher on the depressive mood questionnaire. Conclusions: In advanced stages of both diseases, the pattern of functional deficits associated with parietal and temporal lobe functions (attention, visuoconstruction and language is similar. However, specific differences, already present in the early stage (recognition errors in AD, associated with mediobasal temporal lobe functioning, and depressed mood in PDD, associated with non-motor basal ganglia loops, are also observed in the late stage.

  10. White matter tract signatures of impaired social cognition in frontotemporal lobar degeneration

    Directory of Open Access Journals (Sweden)

    Laura E. Downey

    2015-01-01

    Full Text Available Impairments of social cognition are often leading features in frontotemporal lobar degeneration (FTLD and likely to reflect large-scale brain network disintegration. However, the neuroanatomical basis of impaired social cognition in FTLD and the role of white matter connections have not been defined. Here we assessed social cognition in a cohort of patients representing two core syndromes of FTLD, behavioural variant frontotemporal dementia (bvFTD; n = 29 and semantic variant primary progressive aphasia (svPPA; n = 15, relative to healthy older individuals (n = 37 using two components of the Awareness of Social Inference Test, canonical emotion identification and sarcasm identification. Diffusion tensor imaging (DTI was used to derive white matter tract correlates of social cognition performance and compared with the distribution of grey matter atrophy on voxel-based morphometry. The bvFTD and svPPA groups showed comparably severe deficits for identification of canonical emotions and sarcasm, and these deficits were correlated with distributed and overlapping white matter tract alterations particularly affecting frontotemporal connections in the right cerebral hemisphere. The most robust DTI associations were identified in white matter tracts linking cognitive and evaluative processing with emotional responses: anterior thalamic radiation, fornix (emotion identification and uncinate fasciculus (sarcasm identification. DTI associations of impaired social cognition were more consistent than corresponding grey matter associations. These findings delineate a brain network substrate for the social impairment that characterises FTLD syndromes. The findings further suggest that DTI can generate sensitive and functionally relevant indexes of white matter damage in FTLD, with potential to transcend conventional syndrome boundaries.

  11. The perceptions of cognitively impaired patients and their caregivers of a home telecare system

    Directory of Open Access Journals (Sweden)

    Mehrabian S

    2014-12-01

    Full Text Available Shima Mehrabian,1 Jocelyne Extra,2 Ya-Huei Wu,2 Maribel Pino,2 Latchezar Traykov,1 Anne-Sophie Rigaud2 1Department of Neurology, University Hospital (UH “Alexandrovska”, Sofia, Bulgaria; 2Department of Gerontology, Hôpital Broca, Assitance Publique-Hôpitaux de Paris, EA 4468, Faculte de Médecine, Université Paris Descartes, Paris, France Abstract: Assistive and telecare technologies have been developed to support older adults with cognitive impairments, as well as their caregivers, from their homes. The way potential users perceive telecare and smart home systems plays a key role in their acceptance of this new technology. We evaluate the acceptance of home telecare technologies among patients suffering from cognitive impairment and their caregivers. Prototypes of telecare devices were developed to demonstrate their features and capabilities and to train patients, families, and health care professionals in their use. We conducted semistructured interviews to elicit the perceptions of 30 patients with mild cognitive impairment, 32 patients with Alzheimer’s disease, and 30 caregivers, regarding the risks and advantages of home telecare and smart houses. Survey results reflected participants' largely positive reactions to these technologies. Regarding home telecare, the cognitive stimulation program earned the highest proportion of positive responses, followed by the devices' care of emergencies. The participants generally agreed that home telecare and smart houses could significantly improve their quality of life. However, some technical and ethical concerns, such as the way of provision, installation, and monitoring of the systems, were reported to be in need of addressing before implementation of this system. Keywords: home telecare, Alzheimer’s disease, mild cognitive impairment, caregiver, cognitive stimulation

  12. Gait, dual task and history of falls in elderly with preserved cognition, mild cognitive impairment, and mild Alzheimer's disease

    OpenAIRE

    Ansai, Juliana H.; Andrade, Larissa P.; Rossi, Paulo G.; Takahashi, Anielle C.M.; Vale, Francisco A.C.; Rebelatto, Jos? R.

    2017-01-01

    Background Studies with functional and applicable methods and new cognitive demands involving executive function are needed to improve screening, prevention and rehabilitation of cognitive impairment and falls. Objective to identify differences in gait, dual task performances, and history of falls between elderly people with preserved cognition, mild cognitive impairment and mild Alzheimer's disease. Method A cross-sectional study was conducted. The sample consisted of 40 community-dwelling o...

  13. Naming of objects, faces and buildings in mild cognitive impairment.

    Science.gov (United States)

    Ahmed, Samrah; Arnold, Robert; Thompson, Sian A; Graham, Kim S; Hodges, John R

    2008-06-01

    Accruing evidence suggests that the cognitive deficits in very early Alzheimer's Disease (AD) are not confined to episodic memory, with a number of studies documenting semantic memory deficits, especially for knowledge of people. To investigate whether this difficulty in naming famous people extends to other proper names based information, three naming tasks - the Graded Naming Test (GNT), which uses objects and animals, the Graded Faces Test (GFT) and the newly designed Graded Buildings Test (GBT) - were administered to 69 participants (32 patients in the early prodromal stage of AD, so-called Mild Cognitive Impairment (MCI), and 37 normal control participants). Patients were found to be impaired on all three tests compared to controls, although naming of objects was significantly better than naming of faces and buildings. Discriminant analysis successfully predicted group membership for 100% controls and 78.1% of patients. The results suggest that even in cases that do not yet fulfil criteria for AD naming of famous people and buildings is impaired, and that both these semantic domains show greater vulnerability than general semantic knowledge. A semantic deficit together with the hallmark episodic deficit may be common in MCI, and that the use of graded tasks tapping semantic memory may be useful for the early identification of patients with MCI.

  14. Cognitive reserve and Aβ1-42 in mild cognitive impairment (Argentina-Alzheimer’s Disease Neuroimaging Initiative

    Directory of Open Access Journals (Sweden)

    Harris P

    2015-10-01

    Full Text Available Paula Harris,1,2 Marcos Fernandez Suarez,1 Ezequiel I Surace,1,2 Patricio Chrem Méndez,1 María Eugenia Martín,1 María Florencia Clarens,1 Fernanda Tapajóz,1,2 Maria Julieta Russo,1 Jorge Campos,1 Salvador M Guinjoan,1,2 Gustavo Sevlever,1 Ricardo F Allegri1,2 1Instituto de Investigaciones Neurológicas, 2Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina Background: The purpose of this study was to investigate the relationship between cognitive reserve and concentration of Aβ1-42 in the cerebrospinal fluid (CSF of patients with mild cognitive impairment, those with Alzheimer’s disease, and in control subjects. Methods: Thirty-three participants from the Argentina-Alzheimer’s Disease Neuroimaging Initiative database completed a cognitive battery, the Cognitive Reserve Questionnaire (CRQ, and an Argentinian accentuation reading test (TAP-BA as a measure of premorbid intelligence, and underwent lumbar puncture for CSF biomarker quantification. Results: The CRQ significantly correlated with TAP-BA, education, and Aβ1-42. When considering Aβ1-42 levels, significant differences were found in CRQ scores; higher levels of CSF Aβ1-42 were associated with higher CRQ scores. Conclusion: Reduced Aβ1-42 in CSF is considered as evidence of amyloid deposition in the brain. Previous results suggest that individuals with higher education, higher occupational attainment, and participation in leisure activities (cognitive reserve have a reduced risk of developing Alzheimer’s disease. Our results support the notion that enhanced neural activity has a protective role in mild cognitive impairment, as evidenced by higher CSF Aβ1-42 levels in individuals with more cognitive reserve. Keywords: amyloid, biomarkers, cerebrospinal fluid, Alzheimer’s disease 

  15. Does cognitive impairment impact adherence? A systematic review and meta-analysis of the association between cognitive impairment and medication non-adherence in stroke.

    LENUS (Irish Health Repository)

    Rohde, Daniela

    2017-12-08

    While medication adherence is essential for the secondary prevention of stroke, it is often sub-optimal, and can be compromised by cognitive impairment. This study aimed to systematically review and meta-analyse the association between cognitive impairment and medication non-adherence in stroke.

  16. Subcortical vascular cognitive impairment, no dementia : EEG global power independently predicts vascular impairment and brain symmetry index reflects severity of cognitive decline

    NARCIS (Netherlands)

    Sheorajpanday, Rishi V.A.; Mariën, Peter; Nagels, Guy; Weeren, Arie J.T.M.; Saerens, Jos; Van Putten, Michel J.A.M.; de Deyn, Peter P.

    2014-01-01

    Background and Purpose: Vascular cognitive impairment, no dementia (vCIND) is a prevalent and potentially preventable disorder. Clinical presentation of the small-vessel subcortical subtype may be insidious, and differential difficulties can arise with mild cognitive impairment. We investigated EEG

  17. Subcortical Vascular Cognitive Impairment, No Dementia : EEG Global Power Independently Predicts Vascular Impairment and Brain Symmetry Index Reflects Severity of Cognitive Decline

    NARCIS (Netherlands)

    Sheorajpanday, Rishi V. A.; Marien, Peter; Nagels, Guy; Weeren, Arie J. T. M.; Saerens, Jos; van Putten, Michel J. A. M.; De Deyn, Peter P.

    2014-01-01

    Background and Purpose:Vascular cognitive impairment, no dementia (vCIND) is a prevalent and potentially preventable disorder. Clinical presentation of the small-vessel subcortical subtype may be insidious, and differential difficulties can arise with mild cognitive impairment. We investigated EEG

  18. Effects of Tai Chi Chuan on cognition of elderly women with mild cognitive impairment

    Directory of Open Access Journals (Sweden)

    Juliana Yumi Tizon Kasai

    2010-03-01

    Full Text Available Objective: To detect the effects of Tai Chi Chuan practice on the cognition of elderly subjects with Mild Cognitive Impairment. Methods: This is a pilot study with 26 elderly patients (mean age of 74 years with Mild Cognitive Impairment. The evaluation instruments were Subjective Memory Complaint Scale (SMC, Rivermead Behavioral Memory Test (RBMT and Digit Span Forward and Backward (DSF and DSB from the Wechsler Adult Intelligence Scale (WAIS. One group of 13 patients received two weekly 60-minute classes of Tai Chi Chuan (Yang style for 6 consecutive months, and the rest formed the Control Group. The Tai Chi Chuan Group was also evaluated as to learning of the Tai Chi Chuan practical exercises by means of a Specific Learning Test applied after three months of intervention. Results: After six months of intervention, the TCC Group showed significant improvement on the RBMT and the SMC (p = 0.007 and p = 0.023, respectively. The Control Group showed no significant differences in the cognitive tests during the study. There was a significant correlation between the Tai Chi Chuan Learning Test and RBMT (p = 0.008, showing that patients with a better performance in exercising TCC also showed a better performance in memory. Conclusions: In this study, a six-month program of Tai Chi Chuan afforded a significant improvement of the performance of memory complaints in the elderly with Mild Cognitive Impairment. Additional randomized studies with larger samples and more prolonged follow-up are needed to confirm these benefits.

  19. Global-cognitive health metrics: A novel approach for assessing cognition impairment in adult population.

    Directory of Open Access Journals (Sweden)

    Chia-Kuang Tsai

    Full Text Available Dementia is the supreme worldwide burden for welfare and the health care system in the 21st century. The early identification and control of the modifiable risk factors of dementia are important. Global-cognitive health (GCH metrics, encompassing controllable cardiovascular health (CVH and non-CVH risk factors of dementia, is a newly developed approach to assess the risk of cognitive impairment. The components of ideal GCH metrics includes better education, non-obesity, normal blood pressure, no smoking, no depression, ideal physical activity, good social integration, normal glycated hemoglobin (HbA1c, and normal hearing. This study focuses on the association between ideal GCH metrics and the cognitive function in young adults by investigating the Third Health and Nutrition Examination Survey (NHANES III database, which has not been reported previously. A total of 1243 participants aged 17 to 39 years were recruited in this study. Cognitive functioning was evaluated by the simple reaction time test (SRTT, symbol-digit substitution test (SDST, and serial digit learning test (SDLT. Participants with significantly higher scores of GCH metrics had better cognitive performance (p for trend <0.01 in three cognitive tests. Moreover, better education, ideal physical activity, good social integration and normal glycated hemoglobin were the optimistic components of ideal GCH metrics associated with better cognitive performance after adjusting for covariates (p < 0.05 in three cognitive tests. These findings emphasize the importance of a preventive strategy for modifiable dementia risk factors to enhance cognitive functioning during adulthood.

  20. Clinical features, comorbidity, and cognitive impairment in elderly bipolar patients

    Directory of Open Access Journals (Sweden)

    Rise IV

    2016-05-01

    Full Text Available Ida Vikan Rise,1 Josep Maria Haro,2–4 Bjørn Gjervan,5,61Department of Psychiatry, Sorlandet Hospital, Arendal, Norway; 2Research Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; 3Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain; 4CIBERSAM (Centro de Investigación Biomédica En Red de Salud Mental, Madrid, Spain; 5Department of Psychiatry, North-Trondelag Hospital Trust, Levanger, Norway; 6Department of Medicine, Institute of Neuromedicine, Norwegian University of Science and Technology, Trondheim, NorwayIntroduction: Data specific to late-life bipolar disorder (BD are limited. Current research is sparse and present guidelines are not adapted to this group of patients.Objectives: We present a literature review on clinical characteristics, comorbidities, and cognitive impairment in patients with late-life BD. This review discusses common comorbidities that affect BD elders and how aging might affect cognition and treatment.Methods: Eligible studies were identified in MedLine by the Medical Subject Headings terms “bipolar disorder” and “aged”. We only included original research reports published in English between 2012 and 2015.Results: From 414 articles extracted, 16 studies were included in the review. Cardiovascular and respiratory conditions, type II diabetes, and endocrinological abnormalities were observed as highly prevalent. BD is associated with a high suicide risk. Bipolar elderly had an increased risk of dementia and performed worse on cognitive screening tests compared to age-matched controls across different levels of cognition. Despite high rates of medical comorbidity among bipolar elderly, a systematic under-recognition and undertreatment of cardiovascular disease have been suggested.Conclusion: There was a high burden of physical comorbidities and cognitive impairment in late-life BD. Bipolar elderly might be under-recorded and undertreated in primary medical care, indicating that

  1. Extent and neural basis of semantic memory impairment in mild cognitive impairment.

    Science.gov (United States)

    Barbeau, Emmanuel J; Didic, Mira; Joubert, Sven; Guedj, Eric; Koric, Lejla; Felician, Olivier; Ranjeva, Jean-Philippe; Cozzone, Patrick; Ceccaldi, Mathieu

    2012-01-01

    An increasing number of studies indicate that semantic memory is impaired in mild cognitive impairment (MCI). However, the extent and the neural basis of this impairment remain unknown. The aim of the present study was: 1) to evaluate whether all or only a subset of semantic domains are impaired in MCI patients; and 2) to assess the neural substrate of the semantic impairment in MCI patients using voxel-based analysis of MR grey matter density and SPECT perfusion. 29 predominantly amnestic MCI patients and 29 matched control subjects participated in this study. All subjects underwent a full neuropsychological assessment, along with a battery of five tests evaluating different domains of semantic memory. A semantic memory composite Z-score was established on the basis of this battery and was correlated with MRI grey matter density and SPECT perfusion measures. MCI patients were found to have significantly impaired performance across all semantic tasks, in addition to their anterograde memory deficit. Moreover, no temporal gradient was found for famous faces or famous public events and knowledge for the most remote decades was also impaired. Neuroimaging analyses revealed correlations between semantic knowledge and perirhinal/entorhinal areas as well as the anterior hippocampus. Therefore, the deficits in the realm of semantic memory in patients with MCI is more widespread than previously thought and related to dysfunction of brain areas beyond the limbic-diencephalic system involved in episodic memory. The severity of the semantic impairment may indicate a decline of semantic memory that began many years before the patients first consulted.

  2. Strength Training Decreases Inflammation and Increases Cognition and Physical Fitness in Older Women with Cognitive Impairment.

    Science.gov (United States)

    Chupel, Matheus U; Direito, Fábio; Furtado, Guilherme E; Minuzzi, Luciéle G; Pedrosa, Filipa M; Colado, Juan C; Ferreira, José P; Filaire, Edith; Teixeira, Ana M

    2017-01-01

    Introduction: Cognitive impairment that affects older adults is commonly associated with an inflammatory imbalance, resulting in decreased physical fitness. Exercise has been pointed to mitigate immunosenescence and cognitive impairment associated with aging, while increase in physical fitness. However, few studies explored the relationship between changes in cytokine concentration and improvement on cognition due to elastic band strength training. The aim of this study was to investigate the effects of strength training on pro-and anti-inflammatory cytokines, hematological markers and physical fitness of older women with cognitive impairment. Methods: Thirty-three women (82.7 ± 5.7 years old) participated in the study and were divided in two groups: strength exercise training group (ST; n = 16) and Control Group (CG; n = 17) and were evaluated before and after 28 weeks of the exercise program. The CG did not undergo any type of exercise programs. Data for IL-10, TNF-α, IFN-γ, C-Reactive Protein (CRP), white blood counts (WBC), red blood counts (RBC), Mini Mental State Examination (MMSE) and physical fitness tests were analyzed in both moments. Results: IL-10 increased in the ST group without changes in CG. TNF-α and CRP increased in the control group while no changes were observed for IFN-γ in both groups. Strength training decreased leukocyte and lymphocyte counts and increase hemoglobin, mean cell volume and mean cell hemoglobin concentration. The MMSE score increased in strength training group but remained unchanged in the control group. A correlation between the variation of granulocyte counts and the MMSE scores was also observed within the total sample. An improvement in physical fitness was observed with strength training. Conclusion: Resistance exercise promoted better anti-inflammatory balance and physical performance simultaneously with an increase in cognitive profile in older women with cognitive impairment.

  3. A behavioral rehabilitation intervention for amnestic Mild Cognitive Impairment

    Science.gov (United States)

    Greenaway, Melanie C.; Hanna, Sherrie M.; Lepore, Susan W.; Smith, Glenn E.

    2010-01-01

    Individuals with amnestic Mild Cognitive Impairment (MCI) currently have few treatment options for combating their memory loss. The Memory Support System (MSS) is a calendar and organization system with accompanying 6-week curriculum designed for individuals with progressive memory impairment. Ability to learn the MSS and its utility were assessed in 20 participants. Participants were significantly more likely to successfully use the calendar system after training. Ninety-five percent were compliant with the MSS at training completion, and 89% continued to be compliant at follow-up. Outcome measures revealed a medium effect size for improvement in functional ability. Subjects further reported improved independence, self-confidence, and mood. This initial examination of the MSS suggests that with appropriate training, individuals with amnestic MCI can and will use a memory notebook system to help compensate for memory loss. These results are encouraging that the MSS may help with the symptoms of memory decline in MCI. PMID:18955724

  4. Global efficiency of structural networks mediates cognitive control in Mild Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Rok Berlot

    2016-12-01

    Full Text Available Background: Cognitive control has been linked to both the microstructure of individual tracts and the structure of whole-brain networks, but their relative contributions in health and disease remain unclear. Objective: To determine the contribution of both localised white matter tract damage and disruption of global network architecture to cognitive control, in older age and Mild Cognitive Impairment (MCI.Methods: 25 patients with MCI and 20 age, sex and intelligence-matched healthy volunteers were investigated with 3 Tesla structural magnetic resonance imaging (MRI. Cognitive control and episodic memory were evaluated with established tests. Structural network graphs were constructed from diffusion MRI-based whole-brain tractography. Their global measures were calculated using graph theory. Regression models utilized both global network metrics and microstructure of specific connections, known to be critical for each domain, to predict cognitive scores. Results: Global efficiency and the mean clustering coefficient of networks were reduced in MCI. Cognitive control was associated with global network topology. Episodic memory, in contrast, correlated with individual temporal tracts only. Relationships between cognitive control and network topology were attenuated by addition of single tract measures to regression models, consistent with a partial mediation effect. The mediation effect was stronger in MCI than healthy volunteers, explaining 23-36% of the effect of cingulum microstructure on cognitive control performance. Network clustering was a significant mediator in the relationship between tract microstructure and cognitive control in both groups. Conclusions: The status of critical connections and large-scale network topology are both important for maintenance of cognitive control in MCI. Mediation via large-scale networks is more important in patients with MCI than healthy volunteers. This effect is domain-specific, and true for cognitive

  5. The perceptions of cognitively impaired patients and their caregivers of a home telecare system.

    Science.gov (United States)

    Mehrabian, Shima; Extra, Jocelyne; Wu, Ya-Huei; Pino, Maribel; Traykov, Latchezar; Rigaud, Anne-Sophie

    2015-01-01

    Assistive and telecare technologies have been developed to support older adults with cognitive impairments, as well as their caregivers, from their homes. The way potential users perceive telecare and smart home systems plays a key role in their acceptance of this new technology. We evaluate the acceptance of home telecare technologies among patients suffering from cognitive impairment and their caregivers. Prototypes of telecare devices were developed to demonstrate their features and capabilities and to train patients, families, and health care professionals in their use. We conducted semistructured interviews to elicit the perceptions of 30 patients with mild cognitive impairment, 32 patients with Alzheimer's disease, and 30 caregivers, regarding the risks and advantages of home telecare and smart houses. Survey results reflected participants' largely positive reactions to these technologies. Regarding home telecare, the cognitive stimulation program earned the highest proportion of positive responses, followed by the devices' care of emergencies. The participants generally agreed that home telecare and smart houses could significantly improve their quality of life. However, some technical and ethical concerns, such as the way of provision, installation, and monitoring of the systems, were reported to be in need of addressing before implementation of this system.

  6. Cognitive profiling of Parkinson disease patients with mild cognitive impairment and dementia.

    Science.gov (United States)

    Biundo, Roberta; Weis, Luca; Facchini, Silvia; Formento-Dojot, Patrizia; Vallelunga, Annamaria; Pilleri, Manuela; Antonini, Angelo

    2014-04-01

    Prevalence of mild cognitive impairment (MCI) and dementia in Parkinson disease (PD) is variable because different classification criteria are applied and there is lack of consensus about neuropsychological tests and cut-off used for cognitive profiling. Given the important therapeutic consequences for patient management, we aimed at identifying suitable diagnostic cognitive tests and respective screening cut-off values for MCI and dementia in PD (PDD). We evaluated 105 PD patients using an extensive neuropsychological battery categorized as PD without cognitive impairment (PD-CNT) (35%), PD-MCI (47%) and PDD (18%) based on established criteria and calculated Receiver Operating Characteristic (ROC) curves. We found different sensitivity and specificity among neuropsychological tests in detecting PD-MCI and PDD. In particular performance in attention/set shifting, verbal memory and language abilities, discriminated both PD-MCI and PDD from PD-CNT. Abilities involved mainly in semantic retrieval mechanisms discriminated PD-CNT from PD-MCI but also PD-MCI from PDD. Finally deficits in executive and visual-spatial abilities were only affected in PDD. Our data point to an independent and different load of each test in defining different PD cognitive statuses. These findings can help selection of appropriate cognitive batteries in longitudinal studies and definition of stage-specific therapeutic targets. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Effectiveness of the second-stage rehabilitation in stroke patients with cognitive impairment.

    Science.gov (United States)

    Milinavičienė, Eglė; Rastenytė, Daiva; Kriščiūnas, Aleksandras

    2011-01-01

    The aim of this study was to evaluate the recovery of functional status and effectiveness of the second-stage rehabilitation depending on the degree of cognitive impairment in stroke patients. The study sample comprised 226 stroke patients at the Viršužiglis Hospital of rehabilitation, Hospital of Lithuanian University of Health Sciences. Functional status was evaluated with the Functional Independence Measure, cognitive function with the Mini-Mental Status Examination scale, and severity of neurologic condition with the National Institutes of Health Stroke Scale. The patients were divided into 4 study groups based on cognitive impairment: severe, moderate, mild, or no impairment. More than half (53%) of all cases were found to have cognitive impairment, while patients with different degree of cognitive impairment were equally distributed: mild impairment (18%), moderate impairment (17%), and severe impairment (18%). Improvement of functional status was observed in all study groups (Prehabilitation of stroke patients, functional status as well as cognitive and motor skills were improved both in patients with and without cognitive impairment; however, the patients who were diagnosed with severe or moderate cognitive impairment at the beginning of second-stage rehabilitation showed worse neurological and functional status during the whole second-stage rehabilitation than the patients with mild or no cognitive impairment.

  8. Nutraceuticals in cognitive impairment and Alzheimer’s disease

    Directory of Open Access Journals (Sweden)

    Patrizia eMecocci

    2014-06-01

    Full Text Available Several chemical substances belonging to classes of natural dietary origin display protective properties against some age-related diseases including neurodegenerative ones, particularly Alzheimer’s disease (AD. These compounds, known as nutraceuticals, differ structurally, act therefore at different biochemical and metabolic levels and have shown different types of neuroprotective properties. The aim of this review is to summarize data from observational studies, clinical trials and randomized clinical trials (RCTs in humans on the effects of selected nutraceuticals against age-related cognitive impairment and dementia. We report results from studies on flavonoids, some vitamins and other natural substances that have been studied in AD and that might be beneficial for the maintenance of a good cognitive performance. Due to the substantial lack of high-level evidence studies there is no possibility for recommendation of nutraceuticals in dementia-related therapeutic guidelines. Nevertheless, the strong potential for their neuroprotective action warrants further studies in the field.

  9. Effect of Pain and Mild Cognitive Impairment on Mobility

    DEFF Research Database (Denmark)

    Schepker, Caroline A; Leveille, Suzanne G; Pedersen, Mette Merete

    2016-01-01

    OBJECTIVES: To examine the effect of pain and mild cognitive impairment (MCI)-together and separately-on performance-based and self-reported mobility outcomes in older adults in primary care with mild to moderate self-reported mobility limitations. DESIGN: Cross-sectional analysis. SETTING...... Inventory (BPI) were defined as having pain. MCI was defined using age-adjusted scores on a neuropsychological battery. Multivariable linear regression models assessed associations between pain and MCI, together and separately, and mobility performance (habitual gait speed, Short Physical Performance...

  10. Strategic lacunes and their relationship to cognitive impairment in cerebral small vessel disease

    Directory of Open Access Journals (Sweden)

    Philip Benjamin

    2014-01-01

    Conclusion: Lacunes are important predictors of cognitive impairment in SVD. We highlight the importance of spatial distribution, particularly of anteromedial thalamic lacunes which are associated with impaired information processing speed and may mediate cognitive impairment via disruption of connectivity to the prefrontal cortex.

  11. The influence of social support on cognitive impairment in the elderly

    Directory of Open Access Journals (Sweden)

    Abdul Rashid

    2016-08-01

    Full Text Available To determine the influence of social support on cognitive impairment among elderly Malaysians. Methods This cross sectional study was conducted using a representative sample for Penang, Malaysia. The Elderly Cognitive Assessment Questionnaire (ECAQ was used to screen for cognitive impairment and Oslo-3 Social Support Scale (OSS-3 was used to measure social support.

  12. Cognitive rehabilitation of neuropsychological deficits and mild cognitive impairment: A review of the literature

    Directory of Open Access Journals (Sweden)

    Eliane Correa Miotto

    Full Text Available Abstract Neuropsychological rehabilitation is related to the treatment or optimization of disabilities, handicaps and cognitive deficiencies including emotional, behavioral and personality alterations, aiming at the best cognitive, neurobiological and social re-adaptation. Objective: The main aim of this paper is to review scientific studies published over the last five years on cognitive training with rehabilitation, focusing on elderly subjects with cognitive complaints and patients diagnosed with MCI. Methods: Data were generated from Medline, PsychoInfo and EMBASE including publications from 2002 to 2007 using the search terms "Mild Cognitive Impairment", "Cognitive Complaints", "Rehabilitation" and "Intervention Studies". Data collection criteria were restricted to the quality of evidence Class I. Results: Eight articles out of sixty eight previously selected were chosen because of their randomized studies, including techniques of cognitive rehabilitation in patients with cognitive complaints, MCI and neuropsychological training. Conclusions: The studies showing generalization of rehabilitation techniques to practical real life situations and use of an errorless learning approach were considered more effective in terms of maintaining treatment follow up, although further studies are recommended.

  13. Vascular Cognitive Impairment: risk factors and brain MRI correlates

    NARCIS (Netherlands)

    Reijmer, Y.D.

    2012-01-01

    Vascular disease plays an important role in the development of dementia, also in patients diagnosed with Alzheimer’s disease. Risk factors such as hypertension, obesity, and type 2 diabetes, are associated with a two-fold increased risk of cognitive dysfunction and dementia. The development of

  14. Estrogen receptor alpha and risk for cognitive impairment in postmenopausal women

    DEFF Research Database (Denmark)

    Olsen, Line; Rasmussen, Henrik B; Hansen, Thomas

    2006-01-01

    -item Orientation-Memory-Concentration test in postmenopausal Danish women. Hormone replacement therapy, age and executive cognitive ability were examined as covariates for ESR1 gene effects on cognitive impairment. The XbaI polymorphism showed a marginal effect on cognitive abilities (P=0.054) when adjusted......The estrogen receptor alpha (ESR1) gene has been implicated in the process of cognitive impairment in elderly women. In a paired case-control study, we tested whether two ESR1 gene polymorphisms (the XbaI and PvuII sites) are risk factors for cognitive impairment as measured by the six...... for executive cognitive ability. Using a dominant genetic model for the X allele, we found an elevated risk (executive cognitive ability adjusted P=0.033) for cognitive impairment. Hormone replacement therapy also had a borderline effect on cognitive ability (P=0.049) and this effect was reflected in executive...

  15. Psychological well-being in individuals with mild cognitive impairment

    Directory of Open Access Journals (Sweden)

    Gates N

    2014-05-01

    Full Text Available Nicola Gates,1–3 Michael Valenzuela,3 Perminder S Sachdev,1,2,4 Maria A Fiatarone Singh5,61School of Psychiatry, 2Centre for Healthy Brain Ageing (CheBA, University of New South Wales, Sydney, NSW, Australia; 3Regenerative Neuroscience Group, Brain and Mind Research Institute, University of Sydney, Sydney, NSW, Australia; 4Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia; 5Exercise Health and Performance Faculty Research Group, Sydney Medical School, The University of Sydney, Lidcombe, NSW, Australia; 6Hebrew SeniorLife, Boston, MA, and Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USAObjectives: Cognitive impairments associated with aging and dementia are major sources of burden, deterioration in life quality, and reduced psychological well-being (PWB. Preventative measures to both reduce incident disease and improve PWB in those afflicted are increasingly targeting individuals with mild cognitive impairment (MCI at early disease stage. However, there is very limited information regarding the relationships between early cognitive changes and memory concern, and life quality and PWB in adults with MCI; furthermore, PWB outcomes are too commonly overlooked in intervention trials. The purpose of this study was therefore to empirically test a theoretical model of PWB in MCI in order to inform clinical intervention.Methods: Baseline data from a convenience sample of 100 community-dwelling adults diagnosed with MCI enrolled in the Study of Mental Activity and Regular Training (SMART trial were collected. A series of regression analyses were performed to develop a reduced model, then hierarchical regression with the Baron Kenny test of mediation derived the final three-tiered model of PWB.Results: Significant predictors of PWB were subjective memory concern, cognitive function, evaluations of quality of life, and negative affect, with a final model explaining 61% of the variance

  16. A depressive endophenotype of mild cognitive impairment and Alzheimer's disease.

    Directory of Open Access Journals (Sweden)

    Leigh A Johnson

    Full Text Available Alzheimer's disease (AD is a devastating public health problem that affects over 5.4 million Americans. Depression increases the risk of Mild Cognitive Impairment (MCI and AD. By understanding the influence of depression on cognition, the potential exists to identify subgroups of depressed elders at greater risk for cognitive decline and AD. The current study sought to: 1 clinically identify a sub group of geriatric patients who suffer from depression related cognitive impairment; 2 cross validate this depressive endophenotype of MCI/AD in an independent cohort.Data was analyzed from 519 participants of Project FRONTIER. Depression was assessed with the GDS30 and cognition was assessed using the EXIT 25 and RBANS. Five GDS items were used to create the Depressive endophenotype of MCI and AD (DepE. DepE was significantly negatively related to RBANS index scores of Immediate Memory (B=-2.22, SE=.37, p<0.001, visuospatial skills (B=-1.11, SE=0.26, p<0.001, Language (B=-1.03, SE=0.21, p<0.001, Attention (B=-2.56, SE=0.49, p<0.001, and Delayed Memory (B=-1.54, SE = 037, p<0.001, and higher DepE scores were related to poorer executive functioning (EXIT25; B=0.65, SE=0.19, p=0.001. DepE scores significantly increased risk for MCI diagnosis (odds ratio [OR] = 2.04; 95% CI=1.54-2.69. Data from 235 participants in the TARCC (Texas Alzheimer's Research & Care Consortium were analyzed for cross-validation of findings in an independent cohort. The DepE was significantly related to poorer scores on all measures, and a significantly predicted of cognitive change over 12- and 24-months.The current findings suggest that a depressive endophenotype of MCI and AD exists and can be clinically identified using the GDS-30. Higher scores increased risk for MCI and was cross-validated by predicting AD in the TARCC. A key purpose for the search for distinct subgroups of individuals at risk for AD and MCI is to identify novel treatment and preventative opportunities.

  17. Interplay between glutamatergic and GABAergic neurotransmission alterations in cognitive and motor impairment in minimal hepatic encephalopathy.

    Science.gov (United States)

    Llansola, Marta; Montoliu, Carmina; Agusti, Ana; Hernandez-Rabaza, Vicente; Cabrera-Pastor, Andrea; Gomez-Gimenez, Belen; Malaguarnera, Michele; Dadsetan, Sherry; Belghiti, Majedeline; Garcia-Garcia, Raquel; Balzano, Tiziano; Taoro, Lucas; Felipo, Vicente

    2015-09-01

    The cognitive and motor alterations in hepatic encephalopathy (HE) are the final result of altered neurotransmission and communication between neurons in neuronal networks and circuits. Different neurotransmitter systems cooperate to modulate cognitive and motor function, with a main role for glutamatergic and GABAergic neurotransmission in different brain areas and neuronal circuits. There is an interplay between glutamatergic and GABAergic neurotransmission alterations in cognitive and motor impairment in HE. This interplay may occur: (a) in different brain areas involved in specific neuronal circuits; (b) in the same brain area through cross-modulation of glutamatergic and GABAergic neurotransmission. We will summarize some examples of the (1) interplay between glutamatergic and GABAergic neurotransmission alterations in different areas in the basal ganglia-thalamus-cortex circuit in the motor alterations in minimal hepatic encephalopathy (MHE); (2) interplay between glutamatergic and GABAergic neurotransmission alterations in cerebellum in the impairment of cognitive function in MHE through altered function of the glutamate-nitric oxide-cGMP pathway. We will also comment the therapeutic implications of the above studies and the utility of modulators of glutamate and GABA receptors to restore cognitive and motor function in rats with hyperammonemia and hepatic encephalopathy. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Evolution of diagnostic criteria and assessments for Parkinson's disease mild cognitive impairment.

    Science.gov (United States)

    Goldman, Jennifer G; Holden, Samantha K; Litvan, Irene; McKeith, Ian; Stebbins, Glenn T; Taylor, John-Paul

    2018-04-01

    Mild cognitive impairment has gained recognition as a construct and a potential prodromal stage to dementia in both Alzheimer's disease and Parkinson's disease (PD). Although mild cognitive impairment has been recognized in the Alzheimer's disease field, it is a relatively more recent topic of interest in PD. Recent advances include the development of diagnostic criteria for PD mild cognitive impairment to provide more uniform definitions for clinical and research use. Studies reveal that mild cognitive impairment in PD is frequent, but also heterogeneous, with variable clinical presentations, differences in its progression to dementia, and likely differences in underlying pathophysiology. Application of the International Parkinson and Movement Disorder Society PD Mild Cognitive Impairment Task Force diagnostic criteria has provided insights regarding cognitive measures, functional assessments, and other key topics that may require additional refinement. Furthermore, it is important to consider definitions of PD mild cognitive impairment in the landscape of other related Lewy body disorders, such as dementia with Lewy bodies, and in the context of prodromal and early-stage PD. This article examines the evolution of mild cognitive impairment in concept and definition, particularly in PD, but also in related disorders such as Alzheimer's disease and dementia with Lewy bodies; the development and application of International Parkinson and Movement Disorder Society PD Mild Cognitive Impairment diagnostic criteria; and insights and future directions for the field of PD mild cognitive impairment. © 2018 International Parkinson and Movement Disorder Society. © 2018 International Parkinson and Movement Disorder Society.

  19. Subjective cognitive impairment: functional MRI during a divided attention task.

    Science.gov (United States)

    Rodda, J; Dannhauser, T; Cutinha, D J; Shergill, S S; Walker, Z

    2011-10-01

    Individuals with subjective cognitive impairment (SCI) have persistent memory complaints but normal neurocognitive performance. For some, this may represent a pre-mild cognitive impairment (MCI) stage of Alzheimer's disease (AD). Given that attentional deficits and associated brain activation changes are present early in the course of AD, we aimed to determine whether SCI is associated with brain activation changes during attentional processing. Eleven SCI subjects and 10 controls completed a divided attention task during functional magnetic resonance imaging. SCI and control groups did not differ in sociodemographic, neurocognitive or behavioural measures. When group activation during the divided attention task was compared, the SCI group demonstrated increased activation in left medial temporal lobe, bilateral thalamus, posterior cingulate and caudate. This pattern of increased activation is similar to the pattern of decreased activation reported during divided attention in AD and may indicate compensatory changes. These findings suggest the presence of early functional changes in SCI; longitudinal studies will help to further elucidate the relationship between SCI and AD. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  20. Autonomous unobtrusive detection of mild cognitive impairment in older adults.

    Science.gov (United States)

    Akl, Ahmad; Taati, Babak; Mihailidis, Alex

    2015-05-01

    The current diagnosis process of dementia is resulting in a high percentage of cases with delayed detection. To address this problem, in this paper, we explore the feasibility of autonomously detecting mild cognitive impairment (MCI) in the older adult population. We implement a signal processing approach equipped with a machine learning paradigm to process and analyze real-world data acquired using home-based unobtrusive sensing technologies. Using the sensor and clinical data pertaining to 97 subjects, acquired over an average period of three years, a number of measures associated with the subjects' walking speed and general activity in the home were calculated. Different time spans of these measures were used to generate feature vectors to train and test two machine learning algorithms namely support vector machines and random forests. We were able to autonomously detect MCI in older adults with an area under the ROC curve of 0.97 and an area under the precision-recall curve of 0.93 using a time window of 24 weeks. This study is of great significance since it can potentially assist in the early detection of cognitive impairment in older adults.

  1. Interference impacts working memory in mild cognitive impairment

    Directory of Open Access Journals (Sweden)

    Sara Aurtenetxe

    2016-10-01

    Full Text Available Mild cognitive impairment (MCI is considered a transitional stage between healthy aging and dementia, specifically Alzheimer’s disease (AD. The most common cognitive impairment of MCI includes episodic memory loss and difficulties in working memory (WM. Interference can deplete WM, and an optimal WM performance requires an effective control of attentional resources between the memoranda and the incoming stimuli. Difficulties in handling interference lead to forgetting. However, the interplay between interference and WM in MCI is not well understood and needs further investigation. The current study investigated the effect of interference during a WM task in 20 MCIs and 20 healthy elder volunteers. Participants performed a delayed match-to-sample paradigm which consisted in two interference conditions, distraction and interruption, and one control condition without any interference. Results evidenced a disproportionate impact of interference on the WM performance of MCIs, mainly in the presence of interruption. These findings demonstrate that interference, and more precisely interruption, is an important proxy for memory-related deficits in MCI. Thus the current findings reveal novel evidence regarding the causes of WM forgetting in MCI patients, associated with difficulties in the mechanisms of attentional control.

  2. Cognitive functions in preschool children with specific language impairment.

    Science.gov (United States)

    Reichenbach, Katrin; Bastian, Laura; Rohrbach, Saskia; Gross, Manfred; Sarrar, Lea

    2016-07-01

    A growing body of research has focused on executive functions in children with specific language impairment (SLI). However, results show limited convergence, particularly in preschool age. The current neuropsychological study compared performance of cognitive functions focused on executive components and working memory in preschool children with SLI to typically developing controls. Performance on the measures cognitive flexibility, inhibition, processing speed and phonological short-term memory was assessed. The monolingual, Caucasian study sample consisted of 30 children with SLI (Mage = 63.3 months, SD = 4.3 months) and 30 healthy controls (Mage = 62.2 months, SD = 3.7 months). Groups were matched for age and nonverbal IQ. Socioeconomic status of the participating families was included. Children with SLI had significantly poorer abilities of phonological short-term memory than matched controls. A tendency of poorer abilities in the SLI group was found for inhibition and processing speed. We confirmed phonological short-term memory to be a reliable marker of SLI in preschoolers. Our results do not give definite support for impaired executive function in SLI, possibly owing to limited sensitivity of test instruments in this age group. We argue for a standardization of executive function tests for research use. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  3. Phase Measurement of Cognitive Impairment Specific to Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Armstrong, Carol L., E-mail: armstrongc@email.chop.edu [Children' s Hospital of Philadelphia, Philadelphia, Pennsylvania (United States); Department of Pediatrics, Division of Neuro-Oncology, University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania (United States); Shera, David M. [Children' s Hospital of Philadelphia, Philadelphia, Pennsylvania (United States); Department of Pediatrics, Division of Biostatistics and Epidemiology, University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania (United States); Lustig, Robert A. [Department of Radiation Oncology, University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania (United States); Phillips, Peter C. [Children' s Hospital of Philadelphia, Philadelphia, Pennsylvania (United States); Department of Pediatrics, Division of Neurology and Oncology, University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania (United States)

    2012-07-01

    Purpose: Memory impairment is an early-delayed effect of radiotherapy (RT). The prospective longitudinal measurement of the cognitive phase effects from RT was conducted on treated and untreated brain tumor patients. The study design investigated semantic vs. perceptual and visual vs. verbal memory to determine the most disease-specific measure of RT-related changes and understanding of the neurotoxicity from RT to the brain. Methods and Materials: Tests of memory that had previously shown RT-related phasic changes were compared with experimental tests of memory to test hypotheses about cognition targeted to the neural toxicity of RT. The results from 41 irradiated and 29 nonirradiated patients with low-grade, supratentorial tumors were analyzed. The methods controlled for comorbid white matter risk, recurrence, interval after treatment, and age (18-69 years). The effects were examined before RT and at three points after RT to 1 year using a mixed effects model that included interval, group, surgical status, medication use, practice, and individual random effects. Four new tests of memory and other candidate cognitive tests were investigated, and a post hoc analysis of a comprehensive battery of tests was performed to identify the cognitive processes most specific to RT. Results: The RT effects on memory were identified in the treated group only; among the new tests of memory and the complete neurocognitive battery, the RT effects were significant only for delayed recall (p < 0.009) and interval to recognize (p < 0.002). Tumor location was not related to the treatment effect. Memory decline was specific to retrieval of semantic memories; a double dissociation of semantic from perceptual visual memory was demonstrated in the RT group. Conclusions: These results implicate memory dependent on the semantic cortex and the hippocampal memory system. A cognitive measurement that is brief but specific to neural mechanisms is effective and feasible for studies of RT damage.

  4. Phase Measurement of Cognitive Impairment Specific to Radiotherapy

    International Nuclear Information System (INIS)

    Armstrong, Carol L.; Shera, David M.; Lustig, Robert A.; Phillips, Peter C.

    2012-01-01

    Purpose: Memory impairment is an early-delayed effect of radiotherapy (RT). The prospective longitudinal measurement of the cognitive phase effects from RT was conducted on treated and untreated brain tumor patients. The study design investigated semantic vs. perceptual and visual vs. verbal memory to determine the most disease-specific measure of RT-related changes and understanding of the neurotoxicity from RT to the brain. Methods and Materials: Tests of memory that had previously shown RT-related phasic changes were compared with experimental tests of memory to test hypotheses about cognition targeted to the neural toxicity of RT. The results from 41 irradiated and 29 nonirradiated patients with low-grade, supratentorial tumors were analyzed. The methods controlled for comorbid white matter risk, recurrence, interval after treatment, and age (18–69 years). The effects were examined before RT and at three points after RT to 1 year using a mixed effects model that included interval, group, surgical status, medication use, practice, and individual random effects. Four new tests of memory and other candidate cognitive tests were investigated, and a post hoc analysis of a comprehensive battery of tests was performed to identify the cognitive processes most specific to RT. Results: The RT effects on memory were identified in the treated group only; among the new tests of memory and the complete neurocognitive battery, the RT effects were significant only for delayed recall (p < 0.009) and interval to recognize (p < 0.002). Tumor location was not related to the treatment effect. Memory decline was specific to retrieval of semantic memories; a double dissociation of semantic from perceptual visual memory was demonstrated in the RT group. Conclusions: These results implicate memory dependent on the semantic cortex and the hippocampal memory system. A cognitive measurement that is brief but specific to neural mechanisms is effective and feasible for studies of RT

  5. Five-year follow-up of cognitive impairment in older adults with bipolar disorder.

    Science.gov (United States)

    Schouws, Sigfried N T M; Comijs, Hannie C; Dols, Annemieke; Beekman, Aartjan T F; Stek, Max L

    2016-03-01

    To date, cognitive impairment has been thought to be an integral part of bipolar disorder. In clinical staging models, cognitive impairment is one of the hallmarks to define the clinical stage and it plays an important role in identifying the risk factors for progression to later stages of the illness. It is important to examine neurocognitive performance over longer periods to test the hypothesis of neuroprogression of bipolar disorder. A comprehensive neuropsychological test battery was applied at baseline and five years later to 56 euthymic older outpatients with bipolar disorder (mean age = 68.35 years, range: 60-90 years) and to a demographically matched sample of 44 healthy subjects. A group-by-time repeated measures multivariate analysis of variance was performed to measure changes over time for the two groups. The impact of baseline illness characteristics on the intra-individual change in neurocognitive performance within the bipolar disorder group was studied by using logistic regression analysis. At baseline and at follow-up, patients with bipolar disorder performed worse on all neurocognitive measures compared to the matched healthy subjects. However, there was no significant group-by-time interaction between the patients with bipolar disorder and the comparison group. Although older patients with bipolar disorder had worse cognitive function than healthy subjects, they did not have greater cognitive decline over a five-year period. The change in acquired cognitive impairment of patients with bipolar disorder might parallel the cognitive development as seen in normal aging. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Characterizing executive functioning in older special populations: from cognitively elite to cognitively impaired.

    Science.gov (United States)

    de Frias, Cindy M; Dixon, Roger A; Strauss, Esther

    2009-11-01

    The authors examined the structure and invariance of executive functions (EF) across (a) a continuum of cognitive status in 3 groups of older adults (cognitively elite [CE], cognitively normal [CN], and cognitively impaired [CI]) and (b) a 3-year longitudinal interval. Using latent variable analyses (LISREL 8.80), the authors tested 3-factor models ("Inhibition": Hayling [Burgess & Shallice, 1997], Stroop [Regard, 1981]; "Shifting": Brixton [Burgess & Shallice, 1997], Color Trails [D'Elia et al., 1996]; and "Updating": Reading and Computational Span [Salthouse & Babcock, 1991]) and 1-factor models within each group. Participants (initial N = 570; 53-90 years) were from the Victoria Longitudinal Study (Sample 3, Waves 1 and 2). Cross-sectionally, the authors observed a 3-factor EF structure especially for the CE group and 1-factor solutions for all 3 groups. Longitudinally, temporal invariance was supported for the 3-factor model (CE and CN groups) and the 1-factor model (CI and CN groups). Subgroups with higher cognitive status and greater 3-year stability performed better on EF factors than corresponding groups with lower cognitive status and less stability. Studies of EF structure, performance, dedifferentiation, and dysfunction will benefit from considering initial cognitive status and longitudinal stability.

  7. Improving Sensitivity to Detect Mild Cognitive Impairment: Cognitive Load Dual-Task Gait Speed Assessment.

    Science.gov (United States)

    MacAulay, Rebecca K; Wagner, Mark T; Szeles, Dana; Milano, Nicholas J

    2017-07-01

    Longitudinal research indicates that cognitive load dual-task gait assessment is predictive of cognitive decline and thus might provide a sensitive measure to screen for mild cognitive impairment (MCI). However, research among older adults being clinically evaluated for cognitive concerns, a defining feature of MCI, is lacking. The present study investigated the effect of performing a cognitive task on normal walking speed in patients presenting to a memory clinic with cognitive complaints. Sixty-one patients with a mean age of 68 years underwent comprehensive neuropsychological testing, clinical interview, and gait speed (simple- and dual-task conditions) assessments. Thirty-four of the 61 patients met criteria for MCI. Repeated measure analyses of covariance revealed that greater age and MCI both significantly associated with slower gait speed, pscognitive dual task within a clinically representative population. Cognitive load dual-task gait assessment may provide a cost efficient and sensitive measure to detect older adults at high risk of a dementia disorder. (JINS, 2017, 23, 493-501).

  8. Comorbid visual and cognitive impairment: relationship with disability status and self-rated health among older Singaporeans.

    Science.gov (United States)

    Whitson, Heather E; Malhotra, Rahul; Chan, Angelique; Matchar, David B; Østbye, Truls

    2014-05-01

    The objective of this study was to examine the prevalence and consequences of coexisting vision and cognitive impairments in an Asian population. Data were collected from 4508 community-dwelling Singaporeans aged 60 years and older. Cognition was assessed by the Short Portable Mental Status Questionnaire whereas vision, disability, and self-rated health (SRH) were determined by self-report. Vision impairment was present in 902 (18.5%) participants and cognitive impairment in 835 (13.6%), with 232 (3.5%) participants experiencing both impairments. Persons with the comorbidity experienced higher odds of disability than persons with either single impairment. The association of vision impairment with SRH was stronger among women (odds ratio [OR] = 6.79, 95% confidence interval [CI] = 4.64-9.92) than among men (OR = 1.71, 95% CI = 1.21-2.41). Concurrent cognitive and vision impairment is prevalent in older Singaporeans and is associated with high rates of disability. Gender differences in vision-dependent roles may affect the patient-perceived impact of this comorbidity. © 2012 APJPH.

  9. Gait, dual task and history of falls in elderly with preserved cognition, mild cognitive impairment, and mild Alzheimer's disease.

    Science.gov (United States)

    Ansai, Juliana H; Andrade, Larissa P; Rossi, Paulo G; Takahashi, Anielle C M; Vale, Francisco A C; Rebelatto, José R

    Studies with functional and applicable methods and new cognitive demands involving executive function are needed to improve screening, prevention and rehabilitation of cognitive impairment and falls. to identify differences in gait, dual task performances, and history of falls between elderly people with preserved cognition, mild cognitive impairment and mild Alzheimer's disease. A cross-sectional study was conducted. The sample consisted of 40 community-dwelling older adults with preserved cognition, 40 older adults with mild cognitive impairment, and 38 older adults with mild Alzheimer's disease. The assessment consisted of anamneses, gait (measured by the 10-meter walk test), dual task (measured by the Timed Up and Go Test associated with the motor-cognitive task of calling a phone number), and history of falls in the past year. There were no differences among all groups for all variables. However, the Alzheimer's disease Group performed significantly worse in the dual task than the other groups. No item of dual task could distinguish people with preserved cognition from those with mild cognitive impairment. The groups with cognitive impairment included more fallers, and specific characteristics in history of falls between groups were identified. Dual task could distinguish Alzheimer's disease patients specifically from other cognitive profiles. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

  10. Screening for mild cognitive impairment in patients with cardiovascular risk factors

    Directory of Open Access Journals (Sweden)

    Yaneva-Sirakova T

    2017-12-01

    Full Text Available Teodora Yaneva-Sirakova,1 Latchezar Traykov,2 Julia Petrova,2 Ivan Gruev,3 Dobrin Vassilev1 1Department of Internal Medicine, Cardiology Clinic, 2Department of Neurology, Neurology Clinic, Medical University Sofia, 3Cardiology Clinic, National Transport Hospital “Tsar Boris III”, Sofia, Bulgaria Aim: Cardiovascular risk factors are also risk factors for cognitive impairment. They have cumulative effect in target organ damage. The precise correlation between cardiovascular risk factors and cognitive impairment, as well as assessing the extent to which they may affect cognitive functioning, is difficult to ascertain in everyday clinical practice. Quick, specific, and sensitive neuropsychological tests may be useful in screening for, and the prophylaxis of, target organ damage in hypertensive patients.Methods: We gathered full anamnesis, performed physical examination, laboratory screening and echocardiography. These variables were observed at office and home for all patients, For half of the patients, 24-hour ambulatory blood pressure monitoring and neuropsychological testing using Montreal Cognitive Assessment (MoCA, Mini Mental State Examination (MMSE, Geriatric Depression Scale, and the 4-instrumental activities of daily living scale were undertaken.Results: For a period of 2 years, 931 patients were included after applying the inclusion and exclusion criteria. The mean age was 65.90±10.00 years. Two hundred and sixty three patients (85 [32.32%] males and 178 [67.68%] females were reevaluated after a mean follow-up period of 12 months (6–20 months. The mean results of MoCA and MMSE were significantly lower (p<0.05 in the group of patients with poorly controlled blood pressure and cardiovascular risk factors. There was mild to intermediate negative correlation between Systematic Coronary Risk Evaluation (SCORE and the neuropsychological tests’ results.Conclusion: Cardiovascular risk factors play an important role for the development

  11. Perceived stress, disturbed sleep, and cognitive impairments in patients with work-related stress complaints: a longitudinal study.

    Science.gov (United States)

    Eskildsen, Anita; Fentz, Hanne Nørr; Andersen, Lars Peter; Pedersen, Anders Degn; Kristensen, Simon Bang; Andersen, Johan Hviid

    2017-07-01

    Patients on sick leave due to work-related stress often present with cognitive impairments as well as sleep disturbances. The aim of this longitudinal study was to examine the role of perceived stress and sleep disturbances in the longitudinal development in cognitive impairments in a group of patients with prolonged work-related stress (N = 60) during a period of 12 months following initial professional care-seeking. Objective cognitive impairments (neuropsychological tests) were measured on two occasions - at initial professional care-seeking and at 12-month follow-up. Questionnaires on perceived stress, sleep disturbances, and cognitive complaints were completed seven times during the 12 months which facilitated multilevel analysis with segregation of within-person (change) and between-person (baseline level) components of the time-varying predictors (perceived stress and sleep disturbances). Change in perceived stress was associated with concurrent and subsequent change in self-reported cognitive complaints over the period of 12 months and to a lesser extent the change in performance on neuropsychological tests of processing speed from baseline to 12-month follow-up. Change in sleep disturbances was also associated with concurrent and subsequent change in self-reported cognitive complaints over the 12 months but not with change on neuropsychological test performance. Although the mechanism behind the improvement in cognitive impairments in patients with work-related stress should be further explored in future studies, the results could suggest that improvement in cognitive impairments is partly mediated by decreasing levels of perceived stress and, to a lesser extent, decreasing levels of sleep disturbances. Lay summary This study examines the role of perceived stress and sleep disturbances in respect to the development of cognitive impairments (e.g. memory and concentration) in a group of patients with work-related stress. We found that change in

  12. [Screening methods for mild cognitive impairment in primary care].

    Science.gov (United States)

    Freire Pérez, Alberto

    2017-06-01

    Diagnosis of mild cognitive impairment (MCI) is always clinical and screening methods only indicate that the patient has a higher risk of this condition. In MCI, there is a slight decline in some cognitive abilities that does not affect activities of daily living and therefore does not produce social or occupational disability. The definitive diagnosis of MCI requires a considerable time investment that is very rarely possible to provide in primary care (PC) consultations. Hence the need for PC physicians to employ rapid and simple screening methods (brief cognitive assessment -BCA-) that allow objective identification of patients likely to have MCI in a few minutes. This article reviews the BCA tools that can truly be applied in less than 10 minutes. The phototest is a brief screening tool that is easy to use and interpret by physicians and is well accepted by patients. Consequently, it is one of the most useful tests in PC for screening of both MCI and dementia. In addition to BCA, instrumental activities of daily living scales should also be applied to differentiate MCI from dementia. Copyright © 2017 Sociedad Española de Geriatría y Gerontología. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Cognitive impairments in common and rare somatic diseases

    Directory of Open Access Journals (Sweden)

    Natalia Vyacheslavovna Pizova

    2015-01-01

    Full Text Available The paper gives an update on the pathogenesis, clinical presentation, and pathomorphology of cognitive impairments (CIs in different autoimmune, endocrine, and infectious diseases, such as systemic lupus erythematosus, Sjögren's syndrome, BehНet's disease, primary angiitis of the central nervous system, polyarteritis nodosa, cryoglobulinemic vasculitis, hypothyroidism, herpetic lesion, and neurosyphilis. These patients are observed to have ischemic-hypoxic brain damage, the causes of which are free radical-induced cell injury, oxidative stress, excitation toxicity, cell necrosis and/or apoptosis, inflammation and immune disease, molecular sequestration, and cell death. There is enhanced imbalance in the pro-oxidant and antioxidant systems as cerebrovascular insufficiency progresses; as this takes place, the nerve cells are most susceptible to the induction of free radical reactions. In these cases, antioxidants that block the effects of free radicals and may potentially improve brain perfusion, by assisting the coupling of neurons and vessels, are first-choice drugs. To improve the cognitive status and to prevent the progression of CIs, it is important to build a cognitive reserve in a patient; this is largely favored by the preservation of a proactive approach to life and social bonds, as well as intellectual work.

  14. Caregivers in China: Knowledge of Mild Cognitive Impairment

    Science.gov (United States)

    Dai, Baozhen; Mao, Zongfu; Mei, John; Levkoff, Sue; Wang, Huali; Pacheco, Misty; Wu, Bei

    2013-01-01

    This study aimed to examine the experience and knowledge of mild cognitive impairment (MCI) among Chinese family caregivers of individuals with MCI. The sample was recruited from memory clinics in Zhongnan Hospital in Wuhan, China. In-depth semi-structured interviews were used. Thirteen family members of individuals diagnosed with MCI participated in the study. Data analysis revealed three themes: 1) initial recognition of cognitive decline; 2) experience of the diagnosis of MCI; 3) perception of cognitive decline as a normal part of aging. While family members recognized the serious consequences of memory loss (e.g. getting lost), they would typically not take their family members to see a doctor until something specific triggered their access to the medical care system. The Chinese traditional perception of dementia as part of normal aging may serve to lessen the stigma of individuals with MCI, while the term “laonian chidai” which literally translates to “stupid, demented elderly” may exacerbate the stigma associated with individuals with MCI. It is suggested that family members’ worries may be relieved by improving their access to accurate knowledge of the disease, community-based and institutional care services, and culturally appropriately words are needed for MCI. PMID:23326541

  15. Caregivers in China: knowledge of mild cognitive impairment.

    Directory of Open Access Journals (Sweden)

    Baozhen Dai

    Full Text Available This study aimed to examine the experience and knowledge of mild cognitive impairment (MCI among Chinese family caregivers of individuals with MCI. The sample was recruited from memory clinics in Zhongnan Hospital in Wuhan, China. In-depth semi-structured interviews were used. Thirteen family members of individuals diagnosed with MCI participated in the study. Data analysis revealed three themes: 1 initial recognition of cognitive decline; 2 experience of the diagnosis of MCI; 3 perception of cognitive decline as a normal part of aging. While family members recognized the serious consequences of memory loss (e.g. getting lost, they would typically not take their family members to see a doctor until something specific triggered their access to the medical care system. The Chinese traditional perception of dementia as part of normal aging may serve to lessen the stigma of individuals with MCI, while the term "laonian chidai" which literally translates to "stupid, demented elderly" may exacerbate the stigma associated with individuals with MCI. It is suggested that family members' worries may be relieved by improving their access to accurate knowledge of the disease, community-based and institutional care services, and culturally appropriately words are needed for MCI.

  16. Protective effect of rutin on cognitive impairment caused by phenytoin

    Science.gov (United States)

    Dubey, Shagun; Ganeshpurkar, Aditya; Bansal, Divya; Dubey, Nazneen

    2015-01-01

    Objective: To study the effect of the co-administration of phenytoin (PHT) and rutin in comparison with PHT and piracetam (PIM) on seizure control, cognitive, and motor functions in mice. Materials and Methods: Increasing current electroshock seizure (ICES) test was used to evaluate the effect of the co-administration of PHT and PIM on convulsions. Cognitive functions in mice were assessed by a spontaneous alternation in behavior on a plus maze while motor functions were screened using rolling roller apparatus and by counting the number of arms entries on a plus maze. Brain acetyl-cholinesterase (AChE) activity was also estimated. Statistical Analysis: The expression of data was done as mean ± standard error of the mean. The normally distributed data were subjected to one-way ANOVA followed by Dunnett's test. P < 0.05 was considered significant. Results: The study showed that rutin when co-administered with PHT, significantly reversed PHT-induced reduction in spontaneous alternation without altering the efficacy of PHT against ICES, in both acute and chronic studies. Further, it also reversed PHT-induced increase in AChE activity. Conclusion: Rutin alleviated the PHT-induced cognitive impairment without compromising its antiepileptic efficacy. PMID:26729954

  17. Designing for Mild Cognitive Impairment (MCI): A Design Anthropological Perspective.

    Science.gov (United States)

    Collier, Guy; Kayes, Nicola; Reay, Stephen; Bill, Amanda

    2017-01-01

    This paper will present a design anthropological perspective on an ongoing project called 'Living Well with Mild Cognitive Impairment (MCI)'. The project explores how people with MCI (and their families) manage and respond to changes in their memory and thinking. One of the primary aims of this project is to design an online resource that will support people to 'Live Well' within the context of possible cognitive decline. The resource was originally proposed to function as a kind of online community, where users could both share and learn about home-grown strategies for managing the cognitive changes associated with MCI in everyday life. Much of this project has been guided by the methodological approach of design anthropology, which encourages project researchers and stakeholders to critically examine underlying assumptions and conceptual frameworks, which in this case revolve around the disputed MCI category. In this paper we will provide some background to the Living Well project before highlighting a number of key insights attained from design anthropology.

  18. Long-Term Cognitive Impairment after Hospitalization for Community-Acquired Pneumonia: a Prospective Cohort Study.

    Science.gov (United States)

    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 cognitive domains affected one-third of patients ≥ 65 years old and 20% of younger patients, and another third of survivors had mild cognitive impairment.

  19. Cardiorespiratory Fitness and Cognitive Function are Positively Related Among Participants with Mild and Subjective Cognitive Impairment.

    Science.gov (United States)

    Stuckenschneider, Tim; Askew, Christopher David; Rüdiger, Stefanie; Cristina Polidori, Maria; Abeln, Vera; Vogt, Tobias; Krome, Andreas; Olde Rikkert, Marcel; Lawlor, Brian; Schneider, Stefan

    2018-01-01

    By 2030, about 74 million people will be diagnosed with dementia, and many more will experience subjective (SCI) or mild cognitive impairment (MCI). As physical inactivity has been identified to be a strong modifiable risk factor for dementia, exercise and physical activity (PA) may be important parameters to predict the progression from MCI to dementia, but might also represent disease trajectory modifying strategies for SCI and MCI. A better understanding of the relationship between activity, fitness, and cognitive function across the spectrum of MCI and SCI would provide an insight into the potential utility of PA and fitness as early markers, and treatment targets to prevent cognitive decline. 121 participants were stratified into three groups, late MCI (LMCI), early MCI (EMCI), and SCI based on the Montreal Cognitive Assessment (MoCA). Cognitive function assessments also included the Trail Making Test A+B, and a verbal fluency test. PA levels were evaluated with an interviewer-administered questionnaire (LAPAQ) and an activity monitor. An incremental exercise test was performed to estimate cardiorespiratory fitness and to determine exercise capacity relative to population normative data. ANCOVA revealed that LMCI subjects had the lowest PA levels (LAPAQ, p = 0.018; activity monitor, p = 0.041), and the lowest exercise capacity in relation to normative values (p = 0.041). Moreover, a modest correlation between MoCA and cardiorespiratory fitness (r = 0.25; p cognitive impairment PA and exercise capacity might present a marker for the risk of further cognitive decline. This finding warrants further investigation using longitudinal cohort studies.

  20. Biochemical Markers of Physical Exercise on Mild Cognitive Impairment and Dementia

    DEFF Research Database (Denmark)

    Jensen, Camilla Steen; Hasselbalch, Steen Gregers; Waldemar, Gunhild

    2015-01-01

    BACKGROUND: The cognitive effects of physical exercise in patients with dementia disorders or mild cognitive impairment have been examined in various studies; however the biochemical effects of exercise from intervention studies are largely unknown. The objective of this systematic review...

  1. Episodic-like memory impairment in subtypes of mild cognitive impairment

    Czech Academy of Sciences Publication Activity Database

    Vlček, Kamil; Laczó, J.; Vajnerová, O.; Ort, Michael; Vyhnálek, M.; Hort, J.

    2007-01-01

    Roč. 2007, - (2007), s. 69-69 ISSN 0792-8483. [Annual general meeting of the European Brain and Behaviour Society /39./. 15.09.2007-19.09.2007, Trieste] R&D Projects: GA ČR(CZ) GA309/05/0693; GA ČR(CZ) GA309/06/1231; GA MŠk(CZ) 1M0517 Institutional research plan: CEZ:AV0Z50110509 Keywords : cpo1 * mild cognitive impairment * spatial navigation * Alzheimer 's disease Subject RIV: FH - Neurology

  2. Serum Matrix Metalloproteinase-9 and Cognitive Impairment After Acute Ischemic Stroke.

    Science.gov (United States)

    Zhong, Chongke; Bu, Xiaoqing; Xu, Tan; Guo, Libing; Wang, Xuemei; Zhang, Jintao; Cui, Yong; Li, Dong; Zhang, Jianhui; Ju, Zhong; Chen, Chung-Shiuan; Chen, Jing; Zhang, Yonghong; He, Jiang

    2018-01-06

    The impact of serum matrix metalloproteinases-9 (MMP-9) on cognitive impairment after ischemic stroke is unclear. We aimed to investigate the association between serum MMP-9 in the short-term acute phase of ischemic stroke and cognitive impairment at 3 months. Our study was based on a subsample from the CATIS (China Antihypertensive Trial in Acute Ischemic Stroke); a total of 558 patients with serum MMP-9 levels from 7 of 26 participating sites of the trial were included in this analysis. Cognitive impairment severity was categorized as severe, mild, or none (Mini-Mental State Examination score, impairment was defined as a score of impairment and 153 (27.4%) had severe cognitive impairment at 3 months. After adjustment for age, National Institutes of Health stroke score, education, and other covariates, the odds ratio for the highest quartile of serum MMP-9 compared with the lowest quartile was 3.20 (95% confidence interval, 1.87-5.49) for cognitive impairment. Multiple-adjusted spline regression model showed a linear association between MMP-9 levels and cognitive impairment ( P impairment was defined by Montreal Cognitive Assessment score. Increased serum MMP-9 levels in the short-term phase of ischemic stroke were associated with 3-month cognitive impairment, independently of established risk factors. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  3. The Effect of Psychological Distress and Personality Traits on Cognitive Performances and the Risk of Dementia in Patients with Mild Cognitive Impairment

    NARCIS (Netherlands)

    Ramakers, I.H.G.B.; Honings, S.T.H.; Ponds, R.W.; Aalten, P.; Kohler, S.; Verhey, F.R.J.; Visser, P.J.

    2015-01-01

    Background: The relation between psychological distress, personality traits, and cognitive decline in cognitively impaired patients remains unclear. Objective: To investigate the effect of psychological distress and personality traits on cognitive functioning in subjects with mild cognitive

  4. Sarcopenia and cognitive impairment in elderly women: results from the EPIDOS cohort.

    Science.gov (United States)

    Abellan van Kan, Gabor; Cesari, Matteo; Gillette-Guyonnet, Sophie; Dupuy, Charlotte; Nourhashémi, Fati; Schott, Anne-Marie; Beauchet, Olivier; Annweiler, Cédric; Vellas, Bruno; Rolland, Yves

    2013-03-01

    common pathophysiological pathways are shared between age-related body composition changes and cognitive impairment. evaluate whether current operative sarcopenia definitions are associated with cognition in community-dwelling older women. cross-sectional analyses. a total of 3,025 women aged 75 years and older. body composition (assessed by dual energy X-ray absorptiometry) and cognition (measured by short portable mental status questionnaire) were obtained in all participants. Multivariate logistic regression models assessed the association of six operative definitions of sarcopenia with cognitive impairment. Gait speed (GS, measured over a 6-meter track at usual pace) and handgrip strength (HG, measured by a hand-held dynamometer) were considered additional factors of interest. a total of 492 (16.3%) women were cognitively impaired. The prevalence of sarcopenia ranged from 3.3 to 18.8%. No sarcopenia definition was associated with cognitive impairment after controlling for potential confounders. To proof consistency, the analyses were performed using GS and HG, two well-established predictors of cognitive impairment. Low GS [odds ratio (OR) 2.42, 95% confidence interval (CI) 1.72-3.40] and low HG (OR: 1.81, 95% CI: 1.33-2.46) were associated with cognitive impairment. no significant association was evidenced between different operative sarcopenia definitions and cognitive impairment. The study suggests that the association between physical performance and cognitive impairment in not mediated by sarcopenia.

  5. Alteration patterns of brain glucose metabolism: comparisons of healthy controls, subjective memory impairment and mild cognitive impairment.

    Science.gov (United States)

    Song, In-Uk; Choi, Eun Kyoung; Oh, Jin Kyoung; Chung, Yong-An; Chung, Sung-Woo

    2016-01-01

    Some groups have focused on the detection and management of subjective memory impairment (SMI) as the stage that precedes mild cognitive impairment (MCI). However, there have been few clinical studies that have examined biomarkers of SMI to date. To investigate the differences in glucose metabolism as a prodromal marker of dementia in patients with SMI, MCI, and healthy controls using brain F-18 fluoro-2-deoxyglucose positron emission tomography (FDG-PET). Sixty-eight consecutive patients with SMI, 47 patients with MCI, and 42 age-matched healthy subjects were recruited. All subjects underwent FDG-PET and detailed neuropsychological testing. FDG-PET images were analyzed using the statistical parametric mapping (SPM) program. FDG-PET analysis showed glucose hypometabolism in the periventricular regions of patients with SMI and in the parietal, precentral frontal, and periventricular regions of patients with MCI compared with healthy controls. Interestingly, hypometabolism on FDG-PET was noted in the parietal and precentral frontal regions in MCI patients compared to SMI patients. The results suggest that hypometabolism in the periventricular regions as seen on FDG-PET may play a role as a predictive biomarker of pre-dementia, and the extension of reduced glucose metabolism into parietal regions likely reflects progression of cognitive deterioration. © The Foundation Acta Radiologica 2014.

  6. Face-Name Associative Recognition Deficits in Subjective Cognitive Decline and Mild Cognitive Impairment.

    Science.gov (United States)

    Polcher, Alexandra; Frommann, Ingo; Koppara, Alexander; Wolfsgruber, Steffen; Jessen, Frank; Wagner, Michael

    2017-01-01

    There is a need for more sensitive neuropsychological tests to detect subtle cognitive deficits emerging in the preclinical stage of Alzheimer's disease (AD). Associative memory is a cognitive function supported by the hippocampus and affected early in the process of AD. We developed a short computerized face-name associative recognition test (FNART) and tested whether it would detect memory impairment in memory clinic patients with mild cognitive impairment (MCI) and subjective cognitive decline (SCD). We recruited 61 elderly patients with either SCD (n = 32) or MCI (n = 29) and 28 healthy controls (HC) and compared performance on FNART, self-reported cognitive deterioration in different domains (ECog-39), and, in a reduced sample (n = 46), performance on the visual Paired Associates Learning of the CANTAB battery. A significant effect of group on FNART test performance in the total sample was found (p < 0.001). Planned contrasts indicated a significantly lower associative memory performance in the SCD (p = 0.001, d = 0.82) and MCI group (p < 0.001, d = 1.54), as compared to HCs, respectively. The CANTAB-PAL discriminated only between HC and MCI, possibly because of reduced statistical power. Adjusted for depression, performance on FNART was significantly related to ECog-39 Memory in SCD patients (p = 0.024) but not in MCI patients. Associative memory is substantially impaired in memory clinic patients with SCD and correlates specifically with memory complaints at this putative preclinical stage of AD. Further studies will need to examine the predictive validity of the FNART in SCD patients with regard to longitudinal (i.e., conversion to MCI/AD) and biomarker outcomes.

  7. Clinical and Cognitive Phenotype of Mild Cognitive Impairment Evolving to Dementia with Lewy Bodies

    Directory of Open Access Journals (Sweden)

    Annachiara Cagnin

    2015-11-01

    Full Text Available Objective: The aim of this study was to determine which characteristics could better distinguish dementia with Lewy bodies (DLB from Alzheimer's disease (AD at the mild cognitive impairment (MCI stage, with particular emphasis on visual space and object perception abilities. Methods: Fifty-three patients with mild cognitive deficits that were eventually diagnosed with probable DLB (MCI-DLB: n = 25 and AD (MCI-AD: n = 28 at a 3-year follow-up were retrospectively studied. At the first visit, the patients underwent cognitive assessment including the Qualitative Scoring Mini Mental State Examination Pentagon Test and the Visual Object and Space Perception Battery. The Neuropsychiatric Inventory Questionnaire, Unified Parkinson's Disease Rating Scale (UPDRS and questionnaires for cognitive fluctuations and sleep disorders were also administered. Results: The best clinical predictor of DLB was the presence of soft extrapyramidal signs (mean UPDRS score: 4.04 ± 5.9 detected in 72% of patients, followed by REM sleep behavior disorder (60% and fluctuations (60%. Wrong performances in the pentagon's number of angles were obtained in 44% of DLB and 3.7% of AD patients and correlated with speed of visual attention. Executive functions, visual attention and visuospatial abilities were worse in DLB, while verbal episodic memory impairment was greater in AD. Deficits in the visual-perceptual domain were present in both MCI-DLB and AD. Conclusions: Poor performance in the pentagon's number of angles is specific of DLB and correlates with speed of visual attention. The dorsal visual stream seems specifically more impaired in MCI-DLB with respect to the ventral visual stream, the latter being involved in both DLB and AD. These cognitive features, associated with subtle extrapyramidal signs, should alert clinicians to a diagnostic hypothesis of DLB.

  8. Prefrontal activation may predict working-memory training gain in normal aging and mild cognitive impairment

    NARCIS (Netherlands)

    Vermeij, A.; Kessels, R.P.C.; Heskamp, L.; Simons, E.M.F.; Dautzenberg, P.LJ.; Claassen, J.A.H.R.

    2017-01-01

    Cognitive training has been shown to result in improved behavioral performance in normal aging and mild cognitive impairment (MCI), yet little is known about the neural correlates of cognitive plasticity, or about individual differences in responsiveness to cognitive training. In this study, 21

  9. Potential effects of current drug therapies on cognitive impairment in patients with type 2 diabetes.

    Science.gov (United States)

    Palleria, Caterina; Leporini, Christian; Maida, Francesca; Succurro, Elena; De Sarro, Giovambattista; Arturi, Franco; Russo, Emilio

    2016-07-01

    Type 2 diabetes mellitus is a complex metabolic disease that can cause serious damage to various organs. Among the best-known complications, an important role is played by cognitive impairment. Impairment of cognitive functioning has been reported both in type 1 and 2 diabetes mellitus. While this comorbidity has long been known, no major advances have been achieved in clinical research; it is clear that appropriate control of blood glucose levels represents the best current (although unsatisfactory) approach in the prevention of cognitive impairment. We have focused our attention on the possible effect on the brain of antidiabetic drugs, despite their effects on blood glucose levels, giving a brief rationale on the mechanisms (e.g. GLP-1, BDNF, ghrelin) that might be involved. Indeed, GLP-1 agonists are currently clinically studied in other neurodegenerative diseases (i.e. Parkinson's and Alzheimer's disease); furthermore, also other antidiabetic drugs have proven efficacy in preclinical studies. Overall, promising results are already available and finding new intervention strategies represents a current need in this field of research. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Positive effects of combined cognitive and physical exercise training on cognitive function in older adults with mild cognitive impairment or dementia : A meta-analysis

    NARCIS (Netherlands)

    Karssemeijer, Esther G. A.; Aaronson, Justine A.; Bossers, Willem J.; Smits, Tara; Rikkert, Marcel G. M. Olde; Kessels, Roy P. C.

    2017-01-01

    Combined cognitive and physical exercise interventions have potential to elicit cognitive benefits in older adults with mild cognitive impairment (MCI) or dementia. This meta-analysis aims to quantify the overall effect of these interventions on global cognitive functioning in older adults with MCI

  11. Positive effects of combined cognitive and physical exercise training on cognitive function in older adults with mild cognitive impairment or dementia : A meta-analysis

    NARCIS (Netherlands)

    Karssemeijer, Esther G. A.; Aaronson, Justine A.; Bossers, Willem J.; Smits, Tara; Rikkert, Marcel G. M. Olde; Kessels, Roy P. C.

    Combined cognitive and physical exercise interventions have potential to elicit cognitive benefits in older adults with mild cognitive impairment (MCI) or dementia. This meta-analysis aims to quantify the overall effect of these interventions on global cognitive functioning in older adults with MCI

  12. Memory Binding Test Predicts Incident Amnestic Mild Cognitive Impairment.

    Science.gov (United States)

    Mowrey, Wenzhu B; Lipton, Richard B; Katz, Mindy J; Ramratan, Wendy S; Loewenstein, David A; Zimmerman, Molly E; Buschke, Herman

    2016-07-14

    The Memory Binding Test (MBT), previously known as Memory Capacity Test, has demonstrated discriminative validity for distinguishing persons with amnestic mild cognitive impairment (aMCI) and dementia from cognitively normal elderly. We aimed to assess the predictive validity of the MBT for incident aMCI. In a longitudinal, community-based study of adults aged 70+, we administered the MBT to 246 cognitively normal elderly adults at baseline and followed them annually. Based on previous work, a subtle reduction in memory binding at baseline was defined by a Total Items in the Paired (TIP) condition score of ≤22 on the MBT. Cox proportional hazards models were used to assess the predictive validity of the MBT for incident aMCI accounting for the effects of covariates. The hazard ratio of incident aMCI was also assessed for different prediction time windows ranging from 4 to 7 years of follow-up, separately. Among 246 controls who were cognitively normal at baseline, 48 developed incident aMCI during follow-up. A baseline MBT reduction was associated with an increased risk for developing incident aMCI (hazard ratio (HR) = 2.44, 95% confidence interval: 1.30-4.56, p = 0.005). When varying the prediction window from 4-7 years, the MBT reduction remained significant for predicting incident aMCI (HR range: 2.33-3.12, p: 0.0007-0.04). Persons with poor performance on the MBT are at significantly greater risk for developing incident aMCI. High hazard ratios up to seven years of follow-up suggest that the MBT is sensitive to early disease.

  13. Phase measurement of cognitive impairment specific to radiotherapy.

    Science.gov (United States)

    Armstrong, Carol L; Shera, David M; Lustig, Robert A; Phillips, Peter C

    2012-07-01

    Memory impairment is an early-delayed effect of radiotherapy (RT). The prospective longitudinal measurement of the cognitive phase effects from RT was conducted on treated and untreated brain tumor patients. The study design investigated semantic vs. perceptual and visual vs. verbal memory to determine the most disease-specific measure of RT-related changes and understanding of the neurotoxicity from RT to the brain. Tests of memory that had previously shown RT-related phasic changes were compared with experimental tests of memory to test hypotheses about cognition targeted to the neural toxicity of RT. The results from 41 irradiated and 29 nonirradiated patients with low-grade, supratentorial tumors were analyzed. The methods controlled for comorbid white matter risk, recurrence, interval after treatment, and age (18-69 years). The effects were examined before RT and at three points after RT to 1 year using a mixed effects model that included interval, group, surgical status, medication use, practice, and individual random effects. Four new tests of memory and other candidate cognitive tests were investigated, and a post hoc analysis of a comprehensive battery of tests was performed to identify the cognitive processes most specific to RT. The RT effects on memory were identified in the treated group only; among the new tests of memory and the complete neurocognitive battery, the RT effects were significant only for delayed recall (p measurement that is brief but specific to neural mechanisms is effective and feasible for studies of RT damage. Copyright © 2012 Elsevier Inc. All rights reserved.

  14. The neuroimaging approach to the assessment of mild cognitive impairment

    International Nuclear Information System (INIS)

    Lucignani, Giovanni

    2006-01-01

    Imaging techniques, including emission tomography and magnetic resonance imaging, are progressively being exploited for the classification and prognostic evaluation (indispensable for possible treatments) of mild cognitive impairment (MCI). The main traits of MCI and unsolved issues in its assessment are discussed in two review articles by Feldman and Jacova from the Division of Neurology, Dept. of Medicine, Clinic for Alzheimer Disease and Related Disorders, University of British Columbia, in Vancouver, Canada [1] and Chong and Sahadevan from the Department of Geriatric Medicine, Tan Tock Seng Hospital, Jalan Tan Tock Seng, Singapore [2]. Because MCI has different presentations in terms of the type and degree of cognitive deficits observed, several clinical subtypes of MCI besides the amnestic form have now been recognised and characterised on the basis of deficits in different cognitive domains, either in isolation or in combination with amnesia. The different subtypes of MCI suggest that MCI has a heterogeneous nature, with several possible causes that lead to the same symptoms. This is a field in evolution, and a uniform diagnostic classification of MCI has not yet been accomplished. Lopez et al. from the Departments of Neurology and Psychiatry, University of Pittsburgh, School of Medicine,Pittsburgh, Pennsylvania, USA [3] point out that the classification of MCI subtypes is useful to improve prediction of the subsequent risk of dementia and the type of dementia, and that the manner in which MCI subjects are classified into subgroups has implications for the cognitive profile of the group and thus for our inferences about the aetiology and possible clinical course of the disorder

  15. The neuroimaging approach to the assessment of mild cognitive impairment

    Energy Technology Data Exchange (ETDEWEB)

    Lucignani, Giovanni [University of Milan and Unit of Molecular Imaging, Division of Radiation Therapy, European Institute of Oncology, Institute of Radiological Sciences, Milan (Italy)

    2006-06-15

    Imaging techniques, including emission tomography and magnetic resonance imaging, are progressively being exploited for the classification and prognostic evaluation (indispensable for possible treatments) of mild cognitive impairment (MCI). The main traits of MCI and unsolved issues in its assessment are discussed in two review articles by Feldman and Jacova from the Division of Neurology, Dept. of Medicine, Clinic for Alzheimer Disease and Related Disorders, University of British Columbia, in Vancouver, Canada [1] and Chong and Sahadevan from the Department of Geriatric Medicine, Tan Tock Seng Hospital, Jalan Tan Tock Seng, Singapore [2]. Because MCI has different presentations in terms of the type and degree of cognitive deficits observed, several clinical subtypes of MCI besides the amnestic form have now been recognised and characterised on the basis of deficits in different cognitive domains, either in isolation or in combination with amnesia. The different subtypes of MCI suggest that MCI has a heterogeneous nature, with several possible causes that lead to the same symptoms. This is a field in evolution, and a uniform diagnostic classification of MCI has not yet been accomplished. Lopez et al. from the Departments of Neurology and Psychiatry, University of Pittsburgh, School of Medicine,Pittsburgh, Pennsylvania, USA [3] point out that the classification of MCI subtypes is useful to improve prediction of the subsequent risk of dementia and the type of dementia, and that the manner in which MCI subjects are classified into subgroups has implications for the cognitive profile of the group and thus for our inferences about the aetiology and possible clinical course of the disorder.

  16. Frontal lobe hypoperfusion in mild cognitive impairment patients

    International Nuclear Information System (INIS)

    Liao, S.Q.; Chung, C.P.; Liao, Y.C.; Wang, P.N.; Lee, Y.C.; Liu, H.C.; Liu, R.S.

    2004-01-01

    Objective: Mild cognitive impairement (MCI) refers to the clinical state of individuals who are memory impaired subjectively but are functioning well and do not meet the criteria of dementia. MCI subjects have a high risk of progressing to Alzheimer's disease (AD). It is important to detect the earliest evidence of AD for clinicians to recognize the high risk subjects and to implicate the therapy. The aim of this study was to assess the early change of regional cerebral blood flow (rCBF) in MCI with high risk of AD by SPECT. Methods: Subjects complained of memory impairment with normal cognitive function and intact daily activities were enrolled. Each patient underwent 99mTc-HMPAO SPECT at the time of initial evaluation. Patients were followed for one to five years. The diagnosis of AD was based on the criteria of the Alzheimer's Disease and Related Disorders Association. There were 8 patients (4 males, 4 females; age range, 64-80 yrs; mean, 73.5 yrs) progressing to AD within one year. Ten gender and age matched normal control subjects (NC) were also included. The SPECT images were analyzed by using SPM 99. The image data were transformed into a standard stereotactic space, using a 12-parameter linear and 2x2x2 nonlinear spatial normalization with the template image. Group comparisons of the SPECT images between the 8 rapid AD converters and 10 NCs were performed on a voxel-by-voxel basis using t test. The t statistics was transformed to a normal statistic yielding a Z score for every voxel. Results: In 8 rapid AD converters, rCBF in the right medial frontal gyms (Brodmann area 10; BA 10), anterior cingulated gyms (BA 32) and middle frontal gyms (BA 46) was significantly lower than in NCs (p<0.001). The neuropsychological performances of these 8 cases revealed decrement in short-term memory, mental manipulation and list-generation frequency. Conclusions: rCBF is decreased in right medial frontal, anterior cingulated and middle frontal gyms in MCI patients who

  17. Developing team cognition: A role for simulation

    Science.gov (United States)

    Fernandez, Rosemarie; Shah, Sachita; Rosenman, Elizabeth D.; Kozlowski, Steve W. J.; Parker, Sarah Henrickson; Grand, James A.

    2016-01-01

    SUMMARY STATEMENT Simulation has had a major impact in the advancement of healthcare team training and assessment. To date, the majority of simulation-based training and assessment focuses on the teamwork behaviors that impact team performance, often ignoring critical cognitive, motivational, and affective team processes. Evidence from team science research demonstrates a strong relationship between team cognition and team performance and suggests a role for simulation in the development of this team-level construct. In this article we synthesize research from the broader team science literature to provide foundational knowledge regarding team cognition and highlight best practices for using simulation to target team cognition. PMID:28704287

  18. Validation of the Cuban Version of Addenbrooke's Cognitive Examination-Revised for Screening Mild Cognitive Impairment.

    Science.gov (United States)

    Broche-Pérez, Yunier; López-Pujol, Héctor Alejandro

    2017-01-01

    The diagnostic accuracy of the Cuban version of the revised Addenbrooke's Cognitive Examination (ACE-R) in identifying mild cognitive impairment (MCI) in comparison with the Mini-Mental State Examination (MMSE) was assessed. The Cuban ACE-R was administered to a group of 129 elderly subjects (92 cognitively healthy and 37 subjects with MCI). The t tests for independent samples were used to compare scores of different psychometric scales between groups, and effect sizes (Cohen's d) were calculated. Cronbach's coefficient α was used to evaluate the reliability of psychometric scales. The validity of ACE-R to screen for MCI was assessed by receiver operating characteristic (ROC) curves. The Cuban ACE-R had reliable internal consistency (Cronbach's coefficient α = 0. 879). The optimal cut-off score for ACE-R for detecting MCI was 84/85. The sensitivity and specificity of ACE-R to screen for MCI was superior to those of MMSE. The area under the ROC curve of the Cuban ACE-R was much larger than that of MMSE (0.93 and 0.63) for detecting MCI. The Cuban ACE-R is a valid screening tool for detecting cognitive impairment. It is more sensitive and accurate in screening for MCI than MMSE. © 2018 S. Karger AG, Basel.

  19. Callosal degeneration topographically correlated with cognitive function in amnestic mild cognitive impairment and Alzheimer's disease dementia.

    Science.gov (United States)

    Wang, Pei-Ning; Chou, Kun-Hsien; Chang, Ni-Jung; Lin, Ker-Neng; Chen, Wei-Ta; Lan, Gong-Yau; Lin, Ching-Po; Lirng, Jiing-Feng

    2014-04-01

    Degeneration of the corpus callosum (CC) is evident in the pathogenesis of Alzheimer's disease (AD). However, the correlation of microstructural damage in the CC on the cognitive performance of patients with amnestic mild cognitive impairment (aMCI) and AD dementia is undetermined. We enrolled 26 normal controls, 24 patients with AD dementia, and 40 single-domain aMCI patients with at least grade 1 hippocampal atrophy and isolated memory impairment. Diffusion tensor imaging (DTI) with fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (DA), and radial diffusivity (DR) were measured. The entire CC was parcellated based on fiber trajectories to specific cortical Brodmann areas using a probabilistic tractography method. The relationship between the DTI measures in the subregions of the CC and cognitive performance was examined. Although the callosal degeneration in the patients with aMCI was less extended than in the patients with AD dementia, degeneration was already exhibited in several subregions of the CC at the aMCI stage. Scores of various neuropsychological tests were correlated to the severity of microstructural changes in the subregional CC connecting to functionally corresponding cortical regions. Our results confirm that CC degeneration is noticeable as early as the aMCI stage of AD and the disconnection of the CC subregional fibers to the corresponding Brodmann areas has an apparent impact on the related cognitive performance. Copyright © 2013 Wiley Periodicals, Inc.

  20. SCREENING FOR POSTSTROKE COGNITIVE IMPAIRMENT VIA MINI MENTAL STATE EXAMINATION AND MONTREAL COGNITIVE ASSESSMENT SCALE

    Directory of Open Access Journals (Sweden)

    Mirena Valkova

    2012-10-01

    Full Text Available Objective: The aim of our study is to examine cognitive performance after mild stroke via Mini Mental State Examination (MMSE and Montreal cognitive assessment scale (MoCA and to compare the results.Material and methods: We examined 54 patients with mild stroke (aged 52 to 72 (mean 63.17, SD 5.96; 34 males and 20 females and 54 controls, adjusted by age, sex and education level. All subjects were tested via MMSE (Bulgarian version and MoCa (Bulgarian version. Data was collected in the single step model at the 90th day after stroke incident for patients and at the day of obtaining informed consent for controls. Results: Patients have poorer performance on both MMSE and MoCa than controls. MoCa has comparatively good discriminative validity and sensitivity.Conclusions: Although MMSE is one of the classical screening tools for cognitive impairment widely used in Bulgaria, other screening tools should not be ignored. On the basis of our results, MoCa is also a good screening instrument, especially for poststroke cognitive impairment.

  1. Cognitive decline and amyloid accumulation in patients with mild cognitive impairment

    DEFF Research Database (Denmark)

    Koivunen, Jaana; Karrasch, Mira; Scheinin, Noora M

    2012-01-01

    Background/Aims: The relationship between baseline (11)C-Pittsburgh compound B ((11)C-PIB) uptake and cognitive decline during a 2-year follow-up was studied in 9 patients with mild cognitive impairment (MCI) who converted to Alzheimer's disease (AD) and 7 who remained with MCI. Methods: (11)C......: At baseline, there were statistically significant differences in (11)C-PIB uptake, but not in cognitive test performances between the converters and nonconverters. Memory and executive function declined only in the converters during follow-up. In the converters, lower baseline frontal (11)C-PIB uptake...... was associated with faster decline in verbal learning. Higher baseline uptake in the caudate nucleus was related to faster decline in memory consolidation, and higher temporal uptake was associated with decline in executive function. Conclusion: Higher (11)C-PIB uptake in the caudate nucleus and temporal lobe...

  2. Neural Correlates for Intrinsic Motivational Deficits of Schizophrenia; Implications for Therapeutics of Cognitive Impairment

    Science.gov (United States)

    Takeda, Kazuyoshi; Sumiyoshi, Tomiki; Matsumoto, Madoka; Murayama, Kou; Ikezawa, Satoru; Matsumoto, Kenji; Nakagome, Kazuyuki

    2018-01-01

    The ultimate goal of the treatment of schizophrenia is recovery, a notion related to improvement of cognitive and social functioning. Cognitive remediation therapies (CRT), one of the most effective cognition enhancing methods, have been shown to moderately improve social functioning. For this purpose, intrinsic motivation, related to internal values such as interest and enjoyment, has been shown to play a key role. Although the impairment of intrinsic motivation is one of the characteristics of schizophrenia, its neural mechanisms remain unclear. This is related to the lack of feasible measures of intrinsic motivation, and its response to treatment. According to the self-determination theory (SDT), not only intrinsic motivation, but extrinsic motivation has been reported to enhance learning and memory in healthy subjects to some extent. This finding suggests the contribution of different types of motivation to potentiate the ability of the CRT to treat cognitive impairment of schizophrenia. In this paper, we provide a review of psychological characteristics, assessment methods, and neural correlates of intrinsic motivation in healthy subjects and patients with schizophrenia. Particularly, we focus on neuroimaging studies of intrinsic motivation, including our own. These considerations are relevant to enhancement of functional outcomes of schizophrenia. PMID:29922185

  3. Neural Correlates for Intrinsic Motivational Deficits of Schizophrenia; Implications for Therapeutics of Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Kazuyoshi Takeda

    2018-06-01

    Full Text Available The ultimate goal of the treatment of schizophrenia is recovery, a notion related to improvement of cognitive and social functioning. Cognitive remediation therapies (CRT, one of the most effective cognition enhancing methods, have been shown to moderately improve social functioning. For this purpose, intrinsic motivation, related to internal values such as interest and enjoyment, has been shown to play a key role. Although the impairment of intrinsic motivation is one of the characteristics of schizophrenia, its neural mechanisms remain unclear. This is related to the lack of feasible measures of intrinsic motivation, and its response to treatment. According to the self-determination theory (SDT, not only intrinsic motivation, but extrinsic motivation has been reported to enhance learning and memory in healthy subjects to some extent. This finding suggests the contribution of different types of motivation to potentiate the ability of the CRT to treat cognitive impairment of schizophrenia. In this paper, we provide a review of psychological characteristics, assessment methods, and neural correlates of intrinsic motivation in healthy subjects and patients with schizophrenia. Particularly, we focus on neuroimaging studies of intrinsic motivation, including our own. These considerations are relevant to enhancement of functional outcomes of schizophrenia.

  4. Writing Impairments in Japanese Patients with Mild Cognitive Impairment and with Mild Alzheimer's Disease

    Directory of Open Access Journals (Sweden)

    Atsuko Hayashi

    2015-09-01

    Full Text Available Background/Aims: We investigated writing abilities in patients with the amnestic type of mild cognitive impairment (aMCI and mild Alzheimer's disease (AD. To examine the earliest changes in writing function, we used writing tests for both words and sentences with different types of Japanese characters (Hiragana, Katakana, and Kanji. Methods: A total of 25 aMCI patients, 38 AD patients, and 22 healthy controls performed writing to dictation for Kana and Kanji words, copied Kanji words, and wrote in response to a picture story task. Analysis of variance was used to test the subject group effects on the scores in the above writing tasks. Results: For the written Kanji words, the mild AD group performed worse than the aMCI group and the controls, but there was no difference between the aMCI group and the controls. For the picture story writing task, the mild AD and aMCI groups performed worse than the controls, but the difference between the AD and the aMCI groups was not significant. Conclusions: The mild AD group showed defects in writing Kanji characters, and the aMCI group showed impairments in narrative writing. Our study suggests that narrative writing, which demands complex integration of multiple cognitive functions, can be used to detect the subtle writing deficits in aMCI patients.

  5. Writing Impairments in Japanese Patients with Mild Cognitive Impairment and with Mild Alzheimer's Disease.

    Science.gov (United States)

    Hayashi, Atsuko; Nomura, Hiroshi; Mochizuki, Ruriko; Ohnuma, Ayumu; Kimpara, Teiko; Suzuki, Kyoko; Mori, Etsuro

    2015-01-01

    We investigated writing abilities in patients with the amnestic type of mild cognitive impairment (aMCI) and mild Alzheimer's disease (AD). To examine the earliest changes in writing function, we used writing tests for both words and sentences with different types of Japanese characters (Hiragana, Katakana, and Kanji). A total of 25 aMCI patients, 38 AD patients, and 22 healthy controls performed writing to dictation for Kana and Kanji words, copied Kanji words, and wrote in response to a picture story task. Analysis of variance was used to test the subject group effects on the scores in the above writing tasks. For the written Kanji words, the mild AD group performed worse than the aMCI group and the controls, but there was no difference between the aMCI group and the controls. For the picture story writing task, the mild AD and aMCI groups performed worse than the controls, but the difference between the AD and the aMCI groups was not significant. The mild AD group showed defects in writing Kanji characters, and the aMCI group showed impairments in narrative writing. Our study suggests that narrative writing, which demands complex integration of multiple cognitive functions, can be used to detect the subtle writing deficits in aMCI patients.

  6. Cognitively impaired elderly exhibit insulin resistance and no memory improvement with infused insulin.

    Science.gov (United States)

    Morris, Jill K; Vidoni, Eric D; Mahnken, Jonathan D; Montgomery, Robert N; Johnson, David K; Thyfault, John P; Burns, Jeffrey M

    2016-03-01

    Insulin resistance is a risk factor for Alzheimer's disease (AD), although its role in AD etiology is unclear. We assessed insulin resistance using fasting and insulin-stimulated measures in 51 elderly subjects with no dementia (ND; n = 37) and with cognitive impairment (CI; n = 14). CI subjects exhibited either mild CI or AD. Fasting insulin resistance was measured using the homeostatic model assessment of insulin resistance (HOMA-IR). Insulin-stimulated glucose disposal was assessed using the hyperinsulinemic-euglycemic clamp to calculate glucose disposal rate into lean mass, the primary site of insulin-stimulated glucose disposal. Because insulin crosses the blood-brain barrier, we also assessed whether insulin infusion would improve verbal episodic memory compared to baseline. Different but equivalent versions of cognitive tests were administered in counterbalanced order in the basal and insulin-stimulated state. Groups did not differ in age or body mass index. Cognitively impaired subjects exhibited greater insulin resistance as measured at fasting (HOMA-IR; ND: 1.09 [1.1] vs. CI: 2.01 [2.3], p = 0.028) and during the hyperinsulinemic clamp (glucose disposal rate into lean mass; ND: 9.9 (4.5) vs. AD 7.2 (3.2), p = 0.040). Cognitively impaired subjects also exhibited higher fasting insulin compared to ND subjects, (CI: 8.7 [7.8] vs. ND: 4.2 [3.8] μU/mL; p = 0.023) and higher fasting amylin (CI: 24.1 [39.1] vs. 8.37 [14.2]; p = 0.050) with no difference in fasting glucose. Insulin infusion elicited a detrimental effect on one test of verbal episodic memory (Free and Cued Selective Reminding Test) in both groups (p insulin resistance was observed in cognitively impaired subjects compared to ND controls, insulin infusion did not improve memory. Furthermore, a significant correlation between HOMA-IR and glucose disposal rate was present only in ND (p = 0.0002) but not in cognitively impaired (p = 0.884) subjects, indicating potentially important

  7. Rivastigmine for refractory REM behavior disorder in mild cognitive impairment.

    Science.gov (United States)

    Brunetti, Valerio; Losurdo, Anna; Testani, Elisa; Lapenta, Leonardo; Mariotti, Paolo; Marra, Camillo; Rossini, Paolo Maria; Della Marca, Giacomo

    2014-03-01

    Mild Cognitive Impairment (MCI) and REM Behavior Disorder (RBD) are both associated with a degeneration of ponto-medullary cholinergic pathways. We conducted a placebo-controlled, cross-over pilot trial of Rivastigmine (RVT) in 25 consecutive patients with MCI, who presented RBD refractory to conventional first-line treatments (melatonin up to 5 mg/day and clonazepam up to 2 mg/day). RVT treatment was followed by a significant reduction of RBD episodes when compared with placebo. Our data suggest that, in MCI patients with RBD resistant to conventional therapies (muscle relaxants benzodiazepines or melatonin,) treatment with RVT may induce a reduction in the frequency of RBD episodes compared to placebo.

  8. Role of cognitive enhancement in schizophrenia

    Directory of Open Access Journals (Sweden)

    Galletly C

    2014-05-01

    Full Text Available Cherrie Galletly Discipline of Psychiatry, School of Medicine, The University of Adelaide, Ramsay Health Care (SA Mental Health Services, Northern Adelaide Local Health Network, Adelaide, SA, Australia Abstract: Schizophrenia is a severe and usually chronic psychiatric disorder characterized by dysfunction in many domains. Hallucinations, delusions, and behavioral disturbances are prominent symptoms of the illness, and are appropriately a focus for treatment, but less attention is given to the cognitive deficits that are also typically found in schizophrenia. Whilst impairments in learning, memory, and executive function have been recognized for many decades, deficits in more subtle aspects of cognition have been recognized more recently. These include biases in the evaluation of information and difficulties with emotional and social cognition. Cognitive deficits make a substantial contribution to real-world function, and improving cognition has the potential to improve social and vocational outcomes. This review provides an overview of potential treatments for cognitive deficits in schizophrenia, including medications, psychological therapies, and neurostimulation. Despite optimal medication and case management, many people with schizophrenia do not achieve full remission. There is sufficient evidence to encourage widespread adoption of at least some of the current cognitive enhancement strategies. However, individual patients differ in terms of their symptoms, patterns of cognitive dysfunction, medication response, and social and occupational situations. Considerable work is therefore needed to personalize cognitive remediation to maximize the benefits. However, at present, these methods are underutilized, even when applied in a universal manner where all subjects receive the same treatment. The barriers to wider availability of these treatments are discussed. Keywords: schizophrenia, psychosis, cognition, treatment, remediation

  9. Semantic memory and depressive symptoms in patients with subjective cognitive decline, mild cognitive impairment, and Alzheimer's disease.

    Science.gov (United States)

    Lehrner, J; Coutinho, G; Mattos, P; Moser, D; Pflüger, M; Gleiss, A; Auff, E; Dal-Bianco, P; Pusswald, G; Stögmann, E

    2017-07-01

    Semantic memory may be impaired in clinically recognized states of cognitive impairment. We investigated the relationship between semantic memory and depressive symptoms (DS) in patients with cognitive impairment. 323 cognitively healthy controls and 848 patients with subjective cognitive decline (SCD), mild cognitive impairment (MCI), and Alzheimer's disease (AD) dementia were included. Semantic knowledge for famous faces, world capitals, and word vocabulary was investigated. Compared to healthy controls, we found a statistically significant difference of semantic knowledge in the MCI groups and the AD group, respectively. Results of the SCD group were mixed. However, two of the three semantic memory measures (world capitals and word vocabulary) showed a significant association with DS. We found a difference in semantic memory performance in MCI and AD as well as an association with DS. Results suggest that the difference in semantic memory is due to a storage loss rather than to a retrieval problem.

  10. Modeling of cognitive impairment by disease duration in multiple sclerosis: a cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Anat Achiron

    Full Text Available BACKGROUND/AIMS: Large-scale population studies measuring rates and dynamics of cognitive decline in multiple sclerosis (MS are lacking. In the current cross-sectional study we evaluated the patterns of cognitive impairment in MS patients with disease duration of up to 30 years. METHODS: 1,500 patients with MS were assessed by a computerized cognitive battery measuring verbal and non-verbal memory, executive function, visual spatial perception, verbal function, attention, information processing speed and motor skills. Cognitive impairment was defined as below one standard deviation (SD and severe cognitive impairment as below 2SD for age and education matched healthy population norms. RESULTS: Cognitive performance in our cohort was poorer than healthy population norms. The most frequently impaired domains were information processing speed and executive function. MS patients with secondary-progressive disease course performed poorly compared with clinically isolated syndrome, relapsing-remitting and primary progressive MS patients. By the fifth year from disease onset, 20.9% of patients performed below the 1SD cutoff for impairment, p=0.005, and 6.0% performed below the 2SD cutoff for severe cognitive impairment, p=0.002. By 10 years from onset 29.3% and 9.0% of patients performed below the 1SD and 2SD cutoffs, respectively, p=0.0001. Regression modeling suggested that cognitive impairment may precede MS onset by 1.2 years. CONCLUSIONS: The rates of cognitive impairment in this large sample of MS patients were lower than previously reported and severe cognitive impairment was evident only in a relatively small group of patients. Cognitive impairment differed significantly from expected normal distribution only at five years from onset, suggesting the existence of a therapeutic window during which patients may benefit from interventions to maintain cognitive health.

  11. Acetylcholine receptors in dementia and mild cognitive impairment

    Energy Technology Data Exchange (ETDEWEB)

    Sabri, Osama; Kendziorra, Kai [University of Leipzig, Department of Nuclear Medicine, Leipzig (Germany); Wolf, Henrike; Gertz, Hermann-Josef [University of Leipzig, Department of Psychiatry, Leipzig (Germany); Brust, Peter [Institute of Interdisciplinary Isotope Research, Leipzig (Germany)

    2008-03-15

    To clarify whether changes in the cholinergic transmission occur early in the course of Alzheimer's disease (AD), we carried out positron emission tomography (PET) with the radioligand 2-[{sup 18}F]F-A-85380, which is supposed to be specific for {alpha}4{beta}2 nicotinic acetylcholine receptors (nAChRs). We included patients with moderate to severe AD and patients with amnestic mild cognitive impairment (MCI), presumed to present preclinical AD. Both patients with AD and MCI showed significant reductions in {alpha}4{beta}2 nAChRs in brain regions typically affected by AD pathology. These findings indicate that a reduction in {alpha}4{beta}2 nAChRs occurs during early symptomatic stages of AD. The {alpha}4{beta}2 nAChR availability in these regions correlated with the severity of cognitive impairment, indicating a stage sensitivity of the {alpha}4{beta}2 nAChR status. Together, our results provide evidence for the potential of 2-[{sup 18}]F-A-85380 nAChR PET in the diagnosis of patients at risk for AD. Because of the extraordinary long acquisition time with 2-[{sup 18}F]F-A-85380, we developed the new {alpha}4{beta}2 nAChR-specific radioligands (+)- and (-)-[{sup 18}F]norchloro-fluoro-homoepibatidine (NCFHEB) and evaluated them preclinically. (-)-[{sup 18}F]NCFHEB shows twofold higher brain uptake and significantly shorter acquisition times. Therefore, (-)-[{sup 18}F]NCFHEB should be a suitable radioligand for larger clinical investigations. (orig.)

  12. Prognostic value of posteromedial cortex deactivation in mild cognitive impairment.

    Directory of Open Access Journals (Sweden)

    Jeffrey R Petrella

    2007-10-01

    Full Text Available Normal subjects deactivate specific brain regions, notably the posteromedial cortex (PMC, during many tasks. Recent cross-sectional functional magnetic resonance imaging (fMRI data suggests that deactivation during memory tasks is impaired in Alzheimer's disease (AD. The goal of this study was to prospectively determine the prognostic significance of PMC deactivation in mild cognitive impairment (MCI.75 subjects (34 MCI, 13 AD subjects and 28 controls underwent baseline fMRI scanning during encoding of novel and familiar face-name pairs. MCI subjects were followed longitudinally to determine conversion to AD. Regression and analysis of covariance models were used to assess the effect of PMC activation/deactivation on conversion to dementia as well as in the longitudinal change in dementia measures. At longitudinal follow up of up to 3.5 years (mean 2.5+/-0.79 years, 11 MCI subjects converted to AD. The proportion of deactivators was significantly different across all groups: controls (79%, MCI-Nonconverters (73%, MCI-converters (45%, and AD (23% (p<0.05. Mean PMC activation magnitude parameter estimates, at baseline, were negative in the control (-0.57+/-0.12 and MCI-Nonconverter (-0.33+/-0.14 groups, and positive in the MCI-Converter (0.37+/-0.40 and AD (0.92+/-0.30 groups. The effect of diagnosis on PMC deactivation remained significant after adjusting for age, education and baseline Mini-Mental State Exam (p<0.05. Baseline PMC activation magnitude was correlated with change in dementia ratings from baseline.Loss of physiological functional deactivation in the PMC may have prognostic value in preclinical AD, and could aid in profiling subgroups of MCI subjects at greatest risk for progressive cognitive decline.

  13. Neuropsychiatric symptoms in Vascular Cognitive Impairment: A systematic review

    Directory of Open Access Journals (Sweden)

    Chan Tiel

    Full Text Available Neuropsychiatric symptoms or Behavioral and Psychological Symptoms of Dementia (BPSD are common and invariably appear at some point during the course of the disease, mediated both by cerebrovascular disease and neurodegenerative processes. Few studies have compared the profiles of BPSD in Vascular Cognitive Impairment (VCI of different subtypes (subcortical or cortical and clinical stages (Vascular Cognitive Impairment No Dementia [VaCIND] and Vascular Dementia [VaD].Objective:To review the BPSD associated with different subtypes and stages of VCI using the Neuropsychiatric Inventory (NPI.Methods:Medline, Scielo and Lilacs databases were searched for the period January 2000 to December 2014, with the key words: "BPSD AND Vascular Dementia, "NPI AND Vascular Dementia" and "NPI AND VCI. Qualitative analysis was performed on studies evaluating BPSD in VCI, using the Neuropsychiatric Inventory (NPI.Results:A total of 82 studies were retrieved of which 13 were eligible and thus included. Among the articles selected, 4 compared BPSD in Subcortical Vascular Dementia (SVaD versus Cortical-Subcortical Vascular Dementia (CSVaD, 3 involved comparisons between SVaD and VaCIND, 1 study analyzed differences between CSVaD and VaCIND, while 5 studies assessed BPSD in CSVaD. Subcortical and Cortical-Subcortical VaD were associated predominantly with Apathy and Depression. VaCIND may present fewer behavioral symptoms than VaD.Conclusion:The profile of BPSD differs for different stages of VCI. Determining the most prevalent BPSD in VCI subtypes might be helpful for improving early diagnosis and management of these symptoms.

  14. One-carbon metabolism, cognitive impairment and CSF measures of Alzheimer pathology: homocysteine and beyond.

    Science.gov (United States)

    Dayon, Loïc; Guiraud, Seu Ping; Corthésy, John; Da Silva, Laeticia; Migliavacca, Eugenia; Tautvydaitė, Domilė; Oikonomidi, Aikaterini; Moullet, Barbara; Henry, Hugues; Métairon, Sylviane; Marquis, Julien; Descombes, Patrick; Collino, Sebastiano; Martin, François-Pierre J; Montoliu, Ivan; Kussmann, Martin; Wojcik, Jérôme; Bowman, Gene L; Popp, Julius

    2017-06-17

    Hyperhomocysteinemia is a risk factor for cognitive decline and dementia, including Alzheimer disease (AD). Homocysteine (Hcy) is a sulfur-containing amino acid and metabolite of the methionine pathway. The interrelated methionine, purine, and thymidylate cycles constitute the one-carbon metabolism that plays a critical role in the synthesis of DNA, neurotransmitters, phospholipids, and myelin. In this study, we tested the hypothesis that one-carbon metabolites beyond Hcy are relevant to cognitive function and cerebrospinal fluid (CSF) measures of AD pathology in older adults. Cross-sectional analysis was performed on matched CSF and plasma collected from 120 older community-dwelling adults with (n = 72) or without (n = 48) cognitive impairment. Liquid chromatography-mass spectrometry was performed to quantify one-carbon metabolites and their cofactors. Least absolute shrinkage and selection operator (LASSO) regression was initially applied to clinical and biomarker measures that generate the highest diagnostic accuracy of a priori-defined cognitive impairment (Clinical Dementia Rating-based) and AD pathology (i.e., CSF tau phosphorylated at threonine 181 [p-tau181]/β-Amyloid 1-42 peptide chain [Aβ 1-42 ] >0.0779) to establish a reference benchmark. Two other LASSO-determined models were generated that included the one-carbon metabolites in CSF and then plasma. Correlations of CSF and plasma one-carbon metabolites with CSF amyloid and tau were explored. LASSO-determined models were stratified by apolipoprotein E (APOE) ε4 carrier status. The diagnostic accuracy of cognitive impairment for the reference model was 80.8% and included age, years of education, Aβ 1-42 , tau, and p-tau181. A model including CSF cystathionine, methionine, S-adenosyl-L-homocysteine (SAH), S-adenosylmethionine (SAM), serine, cysteine, and 5-methyltetrahydrofolate (5-MTHF) improved the diagnostic accuracy to 87.4%. A second model derived from plasma included cystathionine

  15. Topiramate and cognitive impairment: evidence and clinical implications.

    Science.gov (United States)

    Mula, Marco

    2012-12-01

    Topiramate is an antiepileptic drug (AED) with multiple mechanisms of action that has been shown to be effective in a number of neuropsychiatric disorders. However, cognitive dysfunction is frequently observed in such patients, often representing a relevant challenge in their management. Moreover, there is a long-held recognition that AEDs may profoundly affect cognitive functions. This paper reviews available data on cognitive adverse events in patients with neurological disorders treated with topiramate, discussing the role of different contributing factors such as the pharmacological properties of the drug, the specific features of the brain disorder, and other variables pertinent to the discussion. All studies agree that up to 10% of patients may complain of treatment-emergent adverse events on cognition. Such problems occur early during treatment (i.e. within 6 weeks) and emerge in a dose-dependent fashion, suggesting that such prevalence may be significantly reduced using the drug in monotherapy and adopting individualized doses and titration schedules. The magnitude of the problem is generally mild to moderate and the subjective perception of the patient needs to be taken into account. In fact, apart from language problems, data are not conclusive. Comparisons with new AEDs are limited to levetiracetam and lamotrigine, in both cases generally disfavoring topiramate, while data regarding first-generation AEDs show clear differences only for verbal fluency.

  16. Intranasal Insulin Therapy for Cognitive Impairment and Neurodegeneration: Current State of the Art

    Science.gov (United States)

    de la Monte, Suzanne M.

    2015-01-01

    Introduction Growing evidence supports the concept that insulin resistance plays an important role in the pathogenesis of cognitive impairment and neurodegeneration, including in Alzheimer's disease (AD). The metabolic hypothesis has led to the development and utilization of insulin- and insulin agonist-based treatments. Therapeutic challenges faced include the ability to provide effective treatments that do not require repeated injections and also minimize potentially hazardous off-target effects. Areas covered This review covers the role of intra-nasal insulin therapy for cognitive impairment and neurodegeneration, particularly Alzheimer's disease. The literature reviewed focuses on data published within the past 5 years as this field is evolving rapidly. The author provides evidence that brain insulin resistance is an important and early abnormality in Alzheimer's disease, and that increasing brain supply and utilization of insulin improves cognition and memory. Emphasis was placed on discussing outcomes of clinical trials and interpreting discordant results to clarify the benefits and limitations of intranasal insulin therapy. Expert Opinion Intranasal insulin therapy can efficiently and directly target the brain to support energy metabolism, myelin maintenance, cell survival, and neuronal plasticity, which begin to fail in the early stages of neurodegeneration. Efforts must continue toward increasing the safety, efficacy, and specificity of intranasal insulin therapy. PMID:24215447

  17. Abstract Word Definition in Patients with Amnestic Mild Cognitive Impairment

    Science.gov (United States)

    Kim, Soo Ryon; Baek, Min Jae; Kim, HyangHee

    2015-01-01

    The aims of this study were to investigate concrete and abstract word definition ability (1) between patients with amnestic mild cognitive impairment (aMCI) and normal adults and (2) between the aMCI subtypes (i.e., amnestic single-domain MCI and amnestic multidomain MCI; asMCI and amMCI) and normal controls. The 68 patients with aMCI (29 asMCI and 39 amMCI) and 93 age- and education-matched normal adults performed word definition tasks composed of five concrete (e.g., train) and five abstract nouns (e.g., jealousy). Task performances were analyzed on total score, number of core meanings, and number of supplementary meanings. The results were as follows. First, the aMCI patients scored significantly poorer than the normal controls in only abstract word definition. Second, both subtypes of aMCI performed worse than the controls in only abstract word definition. In conclusion, a definition task of abstract rather than concrete concepts may provide richer information to show semantic impairment of aMCI. PMID:26347214

  18. Abstract Word Definition in Patients with Amnestic Mild Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Soo Ryon Kim

    2015-01-01

    Full Text Available The aims of this study were to investigate concrete and abstract word definition ability (1 between patients with amnestic mild cognitive impairment (aMCI and normal adults and (2 between the aMCI subtypes (i.e., amnestic single-domain MCI and amnestic multidomain MCI; asMCI and amMCI and normal controls. The 68 patients with aMCI (29 asMCI and 39 amMCI and 93 age- and education-matched normal adults performed word definition tasks composed of five concrete (e.g., train and five abstract nouns (e.g., jealousy. Task performances were analyzed on total score, number of core meanings, and number of supplementary meanings. The results were as follows. First, the aMCI patients scored significantly poorer than the normal controls in only abstract word definition. Second, both subtypes of aMCI performed worse than the controls in only abstract word definition. In conclusion, a definition task of abstract rather than concrete concepts may provide richer information to show semantic impairment of aMCI.

  19. Effects of mild cognitive impairment on emotional scene memory.

    Science.gov (United States)

    Waring, J D; Dimsdale-Zucker, H R; Flannery, S; Budson, A E; Kensinger, E A

    2017-02-01

    Young and older adults experience benefits in attention and memory for emotional compared to neutral information, but this memory benefit is greatly diminished in Alzheimer's disease (AD). Little is known about whether this impairment arises early or late in the time course between healthy aging and AD. This study compared memory for positive, negative, and neutral items with neutral backgrounds between patients with mild cognitive impairment (MCI) and healthy older adults. We also used a divided attention condition in older adults as a possible model for the deficits observed in MCI patients. Results showed a similar pattern of selective memory for emotional items while forgetting their backgrounds in older adults and MCI patients, but MCI patients had poorer memory overall. Dividing attention during encoding disproportionately reduced memory for backgrounds (versus items) relative to a full attention condition. Participants performing in the lower half on the divided attention task qualitatively and quantitatively mirrored the results in MCI patients. Exploratory analyses comparing lower- and higher-performing MCI patients showed that only higher-performing MCI patients had the characteristic scene memory pattern observed in healthy older adults. Together, these results suggest that the effects of emotion on memory are relatively well preserved for patients with MCI, although emotional memory patterns may start to be altered once memory deficits become more pronounced. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Acetylcholine esterase activity in mild cognitive impairment and Alzheimer's disease

    International Nuclear Information System (INIS)

    Herholz, Karl

    2008-01-01

    Impairment of cholinergic neurotransmission is a well-established fact in Alzheimer's disease (AD), but there is controversy about its relevance at the early stages of the disease and in mild cognitive impairment (MCI). In vivo positron emission tomography imaging of cortical acetylcholine esterase (AChE) activity as a marker of cholinergic innervation that is expressed by cholinergic axons and cholinoceptive neurons has demonstrated a reduction of this enzyme activity in manifest AD. The technique is also useful to measure the inhibition of cerebral AChE induced by cholinesterase inhibitors for treatment of dementia symptoms. A reduction of cortical AchE activity was found consistently in all studies of AD and in few cases of MCI who later concerted to AD. The in vivo findings in MCI and very mild AD are still preliminary, and studies seem to suggest that cholinergic innervation and AChE as the main degrading enzyme are both reduced, which might result in partial compensation of their effect. (orig.)

  1. Effect of Pain and Mild Cognitive Impairment on Mobility.

    Science.gov (United States)

    Schepker, Caroline A; Leveille, Suzanne G; Pedersen, Mette M; Ward, Rachel E; Kurlinski, Laura A; Grande, Laura; Kiely, Dan K; Bean, Jonathan F

    2016-01-01

    To examine the effect of pain and mild cognitive impairment (MCI)-together and separately-on performance-based and self-reported mobility outcomes in older adults in primary care with mild to moderate self-reported mobility limitations. Cross-sectional analysis. Academic community outpatient clinic. Individuals aged 65 and older in primary care enrolled in the Boston Rehabilitative Impairment Study in the Elderly who were at risk of mobility decline (N=430). Participants with an average score greater than three on the Brief Pain Inventory (BPI) were defined as having pain. MCI was defined using age-adjusted scores on a neuropsychological battery. Multivariable linear regression models assessed associations between pain and MCI, together and separately, and mobility performance (habitual gait speed, Short Physical Performance Battery), and self-reports of function and disability in various day-to-day activities (Late Life Function and Disability Instrument). The prevalence of pain was 34% and of MCI was 42%; 17% had pain only, 25% had MCI only, 17% had pain and MCI, and 41% had neither. Participants with pain and MCI performed significantly worse than all others on all mobility outcomes (Pmobility outcomes than those with neither (Pmobility, and the presence of both comorbidities was associated with the poorest status. Primary care practitioners who encounter older adults in need of mobility rehabilitation should consider screening them for pain and MCI to better inform subsequent therapeutic interventions. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  2. Visual selective attention in amnestic mild cognitive impairment.

    Science.gov (United States)

    McLaughlin, Paula M; Anderson, Nicole D; Rich, Jill B; Chertkow, Howard; Murtha, Susan J E

    2014-11-01

    Subtle deficits in visual selective attention have been found in amnestic mild cognitive impairment (aMCI). However, few studies have explored performance on visual search paradigms or the Simon task, which are known to be sensitive to disease severity in Alzheimer's patients. Furthermore, there is limited research investigating how deficiencies can be ameliorated with exogenous support (auditory cues). Sixteen individuals with aMCI and 14 control participants completed 3 experimental tasks that varied in demand and cue availability: visual search-alerting, visual search-orienting, and Simon task. Visual selective attention was influenced by aMCI, auditory cues, and task characteristics. Visual search abilities were relatively consistent across groups. The aMCI participants were impaired on the Simon task when working memory was required, but conflict resolution was similar to controls. Spatially informative orienting cues improved response times, whereas spatially neutral alerting cues did not influence performance. Finally, spatially informative auditory cues benefited the aMCI group more than controls in the visual search task, specifically at the largest array size where orienting demands were greatest. These findings suggest that individuals with aMCI have working memory deficits and subtle deficiencies in orienting attention and rely on exogenous information to guide attention. © The Author 2013. 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.

  3. Cognitive impairment in patients with AIDS – prevalence and severity

    Directory of Open Access Journals (Sweden)

    Watkins CC

    2015-01-01

    Full Text Available Crystal C Watkins,1,2 Glenn J Treisman2 1The Memory Center in Neuropsychiatry, Sheppard Pratt Health System, 2Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA Abstract: The advent of highly active antiretroviral therapy has prolonged the life expectancy of HIV patients and decreased the number of adults who progress to AIDS and HIV-associated dementia. However, neurocognitive deficits remain a pronounced consequence of HIV/AIDS. HIV-1 infection targets the central nervous system in subcortical brain areas and leads to high rates of delirium, depression, opportunistic central nervous system infections, and dementia. Long-term HIV replication in the brain occurs in astrocytes and microglia, allowing the virus to hide from antiviral medication and later compromise neuronal function. The associated cognitive disturbance is linked to both viral activity and inflammatory and other mediators from these immune cells that lead to the damage associated with HIV-associated neurocognitive disorders, a general term given for these disturbances. We review the severity and prevalence of the neuropsychiatric complications of HIV including delirium, neurobehavioral impairments (depression, minor cognitive-motor dysfunction, and HIV-associated dementia. Keywords: HIV, delirium, depression, HAND, dementia; HIV-associated neurocognitive disorder

  4. Effectiveness of exercise on cognitive impairment and Alzheimer's disease

    Directory of Open Access Journals (Sweden)

    Balsamo S

    2013-05-01

    Full Text Available Sandor Balsamo,1–4 Jeffrey M Willardson,5 Frederico Santos de Santana,1–4 Jonato Prestes,6 Denise Coscrato Balsamo,4 Dahan da Cunha Nascimento,3–6 Leopoldo dos Santos-Neto,1,2 Otávio T Nobrega1 1Graduate Program in Medical Sciences, School of Medicine, University of Brasília, 2Rheumatology Division, University of Brasília Hospital, 3Department of Physical Education, Euro-American University Center, 4GEPEEFS (Strength Training and Health Research Group, Brasília, Brazil; 5Kinesiology and Sports Studies Department, Eastern Illinois University, Charleston, IL, USA; 6Graduate Program in Physical Education and Health, Catholic University of Brasilia, Brasilia, Brazil Abstract: Physical activity has a protective effect on brain function in older people. Here, we briefly reviewed the studies and results related to the effects of exercise on cognitive impairment and Alzheimer's disease. The main findings from the current body of literature indicate positive evidence for structured physical activity (cardiorespiratory and resistance exercise as a promising non-pharmacological intervention for preventing cognitive decline. More studies are needed to determine the mechanisms involved in this preventative effect, including on strength, cardiorespiratory, and other types of exercise. Thus, the prevention of Alzheimer's disease may depend on healthy lifestyle habits, such as a structured physical fitness program. Keywords: randomized controlled trial, memory disorders, healthy lifestyle habits, physical activity

  5. Evaluating brief cognitive impairment screening instruments among African Americans.

    Science.gov (United States)

    Kiddoe, Jared M; Whitfield, Keith E; Andel, Ross; Edwards, Christopher L

    2008-07-01

    This article compared and contrasted the Telephone Interview of Cognitive Status (TICS) to the racially-sensitive Short Portable Mental Status Questionnaire (SPMSQ). The empirical questions addressed was whether the TICS over-represented African American (AA) cognitive impairment (CI) relative to the SPMSQ, if there were age differences in CI prevalence between younger subjects (ages 50-64) and older ones (>64 years) and on accuracy to detect CI in individuals with higher levels of educations (> or =13 years) versus those with lower education levels (TICS at 45.0%. Within the younger group, TICS and CI prevalence was 49.3 and 80% among the older group. Within the younger group SPMSQ and CI prevalence was 14.5 and 53.8% among the older group. Within the higher educated group, TICS and CI prevalence was 36.7 and 51.4% among the lower educated. Within the higher educated group, SPMSQ and CI prevalence was 7.7 and 14.5% among the lower educated. Findings are consistent with our hypotheses that the TICS would be a less accurate assessor of CI among AAs.

  6. The beneficial role of resveratrol on chlorpyrifos-induced cognitive ...

    African Journals Online (AJOL)

    ... malondialdehyde (MDA) concentration when compared with the control. In conclusion, 30mg/kg resveratrol suppressed memory impairment, decreased malondialdehyde levels, increased catalase activity, superoxide dismutase activity and glutathione levels in our chlorpyrifos-induced cognitive impairment mice model.

  7. Tai Ji Quan and global cognitive function in older adults with cognitive impairment: a pilot study.

    Science.gov (United States)

    Li, Fuzhong; Harmer, Peter; Liu, Yu; Chou, Li-Shan

    2014-01-01

    This study evaluated whether Tai Ji Quan: Moving for Better Balance (TJQMBB) could improve global cognitive function in older adults with cognitive impairment. Using a nonrandomized control group pretest-posttest design, participants aged ≥65 years who scored between 20 and 25 on the Mini-Mental State Examination (MMSE) were allocated into either a 14-week TJQMBB program (n=22) or a control group (n=24). The primary outcome was MMSE as a measure of global cognitive function with secondary outcomes of 50-ft speed walk, Timed Up&Go, and Activities-Specific Balance Confidence (ABC) scale. At 14 weeks, Tai Ji Quan participants showed significant improvement on MMSE (mean=2.26, pJi Quan participants performed significantly better compared to the controls in both physical performance and balance efficacy measures (p<0.05). Improvement in cognition as measured by MMSE was related to improved physical performance and balance efficacy. These results provide preliminary evidence of the utility of the TJQMBB program to promote cognitive function in older adults in addition to physical benefits. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  8. Does sleep deprivation impair orthopaedic surgeons' cognitive and psychomotor performance?

    Science.gov (United States)

    O'Brien, Michael J; O'Toole, Robert V; Newell, Mary Zadnik; Lydecker, Alison D; Nascone, Jason; Sciadini, Marcus; Pollak, Andrew; Turen, Clifford; Eglseder, W Andrew

    2012-11-07

    Sleep deprivation may slow reaction time, cloud judgment, and impair the ability to think. Our purpose was to study the cognitive and psychomotor performances of orthopaedic trauma surgeons on the basis of the amount of sleep that they obtained. We prospectively studied the performances of thirty-two orthopaedic trauma surgeons (residents, fellows, and attending surgeons) over two four-week periods at an urban academic trauma center. Testing sessions used handheld computers to administer validated cognitive and psychomotor function tests. We conducted a multivariate analysis to examine the independent association between test performance and multiple covariates, including the amount of sleep the night before testing. Our analysis demonstrated that orthopaedic surgeons who had slept four hours or less the night before the test had 1.43 times the odds (95% confidence interval, 1.04 to 1.95; p = 0.03) of committing at least one error on an individual test compared with orthopaedic surgeons who had slept more than four hours the previous night. The Running Memory test, which assesses sustained attention, concentration, and working memory, was most sensitive to deterioration in performance in participants who had had four hours of sleep or less; when controlling for other covariates, the test demonstrated a 72% increase in the odds of making at least one error (odds ratio, 1.72 [95% confidence interval, 1.02 to 2.90]; p = 0.04). No significant decrease in performance with sleep deprivation was shown with the other three tests. Orthopaedic trauma surgeons showed deterioration in performance on a validated cognitive task when they had slept four hours or less the previous night. It is unknown how performance on this test relates to surgical performance.

  9. Classifying cognitive profiles using machine learning with privileged information in Mild Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Hanin Hamdan Alahmadi

    2016-11-01

    Full Text Available Early diagnosis of dementia is critical for assessing disease progression and potential treatment. State-or-the-art machine learning techniques have been increasingly employed to take on this diagnostic task. In this study, we employed Generalised Matrix Learning Vector Quantization (GMLVQ classifiers to discriminate patients with Mild Cognitive Impairment (MCI from healthy controls based on their cognitive skills. Further, we adopted a ``Learning with privileged information'' approach to combine cognitive and fMRI data for the classification task. The resulting classifier operates solely on the cognitive data while it incorporates the fMRI data as privileged information (PI during training. This novel classifier is of practical use as the collection of brain imaging data is not always possible with patients and older participants.MCI patients and healthy age-matched controls were trained to extract structure from temporal sequences. We ask whether machine learning classifiers can be used to discriminate patients from controls based on the learning performance and whether differences between these groups relate to individual cognitive profiles. To this end, we tested participants in four cognitive tasks: working memory, cognitive inhibition, divided attention, and selective attention. We also collected fMRI data before and after training on the learning task and extracted fMRI responses and connectivity as features for machine learning classifiers. Our results show that the PI guided GMLVQ classifiers outperform the baseline classifier that only used the cognitive data. In addition, we found that for the baseline classifier, divided attention is the only relevant cognitive feature. When PI was incorporated, divided attention remained the most relevant feature while cognitive inhibition became also relevant for the task. Interestingly, this analysis for the fMRI GMLVQ classifier suggests that (1 when overall fMRI signal for structured stimuli is

  10. Preoperative Cognitive Impairment As a Predictor of Postoperative Outcomes in a Collaborative Care Model.

    Science.gov (United States)

    Zietlow, Kahli; McDonald, Shelley R; Sloane, Richard; Browndyke, Jeffrey; Lagoo-Deenadayalan, Sandhya; Heflin, Mitchell T

    2018-03-01

    To compare postoperative outcomes of individuals with and without cognitive impairment enrolled in the Perioperative Optimization of Senior Health (POSH) program at Duke University, a comanagement model involving surgery, anesthesia, and geriatrics. Retrospective analysis of individuals enrolled in a quality improvement program. Tertiary academic center. Older adults undergoing surgery and referred to POSH (N = 157). Cognitive impairment was defined as a score less than 25 out of 30 (adjusted for education) on the St. Louis University Mental Status (SLUMS) Examination. Median length of stay (LOS), mean number of postoperative complications, rates of postoperative delirium (POD, %), 30-day readmissions (%), and discharge to home (%) were compared using bivariate analysis. Seventy percent of participants met criteria for cognitive impairment (mean SLUMS score 20.3 for those with cognitive impairment and 27.7 for those without). Participants with and without cognitive impairment did not significantly differ in demographic characteristics, number of medications (including anticholinergics and benzodiazepines), or burden of comorbidities. Participants with and without cognitive impairment had similar LOS (P = .99), cumulative number of complications (P = .70), and 30-day readmission (P = .20). POD was more common in those with cognitive impairment (31% vs 24%), but the difference was not significant (P = .34). Participants without cognitive impairment had higher rates of discharge to home (80.4% vs 65.1%, P = .05). Older adults with and without cognitive impairment referred to the POSH program fared similarly on most postoperative outcomes. Individuals with cognitive impairment may benefit from perioperative geriatric comanagement. Questions remain regarding the validity of available measures of cognition in the preoperative period. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

  11. Metabolic syndrome and cognitive decline: the role of physical activity

    Directory of Open Access Journals (Sweden)

    M. Rinaldi

    2013-01-01

    Full Text Available Metabolic Syndrome (MetS is a cluster of conditions, each of which represents a risk factor for cardiovascular disease: central obesity, hyperglycemia, dyslipidemia and hypertension. Any of these conditions and MetS itself have been associated to Alzheimer's Disease and Vascular Dementia. In recent years there is a growing evidence for the role of physical activity in preventing metabolic diseases and cognitive decline. In our research we assessed the prevalence of MetS in a sample of 154 elderly people. Furthermore, we evaluated cognition (with Mini Mental State Examination, MMSE  and the physical activity level in every patient. We found a significant association between MetS, borderline cognitive impairment and sedentary lifestyle.

  12. Physicians' Perspectives on Caring for Cognitively Impaired Elders.(author Abstract)

    Science.gov (United States)

    Adams, Wendy L.; McIlvain, Helen E.; Geske, Jenenne A.; Porter, Judy L.

    2005-01-01

    Purpose: This study aims to develop ah in-depth understanding of the issues important to primary care physicians in providing care to cognitively impaired elders. Design and Methods: In-depth interviews were conducted with 20 primary care physicians. Text coded as "cognitive impairment" was retrieved and analyzed by use of grounded theory analysis…

  13. Cognitive impairment in the remitted state of unipolar depressive disorder: A systematic review

    DEFF Research Database (Denmark)

    Hasselbalch, Bo Jacob; Knorr, Ulla; Kessing, Lars Vedel

    2010-01-01

    BACKGROUND: It is unclear whether cognitive impairment is prevalent in the remitted state of unipolar disorder. AIM: To evaluate whether cognitive function is impaired in the remitted state in patients with unipolar depression compared with healthy control individuals, and to investigate the asso...

  14. Motor and cognitive impairment after stroke : A common bond or a simultaneous deficit?

    NARCIS (Netherlands)

    Verstraeten, S.M.M.; Mark, R.E.; Sitskoorn, M.M.

    2016-01-01

    Background: The prevalence of both motor deficit and cognitive impairment after stroke is high and persistent. Motor impairment, especially paresis, is often ore obvious to both patients and their carers while cognitive problems can also have devastating effects on quality of life. The current

  15. Cognitive Impairment among the Aging Population in a Community in Southwest Nigeria

    Science.gov (United States)

    Adebiyi, Akindele O.; Ogunniyi, Adesola; Adediran, Babatunde A.; Olakehinde, Olaide O.; Siwoku, Akeem A.

    2016-01-01

    Background: Vascular risk models can be quite informative in assisting the clinician to make a prediction of an individual's risk of cognitive impairment. Thus, a simple marker is a priority for low-capacity settings. This study examines the association of selected simple to deploy vascular markers with cognitive impairment in an elderly…

  16. Corpus callosum tissue loss and development of motor and global cognitive impairment

    DEFF Research Database (Denmark)

    Frederiksen, Kristian S; Garde, Ellen; Skimminge, Arnold

    2011-01-01

    To examine the impact of corpus callosum (CC) tissue loss on the development of global cognitive and motor impairment in the elderly.......To examine the impact of corpus callosum (CC) tissue loss on the development of global cognitive and motor impairment in the elderly....

  17. Impaired Cognition in Rats with Cortical Dysplasia: Additional Impact of Early-Life Seizures

    Science.gov (United States)

    Lucas, Marcella M.; Lenck-Santini, Pierre-Pascal; Holmes, Gregory L.; Scott, Rod C.

    2011-01-01

    One of the most common and serious co-morbidities in patients with epilepsy is cognitive impairment. While early-life seizures are considered a major cause for cognitive impairment, it is not known whether it is the seizures, the underlying neurological substrate or a combination that has the largest impact on eventual learning and memory. Teasing…

  18. Undiagnosed cognitive impairment, health status and depressive symptoms in patients with type 2 diabetes

    NARCIS (Netherlands)

    Koekkoek, Paula S.; Biessels, Geert Jan; Kooistra, Minke; Janssen, Jolien; Kappelle, L. Jaap; Rutten, Guy E H M

    2015-01-01

    Aims Type 2 diabetes (T2DM) is associated with cognitive impairment. We examined whether undiagnosed cognitive impairment in T2DM-patients is associated with a reduced health status and depressive symptoms. Methods In an observational study, 225 T2DM-patients aged < 70 years were examined at their

  19. Sleep and its associations with perceived and objective cognitive impairment in individuals with multiple sclerosis.

    Science.gov (United States)

    Hughes, Abbey J; Parmenter, Brett A; Haselkorn, Jodie K; Lovera, Jesus F; Bourdette, Dennis; Boudreau, Eilis; Cameron, Michelle H; Turner, Aaron P

    2017-08-01

    Problems with sleep and cognitive impairment are common among people with multiple sclerosis (MS). The present study examined the relationship between self-reported sleep and both objective and perceived cognitive impairment in MS. Data were obtained from the baseline assessment of a multi-centre intervention trial (NCT00841321). Participants were 121 individuals with MS. Nearly half (49%) of participants met the criteria for objective cognitive impairment; however, cognitively impaired and unimpaired participants did not differ on any self-reported sleep measures. Nearly two-thirds (65%) of participants met the criteria for 'poor' sleep, and poorer sleep was significantly associated with greater levels of perceived cognitive impairment. Moreover, the relationships between self-reported sleep and perceived cognitive impairment were significant beyond the influence of clinical and demographic factors known to influence sleep and cognitive functioning (e.g. age, sex, education level, disability severity, type of MS, disease duration, depression and fatigue). However, self-reported sleep was not associated with any measures of objective cognitive impairment. Among different types of perceived cognitive impairment, poor self-reported sleep was most commonly related to worse perceived executive function (e.g. planning/organization) and prospective memory. Results from the present study emphasize that self-reported sleep is significantly and independently related to perceived cognitive impairment in MS. In terms of clinical implications, interventions focused on improving sleep may help improve perceived cognitive function and quality of life in this population; however, the impact of improved sleep on objective cognitive function requires further investigation. © 2017 European Sleep Research Society.

  20. Association Between Frailty and Cognitive Impairment: Cross-Sectional Data From Toulouse Frailty Day Hospital.

    Science.gov (United States)

    Fougère, Bertrand; Daumas, Matthieu; Lilamand, Matthieu; Sourdet, Sandrine; Delrieu, Julien; Vellas, Bruno; Abellan van Kan, Gabor

    2017-11-01

    A consensus panel, based on epidemiologic evidence, argued that physical frailty is often associated with cognitive impairment, possibly because of common underlying pathophysiological mechanisms. The concepts of cognitive frailty and motoric cognitive risk were recently proposed in literature and may represent a prodromal stage for neurodegenerative diseases. The purpose of this study was to analyze the relationship between cognition and the components of the physical phenotype of frailty. Participants admitted to the Toulouse frailty day hospital aged 65 years or older were included in this cross-sectional study. Cognitive impairment was identified using the Mini-Mental State Examination (MMSE) and the Clinical Dementia Rating (CDR). Frailty was assessed using the physical phenotype as defined by Fried's criteria. We divided the participants into 2 groups: participants with normal cognition (CDR = 0) and participants who had cognitive impairment (CDR = 0.5). Participants with CDR >0.5 were excluded. Data from 1620 participants, mean age 82 years and 63% of women were analyzed. Cognitive impairment was identified in 52.5% of the participants. Frailty was identified in 44.7% of the sample. There were more frail subjects in the impaired group than the normal cognitive group (51% vs 38%, P impairment [adjusted odds ratio (OR) 1.66, 95% confidence interval (CI) 1.12-2.46]. Subsequent analysis showed that the association between cognitive impairment and frailty was only observed considering one of the 5 frailty criteria: gait speed (adjusted OR 1.89, 95% CI 1.55-2.32). Physical frailty and in particular slow gait speed were associated with cognitive impairment. Future research including longitudinal studies should exploit the association between cognitive impairment and frailty. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  1. Pulse wave velocity is associated with cognitive impairment in hemodialysis patients.

    Science.gov (United States)

    Angermann, Susanne; Baumann, Marcus; Wassertheurer, Siegfried; Mayer, Christopher Clemens; Steubl, Dominik; Hauser, Christine; Suttmann, Yana; Reichelt, Anna-Lena; Satanovskij, Robin; Lorenz, Georg; Lukas, Moritz; Haller, Bernhard; Heemann, Uwe; Grimmer, Timo; Schmaderer, Christoph

    2017-07-01

    Cognitive impairment in hemodialysis patients is common and associated with adverse outcomes. So far, the underlying pathogenesis remains unclear. Therefore, we examined the potential relationship between cognitive impairment and three different categories of risk factors with particular focus on arterial stiffness measured by pulse wave velocity (PWV). A total of 201 chronic hemodialysis patients underwent cognitive testing under standardized conditions using the Montreal Cognitive Assessment (MoCA). Demographic data including cardiovascular risk factors, dialysis-associated factors as well as factors related to chronic kidney disease (CKD) were analyzed. To account for arterial stiffness, PWV was measured by ambulatory blood pressure monitoried with an oscillometric device that records brachial blood pressure along with pulse waves. In our cohort, 60.2% of patients showed pathological MoCA test results indicating cognitive impairment. PWV was significantly associated with cognitive impairment apart from age, educational level, diabetes, and hypercholesterolemia. High prevalence of cognitive impairment in hemodialysis patients was confirmed. For the first time, an association between cognitive impairment and arterial stiffness was detected in a larger cohort of hemodialysis patients. Concerning the underlying pathogenesis of cognitive impairment, current results revealed a potential involvement of arterial stiffness, which has to be further evaluated in future studies. © 2017 The Author(s). Published by Portland Press Limited on behalf of the Biochemical Society.

  2. Higher Self-Control Capacity Predicts Lower Anxiety-Impaired Cognition during Math Examinations.

    Science.gov (United States)

    Bertrams, Alex; Baumeister, Roy F; Englert, Chris

    2016-01-01

    We assumed that self-control capacity, self-efficacy, and self-esteem would enable students to keep attentional control during tests. Therefore, we hypothesized that the three personality traits would be negatively related to anxiety-impaired cognition during math examinations. Secondary school students (N = 158) completed measures of self-control capacity, self-efficacy, and self-esteem at the beginning of the school year. Five months later, anxiety-impaired cognition during math examinations was assessed. Higher self-control capacity, but neither self-efficacy nor self-esteem, predicted lower anxiety-impaired cognition 5 months later, over and above baseline anxiety-impaired cognition. Moreover, self-control capacity was indirectly related to math grades via anxiety-impaired cognition. The findings suggest that improving self-control capacity may enable students to deal with anxiety-related problems during school tests.

  3. Higher Self-Control Capacity Predicts Lower Anxiety-Impaired Cognition During Math Examinations

    Directory of Open Access Journals (Sweden)

    Alex eBertrams

    2016-03-01

    Full Text Available We assumed that self-control capacity, self-efficacy, and self-esteem would enable students to keep attentional control during tests. Therefore, we hypothesized that the three personality traits would be negatively related to anxiety-impaired cognition during math examinations. Secondary school students (N = 158 completed measures of self-control capacity, self-efficacy, and self-esteem at the beginning of the school year. Five months later, anxiety-impaired cognition during math examinations was assessed. Higher self-control capacity, but neither self-efficacy nor self-esteem, predicted lower anxiety-impaired cognition five months later, over and above baseline anxiety-impaired cognition. Moreover, self-control capacity was indirectly related to math grades via anxiety-impaired cognition. The findings suggest that improving self-control capacity may enable students to deal with anxiety-related problems during school tests.

  4. Gait and Cognition in Parkinson’s Disease: Cognitive Impairment Is Inadequately Reflected by Gait Performance during Dual Task

    Directory of Open Access Journals (Sweden)

    Heiko Gaßner

    2017-10-01

    Full Text Available IntroductionCognitive and gait deficits are common symptoms in Parkinson’s disease (PD. Motor-cognitive dual tasks (DTs are used to explore the interplay between gait and cognition. However, it is unclear if DT gait performance is indicative for cognitive impairment. Therefore, the aim of this study was to investigate if cognitive deficits are reflected by DT costs of spatiotemporal gait parameters.MethodsCognitive function, single task (ST and DT gait performance were investigated in 67 PD patients. Cognition was assessed by the Montreal Cognitive Assessment (MoCA followed by a standardized, sensor-based gait test and the identical gait test while subtracting serial 3’s. Cognitive impairment was defined by a MoCA score <26. DT costs in gait parameters [(DT − ST/ST × 100] were calculated as a measure of DT effect on gait. Correlation analysis was used to evaluate the association between MoCA performance and gait parameters. In a linear regression model, DT gait costs and clinical confounders (age, gender, disease duration, motor impairment, medication, and depression were correlated to cognitive performance. In a subgroup analysis, we compared matched groups of cognitively impaired and unimpaired PD patients regarding differences in ST, DT, and DT gait costs.ResultsCorrelation analysis revealed weak correlations between MoCA score and DT costs of gait parameters (r/rSp ≤ 0.3. DT costs of stride length, swing time variability, and maximum toe clearance (|r/rSp| > 0.2 were included in a regression analysis. The parameters only explain 8% of the cognitive variance. In combination with clinical confounders, regression analysis showed that these gait parameters explained 30% of MoCA performance. Group comparison revealed strong DT effects within both groups (large effect sizes, but significant between-group effects in DT gait costs were not observed.ConclusionThese findings suggest that DT gait performance is not indicative

  5. Functional Components of Cognitive Impairment in Multiple Sclerosis: A Cross-Sectional Investigation

    Directory of Open Access Journals (Sweden)

    Jordi A. Matias-Guiu

    2017-11-01

    Full Text Available BackgroundCognitive impairment is frequent and disabling in multiple sclerosis (MS. Changes in information processing speed constitute the most important cognitive deficit in MS. However, given the clinical and topographical variability of the disease, cognitive impairment may vary greatly and appear in other forms in addition to slower information processing speed. Our aim was to determine the frequency of cognitive impairment, the principal cognitive domains, and components involved in MS and to identify factors associated with presence of cognitive impairment in these patients in a large series of patients.MethodsCross-sectional study of 311 patients with MS [236 with relapsing-remitting MS (RRMS, 52 with secondary progressive MS (SPMS, and 23 with primary progressive MS (PPMS]. Patients’ cognitive function was assessed with a comprehensive neuropsychological assessment protocol. Patients displaying deficits in 2 or more cognitive domains were considered to have cognitive impairment associated with MS. We conducted a principal component analysis to detect different cognitive patterns by identifying clusters of tests highly correlated to one another.ResultsCognitive impairment was detected in 41.5% of the sample, and it was more frequent in patients with SPMS and PPMS (P = 0.002. Expanded Disability Status Scale scores and education were independent predictors of cognitive impairment. Principal component analysis identified seven clusters: attention and basic executive function (including information processing speed, planning and high-level executive function, verbal memory and language, executive and visuospatial performance time, fatigue-depression, visuospatial function, and basic attention and verbal/visual working memory. Mean scoring of components 2 (high-order executive functioning and 3 (verbal memory-language was higher in patients with RRMS than in those with PPMS (component 2 and SPMS (component 3.ConclusionMS is linked to

  6. 18F-FDG PET in Parkinsonism: Differential Diagnosis and Evaluation of Cognitive Impairment.

    Science.gov (United States)

    Meyer, Philipp T; Frings, Lars; Rücker, Gerta; Hellwig, Sabine

    2017-12-01

    Accurate differential diagnosis of parkinsonism is of paramount therapeutic and prognostic importance. In addition, with the development of invasive therapies and novel disease-specific therapies, strategies for patient enrichment in trial populations are of growing importance. Imaging disease-specific patterns of regional glucose metabolism with PET and 18 F-FDG allows for a highly accurate distinction between Parkinson disease (PD) and atypical parkinsonian syndromes, including multiple-system atrophy, progressive supranuclear palsy, and corticobasal degeneration. On the basis of a preliminary metaanalysis of currently available studies with inclusion of multiple disease groups, we estimated that the diagnostic sensitivity and specificity for visual PET readings supported by voxel-based statistical analyses for diagnosis of atypical parkinsonian syndromes are 91.4% and 90.6%, respectively. The diagnostic specificity of 18 F-FDG PET for diagnosing multiple-system atrophy, progressive supranuclear palsy, and corticobasal degeneration was consistently shown to be high (>90%), whereas sensitivity was more variable (>75%). It is increasingly acknowledged that cognitive impairment represents a major challenge in PD, with mild cognitive impairment being a prodromal stage of PD with dementia (PDD). In line with clinical and neuropsychologic studies, recent PET studies demonstrated that posterior cortical dysfunction in nondemented PD patients precedes cognitive decline and the development of PDD by several years. Taken together, the current literature underscores the utility of 18 F-FDG PET for diagnostic evaluation of parkinsonism and the promising role of 18 F-FDG PET for assessment and risk stratification of cognitive impairment in PD. © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

  7. Optimizing Neuropsychological Assessments for Cognitive, Behavioral, and Functional Impairment Classification: A Machine Learning Study

    Directory of Open Access Journals (Sweden)

    Petronilla Battista

    2017-01-01

    Full Text Available Subjects with Alzheimer’s disease (AD show loss of cognitive functions and change in behavioral and functional state affecting the quality of their daily life and that of their families and caregivers. A neuropsychological assessment plays a crucial role in detecting such changes from normal conditions. However, despite the existence of clinical measures that are used to classify and diagnose AD, a large amount of subjectivity continues to exist. Our aim was to assess the potential of machine learning in quantifying this process and optimizing or even reducing the amount of neuropsychological tests used to classify AD patients, also at an early stage of impairment. We investigated the role of twelve state-of-the-art neuropsychological tests in the automatic classification of subjects with none, mild, or severe impairment as measured by the clinical dementia rating (CDR. Data were obtained from the ADNI database. In the groups of measures used as features, we included measures of both cognitive domains and subdomains. Our findings show that some tests are more frequently best predictors for the automatic classification, namely, LM, ADAS-Cog, AVLT, and FAQ, with a major role of the ADAS-Cog measures of delayed and immediate memory and the FAQ measure of financial competency.

  8. Depression and cognitive impairment among newly admitted nursing home residents in the USA.

    Science.gov (United States)

    Ulbricht, Christine M; Rothschild, Anthony J; Hunnicutt, Jacob N; Lapane, Kate L

    2017-11-01

    The objective of this study is to describe the prevalence of depression and cognitive impairment among newly admitted nursing home residents in the USA and to describe the treatment of depression by level of cognitive impairment. We identified 1,088,619 newly admitted older residents between 2011 and 2013 with an active diagnosis of depression documented on the Minimum Data Set 3.0. The prevalence of receiving psychiatric treatment was estimated by cognitive impairment status and depression symptoms. Binary logistic regression using generalized estimating equations provided adjusted odds ratios and 95% confidence intervals for the association between level of cognitive impairment and receipt of psychiatric treatment, adjusted for clustering of residents within nursing homes and resident characteristics. Twenty-six percent of newly admitted residents had depression; 47% of these residents also had cognitive impairment. Of those who had staff assessments of depression, anhedonia, impaired concentration, psychomotor disturbances, and irritability were more commonly experienced by residents with cognitive impairment than residents without cognitive impairment. Forty-eight percent of all residents with depression did not receive any psychiatric treatment. Approximately one-fifth of residents received a combination of treatment. Residents with severe cognitive impairment were less likely than those with intact cognition to receive psychiatric treatment (adjusted odds ratio = 0.95; 95% confidence interval: 0.93-0.98). Many newly admitted residents with an active diagnosis of depression are untreated, potentially missing an important window to improve symptoms. The extent of comorbid cognitive impairment and depression and lack of treatment suggest opportunities for improved quality of care in this increasingly important healthcare setting. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  9. Comparative Effects of Education and Bilingualism on the Onset of Mild Cognitive Impairment.

    Science.gov (United States)

    Ramakrishnan, Subasree; Mekala, Shailaja; Mamidipudi, Annapurna; Yareeda, Sireesha; Mridula, Rukmini; Bak, Thomas H; Alladi, Suvarna; Kaul, Subhash

    2017-01-01

    Increasing evidence suggests that life course factors such as education and bilingualism may have a protective role against dementia due to Alzheimer disease. This study aimed to compare the effects of education and bilingualism on the onset of cognitive decline at the stage of mild cognitive impairment (MCI). A total of 115 patients with MCI evaluated in a specialty memory clinic in Hyderabad, India, formed the cohort. MCI was diagnosed according to Petersen's criteria following clinical evaluation and brain imaging. Age at onset of MCI was compared between bilinguals and monolinguals, and across subjects with high and low levels of education, adjusting for possible confounding variables. The bilingual MCI patients were found to have a clinical onset of cognitive complaints 7.4 years later than monolinguals (65.2 vs. 58.1 years; p = 0.004), while years of education was not associated with delayed onset (1-10 years of education, 59.1 years; 11-15 years of education, 62.6 years; >15 years of education, 62.2 years; p = 0.426). The effect of bilingualism is protective against cognitive decline, and lies along a continuum from normal to pathological states. In comparison, the role of years of education is less robust. © 2017 S. Karger AG, Basel.

  10. Quantifying cognition and behavior in normal aging, mild cognitive impairment, and Alzheimer's disease

    Science.gov (United States)

    Giraldo, Diana L.; Sijbers, Jan; Romero, Eduardo

    2017-11-01

    The diagnosis of Alzheimer's disease (AD) and mild cognitive impairment (MCI) is based on neuropsychological evaluation of the patient. Different cognitive and memory functions are assessed by a battery of tests that are composed of items devised to specifically evaluate such upper functions. This work aims to identify and quantify the factors that determine the performance in neuropsychological evaluation by conducting an Exploratory Factor Analysis (EFA). For this purpose, using data from the Alzheimer's Disease Neuroimaging Initiative (ADNI), EFA was applied to 67 item scores taken from the baseline neuropsychological battery of the three phases of ADNI study. The found factors are directly related to specific brain functions such as memory, behavior, orientation, or verbal fluency. The identification of factors is followed by the calculation of factor scores given by weighted linear combinations of the items scores.

  11. Clinical and biological predictors of Alzheimer's disease in patients with amnestic mild cognitive impairment

    OpenAIRE

    Forlenza,Orestes V.; Diniz,Breno S.; Talib,Leda L.; Radanovic,Marcia; Yassuda,Monica S.; Ojopi,Elida B.; Gattaz,Wagner F.

    2010-01-01

    OBJECTIVE: To identify predictors of the progression from pre-dementia stages of cognitive impairment in Alzheimer's disease is relevant to clinical management and to substantiate the decision of prescribing antidementia drugs. METHOD: Longitudinal study of a cohort of elderly adults with amnestic mild cognitive impairment and healthy controls, carried out to estimate the risk and characterize predictors of the progression to Alzheimer's disease. RESULTS: Patients with amnestic mild cognitive...

  12. Pharmacological and Non-pharmacological Therapies of Cognitive Impairment in Multiple Sclerosis.

    Science.gov (United States)

    Miller, Elzbieta; Morel, Agnieszka; Redlicka, Justyna; Miller, Igor; Saluk, Joanna

    2018-01-01

    Cognitive impairment is one of the most important clinical features of neurodegenerative disorders including multiple sclerosis (MS). Conducted research shows that up to 65 percent of MS patients have cognitive deficits such as episodic memory, sustained attention, reduced verbal fluency; however, the cognitive MS domain is information processing speed. It is the first syndrome of cognitive dysfunction and the most widely affected in MS. Occasionally these impairments occur even before the appearance of physical symptoms. Therefore, this review focused on the current status of our knowledge about possible methods of treatment cognitive impairment in MS patients including novel strategies. Research and online content was performed using Medline and EMBASE databases. The most recent research suggests that cognitive impairment is correlated with brain lesion volume and brain atrophy. The examination of the cognitive impairment is usually based on particular neuropsychological batteries. However, it can be not enough to make a precise diagnosis. This creates a demand to find markers that might be useful for identifying patients with risk of cognitive impairment at an early stage of the disease. Currently the most promising methods consist of neuroimaging indicators, such as diffusion tensor imaging, the magnetization transfer ratio, and N-acetyl aspartate levels. Diagnosis problems are strictly connected with treatment procedures. There are two main cognitive therapies: pharmacological (disease modifying drugs (DMD), symptomatic treatments) and non-pharmacological interventions that are focused on psychological and physical rehabilitation. Some trials have shown a positive association between physical activity and the cognitive function. This article is an overview of the current state of knowledge related to cognition impairment treatment in MS. Additionally, novel strategies for cognitive impairments such as cryostimulation and other complementary methods are

  13. Peripheral surgical wounding may induce cognitive impairment through interlukin-6-dependent mechanisms in aged mice

    OpenAIRE

    Dong, Yuanlin; Xu, Zhipeng; Huang, Lining; Zhang, Yiying; Xie, Zhongcong

    2016-01-01

    Post-operative cognitive dysfunction (POCD) is associated with morbidity, mortality and increased cost of medical care. However, the neuropathogenesis and targeted interventions of POCD remain largely to be determined. We have found that the peripheral surgical wounding induces an age-dependent A? accumulation, neuroinflammation and cognitive impairment in aged mice. Pro-inflammatory cytokine interlukin-6 (IL-6) has been reported to be associated with cognitive impairment in rodents and human...

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

    Science.gov (United States)

    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.

  15. Category verbal fluency performance may be impaired in amnestic mild cognitive impairment

    Directory of Open Access Journals (Sweden)

    Márcio Luiz Figueredo Balthazar

    Full Text Available Abstract To study category verbal fluency (VF for animals in patients with amnestic mild cognitive impairment (aMCI, mild Alzheimer disease (AD and normal controls. Method: Fifteen mild AD, 15 aMCI, and 15 normal control subjects were included. Diagnosis of AD was based on DSM-IV and NINCDS-ADRDA criteria, while aMCI was based on the criteria of the International Working Group on Mild Cognitive Impairment, using CDR 0.5 for aMCI and CDR 1 for mild AD. All subjects underwent testing of category VF for animals, lexical semantic function (Boston Naming-BNT, CAMCOG Similarities item, WAIS-R forward and backward digit span, Rey Auditory Verbal Learning (RAVLT, Mini-Mental Status Examination (MMSE, and other task relevant functions such as visual perception, attention, and mood state (with Cornell Scale for Depression in Dementia. Data analysis used ANOVA and a post-hoc Tukey test for intergroup comparisons, and Pearson's coefficient for correlations of memory and FV tests with other task relevant functions (statistical significance level was p<0.05. Results: aMCI patients had lower performance than controls on category VF for animals and on the backward digit span subtest of WAIS-R but higher scores compared with mild AD patients. Mild AD patients scored significantly worse than aMCI and controls across all tests. Conclusion: aMCI patients may have poor performance in some non-memory tests, specifically category VF for animals in our study, where this could be attributable to the influence of working memory.

  16. Biological Factors Contributing to the Response to Cognitive Training in Mild Cognitive Impairment.

    Science.gov (United States)

    Peter, Jessica; Schumacher, Lena V; Landerer, Verena; Abdulkadir, Ahmed; Kaller, Christoph P; Lahr, Jacob; Klöppel, Stefan

    2018-01-01

    In mild cognitive impairment (MCI), small benefits from cognitive training were observed for memory functions but there appears to be great variability in the response to treatment. Our study aimed to improve the characterization and selection of those participants who will benefit from cognitive intervention. We evaluated the predictive value of disease-specific biological factors for the outcome after cognitive training in MCI (n = 25) and also considered motivation of the participants. We compared the results of the cognitive intervention group with two independent control groups of MCI patients (local memory clinic, n = 20; ADNI cohort, n = 302). The primary outcome measure was episodic memory as measured by verbal delayed recall of a 10-word list. Episodic memory remained stable after treatment and slightly increased 6 months after the intervention. In contrast, in MCI patients who did not receive an intervention, episodic memory significantly decreased during the same time interval. A larger left entorhinal cortex predicted more improvement in episodic memory after treatment and so did higher levels of motivation. Adding disease-specific biological factors significantly improved the prediction of training-related change compared to a model based simply on age and baseline performance. Bootstrapping with resampling (n = 1000) verified the stability of our finding. Cognitive training might be particularly helpful in individuals with a bigger left entorhinal cortex as individuals who did not benefit from intervention showed 17% less volume in this area. When extended to alternative treatment options, stratification based on disease-specific biological factors is a useful step towards individualized medicine.

  17. Informant-reported cognitive symptoms that predict amnestic mild cognitive impairment

    Directory of Open Access Journals (Sweden)

    Malek-Ahmadi Michael

    2012-02-01

    Full Text Available Abstract Background Differentiating amnestic mild cognitive impairment (aMCI from normal cognition is difficult in clinical settings. Self-reported and informant-reported memory complaints occur often in both clinical groups, which then necessitates the use of a comprehensive neuropsychological examination to make a differential diagnosis. However, the ability to identify cognitive symptoms that are predictive of aMCI through informant-based information may provide some clinical utility in accurately identifying individuals who are at risk for developing Alzheimer's disease (AD. Methods The current study utilized a case-control design using data from an ongoing validation study of the Alzheimer's Questionnaire (AQ, an informant-based dementia assessment. Data from 51 cognitively normal (CN individuals participating in a brain donation program and 47 aMCI individuals seen in a neurology practice at the same institute were analyzed to determine which AQ items differentiated aMCI from CN individuals. Results Forward stepwise multiple logistic regression analysis which controlled for age and education showed that 4 AQ items were strong indicators of aMCI which included: repetition of statements and/or questions [OR 13.20 (3.02, 57.66]; trouble knowing the day, date, month, year, and time [OR 17.97 (2.63, 122.77]; difficulty managing finances [OR 11.60 (2.10, 63.99]; and decreased sense of direction [OR 5.84 (1.09, 31.30]. Conclusions Overall, these data indicate that certain informant-reported cognitive symptoms may help clinicians differentiate individuals with aMCI from those with normal cognition. Items pertaining to repetition of statements, orientation, ability to manage finances, and visuospatial disorientation had high discriminatory power.

  18. Clinical characteristics and quality of life of older adults with cognitive impairment in Macao.

    Science.gov (United States)

    Lam Nogueira, Bernice O C; Li, Lu; Meng, Li-Rong; Ungvari, Gabor S; Ng, Chee H; Chiu, Helen F K; Kuok, Kenny C F; Tran, Linda; Xiang, Yu-Tao

    2018-02-06

    Little is known about the characteristics of older adults with cognitive impairment in Macao. This study aimed to determine the prevalence of cognitive impairment and the quality of life (QOL) of older adults living in the community and nursing homes. A consecutive sample of 413 subjects (199 from the community; 214 from nursing homes) was recruited and interviewed using standardized instruments. Cognition was measured with the Repeatable Battery for the Assessment of Neuropsychological Status and QOL with the brief version of the World Health Organization Quality of Life instrument. Altogether 87 subjects (21.0%) had cognitive impairment. On multivariate analyses, advanced age (P impairment. Married marital status (P = 0.01, OR = 0.3, 95%CI: 0.1-0.7) and higher education level (P impairment. After the confounders were controlled for, cognitive impairment was significantly associated with the lower psychological (F (11,412)  = 6.3, P = 0.01) and social relationship domains of QOL (F (11,412)  = 4.0, P = 0.04). Cognitive impairment was found to be common in community-dwelling and nursing home resident older adults in Macao. Given cognitive impairment's negative impact on QOL, appropriate strategies should be implemented to improve access to treatment in this population. © 2018 Japanese Psychogeriatric Society.

  19. Novel fMRI working memory paradigm accurately detects cognitive impairment in Multiple Sclerosis

    Science.gov (United States)

    Nelson, Flavia; Akhtar, Mohammad A.; Zúñiga, Edward; Perez, Carlos A.; Hasan, Khader M.; Wilken, Jeffrey; Wolinsky, Jerry S.; Narayana, Ponnada A.; Steinberg, Joel L.

    2016-01-01

    Background Cognitive impairment (CI) cannot be diagnosed by MRI. Functional MRI (fMRI) paradigms such as the immediate/delayed memory task (I/DMT), detect varying degrees of working memory. Preliminary findings using I/DMT, showed differences in Blood Oxygenation Level Dependent (BOLD) activation between impaired (MSCI, n=12) and non-impaired (MSNI, n=9) MS patients. Objectives To confirm CI detection based on I/DMT’ BOLD activation in a larger cohort of MS patients. The role of T2 lesion volume (LV) and EDSS in magnitude of BOLD signal were also sought. Methods Fifty patients [EDSS mean (m) = 3.2, DD m =12 yr., age m =40yr.] underwent the Minimal Assessment of Cognitive Function in MS (MACFIMS) and the I/DMT. Working-memory activation (WMa) represents BOLD signal during DMT minus signal during IMT. CI was based on MACFIMS. Results 10 MSNI, 30 MSCI and 4 borderline patients were included in analyses. ANOVA showed MSNI had significantly greater WMa than MSCI, in the left (L) prefrontal cortex and L supplementary motor area (p = 0.032). Regression analysis showed significant inverse correlations between WMa and T2 LV/EDSS in similar areas (p = 0.005, 0.004 respectively). Conclusion I/DMT-based BOLD activation detects CI in MS, larger studies are needed to confirm these findings. PMID:27613119

  20. Transitions to mild cognitive impairments, dementia, and death: findings from the Nun Study.

    Science.gov (United States)

    Tyas, Suzanne L; Salazar, Juan Carlos; Snowdon, David A; Desrosiers, Mark F; Riley, Kathryn P; Mendiondo, Marta S; Kryscio, Richard J

    2007-06-01

    The potential of early interventions for dementia has increased interest in cognitive impairments less severe than dementia. However, predictors of the trajectory from intact cognition to dementia have not yet been clearly identified. The purpose of this study was to determine whether known risk factors for dementia increased the risk of mild cognitive impairments or progression from mild cognitive impairments to dementia. A polytomous logistic regression model was used, with parameters governing transitions within transient states (intact cognition, mild cognitive impairments, global impairment) estimated separately from parameters governing the transition from transient to absorbing state (dementia or death). Analyses were based on seven annual examinations (1991-2002) of 470 Nun Study participants aged > or = 75 years at baseline and living in the United States. Odds of developing dementia increased with age primarily for those with low educational levels. In these women, presence of an apolipoprotein E gene *E4 allele increased the odds more than fourfold by age 95 years. Age, education, and the apolipoprotein E gene were all significantly associated with mild cognitive impairments. Only age, however, was associated with progression to dementia. Thus, risk factors for dementia may operate primarily by predisposing individuals to develop mild cognitive impairments; subsequent progression to dementia then depends on only time and competing mortality.

  1. [Predictors of cognitive impairment in population over 64 years institutionalized and non-institutionalized].

    Science.gov (United States)

    Leiva-Saldaña, Antonio; Sánchez-Ramos, José Luis; León-Jariego, José Carlos; Palacios-Gómez, Leopoldo

    2016-01-01

    Describe the factors which can be associated with cognitive impairment in institutionalized and non-institutionalized elderly. Cross-sectional study of 200 people aged over 64 in Huelva (Spain) in 2014. Of these, 100 people were institutionalized in a residential facility and 100 were not. Cognitive impairment was assessed using the Mini-Mental State Examination (MMSE-35), basic activities of daily living by Barthel index, general health through the Goldberg GHQ-28 and social, clinical and behavioural variables were contemplated in the study. The association of cognitive impairment with all the variables was analysed using Chi-square test. Finally, a multivariate analysis was performed using logistic regression to identify possible joint influence of variables to study on the cognitive impairment. The prevalence of cognitive impairment in those institutionalized was 47%, higher than that of non-institutionalized group which was only 8% (p<.001). The dependence for basic activities for daily living and learning activities were the only variables in both groups which were associated with the cognitive impairment. Institutionalization (OR=5.368), age (OR=1.066) and dependence for basic activities (OR=5.036) were negatively associated with CI, while learning activities (OR=.227) were associated in a positive way. Conducting learning activities and the promotion of personal autonomy can delay cognitive impairment in older people. It is important to include cognitive stimulation programs aimed at the old population, especially in residential institutions. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  2. Cognitive profiles in Mild Cognitive Impairment (MCI patients associated with Parkinson′s disease and cognitive disorders

    Directory of Open Access Journals (Sweden)

    Michele Pistacchi

    2015-01-01

    Full Text Available Background: Mild cognitive impairment (MCI is rapidly becoming one of the most common clinical manifestations affecting the elderly and represents an heterogeneous clinical syndrome that can be ascribed to different etiologies; the construct of MCI in Parkinson′s disease (PD (MCI-PD is more recent but the range of deficits is still variable. Early recognition and accurate classification of MCI-PD could offer opportunities for novel therapeutic interventions to improve the natural pathologic course. Objective: To investigate the clinical phenotype of amnestic mild cognitive impairment (aMCI and in patients with PD and MCI (MCI-PD. Materials and Methods: Seventy-three patients with aMCI and in 38 patients with MCI-PD were enrolled. They all underwent Mini-mental State Examination (MMSE, the Rey auditory-verbal learning test and the immediate visual memory (IVM item of the Mental Deterioration Battery, the Rey auditory-verbal learning test included the Rey-immediate (Rey-I, and the delayed recall of the word list (Rey test deferred, Rey-D. The Geriatric Depression Scale (GDS was used for mood assessment. Results: The results of the Rey-I and Rey-D and of the IVM item showed statistically significant differences between the aMCI and the MCI-PD group. The mean Rey-I and Rey-D score was significantly lower as well as the IVM score was higher in patients with aMCI than in those with MCI-PD, aMCI patients showed greater impairment in long-term memory, whereas more aMCI than MCI-PD patients had preserved attention, computation, praxis, and conceptualization. Conclusions: Our findings demonstrate that the cognitive deficit profile is specific for each of the two disorders: Memory impairment was a typical feature in aMCI patients while MCI-PD patients suffered from executive functions and visuospatial attention deficits.

  3. Amyloid-beta 40 as a biomarker of cognitive impairment in acute ischemic stroke

    Directory of Open Access Journals (Sweden)

    Aleksey A. Kulesh

    2017-01-01

    Full Text Available Aim: to study the role of amyloid-beta 40 (Aβ 40 in the development of cognitive impairment in acute ischemic stroke.Materials and methods. The study included 70 patients aged 33–86 years, 46 men and 24 women. In patients with acute ischemic stroke cognitive status was assessed with Mini-Mental State Examination (MMSE, Montreal Cognitive Assessment Test (MoCA, Frontal Assessment Battery (FAB, Schulte tables, Clock Drawing Test, Test for Semantic Verbal Fluency and Five Words Test. The concentration of Aβ 40 in the cerebrospinal fluid was determined. Morphometric (size of the infarct and leukoaraiosis area, volume of the brain ventricles and hippocampus and diffusion-tensor parameters of MRI (fractional anisotropy of putamen, thalamus, hippocampus, corpus callosum, limbs of the internal capsule, the cingulate, the superior longitudinal and inferior fronto-occipital tracts were studied.Results. The concentration of Aβ 40 in the cerebrospinal fluid was 436,4 (226,0–514,0 pg/ml. The protein level was associated with the result of subtests «Orientation» (MMSE and «Attention» (MoCA, as well as indirect recall with cues in MoCA. Patients with MMSE score of 24–27 points were characterized by a lower concentration of Aβ 40 as compared to patients with a score less than 24 points. Aβ 40 concentration more than 436,4 pg/mL was associated with a more severe somatic co-morbidity of stroke (hypertension, lower hemoglobin and albumin level, higher erythrocyte sedimentation rate, a smaller volume of the brain ventricles, lower fractional anisotropy of the thalamus, cingulate tracts and contralateral hippocampus. Aβ 40 concentration more than 436,4 pg/mL was also associated with a lower global cognitive status (according to the MMSE and MoCA, as well as the reduction in certain cognitive functions, namely, attention, visual-spatial functions and memory.Conclusions. The concentration of Aβ 40 in the cerebrospinal fluid is a biological marker of

  4. Learning to predict is spared in mild cognitive impairment due to Alzheimer's disease.

    Science.gov (United States)

    Baker, Rosalind; Bentham, Peter; Kourtzi, Zoe

    2015-10-01

    Learning the statistics of the environment is critical for predicting upcoming events. However, little is known about how we translate previous knowledge about scene regularities to sensory predictions. Here, we ask whether patients with mild cognitive impairment due to Alzheimer's disease (MCI-AD) that are known to have spared implicit but impaired explicit recognition memory are able to learn temporal regularities and predict upcoming events. We tested the ability of MCI-AD patients and age-matched controls to predict the orientation of a test stimulus following exposure to sequences of leftwards or rightwards oriented gratings. Our results demonstrate that exposure to temporal sequences without feedback facilitates the ability to predict an upcoming stimulus in both MCI-AD patients and controls. Further, we show that executive cognitive control may account for individual variability in predictive learning. That is, we observed significant positive correlations of performance in attentional and working memory tasks with post-training performance in the prediction task. Taken together, these results suggest a mediating role of circuits involved in cognitive control (i.e. frontal circuits) that may support the ability for predictive learning in MCI-AD.

  5. Cognitive impairment related changes in the elemental concentration in the brain of old rat

    Energy Technology Data Exchange (ETDEWEB)

    Serpa, R.F.B. [Federal University of Rio de Janeiro/COPPE, Nuclear Instrumentation Laboratory, P.O. Box: 68509, Zip Code: 21941-972, Rio de Janeiro (Brazil)]. E-mail: renata@lin.ufrj.br; Jesus, E.F.O. de [University of Rio de Janeiro State, Physics Institute, RJ (Brazil); Anjos, M.J. [Federal University of Rio de Janeiro/COPPE, Nuclear Instrumentation Laboratory, P.O. Box: 68509, Zip Code: 21941-972, Rio de Janeiro (Brazil); University of Rio de Janeiro State, Physics Institute, RJ (Brazil); Lopes, R.T. [Federal University of Rio de Janeiro/COPPE, Nuclear Instrumentation Laboratory, P.O. Box: 68509, Zip Code: 21941-972, Rio de Janeiro (Brazil); Carmo, M.G.T. do [Federal University of Rio de Janeiro, Nutrition Institute, RJ (Brazil); Rocha, M.S. [Federal University of Rio de Janeiro, Department of Basics and Clinic Pharmacy, RJ (Brazil); Rodrigues, L.C. [Federal University of Rio de Janeiro, Department of Basics and Clinic Pharmacy, RJ (Brazil); Moreira, S. [University of Campinas State, Civil Engineering Department, SP (Brazil); Martinez, A.M.B. [Federal University of Rio de Janeiro, Department of Histology and Embryology, RJ (Brazil)

    2006-11-15

    In order to evaluate the elemental concentration as a function of learning and memory deficiency, six different structures of the brain were analyzed by total reflection X-ray fluorescence spectrometry with synchrotron radiation (SR-TXRF). To evaluate the cognitive processes, the animals were tested in an adaptation of the Morris water maze. After the test, the animals were divided into two groups: cognitively healthy (control group) and cognitively impaired. The measurements were carried out at XRF beam line at Light Synchrotron Brazilian laboratory, Campinas, Brazil. The following elements were identified: Al, P, S, Cl, K, Ca, Ti, Cr, Fe, Cu, Zn, Br and Rb. K concentration was higher in all regions of the brain studied for control group than the cognitively impaired group. Moreover, the control group presented higher levels for P and Fe in the entorhinal cortex, in the temporal cortex (only P), in the hypothalamus and in the thalamus, than the cognitively impaired group. Br concentration in the animals which presented cognitive impairment was three times larger in the hypothalamus and thalamus, twice larger in temporal cortex and higher in visual cortex than the cognitively healthy group. Cu was more remarkable in the hippocampus and hypothalamus from the animals with cognitive impairment than the control group. We observed that the cognitively impaired group presented highest concentrations of Br and Cu in certain areas than the control group, on the other hand, this group presented highest levels of K for all brain areas studied.

  6. Cognitive impairment related changes in the elemental concentration in the brain of old rat

    International Nuclear Information System (INIS)

    Serpa, R.F.B.; Jesus, E.F.O. de; Anjos, M.J.; Lopes, R.T.; Carmo, M.G.T. do; Rocha, M.S.; Rodrigues, L.C.; Moreira, S.; Martinez, A.M.B.

    2006-01-01

    In order to evaluate the elemental concentration as a function of learning and memory deficiency, six different structures of the brain were analyzed by total reflection X-ray fluorescence spectrometry with synchrotron radiation (SR-TXRF). To evaluate the cognitive processes, the animals were tested in an adaptation of the Morris water maze. After the test, the animals were divided into two groups: cognitively healthy (control group) and cognitively impaired. The measurements were carried out at XRF beam line at Light Synchrotron Brazilian laboratory, Campinas, Brazil. The following elements were identified: Al, P, S, Cl, K, Ca, Ti, Cr, Fe, Cu, Zn, Br and Rb. K concentration was higher in all regions of the brain studied for control group than the cognitively impaired group. Moreover, the control group presented higher levels for P and Fe in the entorhinal cortex, in the temporal cortex (only P), in the hypothalamus and in the thalamus, than the cognitively impaired group. Br concentration in the animals which presented cognitive impairment was three times larger in the hypothalamus and thalamus, twice larger in temporal cortex and higher in visual cortex than the cognitively healthy group. Cu was more remarkable in the hippocampus and hypothalamus from the animals with cognitive impairment than the control group. We observed that the cognitively impaired group presented highest concentrations of Br and Cu in certain areas than the control group, on the other hand, this group presented highest levels of K for all brain areas studied

  7. Screening an elderly hearing impaired population for mild cognitive impairment using Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA).

    Science.gov (United States)

    Lim, Magdalene Yeok Leng; Loo, Jenny Hooi Yin

    2018-07-01

    To determine if there is an association between hearing loss and poorer cognitive scores on Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) and to determine if poor hearing acuity affects scoring on the cognitive screening tests of MMSE and MoCA. One hundred fourteen elderly patients (Singapore residents) aged between 55 and 86 years were sampled. Participants completed a brief history questionnaire, pure tone audiometry, and 2 cognitive screening tests-the MMSE and MoCA. Average hearing thresholds of the better ear in the frequencies of 0.5, 1, 2, and 4 kHz were used for data analysis. Hearing loss was significantly associated with poorer cognitive scores in Poisson regression models adjusted for age. Mini-Mental State Examination scores were shown to decrease by 2.8% (P = .029), and MoCA scores by 3.5% (P = .013) for every 10 dB of hearing loss. Analysis of hearing-sensitive components of "Registration" and "Recall" in MMSE and MoCA using chi-square tests showed significantly poorer performance in the hearing loss group as compared to the normal hearing group. Phonetic analysis of target words with high error rates shows that the poor performance was likely contributed by decreased hearing acuity, on top of a possible true deficit in cognition in the hearing impaired. Hearing loss is associated with poorer cognitive scores on MMSE and MoCA, and cognitive scoring is likely confounded by poor hearing ability. This highlights an important, often overlooked aspect of sensory impairment during cognitive screening. Provisions should be made when testing for cognition in the hearing-impaired population to avoid over-referral and subsequent misdiagnoses of cognitive impairment. Copyright © 2018 John Wiley & Sons, Ltd.

  8. Brain magnetic resonance imaging correlates of impaired cognition in patients with type 2 diabetes.

    NARCIS (Netherlands)

    Manschot, S.M.; Brands, A.M.; Grond, J. van der; Kessels, R.P.C.; Algra, A.; Kappelle, L.J.; Biessels, G.J.

    2006-01-01

    The structural correlates of impaired cognition in type 2 diabetes are unclear. The present study compared cognition and brain magnetic resonance imaging (MRI) between type 2 diabetic patients and nondiabetic control subjects and assessed the relationship between cognition and MRI findings and blood

  9. Association of social and cognitive impairment and biomarkers in autism spectrum disorders

    Science.gov (United States)

    2014-01-01

    Objectives The neurological basis for autism is still not fully understood, and the role of the interaction between neuro-inflammation and neurotransmission impairment needs to be clearer. This study aims to test the possible association between impaired levels of gamma aminobutyric acid (GABA), serotonin, dopamine, oxytocin, and interferon-γ-induced protein-16 (IFI16) and the severity of social and cognitive dysfunctions in individuals with autism spectrum disorders. Materials and methods GABA, serotonin, dopamine, oxytocin, and IFI16 as biochemical parameters related to neurochemistry and inflammation were determined in the plasma of 52 Saudi autistic male patients, categorized as mild-moderate and severe as indicated by their Childhood Autism Rating Scale (CARS) or social responsiveness scale (SRS), and compared to 30 age- and gender-matched control samples. Results The data indicated that Saudi patients with autism have remarkably impaired plasma levels of the measured parameters compared to age and gender-matched controls. While serotonin in platelet-free plasma and dopamine did not correlated with the severity in social and cognitive dysfunction, GABA, oxytocin, and IFI16 were remarkably associated with the severity of both tested scores (SRS and CARS). Conclusions The relationship between the selected parameters confirms the role of impaired neurochemistry and neuro-inflammation in the etiology of autism spectrum disorders and the possibility of using GABA, oxytocin, and IFI16 as markers of autism severity. Receiver operating characteristic analysis together with predictiveness diagrams proved that the measured parameters could be used as predictive biomarkers of clinical symptoms and provide significant guidance for future therapeutic strategy to re-establish physiological homeostasis. PMID:24400970

  10. Impaired Representation of Time in Schizophrenia Is Linked to Positive Symptoms and Cognitive Demand.

    Directory of Open Access Journals (Sweden)

    Jutta Peterburs

    Full Text Available Time processing critically relies on the mesencephalic dopamine system and striato-prefrontal projections and has thus been suggested to play a key role in schizophrenia. Previous studies have provided evidence for an acceleration of the internal clock in schizophrenia that may be linked to dopaminergic pathology. The present study aimed to assess the relationship between altered time processing in schizophrenia and symptom manifestation in 22 patients and 22 controls. Subjects were required to estimate the time needed for a visual stimulus to complete a horizontal movement towards a target position on trials of varying cognitive demand. It was hypothesized that patients - compared to controls - would be less accurate at estimating the movement time, and that this effect would be modulated by symptom manifestation and task difficulty. In line with the notion of an accelerated internal clock due to dopaminergic dysregulation, particularly patients with severe positive symptoms were expected to underestimate movement time. However, if altered time perception in schizophrenia was better explained in terms of cognitive deficits, patients with severe negative symptoms should be specifically impaired, while generally, task performance should correlate with measures of processing speed and cognitive flexibility. Patients underestimated movement time on more demanding trials, although there was no link to disease-related cognitive dysfunction. Task performance was modulated by symptom manifestation. Impaired estimation of movement time was significantly correlated with PANSS positive symptom scores, with higher positive symptom scores associated with stronger underestimation of movement time. The present data thus support the notion of a deficit in anticipatory and predictive mechanisms in schizophrenia that is modulated both by symptom manifestation and by cognitive demand.

  11. Resveratrol Improves Cognitive Impairment by Regulating Apoptosis and Synaptic Plasticity in Streptozotocin-Induced Diabetic Rats

    Directory of Open Access Journals (Sweden)

    Zhiyan Tian

    2016-12-01

    Full Text Available Aims: To investigate the effects of resveratrol on cognitive impairment in streptozotocin (STZ-induced diabetic rats and to explore the mechanisms of that phenomenon. Methods: Sixty healthy male Sprague Dawley rats were randomly divided into four groups: normal control group (Con group, n = 15, Res group (normal Sprague Dawley rats treated with resveratrol, n = 15, diabetes mellitus group (DM group, n = 15 and DM + Res group (diabetic rats treat with resveratrol, n = 15. Streptozotocin (STZ was injected intraperitoneally to establish the diabetic model. One week after diabetic model induction, the animals in the Res group and the DM + Res group received resveratrol intraperitoneally once a day for consecutive 4 weeks. The Morris water maze test was applied to assess the effect of resveratrol on learning and memory. To explore the mechanisms of resveratrol on cognition, we detected the protein expression levels of Caspase-3, Bcl-2, Bax, NMDAR1 (N-Methyl-d-Aspartate receptor and BDNF (Brain Derived Neurotrophic Factor via western blotting analysis. Results: Resveratrol has no obvious effect on normal SD rats. Compared to Con group, cognitive ability was significantly impaired with increased expression of Caspase-3, Bax and down-regulation of Bcl-2, NMDAR1 and BDNF in diabetic rats. By contrast, resveratrol treatment improved the cognitive decline. Evidently, resveratrol treatment reversed diabetes-induced changes of protein expression. Conclusions: Resveratrol significantly ameliorates cognitive decline in STZ-induced diabetic model rats. The potential mechanism underlying the protective effect could be attributed to the inhibition of hippocampal apoptosis through the Bcl-2, Bax and Caspase-3 signaling pathways and improvement of synaptic dysfunction. BDNF may also play an indispensable role in this mechanism.

  12. First translational 'Think Tank' on cerebrovascular disease, cognitive impairment and dementia.

    Science.gov (United States)

    Barone, Frank C; Gustafson, Deborah; Crystal, Howard A; Moreno, Herman; Adamski, Mateusz G; Arai, Ken; Baird, Alison E; Balucani, Clotilde; Brickman, Adam M; Cechetto, David; Gorelick, Philip; Biessels, Geert Jan; Kiliaan, Amanda; Launer, Lenore; Schneider, Julie; Sorond, Farzaneh A; Whitmer, Rachel; Wright, Clinton; Zhang, Zheng Gang

    2016-02-13

    As the human population continues to age, an increasing number of people will exhibit significant deficits in cognitive function and dementia. It is now recognized that cerebrovascular, metabolic and neurodegenerative diseases all play major roles in the evolution of cognitive impairment and dementia. Thus with our more recent recognition of these relationships and our need to understand and more positively impact on this world health problem, "The Leo and Anne Albert Charitable Trust" (Gene Pranzo, Trustee with significant support from Susan Brogan, Meeting Planner) provided generous support for this inaugural international workshop that was held from April 13-16, 2015 at the beautiful Ritz Carlton Golf Resort in North Naples, Florida. Researchers from SUNY Downstate Medical Center, Brooklyn, NY organized the event by selecting the present group of translationally inclined preclinical, clinical and population scientists focused on cerebrovascular disease (CVD) risk and its progression to vascular cognitive impairment (VCI) and dementia. Participants at the workshop addressed important issues related to aging, cognition and dementia by: (1) sharing new data, information and perspectives that intersect vascular, metabolic and neurodegenerative diseases, (2) discussing gaps in translating population risk, clinical and preclinical information to the progression of cognitive loss, and (3) debating new approaches and methods to fill these gaps that can translate into future therapeutic interventions. Participants agreed on topics for group discussion prior to the meeting and focused on specific translational goals that included promoting better understanding of dementia mechanisms, the identification of potential therapeutic targets for intervention, and discussed/debated the potential utility of diagnostic/prognostic markers. Below summarizes the new data-presentations, concepts, novel directions and specific discussion topics addressed by this international

  13. Different Functional and Microstructural Changes Depending on Duration of Mild Cognitive Impairment in Parkinson Disease.

    Science.gov (United States)

    Shin, N-Y; Shin, Y S; Lee, P H; Yoon, U; Han, S; Kim, D J; Lee, S-K

    2016-05-01

    The higher cortical burden of Lewy body and Alzheimer disease-type pathology has been reported to be associated with a faster onset of cognitive impairment of Parkinson disease. So far, there has been a few studies only about the changes of gray matter volume depending on duration of cognitive impairment in Parkinson disease. Therefore, our aim was to evaluate the different patterns of structural and functional changes in Parkinson disease with mild cognitive impairment according to the duration of parkinsonism before mild cognitive impairment. Fifty-nine patients with Parkinson disease with mild cognitive impairment were classified into 2 groups on the basis of shorter (parkinsonism before mild cognitive impairment. Fifteen drug-naïve patients with de novo Parkinson disease with intact cognition were included for comparison. Cortical thickness, Tract-Based Spatial Statistics, and seed-based resting-state functional connectivity analyses were performed. Age, sex, years of education, age at onset of parkinsonism, and levodopa-equivalent dose were included as covariates. The group with shorter duration of parkinsonism before mild cognitive impairment showed decreased fractional anisotropy and increased mean and radial diffusivity values in the frontal areas compared with the group with longer duration of parkinsonism before mild cognitive impairment (corrected P parkinsonism before mild cognitive impairment showed decreased resting-state functional connectivity in the default mode network area when the left or right posterior cingulate was used as a seed, and in the dorsolateral prefrontal areas when the left or right caudate was used as a seed (corrected P parkinsonism before mild cognitive impairment showed decreased resting-state functional connectivity mainly in the medial prefrontal cortex when the left or right posterior cingulate was used as a seed, and in the parieto-occipital areas when the left or right caudate was used as a seed (corrected P Parkinson

  14. Altered Wnt Signaling Pathway in Cognitive Impairment Caused by Chronic Intermittent Hypoxia: Focus on Glycogen Synthase Kinase-3β and β-catenin

    Directory of Open Access Journals (Sweden)

    Yue-Ying Pan

    2016-01-01

    Conclusions: Wnt/β-catenin signaling pathway abnormalities possibly play an important role in the development of cognitive deficits among mice exposed to CIH and that LiCl might attenuate CIH-induced cognitive impairment via Wnt/β-catenin signaling pathway.

  15. Assessment of cognitive impairment in patients with Parkinson's disease: prevalence and risk factors

    Directory of Open Access Journals (Sweden)

    Wang Q

    2014-02-01

    Full Text Available Qiumei Wang,1 Zhenxin Zhang,2 Ling Li,2 Hongbo Wen,2 Qun Xu3,4 1Department of Geriatrics, 2Department of Neurology, 3School of Basic Medicine, Peking Union Medical College Hospital, 4Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing, People's Republic of China Background: Although Parkinson's disease (PD is clinically characterized by motor symptoms, cognitive impairment is one of the most disabling non-motor symptoms. Despite it attracting increasing attention worldwide, less is known about its prevalence in the Chinese population. The objective of this study was to assess cognitive impairment and related risk factors in Chinese PD patients. Methods: We collected the demographic, diagnostic, and treatment information of 901 PD patients from 42 centers throughout the People's Republic of China, then administered a battery of neuropsychological tests, to assess motor, cognitive, and neuropsychiatric symptoms. Results: Overall, 193 of 901 (21.4% PD patients met the criteria for dementia (PD-D, and 206 (22.8% met the criteria for mild cognitive impairment (PD-MCI. Visuospatial dysfunction and attention/executive impairment predominated. Increased severity of cognitive impairment was associated with greater motor impairment. Patients with psychiatric symptoms, such as depression and hallucinations, were more likely to have dementia. Potentially, the younger-aged and more educated are shown less cognitive impairment, but age at onset, and levodopa equivalent dose, were not associated with the presence of cognitive dysfunction. Conclusion: The prevalence and profile of cognitive impairment in Chinese PD patients, as well as the risk factors, are similar as those reported for other races, but the frequency of nonamnestic cognitive domains differs. Keywords: cognitive impairment, risk factor, prevalence, Parkinson's disease

  16. Gray matter trophism, cognitive impairment, and depression in patients with multiple sclerosis.

    Science.gov (United States)

    Pravatà, Emanuele; Rocca, Maria A; Valsasina, Paola; Riccitelli, Gianna C; Gobbi, Claudio; Comi, Giancarlo; Falini, Andrea; Filippi, Massimo

    2017-12-01

    Cognitive impairment and depression frequently affects patients with multiple sclerosis (MS). However, the relationship between the occurrence of depression and cognitive impairment and the development of cortical atrophy has not been fully elucidated yet. To investigate the association of cortical and deep gray matter (GM) volume with depression and cognitive impairment in MS. Three-dimensional (3D) T1-weighted scans were obtained from 126 MS patients and 59 matched healthy controls. Cognitive impairment was assessed using the Brief Repeatable Battery of Neuropsychological Tests and depression with the Montgomery-Asberg Depression Rating Scale (MADRS). Using FreeSurfer and FIRST software, we assessed cortical thickness (CTh) and deep GM volumetry. Magnetic resonance imaging (MRI) variables explaining depression and cognitive impairment were investigated using factorial and classification analysis. Multivariate regression models correlated GM abnormalities with symptoms severity. Compared with controls, MS patients exhibited widespread bilateral cortical thinning involving all brain lobes. Depressed MS showed selective CTh decrease in fronto-temporal regions, whereas cognitive impairment MS exhibited widespread fronto-parietal cortical and subcortical GM atrophy. Frontal cortical thinning was the best predictor of depression ( C-statistic = 0.7), whereas thinning of the right precuneus and high T2 lesion volume best predicted cognitive impairment ( C-statistic = 0.8). MADRS severity correlated with right entorhinal cortex thinning, whereas cognitive impairment severity correlated with left entorhinal and thalamus atrophy. MS-related depression is linked to circumscribed CTh changes in areas deputed to emotional behavior, whereas cognitive impairment is correlated with cortical and subcortical GM atrophy of circuits involved in cognition.

  17. Is anemia associated with cognitive impairment and delirium among older acute surgical patients?

    Science.gov (United States)

    Myint, Phyo Kyaw; Owen, Stephanie; McCarthy, Kathryn; Pearce, Lyndsay; Moug, Susan J; Stechman, Michael J; Hewitt, Jonathan; Carter, Ben

    2018-03-01

    The determinants of cognitive impairment and delirium during acute illness are poorly understood, despite being common among older people. Anemia is common in older people, and there is ongoing debate regarding the association between anemia, cognitive impairment and delirium, primarily in non-surgical patients. Using data from the Older Persons Surgical Outcomes Collaboration 2013 and 2014 audit cycles, we examined the association between anemia and cognitive outcomes in patients aged ≥65 years admitted to five UK acute surgical units. On admission, the Confusion Assessment Method was carried out to detect delirium. Cognition was assessed using the Montreal Cognitive Assessment, and two levels of impairment were defined as Montreal Cognitive Assessment cognitive impairment or delirium. The adjusted odds ratios of cognitive impairment were 0.95 (95% CI 0.56-1.61) and 1.00 (95% CI 0.61-1.64) for the Montreal Cognitive Assessment cognitive outcomes among older people in this acute surgical setting. Considering the retrospective nature of the study and possible lack of power, findings should be taken with caution. Geriatr Gerontol Int 2018; ••: ••-••. © 2018 The Authors Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.

  18. Physical Performance Is Associated with Working Memory in Older People with Mild to Severe Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    K. M. Volkers

    2014-01-01

    Full Text Available Background. Physical performances and cognition are positively related in cognitively healthy people. The aim of this study was to examine whether physical performances are related to specific cognitive functioning in older people with mild to severe cognitive impairment. Methods. This cross-sectional study included 134 people with a mild to severe cognitive impairment (mean age 82 years. Multiple linear regression was performed, after controlling for covariates and the level of global cognition, with the performances on mobility, strength, aerobic fitness, and balance as predictors and working memory and episodic memory as dependent variables. Results. The full models explain 49–57% of the variance in working memory and 40–43% of episodic memory. Strength, aerobic fitness, and balance are significantly associated with working memory, explaining 3–7% of its variance, irrespective of the severity of the cognitive impairment. Physical performance is not related to episodic memory in older people with mild to severe cognitive impairment. Conclusions. Physical performance is associated with working memory in older people with cognitive impairment. Future studies should investigate whether physical exercise for increased physical performance can improve cognitive functioning. This trial is registered with ClinicalTrials.gov NTR1482.

  19. Association between intake of B vitamins and cognitive function in elderly Koreans with cognitive impairment.

    Science.gov (United States)

    Kim, Hyesook; Kim, Ggotpin; Jang, Won; Kim, Seong Yoon; Chang, Namsoo

    2014-12-17

    It is possible that blood B vitamins level and cognitive function may be affected by dietary intake of these vitamins, no study however has yet been conducted on relationships between B vitamins intake and cognitive function among elderly population in Korea. This study examined the relationship between B vitamins intake and cognitive function among elderly in South Korea. Participants consisted of 100 adults with mild cognitive impairment (MCI), 100 with Alzheimer's disease (AD), and 121 normal subjects. Dietary intake data that included the use of dietary supplements were obtained using a 24-hour recall method by well-trained interviewers. Plasma folate and vitamin B12 concentrations were analyzed by radioimmunoassay, and homocysteine (Hcy) was assessed by a high performance liquid chromatography-fluorescence method. Plasma levels of folate and vitamin B12 were positively correlated with B vitamins intake; and plasma Hcy was negatively correlated with total intake of vitamin B2, vitamin B6, vitamin B12 and folate. In the AD group, a multiple regression analysis after adjusting for covariates revealed positive relationships between vitamin B2 intake and test scores for the MMSE-KC, Boston Naming, Word Fluency, Word List Memory and Constructional Recall Tests; and between vitamin B6 intake and the MMSE-KC, Boston Naming, Word Fluency, Word List Memory, Word List Recognition, Constructional Recall and Constructional Praxis Tests. Positive associations were observed between vitamin B12 intake and the MMSE-KC, Boston Naming, Constructional Recall and Constructional Praxis Tests, and between folate intake and the Constructional Recall Test. In the MCI group, vitamin B2 intake was positively associated with the MMSE-KC and Boston Naming Test, vitamin B6 intake was positively associated with the Boston Naming Test, and folate intake was positively associated with the MMSE-KC and Word List Memory test. No associations were observed in the normal group. These results