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

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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.

Is impaired cerebral vasoreactivity an early marker of cognitive decline in multiple sclerosis patients?

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Metzger, Aude; Le Bars, Emmanuelle; Deverdun, Jeremy; Molino, François; Maréchal, Bénédicte; Picot, Marie-Christine; Ayrignac, Xavier; Carra, Clarisse; Bauchet, Luc; Krainik, Alexandre; Labauge, Pierre; Menjot de Champfleur, Nicolas

2018-03-01

The link between cerebral vasoreactivity and cognitive status in multiple sclerosis remains unclear. The aim of the present study was to investigate a potential decrease of cerebral vasoreactivity in multiple sclerosis patients and correlate it with cognitive status. Thirty-three patients with multiple sclerosis (nine progressive and 24 remitting forms, median age: 39 years, 12 males) and 22 controls underwent MRI with a hypercapnic challenge to assess cerebral vasoreactivity and a neuropsychological assessment. Cerebral vasoreactivity, measured as the cerebral blood flow percent increase normalised by end-tidal carbon dioxide variation, was assessed globally and by regions of interest using the blood oxygen level-dependent technique. Non-parametric statistics tests were used to assess differences between groups, and associations were estimated using linear models. Cerebral vasoreactivity was lower in patients with cognitive impairment than in cognitively normal patients (p=0.004) and was associated with education level in patients (R 2 = 0.35; p = 0.047). There was no decrease in cerebral vasoreactivity between patients and controls. Cognitive impairment in multiple sclerosis may be mediated through decreased cerebral vasoreactivity. Cerebral vasoreactivity could therefore be considered as a marker of cognitive decline in multiple sclerosis. • Cerebral vasoreactivity does not differ between multiple sclerosis patients and controls. • Cerebral vasoreactivity measure is linked to cognitive impairment in multiple sclerosis. • Cerebral vasoreactivity is linked to level of education in multiple sclerosis.

Cortisol and cognitive function in midlife: the role of childhood cognition and educational attainment.

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Gaysina, Darya; Gardner, Michael P; Richards, Marcus; Ben-Shlomo, Yoav

2014-09-01

Adult cognition and age-related cognitive decline can be influenced by dysregulation of the hypothalamic pituitary adrenal axis with concomitant changes in cortisol levels. However, very little is known about the role of childhood cognition and educational attainment in this relationship. Using data from the British 1946 birth cohort, the present study investigated: (1) associations between cortisol levels and patterns and cognitive function in midlife; (2) direct and interactive effects of childhood cognition, educational attainment and cortisol on cognitive function in midlife. Verbal memory, letter search speed and reaction time were assessed at age 60-64 years. Salivary cortisol samples (wakening, 30 min after wakening and evening) were collected at the same age. Childhood cognitive ability was measured at ages 8, 11, and 15, and educational level was reported at age 26. Associations between cortisol, childhood cognition, educational attainment and cognitive function in midlife were tested using linear regression and structural equation modelling approaches. Higher evening cortisol level was associated with slower reaction time and lower verbal memory. These associations were independent of childhood cognition and education as well as a range of other potential confounders. Childhood cognition and education were not directly associated with evening cortisol. However, there was a significant interaction effect between childhood cognition and evening cortisol on reaction time (p=.002): higher evening cortisol was associated with slower reaction time only among those with low childhood cognitive ability. There was little evidence of associations between the other cortisol measures and cognitive function. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

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

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

2008-08-01

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

Self-awareness of cognitive efficiency: Differences between healthy elderly and patients with mild cognitive impairment (MCI).

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Fragkiadaki, Stella; Kontaxopoulou, Dionysia; Beratis, Ion N; Andronas, Nikolaos; Economou, Alexandra; Yannis, George; Papanicolaou, Andrew; Papageorgiou, Sokratis G

2016-12-01

Self-estimation of performance implies the ability to understand one's own performance with relatively objective terms. Up to date, few studies have addressed this topic in mild cognitive impairment (MCI) patients. The aim of the present study was to compare objective measures of performance with subjective perception of specific performance on cognitive tests and investigate differences in assessment between MCI patients and healthy elderly. Thirty-five participants diagnosed with MCI (women = 16, men = 19, mean age = 65.09 years ±SD = 7.81, mean education = 12.83 years ±SD = 4.32) and 35 control subjects similar in terms of age and education (women = 20, men = 15, mean age = 62.46 years ± SD = 9.35, mean education = 14.26 ± SD = 2.84) were examined with an extended battery of neuropsychological tests. After every test they were asked to self-evaluate their performance by comparing it to what they considered as average for people of their age and educational level. This self-evaluation was reported on a scale ranging from -100 to +100. Significant differences were found in the self-assessment patterns of the two groups in memory measures of verbal and visual delayed recall, visuospatial perception, and tests of attention. MCI patients overestimated their performance on every cognitive domain while control participants underestimated their performance on measures of verbal memory. The present results indicate that accuracy of self-report is not uniform across groups and functional areas. The discrepancies in the MCI patients indicate unawareness of their memory deficits, which is contradictory to subjective memory complaints as being an important component for clinical diagnosis.

Cognition and Comorbidity Behavior in Hospitalized Patients Suffering from Stroke. Seychelles 2010-2011

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Armando Carlos Roca Socarras

2012-10-01

Full Text Available Background: cognitive impairment and high comorbidity are common health problems in patients with cerebrovascular disease. Objective: to describe the behavior of cognitive impairment and comorbidity in hospitalized patients suffering from stroke. Method: descriptive study of 77 patients with ischemic stroke admitted from April 2010 to December 2011, in Seychelles General Hospital. The behavior of this disease in relation to variables such as age, presence of chronic noncommunicable diseases, cognitive impairment, educational level, affected cerebral hemisphere and time of evolution was analyzed. Results: 68,9 % of patients presented cognitive impairment, their average age was 74,2 (± 9,19 years old compared to 62,4 (± 14,2 years old for those with no cognitive impairment. We found a higher frequency of chronic noncommunicable diseases in cognitively impaired patients with a Charlson comorbidity index of 2,11 (± 0,97. 18 patients with cognitive impairment and 23 patients with no cognitive impairment were diagnosed with depression. Conclusions: more than half of hospitalized patients experienced cognitive impairment and in most cases previous to cerebrovascular disease. Male patients predominated. There was an increase in age, severity of depression, as well as in the frequency of chronic noncommunicable diseases, and myocardial infarction of considerable size, in respect to patients with no cognitive impairment.

Validity of Montreal Cognitive Assessment in non-english speaking patients with Parkinson's disease.

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Krishnan, Syam; Justus, Sunitha; Meluveettil, Radhamani; Menon, Ramshekhar N; Sarma, Sankara P; Kishore, Asha

2015-01-01

The Montreal Cognitive Assessment is a brief and easy screening tool for accurately testing cognitive dysfunction in Parkinson's disease. We tested its validity for use in non-English (Malayalam) speaking patients with Parkinson's disease. We developed a Malayalam (a south-Indian language) version of Montreal Cognitive Assessment and applied to 70 patients with Parkinson's disease and 60 age- and education-matched healthy controls. Metric properties were assessed, and the scores were compared with the performance in validated Malayalam versions of Mini Mental Status Examination and Addenbrooke's Cognitive Examination. The Montreal Cognitive Assessment-Malayalam showed good internal consistency and test-retest reliability and its scores correlated with Mini Mental Status Examination (patients: R = 0.70; P speaking Parkinson's disease patients for early screening and potential future interventions for cognitive dysfunction.

Performance of low-educated elders with depression on Addenbrooke's Cognitive Examination-Revised (ace-r test

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Michele Beckert

Full Text Available Along with cognitive disorders, depression has been a concern for mental health services due to its highly debilitating effect on the functioning and quality of life of the elderly. However, there is still little understanding of the cognitive alterations resulting from depression or of the difficult differential diagnosis with mild cognitive impairment (MCI. It is known that performance on cognitive tests is strongly influenced by education but few studies have been conducted involving low-educated populations. Objective : To evaluate the performance of elders with low education and no dementia on Addenbrooke's Cognitive Examination-Revised (ACE-R test and its cognitive domains, and compare patients with Current Major Depressive Episode (CMDE against those without depressive symptoms. Methods : A retrospective, cross-sectional analytical study was conducted based on medical files of patients treated at the Cerebral Aging Clinic of the Hospital São Lucas of the PUCRS. The study included 116 individuals with low education (< 8 years of education aged between 60 and 84 (69.6 ± 6.4 years, with MCDE (N = 41 and controls (N = 75. Results : No significant difference was observed between control and MCDE groups in median scores on the ACE-R, Mini-Mental State Examination, and the five cognitive domains. There was also no difference between the groups on separate analyses of results on the clock drawing test, the categorical verbal and phonological fluency test, and the naming test. Conclusion : The results of this study showed that depressive symptoms did not influence scores on the ACE-R tests conducted in elders with low education.

Different cognitive profiles of Brazilian patients with relapsing-remitting and primary progressive multiple sclerosis

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Dóra-Neide Rodrigues

2011-08-01

Full Text Available Cognitive impairment is a symptom of multiple sclerosis (MS. Different clinical forms of multiple sclerosis have different cognitive profiles, according to findings of previous studies which used extensive batteries of neuropsychological tests. OBJECTIVE: To investigate cognitive profiles of Brazilian patients with relapsing-remitting multiple sclerosis (RRMS and primary progressive multiple sclerosis (PPMS by using a brief battery of neuropsychological tests. METHOD: Sixty-six patients, within 18-65 of age and 3-18 years of education, were paired with healthy control subjects, regarding gender, age, and education level. RESULTS: On Symbol Digit Modalities Test and Hooper Visual Organization Test, cognition was affected in 50% in RRMS and 69% in PPMS. Fluency of "F" was impaired in 24% of RRMS and 81% of PPMS. Immediate recall was affected in 32% of RRMS and in 63% of PPMS; whereas late recall, in 46% of relapsing-remitting and in 69% of primary progressive. CONCLUSION: Cognitive profiles of relapsing-remitting and primary progressive patients are different

Pulse wave velocity is associated with cognitive impairment in hemodialysis patients.

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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.

Cognitive function in patients with primary adrenal insufficiency (Addison's disease).

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Schultebraucks, Katharina; Wingenfeld, Katja; Heimes, Jana; Quinkler, Marcus; Otte, Christian

2015-05-01

Patients with primary adrenal insufficiency (AI) need to replace glucocorticoids and mineralocorticoids that act on glucocorticoid (GR) and mineralocorticoid receptors (MR). Both receptors are highly expressed in the hippocampus and are closely associated with cognitive function, which might be impaired by insufficient or increased GR and MR stimulation. However, little is known about cognitive function in patients with AI. It was examined whether patients with AI exhibit worse cognitive function compared to sex-, age-, and education-matched controls. Cognitive function (executive function, concentration, verbal memory, visual memory, working memory, and autobiographical memory) was assessed in 30 patients with AI (mean age 52.4 yrs. ±14.4, n=21 women, mean duration of illness 18.2 yrs. ±11.1) and 30 matched controls. We also measured depressive symptoms, body mass index (BMI), and blood pressure. Patients with AI showed more depressive symptoms, had a greater BMI and lower systolic blood pressure compared to controls. Adjusted analyses controlling for these variables revealed that patients with AI performed significantly worse in verbal learning (F=7.8, p=.007). Executive function, concentration, working memory, verbal memory, visuospatial memory, and autobiographical memory did not differ between groups. No clinically relevant cognitive impairment was found in patients with AI compared to matched controls. Even long-term glucocorticoid and mineralocorticoid substitution over almost two decades appears to have only subtle effects on cognition in patients with AI. Copyright © 2015 Elsevier Ltd. All rights reserved.

Social Cognitive Determinants of Patient Education Intention among Nurses

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Mehdi Mirzaei-Alavijeh

2017-06-01

Full Text Available Background and Objectives: Patient education is an important nursing duty. This practice is considered as one of the standards of nursing care quality, which plays an important role in the health promotion of the patients. Regarding this, the present study aimed to determine the predictors of behavioral intention of patient education among the nurses based on the theory of planned behavior. Materials and Methods: This descriptive cross-sectional study was conducted on 300 nurses working at teaching hospitals affiliated to Kermanshah University of Medical Sciences, Kermanshah, Iran. The study population was selected through cluster sampling with a probability proportional to size. The data were collected using self-report questionnaire. The questionnaire consisted of two parts, including items related to demographic data and theory of planned behavior regarding the intention of patient education. The data were analyzed using linear regression, Chi-square test, t-test, ANOVA, and Pearson correlation in SPSS version 16. P-value less than 0.05 was considered statistically significant. Results: Attitudes, subjective norms, and perceived behavioral control accounted for 35% of the variance in patient education behavioral intention among the nurses (R2=0.35, out of which attitude was the strongest predictor (ß=0.287. Furthermore, behavioral intention was significantly correlated with subjective norms (r=0.470, P<0.001, perceived behavioral control (r=0.384, P<0.001, and attitude (r=0.508, P<0.001. Conclusion: As the findings indicated, attitude had a higher impact on the nurses’ behavioral intention of patient education. Therefore, it is suggested to pay more attention to this determinant.

Educational Cognitive Technologies as Human Adaptation Strategies

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Marja Nesterova

2017-07-01

Full Text Available Modernity is characterized by profound changes in all spheres of human life caused by the global transformations on macro and micro levels of social reality. These changes allow us to speak about the present as the era of civilizational transition in the mode of uncertainty. Therefore, this situation demands qualitative transformations of human adaptive strategies and educational technologies accordingly. The dominant role in the dynamics of pedagogics and andragogy’s landscape belongs to transformative learning. The transformative learning theory is considered as the relevant approach to education of the individual, which is able to become an autonomous communicative actor of the social complexity. The article considers the cognitive technologies of social cohesion development and perspectives of their implementation in the educational dimension. In addition to implementing the principles of inclusion, equity in education, an important factor for improving social cohesion, stability and unity of society is the development of cognitive educational technologies. The key factors and foundations for the cognitive educational technologies are transversal competencies. They create the conditions for civil, public dialogue, non-violent type of communication. These “21st century skills” are extremely important for better human adaptation. One of the aspects and roots of social adaptation is social cohesion. Mutual determinations and connections between social cohesion development and transversal competences have been shown. The perspective direction of further researches is to find a methodological base for the further development of cognitive education technologies and platform for realization of innovative services for educational programs. New educational paradigm offers the concept of human adaptation as cognitive effectiveness and how to reach it through educational technologies. The article includes topics of creative thinking, teambuilding

The Global Cognition, Frontal Lobe Dysfunction and Behavior Changes in Chinese Patients with Multiple System Atrophy.

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Bei Cao

Full Text Available Studies on cognition in multiple system atrophy (MSA patients are limited.A total of 110 MSA patients were evaluated using Addenbrooke's Cognitive Examination-Revised (ACE-R, Frontal Assessment Battery (FAB, Frontal Behavioral Inventory (FBI, and Unified MSA Rating Scale (UMSARS tests. Fifty-five age-, sex-, education- and domicile-matched healthy controls were recruited to perform the FAB and ACE-R scales.Approximately 32.7% of the patients had global cognitive deficits with the most impaired domain being verbal fluency and visuospatial ability (26.4%, followed by memory (24.5%, language (20% and orientation/attention (20% based on a cut-off score of ACE-R ≤ 70. A total of 41.6% of the patients had frontal lobe dysfunction, with inhibitory control (60.9% as the most impaired domain based on a cut-off score of FAB ≤14. Most patients (57.2% showed moderate frontal behavior changes (FBI score 4-15, with incontinence (64.5% as the most impaired domain. The binary logistic regression model revealed that an education level < 9 years (OR:13.312, 95% CI:2.931-60.469, P = 0.001 and UMSARS ≥ 40 (OR: 2.444, 95%CI: 1.002-5.962, P< 0.049 were potential determinants of abnormal ACE-R, while MSA-C (OR: 4.326, 95%CI: 1.631-11.477, P = 0.003, an education level < 9 years (OR:2.809 95% CI:1.060-7.444, P = 0.038 and UMSARS ≥ 40 (OR:5.396, 95%CI: 2.103-13.846, P < 0.0001 were potential determinants of abnormal FAB.Cognitive impairment is common in Chinese MSA patients. MSA-C patients with low education levels and severe motor symptoms are likely to experience frontal lobe dysfunction, while MSA patients with low education levels and severe motor symptoms are likely to experience global cognitive deficits. These findings strongly suggest that cognitive impairment should not be an exclusion criterion for the diagnosis of MSA.

The assessment of changes in cognitive functioning: age-, education-, and gender-specific reliable change indices for older adults tested on the CERAD-NP battery: results of the German Study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe).

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Stein, Janine; Luppa, Melanie; Luck, Tobias; Maier, Wolfgang; Wagner, Michael; Daerr, Moritz; van den Bussche, Hendrik; Zimmermann, Thomas; Köhler, Mirjam; Bickel, Horst; Mösch, Edelgard; Weyerer, Siegfried; Kaufeler, Teresa; Pentzek, Michael; Wiese, Birgitt; Wollny, Anja; König, Hans-Helmut; Riedel-Heller, Steffi G

2012-01-01

The Consortium to Establish a Registry for Alzheimer's Disease-Neuropsychological (CERAD-NP) battery represents a commonly used neuropsychological instrument to measure cognitive functioning in the elderly. This study provides normative data for changes in cognitive function that normally occur in cognitively healthy individuals to interpret changes in CERAD-NP test scores over longer time periods. Longitudinal cohort study with three assessments at 1.5-year intervals over a period of 3 years. : Primary care medical record registry sample. As part of the German Study on Ageing, Cognition, and Dementia in Primary Care Patients, a sample of 1,450 cognitively healthy general practitioner patients, age 75 years and older, was assessed. Age-, education-, and gender-specific Reliable Change Indices (RCIs) were computed for a 90% confidence interval for selected subtests of the CERAD-NP battery. Across different age, education, and gender subgroups, changes from at least six to nine points in Verbal Fluency, four to eight points in Word List Memory, two to four points in Word List Recall, and one to four points in Word List Recognition indicated significant (i.e. reliable) changes in CERAD-NP test scores at the 90% confidence level. Furthermore, the calculation of RCIs for individual patients is demonstrated. Smaller changes in CERAD-NP test scores can be interpreted with only high uncertainty because of probable measurement error, practice effects, and normal age-related cognitive decline. This study, for the first time, provides age-, education-, and gender-specific CERAD-NP reference values on the basis of RCI methods for the interpretation of cognitive changes in older-age groups.

Investigation of cognitive circuits using steady-state cerebral blood volume and diffusion tensor imaging in patients with mild cognitive impairment following electrical injury

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Park, Chang-hyun; Seo, Cheong Hoon; Joo, So Young; Jung, Myung Hun; Jang, Soyeon; Lee, Ho Young; Ohn, Suk Hoon

2017-01-01

We utilized cerebral blood volume (CBV) magnetic resonance imaging and diffusion tensor imaging (DTI) to investigate changes in cognitive networks in patients experiencing cognitive dysfunction following electrical injury. Cognitive function was assessed across various domains, including attention, verbal memory, executive function, and language. Depressive symptoms were also evaluated. CBV maps and DTI measures were obtained from 24 patients (age, 41.8 ± 5.8 years; education, 13.3 ± 1.9 years) and 24 healthy controls (age, 42.3 ± 2.7 years; education, 14.3 ± 1.9 years). CBV maps and DTI measures were compared between patients and controls, and correlations between these measures and each cognitive assessment score were examined. Patients exhibited lower attention, verbal memory, and executive function scores than controls (all p < 0.01). Patients also exhibited higher depression scores than controls (p < 0.01), as well as a predominant increase in CBV in the cerebellar vermis relative to that of controls (height p < uncorrected 0.001, extent p < corrected 0.05). Correlation analyses revealed a strong association between executive function scores and CBV in the bilateral posterior cingulate cortex and left mammillary body in patients (height p < uncorrected 0.001, extent p < corrected 0.05). There were no significant differences in DTI measures between patients and controls. The CBV maps showed hypermetabolism in the cerebello-limbic system; DTI did not find any microstructural changes. Our results suggest that patients experiencing cognitive dysfunction following electrical injury may possess a cognitive reserve that protects against deteriorating conditions such as dementia. (orig.)

Investigation of cognitive circuits using steady-state cerebral blood volume and diffusion tensor imaging in patients with mild cognitive impairment following electrical injury

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Park, Chang-hyun [Catholic University of Korea, Department of Psychiatry, College of Medicine, Seoul (Korea, Republic of); Seo, Cheong Hoon; Joo, So Young [Hallym University College of Medicine, Department of Physical Medicine and Rehabilitation, Hangang Sacred Heart Hospital, Seoul (Korea, Republic of); Jung, Myung Hun [Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Department of Psychiatry, Dongan-gu Anyang, Gyeonggi-do (Korea, Republic of); Jang, Soyeon; Lee, Ho Young; Ohn, Suk Hoon [Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Department of Physical Medicine and Rehabilitation, Dongan-gu Anyang, Gyeonggi-do (Korea, Republic of)

2017-09-15

We utilized cerebral blood volume (CBV) magnetic resonance imaging and diffusion tensor imaging (DTI) to investigate changes in cognitive networks in patients experiencing cognitive dysfunction following electrical injury. Cognitive function was assessed across various domains, including attention, verbal memory, executive function, and language. Depressive symptoms were also evaluated. CBV maps and DTI measures were obtained from 24 patients (age, 41.8 ± 5.8 years; education, 13.3 ± 1.9 years) and 24 healthy controls (age, 42.3 ± 2.7 years; education, 14.3 ± 1.9 years). CBV maps and DTI measures were compared between patients and controls, and correlations between these measures and each cognitive assessment score were examined. Patients exhibited lower attention, verbal memory, and executive function scores than controls (all p < 0.01). Patients also exhibited higher depression scores than controls (p < 0.01), as well as a predominant increase in CBV in the cerebellar vermis relative to that of controls (height p < uncorrected 0.001, extent p < corrected 0.05). Correlation analyses revealed a strong association between executive function scores and CBV in the bilateral posterior cingulate cortex and left mammillary body in patients (height p < uncorrected 0.001, extent p < corrected 0.05). There were no significant differences in DTI measures between patients and controls. The CBV maps showed hypermetabolism in the cerebello-limbic system; DTI did not find any microstructural changes. Our results suggest that patients experiencing cognitive dysfunction following electrical injury may possess a cognitive reserve that protects against deteriorating conditions such as dementia. (orig.)

Neurodegenerative properties of chronic pain: cognitive decline in patients with chronic pancreatitis.

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Marijtje L A Jongsma

Full Text Available Chronic pain has been associated with impaired cognitive function. We examined cognitive performance in patients with severe chronic pancreatitis pain. We explored the following factors for their contribution to observed cognitive deficits: pain duration, comorbidity (depression, sleep disturbance, use of opioids, and premorbid alcohol abuse. The cognitive profiles of 16 patients with severe pain due to chronic pancreatitis were determined using an extensive neuropsychological test battery. Data from three cognitive domains (psychomotor performance, memory, executive functions were compared to data from healthy controls matched for age, gender and education. Multivariate multilevel analysis of the data showed decreased test scores in patients with chronic pancreatitis pain in different cognitive domains. Psychomotor performance and executive functions showed the most prominent decline. Interestingly, pain duration appeared to be the strongest predictor for observed cognitive decline. Depressive symptoms, sleep disturbance, opioid use and history of alcohol abuse provided additional explanations for the observed cognitive decline in some of the tests, but to a lesser extent than pain duration. The negative effect of pain duration on cognitive performance is compatible with the theory of neurodegenerative properties of chronic pain. Therefore, early and effective therapeutic interventions might reduce or prevent decline in cognitive performance, thereby improving outcomes and quality of life in these patients.

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

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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.

Relationship between blood pressure, cognitive function and education level in elderly patients with diabetes: a preliminary study.

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Talfournier, J; Bitu, J; Paquet, C; Gobron, C; Guillausseau, P J; Hugon, J; Dumurgier, J

2013-10-01

This study aimed to assess the relationship between blood pressure and cognitive function in elderly patients with diabetes mellitus (DM). A total of 32 patients with DM aged ≥ 65 years (seven women and 25 men; mean ± SD age: 74.3 ± 6.4 years) were included in this cross-sectional study. Relationships between blood pressure and neuropsychological tests were determined using Spearman's rank correlations (ρ) and multivariable linear regression models. Lower diastolic blood pressure was associated with lower scores on the Frontal Assessment Battery (ρ=0.32, P=0.02), longer times to complete the Trail Making Test Part B (ρ=0.51, P=0.003), lower scores for the Finger Tapping Test (ρ=0.36, P=0.046) and less verbal fluency (ρ=0.36, P=0.047). In multivariable models, these relationships were attenuated after adjusting for levels of education. There was an association between lower diastolic blood pressure and poorer executive function in this cohort of elderly DM patients. These results underline the importance of systematic cognitive evaluation in elderly patients with DM, and suggest that a too-low diastolic blood pressure may have deleterious effects on mental function. Larger studies in the future are required to confirm these preliminary results. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Delirium in elderly patients: association with educational attainment.

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Martins, Sónia; Paiva, José Artur; Simões, Mário R; Fernandes, Lia

2017-04-01

Among cognitive reserve markers, educational attainment is the most widely studied, with several studies establishing a strong association with risk of dementia. However, it has not yet been fully examined in delirium. This study aims to analyse the relationship between educational attainment and delirium. The study included elderly hospitalised patients admitted (≥48 h) into an intermediate care unit (IMCU) of Intensive Care Medicine Service. Exclusion criteria were as follows: Glasgow Coma Scale (total≤11), blindness/deafness, inability to communicate or to speak Portuguese. The European Portuguese Version of the Confusion Assessment Method (CAM) was used for delirium assessment. The final sample (n=157) had a mean age of 78.8 (SD=7.6) the majority being female (52.2%), married (51.5%) and with low educational level (49%). According to CAM, 21% of the patients had delirium. The delirium group presented the fewest years of education (median 1 vs. 4), with statistical significance (p=0.003). Delirium was more frequent among male patients [odds ratio (OR) 0.32; 95% confidence interval (CI) 0.12-0.86; p=0.023], as well as those patients with lower education (OR 0.76; 95% CI 0.62-0.95; p=0.016), and with respiratory disease (OR 3.35; 95% CI 1.20-9.33; p=0.020), after controlling for age and medication. Similar to previous studies, these findings point to a negative correlation between education and delirium. This study appears as an attempt to contribute to the knowledge about the role of cognitive reserve in risk of delirium, particularly because is the first one that has been carried out in an IMCU, with lower educated elderly patients. Further studies are needed to clarify this relationship considering other markers (e.g. cognitive activities), which can contribute to the definition of preventive strategies.

Analysis of cognitive status in patients with type 2 diabetes

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Irina V. Gatckikh

2018-02-01

Full Text Available Background: Cognitive impairment is a common complication of type 2 diabetes, greatly reduce the quality of life and daily functioning of patients, as well as have an impact on their compliance to therapy. Aim: Explore the nature and frequency of cognitive impairment in patients with type 2 diabetes, their relation to carbohydrate metabolism. Materials and methods: The study involved 113 patients with type 2 diabetes aged 40–70 years, with disease duration of more than 12 months; Control group consisted of 33 persons, stateless persons with type 2 diabetes, matched by age, sex, level of education, the presence of cardiovascular diseases such as hypertension and coronary heart disease. The complex included a survey of clinical and laboratory tests, instrumental, neuropsychological testing. To screen for cognitive impairment used by the Montreal Cognitive Assessment Scale (MоСа test, for the study of the frontal functions FAB (frontal dysfunction battery. Results: The study of cognitive impairment were diagnosed in 53,1 ± 9,2% of patients with type 2 diabetes, which is statistically significantly higher than in those in the control group 15,2 ± 12,2%. In patients with type 2 diabetes prevailed violations fronto-subcortical type with a reduction in short-term memory function, attention and constructive praxis. Cognitive impairment correlated with indices of carbohydrate metabolism (HbA1c, fasting glucose, disease duration 7 [5, 12] years and the patient's. Conclusions: These data confirm the impact of hyperglycemia as a major pathogenic factor and duration of the disease on the formation and progression of cognitive impairment in patients with type 2 diabetes.

Correlation between the Quality of Attention and Cognitive Competence with Motor Action in Stroke Patients

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Arsic, S.; Konstantinovic, Lj.; Eminovic, F.; Pavlovic, D.; Popovic, M. B.; Arsic, V.

2015-01-01

It is considered that cognitive function and attention could affect walking, motion control, and proper conduct during the walk. To determine whether there is a difference in the quality of attention and cognitive ability in stroke patients and patients without neurological damage of similar age and education and to determine whether the connection of attention and cognition affects motor skills, the sample consisted of 50 stroke patients tested with hemiparesis, involved in the process of re...

Sex-sensitive cognitive performance in untreated patients with early onset gender identity disorder.

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Haraldsen, I R; Opjordsmoen, S; Egeland, T; Finset, A

2003-10-01

We explored whether the cognitive performance of gender identity disorder patients (GID) was comparable to that of their biological sex or skewed towards that of their gender identity. We tested four potentially sex-sensitive cognitive factors (rotation, visualization, perception, and verbalization) as well as two neutral factors (logic and arithmetic) in GID patients from Norway (GID-N, n = 33) or the USA (GID-US, n = 19) and in a control group (C, n = 29). The testing was undertaken prior to cross sex hormone treatment. Four-way ANOVA was applied in the final analysis of the cognitive performance and its dependency on different predictors (age, biological sex, education, group). In both GID groups as well as in the control group (C) males excelled in visualization and rotation, also when controlling for potential confounders (biological sex, group, age and education). No female advantage was detected. Furthermore, no interaction between biological sex and group assignment was revealed in the samples. In this study the cognitive pattern of GID patients is consistent with that of their biological sex and not that of their gender identity.

Body mass index, cognitive deficit and depressive symptoms in high cardiovascular risk patients

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Amanda Lucas da Costa

Full Text Available Abstract To evaluate the relationship of obesity, cognitive impairment and depressive symptoms in patients with high cardiovascular risk. Methods: A sample of 93 patients aged 50 years or older was selected from the Center of Dyslipidemia and High Cardiovascular Risk from Hospital de Clínicas de Porto Alegre (HCPA. Patients with stroke were excluded. For cognitive evaluation, the MMSE (Mini Mental State Examination was used. A score of 24 or less was considered as cognitive impairment, and for those who had 4 years or less of education, the cutoff point was 17. The GDS-15 (Geriatric Depression Scale was also used, with the cutoff of 6 for presence of depressive symptoms. Results: Obese patients showed lower mean MMSE scores compared to non-obese patients (p=0.0012. Additionally, for every one point increase in BMI above 30 there was a 27% increase in the chances of the patient having cognitive impairment. The obese patients presented 31% chance of having cognitive impairment compared with overweight subjects. Conclusions: Our findings corroborated the association between obesity and cognitive impairment in high cardiovascular risk patients. This association however, was not observed for depressive symptoms.

Cognitive aspect of education for democracy

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Đurišić-Bojanović Mirosava

2005-01-01

Full Text Available Education for democracy is of particular importance for a society undergoing democratization. The paper investigates a cognitive aspect of education for democracy, and identifies psychological predispositions for the acceptance of plurality of ideas as a central indicator of democratic thinking. The acceptance of plurality is defined as the ability of an individual to consider different arguments in controversial topics, to accept the existence of different ideas in a discussion as well as different explanations. This psychological phenomenon integrates certain cognitive affective and conative characteristics. The acceptance of plurality of ideas is a fundamental prerequisite for democratic communication, therefore a prerequisite for the creation of democratic climate in a society. The concept of cognitive style has been examined from the perspective of different research traditions in an attempt to identify a psychological profile of cognitive style, provisionally named pluralist profile, which would help an individual behave democratically. The paper also studies the connection between the manner of thinking, personality characteristics and cognitive style. It is the author’s conclusion that it is reasonable to assume that there are ways to encourage the development of pluralistic cognitive style by practicing the acceptance of different ideas through teaching process which would significantly improve the effectiveness of education for democracy.

"THE RELATION OF HYPERHOMOCYSTEINEMIA TO COGNITIVE FUNCTION AND BRAIN ATROPHY IN PATIENTS WITH MULTIPLE SCLEROSIS "

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M. Ghaffarpour

2007-06-01

Full Text Available Cognitive impairment may be a common even at the onset of multiple sclerosis (MS. In this case-control study, we tried to find out the probable relationship between homocysteine levels and cerebral atrophy or cognitive impairment in patients with multiple sclerosis. One hundred fifty six patients who had MS according to McDonald diagnostic criteria were included in this study. Patients’ age, gender, and educational level, MS duration and clinical type, disability, cognitive function state based on minimental state examination (MMSE, presence of hyperhomocysteinemia, and brain atrophy were evaluated. There was no statistically significant relationship between hyperhomocysteinemia and cognitive status. Total homocysteine levels had a significant correlation with MMSE score only in those patients with elementary level of education. Also total homocysteine levels and overall cerebral atrophy did not indicate significant relationship according to those independent variables mentioned above except in the patients with EDSS less than 6. When intercaudate ratio > 0.10 was applied as a criterion for cerebral atrophy, we found that hyperhomocysteinemia related significantly to intercaudate ratio > 0.10 in females, aged between 21 and 30 years, MS duration ≤ 5 years, primary progressive MS and relapsing-remitting MS clinical types, EDSS ≤ 3 and elementary level of education. We suggest applying MMSE only for the first step of cognitive function survey. In the next steps, much more exact test must be used (e.g. MSNQ. Also we can not suggest measuring plasma homocysteine level as criterion for monitoring the cognitive function in patients with MS.

Evaluating the relationship between education level and cognitive impairment with the Montreal Cognitive Assessment Test.

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Yancar Demir, Esra; Özcan, Tuba

2015-09-01

Mild cognitive impairment (MCI) is defined as 'a cognitive decline greater than that expected for an individual's age and education level but that does not interfere notably with activities of daily life'. The Montreal Cognitive Assessment (MoCA) is a screening test for MCI. We investigated the performance of the Turkish version of the MoCA in detecting MCI among elderly persons in a rural area, the majority of whom have a low level of education. We evaluated 50 consecutive men referred from an outpatient clinic. Educational level was divided into three categories: group 1, less than primary (5 years). We evaluated the effect of education on MoCA scores and compared subjects' test performance among the different categories of education level. A total of 50 male patients with MCI (mean age: 70.74 ± 7.87) met the inclusion criteria. There were no differences in the total scores based on education or in the subscores for visuospatial/executive function, naming, attention, abstraction and delayed recall. Language was the only domain that showed significant differences between the groups. In post-hoc analysis, differences were found between groups 1 and 3 and between groups 1 and 2. Group 1 had significantly lower scores for language. The repeat subscore for language was significantly lower in group 1 than in group 2. In fluency, there were significant differences between groups 2 and 3 and between group 1 and 3. To our knowledge, this is the first study to analyze the applicability of the Turkish version of MoCA in populations with little education. Our results emphasize the need to adapt the language sections of this test, so it can be easily used in populations with low education levels. © 2014 The Authors. Psychogeriatrics © 2014 Japanese Psychogeriatric Society.

Quick screening of cognitive function in Indian multiple sclerosis patients using Montreal cognitive assessment test-short version

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Darshpreet Kaur

2013-01-01

Full Text Available Background: Cognitive impairments in multiple sclerosis (MS are now well recognized worldwide, but unfortunately this domain has been less explored in India due to many undermining factors. The aim of this study was to evaluate cognitive impairments in Indian MS patients with visual or upper limb motor problems with the help of short version of Montreal cognitive assessment test (MoCA. Subjects and Methods: Thirty MS patients and 50 matched controls were recruited for the 12 points MoCA task. Receiver operating characteristic curve (ROC analysis was performed to determine optimal sensitivity and specificity of the 12 points MoCA in differentiating cognitively impaired patients and controls. Results: The mean 12 points MoCA scores of the controls and MS patients were 11.56 ± 0.67 and 8.06 ± 1.99, respectively. In our study, the optimal cut-off value for 12 points MoCA to be able to differentiate patients with cognitive impairments from controls is 10/12. Accordingly, 73.3% patients fell below the cut off value. Both the groups did not have significant statistical differences with regard to age and educational years. Conclusion: The 12 points, short version of MoCA, is a useful brief screening tool for quick and early detection of mild cognitive impairments in subjects with MS. It can be administered to patients having visual and motor problems. It is of potential use by primary care physicians, nurses, and other allied health professionals who need a quick screening test. No formal training for administration is required. Financial and time constraints should not limit the use of the proposed instrument.

Montreal Cognitive Assessment Performance in Patients with Parkinson’s Disease with “Normal” Global Cognition According to Mini-Mental State Examination Score

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Nazem, Sarra; Siderowf, Andrew D.; Duda, John E.; Have, Tom Ten; Colcher, Amy; Horn, Stacy S.; Moberg, Paul J.; Wilkinson, Jayne R.; Hurtig, Howard I.; Stern, Matthew B.; Weintraub, Daniel

2009-01-01

OBJECTIVES To examine Montreal Cognitive Assessment (MoCA) performance in patients with Parkinson’s disease (PD) with “normal” global cognition according to Mini-Mental State Examination (MMSE) score. DESIGN A cross-sectional comparison of the MoCA and the MMSE. SETTING Two movement disorders centers at the University of Pennsylvania and the Philadelphia Veterans Affairs Medical Center. PARTICIPANTS A convenience sample of 131 patients with idiopathic PD who were screened for cognitive and psychiatric complications. MEASUREMENTS Subjects were administered the MoCA and MMSE, and only subjects defined as having a normal age- and education-adjusted MMSE score were included in the analyses (N = 100). As previously recommended in patients without PD, a MoCA score less than 26 was used to indicate the presence of at least mild cognitive impairment (MCI). RESULTS Mean MMSE and MoCA scores ± standard deviation were 28.8 ± 1.1 and 24.9 ± 3.1, respectively. More than half (52.0%) of subjects with normal MMSE scores had cognitive impairment according to their MoCA score. Impairments were seen in numerous cognitive domains, including memory, visuospatial and executive abilities, attention, and language. Predictors of cognitive impairment on the MoCA using univariate analyses were male sex, older age, lower educational level, and greater disease severity; older age was the only predictor in a multivariate model. CONCLUSION Approximately half of patients with PD with a normal MMSE score have cognitive impairment based on the recommended MoCA cutoff score. These results suggest that MCI is common in PD and that the MoCA is a more sensitive instrument than the MMSE for its detection. PMID:19170786

A Cognitive Apprenticeship-Based Faculty Development Intervention for Emergency Medicine Educators

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Chris Merritt

2017-12-01

Full Text Available In just a few years of preparation, emergency medicine (EM trainees must achieve expertise across the broad spectrum of skills critical to the practice of the specialty. Though education occurs in many contexts, much learning occurs on the job, caring for patients under the guidance of clinical educators. The cognitive apprenticeship framework, originally described in primary and secondary education, has been applied to workplace-based medical training. The framework includes a variety of teaching methods: scaffolding, modeling, articulation, reflection, and exploration, applied in a safe learning environment. Without understanding these methods within a theoretical framework, faculty may not apply the methods optimally. Here we describe a faculty development intervention during which participants articulate, share, and practice their own applications of cognitive-apprenticeship methods to learners in EM. We summarize themes identified by workshop participants, and provide suggestions for tailoring the application of these methods to varying levels of EM learners. The cognitive-apprenticeship framework allows for a common understanding of the methods used in clinical teaching toward independence. Clinical educators should be encouraged to reflect critically on their methods, while being offered the opportunity to share and learn from others.

Cross-sex hormone treatment does not change sex-sensitive cognitive performance in gender identity disorder patients.

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Haraldsen, Ira R; Egeland, Thore; Haug, Egil; Finset, Arnstein; Opjordsmoen, Stein

2005-12-15

Cognitive performance in untreated early onset gender identity disorder (GID) patients might correspond to their born sex and not to their perceived gender. As a current mode of intervention, cross-sex hormone treatment causes considerable physical changes in GID patients. We asked, as has been suggested, whether this treatment skews cognitive performance towards that of the acquired sex. Somatically healthy male and female early onset GID patients were neuropsychologically tested before, 3 and 12 months after initiating cross-sex hormone treatment, whereas untreated healthy subjects without GID served as controls (C). Performance was assessed by testing six cognitive abilities (perception, arithmetic, rotation, visualization, logic, and verbalization), and controlled for age, education, born sex, endocrine differences and treatment by means of repeated measures analysis of variance. GID patients and controls showed an identical time-dependent improvement in cognitive performance. The slopes were essentially parallel for males and females. There was no significant three-way interaction of born sex by group by time for the six investigated cognitive abilities. Only education and age significantly influenced this improvement. Despite the substantial somatic cross-sex changes in GID patients, no differential effect on cognition over time was found between C and GID participants. The cognitive performance of cross-sex hormone-treated GID patients was virtually identical to that of the control group. The documented test-retest effect should be taken into consideration when evaluating treatment effects generally in psychiatry.

Education, bilingualism, and cognitive trajectories: Sacramento Area Latino Aging Study (SALSA).

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Mungas, Dan; Early, Dawnté R; Glymour, M Maria; Zeki Al Hazzouri, Adina; Haan, Mary N

2018-01-01

This study examined the influence of education, country where education occurred, and monolingual-bilingual (English/Spanish) language usage on late life cognitive trajectories in the Sacramento Area Latino Study on Aging (SALSA), an epidemiological study of health and cognition in Hispanics, mostly of Mexican origin, age 60 and over (N = 1,499). SALSA followed a large cohort of older Latinos for up to 7 assessment waves from 1998 to 2007. Global cognition was assessed by using the Modified Mini Mental State Examination, and the Spanish English Verbal Learning Test was used to measure episodic memory. Education, country of origin, and language usage patterns were collected at the baseline assessment and used as predictors of longitudinal trajectories of cognition. Parallel process mixed effects models were used to examine effects of education and language variables on baseline cognition and rate of cognitive decline. Mixed effects longitudinal models showed that education had strong effects on baseline global cognition and verbal memory but was not related to decline over up to 9 years of longitudinal follow-up. Differences in education effects between subgroups educated in Mexico and in the United States were minor. Monolingual-bilingual language usage was not related to cognitive decline, and bilinguals did not significantly differ from monolingual English speakers on baseline cognitive scores. Hypotheses that higher education and bilingualism protect against late life cognitive decline were not supported and education effects on late-life cognitive trajectories did not substantially differ across U.S.- and Mexico-educated groups. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Development of an inter-professional screening instrument for cancer patients' education process.

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Vaartio-Rajalin, Heli; Huumonen, Tuula; Iire, Liisa; Jekunen, Antti; Leino-Kilpi, Helena; Minn, Heikki; Paloniemi, Jenni; Zabalegui, Adelaida

2016-02-01

The aim of this paper is to describe the development of an inter-professional screening instrument for cancer patients' cognitive resources, knowledge expectations and inter-professional collaboration within patient education. Four empirical datasets during 2012-2014 were analyzed in order to identify main categories, subcategories and items for inter-professional screening instrument. Our inter-professional screening instrument integrates the critical moments of cancer patient education and the knowledge expectation types obtained from patient datasets to assessment of patients' cognitive resources, knowledge expectations and comprehension; and intra; and inter-professional. Copyright © 2015 Elsevier Inc. All rights reserved.

The impact of subjective cognitive fatigue and depression on cognitive function in patients with multiple sclerosis.

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Golan, Daniel; Doniger, Glen M; Wissemann, Karl; Zarif, Myassar; Bumstead, Barbara; Buhse, Marijean; Fafard, Lori; Lavi, Idit; Wilken, Jeffrey; Gudesblatt, Mark

2018-02-01

The association between subjective cognitive fatigue and objective cognitive dysfunction in patients with multiple sclerosis (PwMS) has been studied, with conflicting results. To explore the impact of fatigue on cognitive function, while controlling for the influence of depression, disability, comorbidities, and psychotropic medications. PwMS completed a computerized cognitive testing battery with age- and education-adjusted cognitive domain scores. Disability (Expanded Disability Status Scale (EDSS)), cognitive fatigue, and depression were concurrently evaluated. In all, 699 PwMS were included. Both cognitive fatigue and depression were significantly and negatively correlated with the same cognitive domains: information processing speed, executive function, attention, motor function, and memory (-0.15 ⩽ r ⩽ -0.14 for cognitive fatigue; -0.24 ⩽ r ⩽ -0.19 for depression). Multivariate analysis revealed significant but small independent correlations only between depression and neuropsychological test results, while cognitive fatigue had no independent correlation with objective cognitive function except for a trend toward impaired motor function in highly fatigued PwMS. Depression and cognitive fatigue accounted for no more than 6% of the variance in objective cognitive domain scores. Cognitive fatigue is not independently related to objective cognitive impairment. Depression may influence cognitive function of PwMS primarily when it is severe. Cognitive impairment in PwMS should not be ascribed to fatigue or mild depression.

Assessment of cognitive impairment in long-term oxygen therapy-dependent COPD patients.

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Karamanli, Harun; Ilik, Faik; Kayhan, Fatih; Pazarli, Ahmet Cemal

2015-01-01

A number of studies have shown that COPD, particularly in its later and more severe stages, is associated with various cognitive deficits. Thus, the primary goal of the present study was to elucidate the extent of cognitive impairment in patients with long-term oxygen therapy-dependent (LTOTD) COPD. In addition, this study aimed to determine the effectiveness of two cognitive screening tests, the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA), for COPD patients and the ability of oxygen therapy to mitigate COPD-related deficits in cognitive function. The present study enrolled 45 subjects: 24 nonuser and 21 regular-user LTOTD-COPD patients. All subjects had a similar grade of education, and there were no significant differences regarding age or sex. The MoCA (cutoff: therapy increased the risk of cognitive impairment (MoCA, P=0.007 and MMSE, P=0.014), and the MoCA and MMSE scores significantly correlated with the number of emergency admissions and the number of hospitalizations in the last year. In the present study, the nonuser LTOTD-COPD group exhibited a significant decrease in cognitive status compared with the regular-user LTOTD-COPD group. This suggests that the assessment of cognitive function in nonuser LTOTD-COPD patients and the use of protective strategies, such as continuous supplemental oxygen treatment, should be considered during the management of COPD in this population. In addition, the MoCA score was superior to the MMSE score for the determination of cognitive impairment in the nonuser LTOTD-COPD patients.

Geoscience Education Research: The Role of Collaborations with Education Researchers and Cognitive Scientists

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Manduca, C. A.; Mogk, D. W.; Kastens, K. A.; Tikoff, B.; Shipley, T. F.; Ormand, C. J.; Mcconnell, D. A.

2011-12-01

Geoscience Education Research aims to improve geoscience teaching and learning by understanding clearly the characteristics of geoscience expertise, the path from novice to expert, and the educational practices that can speed students along this path. In addition to expertise in geoscience and education, this research requires an understanding of learning -the domain of cognitive scientists. Beginning in 2002, a series of workshops and events focused on bringing together geoscientists, education researchers, and cognitive scientists to facilitate productive geoscience education research collaborations. These activities produced reports, papers, books, websites and a blog developing a research agenda for geoscience education research at a variety of scales: articulating the nature of geoscience expertise, and the overall importance of observation and a systems approach; focusing attention on geologic time, spatial skills, field work, and complex systems; and identifying key research questions in areas where new technology is changing methods in geoscience research and education. Cognitive scientists and education researchers played critical roles in developing this agenda. Where geoscientists ask questions that spring from their rich understanding of the discipline, cognitive scientists and education researchers ask questions from their experience with teaching and learning in a wide variety of disciplines and settings. These interactions tend to crystallize the questions of highest importance in addressing challenges of geoscience learning and to identify productive targets for collaborative research. Further, they serve as effective mechanisms for bringing research techniques and results from other fields into geoscience education. Working productively at the intersection of these fields requires teams of cognitive scientists, geoscientists, and education reserachers who share enough knowledge of all three domains to have a common articulation of the research

The continuing benefits of education: adult education and midlife cognitive ability in the British 1946 birth cohort.

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Hatch, Stephani L; Feinstein, Leon; Link, Bruce G; Wadsworth, Michael E J; Richards, Marcus

2007-11-01

Evidence shows education positively impacts cognitive ability. However, researchers have given little attention to the potential impact of adult education on cognitive ability, still malleable in midlife. The primary study aim was to examine whether there were continuing effects of education over the life course on midlife cognitive ability. This study used data from the Medical Research Council National Survey of Health and Development, also known as the British 1946 birth cohort, and multivariate regression to estimate the continuing effects of adult education on multiple measures of midlife cognitive ability. Educational attainment completed by early adulthood was associated with all measures of cognitive ability in late midlife. The continued effect of education was apparent in the associations between adult education and higher verbal ability, verbal memory, and verbal fluency in late midlife. We found no association between adult education and mental speed and concentration. Associations between adult education and midlife cognitive ability indicate wider benefits of education to health that may be important for social integration, well-being, and the delay of cognitive decline in later life.

Association between academic performance and cognitive dysfunction in patients with juvenile systemic lupus erythematosus

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Renan Bazuco Frittoli

2016-06-01

Full Text Available Abstract Objective To determine whether there is an association between the profile of cognitive dysfunction and academic outcomes in patients with juvenile systemic lupus erythematosus (JSLE. Methods Patients aged ≤18 years at the onset of the disease and education level at or above the fifth grade of elementary school were selected. Cognitive evaluation was performed according to the American College of Rheumatology (ACR recommendations. Symptoms of anxiety and depression were assessed by Beck scales; disease activity was assessed by Systemic Lupus Erythematosus Disease Activity Index (SLEDAI; and cumulative damage was assessed by Systemic Lupus International Collaborating Clinics (SLICC. The presence of autoantibodies and medication use were also assessed. A significance level of 5% (p < 0.05 was adopted. Results 41 patients with a mean age of 14.5 ± 2.84 years were included. Cognitive dysfunction was noted in 17 (41.46% patients. There was a significant worsening in mathematical performance in patients with cognitive dysfunction (p = 0.039. Anxiety symptoms were observed in 8 patients (19.51% and were associated with visual perception (p = 0.037 and symptoms of depression were observed in 1 patient (2.43%. Conclusion Patients with JSLE concomitantly with cognitive dysfunction showed worse academic performance in mathematics compared to patients without cognitive impairment.

From Cognitive to Educational Neuroscience

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Dündar, Sefa; Ayvaz, Ülkü

2016-01-01

In recent years, several theoretical discussions as to the relationship between neuroscience and education have been held. Researchers have started to have cooperation over neuroscience and the interdisciplinary researches in which education is included. It was found that there were interactions between cognitive neuroscience and educational…

Is impaired cerebral vasoreactivity an early marker of cognitive decline in multiple sclerosis patients?

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Metzger, Aude; Le Bars, Emmanuelle; Deverdun, Jeremy; Molino, Francois; Marechal, Benedicte; Picot, Marie-Christine; Ayrignac, Xavier; Carra, Clarisse; Labauge, Pierre; Bauchet, Luc; Krainik, Alexandre; Menjot de Champfleur, Nicolas

2018-01-01

The link between cerebral vasoreactivity and cognitive status in multiple sclerosis remains unclear. The aim of the present study was to investigate a potential decrease of cerebral vasoreactivity in multiple sclerosis patients and correlate it with cognitive status. Thirty-three patients with multiple sclerosis (nine progressive and 24 remitting forms, median age: 39 years, 12 males) and 22 controls underwent MRI with a hypercapnic challenge to assess cerebral vasoreactivity and a neuropsychological assessment. Cerebral vasoreactivity, measured as the cerebral blood flow percent increase normalised by end-tidal carbon dioxide variation, was assessed globally and by regions of interest using the blood oxygen level-dependent technique. Non-parametric statistics tests were used to assess differences between groups, and associations were estimated using linear models. Cerebral vasoreactivity was lower in patients with cognitive impairment than in cognitively normal patients (p=0.004) and was associated with education level in patients (R 2 = 0.35; p = 0.047). There was no decrease in cerebral vasoreactivity between patients and controls. Cognitive impairment in multiple sclerosis may be mediated through decreased cerebral vasoreactivity. Cerebral vasoreactivity could therefore be considered as a marker of cognitive decline in multiple sclerosis. (orig.)

Is impaired cerebral vasoreactivity an early marker of cognitive decline in multiple sclerosis patients?

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Metzger, Aude [University Hospital Center, Department of Neurology, Montpellier (France); University Hospital Center, Department of Neurology, Memory Ressource and Research Center, Montpellier (France); Le Bars, Emmanuelle; Deverdun, Jeremy [Centre Hospitalier Regional Universitaire de Montpellier, Departement de Neuroradiologie, Hopital Gui de Chauliac, Montpellier (France); Centre Hospitalier Regional Universitaire de Montpellier, Institut d' Imagerie Fonctionnelle Humaine (I2FH), Hopital Gui de Chauliac, Montpellier (France); Universite de Montpellier, Laboratoire Charles Coulomb, CNRS UMR 5221, Montpellier (France); Molino, Francois [Universite de Montpellier, Laboratoire Charles Coulomb, CNRS UMR 5221, Montpellier (France); Universite de Montpellier, Institut de Genomique Fonctionnelle, CNRS UMR 5203, INSERM U661, Montpellier (France); Marechal, Benedicte [Siemens Healthcare, Advanced Clinical Imaging Technology, Lausanne (Switzerland); CHUV, Department of Radiology, Lausanne (Switzerland); LTS5, EPFL, Lausanne (Switzerland); Picot, Marie-Christine [Centre Hospitalier Regional Universitaire de Montpellier, Departement de Biostatistiques, Montpellier (France); Ayrignac, Xavier; Carra, Clarisse; Labauge, Pierre [University Hospital Center, Department of Neurology, Montpellier (France); Bauchet, Luc [Centre Hospitalier Regional Universitaire de Montpellier, Departement de Neurochirurgie, Hopital Gui de Chauliac, Montpellier (France); Hopital Saint Eloi, Institut de Neurosciences de Montpellier, INSERM U1051, Montpellier (France); Krainik, Alexandre [University Hospital of Grenoble, MR Unit CS 10217, Grenoble (France); Menjot de Champfleur, Nicolas [Centre Hospitalier Regional Universitaire de Montpellier, Departement de Neuroradiologie, Hopital Gui de Chauliac, Montpellier (France); Centre Hospitalier Regional Universitaire de Montpellier, Institut d' Imagerie Fonctionnelle Humaine (I2FH), Hopital Gui de Chauliac, Montpellier (France); Universite de Montpellier, Laboratoire Charles Coulomb, CNRS UMR 5221, Montpellier (France); Centre Hospitalier Universitaire Caremeau, Departement d' Imagerie Medicale, Nimes (France)

2018-03-15

The link between cerebral vasoreactivity and cognitive status in multiple sclerosis remains unclear. The aim of the present study was to investigate a potential decrease of cerebral vasoreactivity in multiple sclerosis patients and correlate it with cognitive status. Thirty-three patients with multiple sclerosis (nine progressive and 24 remitting forms, median age: 39 years, 12 males) and 22 controls underwent MRI with a hypercapnic challenge to assess cerebral vasoreactivity and a neuropsychological assessment. Cerebral vasoreactivity, measured as the cerebral blood flow percent increase normalised by end-tidal carbon dioxide variation, was assessed globally and by regions of interest using the blood oxygen level-dependent technique. Non-parametric statistics tests were used to assess differences between groups, and associations were estimated using linear models. Cerebral vasoreactivity was lower in patients with cognitive impairment than in cognitively normal patients (p=0.004) and was associated with education level in patients (R{sup 2} = 0.35; p = 0.047). There was no decrease in cerebral vasoreactivity between patients and controls. Cognitive impairment in multiple sclerosis may be mediated through decreased cerebral vasoreactivity. Cerebral vasoreactivity could therefore be considered as a marker of cognitive decline in multiple sclerosis. (orig.)

Symptoms of depression in patients with mild cognitive impairment in Parkinson's disease

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Ana Lara Soares Blum Malak

Full Text Available ABSTRACT Objective: To investigate the most frequent depressive symptoms and their association with cognition in Parkinson's disease (PD patients with mild cognitive impairment (MCI. Methods: 48 patients with PD and 44 controls (CG, aged between 50 and 80 years and with at least 4 years of formal education, all with MCI and none diagnosed with depression, were assessed. Patients and controls were matched for age, education, and Mini-Mental State Examination (MMSE score. Participants underwent clinical evaluation with a neurologist followed by neuropsychological assessment employing the instruments: MMSE, Clock Drawing Test, Verbal Fluency Test (semantic and phonemic, Figures Memory Test (FMT, Stroop Test, Trail Making Test, Digit Span (WAIS III, Rey Auditory Verbal Learning Test (RAVLT, Hooper Visual Organization Test, and Beck Depression Inventory (BDI. Results: The most frequent depressive symptoms in the PD group were: difficulty working, fatigue and sleep disorders (the latter also being present in CG. BDI score correlated negatively with learning and recognition memory in both groups. Episodic memory, evaluated by the FMT and RAVLT tests, was the cognitive function showing greatest impairment. Conclusion: Some of the depressive symptoms observed in PD patients with MCI seem to be attributable to complications of PD, while others are common to both PD and MCI, making differential diagnoses complex but crucial.

Predicting early cognitive decline in newly-diagnosed Parkinson's patients: A practical model.

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Hogue, Olivia; Fernandez, Hubert H; Floden, Darlene P

2018-06-19

To create a multivariable model to predict early cognitive decline among de novo patients with Parkinson's disease, using brief, inexpensive assessments that are easily incorporated into clinical flow. Data for 351 drug-naïve patients diagnosed with idiopathic Parkinson's disease were obtained from the Parkinson's Progression Markers Initiative. Baseline demographic, disease history, motor, and non-motor features were considered as candidate predictors. Best subsets selection was used to determine the multivariable baseline symptom profile that most accurately predicted individual cognitive decline within three years. Eleven per cent of the sample experienced cognitive decline. The final logistic regression model predicting decline included five baseline variables: verbal memory retention, right-sided bradykinesia, years of education, subjective report of cognitive impairment, and REM behavior disorder. Model discrimination was good (optimism-adjusted concordance index = .749). The associated nomogram provides a tool to determine individual patient risk of meaningful cognitive change in the early stages of the disease. Through the consideration of easily-implemented or routinely-gathered assessments, we have identified a multidimensional baseline profile and created a convenient, inexpensive tool to predict cognitive decline in the earliest stages of Parkinson's disease. The use of this tool would generate prediction at the individual level, allowing clinicians to tailor medical management for each patient and identify at-risk patients for clinical trials aimed at disease modifying therapies. Copyright © 2018. Published by Elsevier Ltd.

Cognitive apprenticeship in health sciences education: a qualitative review.

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Lyons, Kayley; McLaughlin, Jacqueline E; Khanova, Julia; Roth, Mary T

2017-08-01

Cognitive apprenticeship theory emphasizes the process of making expert thinking "visible" to students and fostering the cognitive and meta-cognitive processes required for expertise. The purpose of this review was to evaluate the use of cognitive apprenticeship theory with the primary aim of understanding how and to what extent the theory has been applied to the design, implementation, and analysis of education in the health sciences. The initial search yielded 149 articles, with 45 excluded because they contained the term "cognitive apprenticeship" only in reference list. The remaining 104 articles were categorized using a theory talk coding scheme. An in depth qualitative synthesis and review was conducted for the 26 articles falling into the major theory talk category. Application of cognitive apprenticeship theory tended to focus on the methods dimension (e.g., coaching, mentoring, scaffolding), with some consideration for the content and sociology dimensions. Cognitive apprenticeship was applied in various disciplines (e.g., nursing, medicine, veterinary) and educational settings (e.g., clinical, simulations, online). Health sciences education researchers often used cognitive apprenticeship to inform instructional design and instrument development. Major recommendations from the literature included consideration for contextual influences, providing faculty development, and expanding application of the theory to improve instructional design and student outcomes. This body of research provides critical insight into cognitive apprenticeship theory and extends our understanding of how to develop expert thinking in health sciences students. New research directions should apply the theory into additional aspects of health sciences educational research, such as classroom learning and interprofessional education.

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

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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.

Effects of Combined Physical and Cognitive Exercises on Cognition and Mobility in Patients With Mild Cognitive Impairment: A Randomized Clinical Trial.

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Shimada, Hiroyuki; Makizako, Hyuma; Doi, Takehiko; Park, Hyuntae; Tsutsumimoto, Kota; Verghese, Joe; Suzuki, Takao

2017-11-17

Although participation in physical and cognitive activities is encouraged to reduce the risk of dementia, the preventive efficacy of these activities for patients with mild cognitive impairment is unestablished. To compare the cognitive and mobility effects of a 40-week program of combined cognitive and physical activity with those of a health education program. A randomized, parallel, single-blind controlled trial. A population-based study of participants recruited from Obu, a residential suburb of Nagoya, Japan. Between August 2011 and February 2012, we evaluated 945 adults 65 years or older with mild cognitive impairment, enrolled 308, and randomly assigned them to the combined activity group (n = 154) or the health education control group (n = 154). The combined activity program involved weekly 90-minute sessions for 40 weeks focused on physical and cognitive activities. The control group attended 90-minute health promotion classes thrice during the 40-week trial period. The outcome measures were assessed at the study's beginning and end by personnel blinded to mild cognitive impairment subtype and group. The primary endpoints were postintervention changes in scores on (1) the Mini-Mental State Examination as a measure of general cognitive status and memory, (2) the Wechsler Memory Scale-Revised-Logical Memory II, and (3) the Rey Auditory Verbal Learning Test. We applied mobility assessments and assessed brain atrophy with magnetic resonance imaging. Compared with the control group, the combined activity group showed significantly greater scores on the Mini-Mental State Examination (difference = 0.8 points, P = .012) and Wechsler Memory Scale-Revised-Logical Memory II (difference = 1.0, P = .004), significant improvements in mobility and the nonmemory domains and reduced left medial temporal lobe atrophy in amnestic mild cognitive impairment (Z-score difference = -31.3, P physical and cognitive activity improves or maintains

Screening for cognitive dysfunction in ALS: validation of the Edinburgh Cognitive and Behavioural ALS Screen (ECAS) using age and education adjusted normative data.

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Pinto-Grau, Marta; Burke, Tom; Lonergan, Katie; McHugh, Caroline; Mays, Iain; Madden, Caoifa; Vajda, Alice; Heverin, Mark; Elamin, Marwa; Hardiman, Orla; Pender, Niall

2017-02-01

Cognitive and behavioural changes are an important aspect in Amyotrophic Lateral Sclerosis (ALS). The Edinburgh Cognitive and Behavioural ALS Screen (ECAS) briefly assesses these changes in ALS. To validate the ECAS against a standardised neuropsychological battery and assess its sensitivity and specificity using age and education adjusted cut-off scores. 30 incident ALS cases were assessed on both, ECAS and neuropsychological battery. Age and education adjusted cut-off scores were created from a sample of 82 healthy controls. ECAS composite scores (Total, ALS Specific and Non-Specific) were highly correlated with battery composite scores. High correlations were also observed between ECAS and full battery cognitive domains and subtests. The ECAS Total, ALS Specific and Non-Specific scores were highly sensitive to cognitive impairment. ECAS ALS-Specific cognitive domains also evidenced high sensitivity. Individual subtest sensitivity was medium to low, suggesting that caution should be used when interpreting these scores. Low positive predictive values indicated the presence of false positives. Psychometric properties of the ECAS using age and education adjusted norms indicate that the ECAS, when used as an overall measure of cognitive decline, is highly sensitive. Further comprehensive assessment is required for patients that present as impaired on the ECAS.

Cognitive Deficits as a Mediator of Poor Occupational Function in Remitted Major Depressive Disorder Patients

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Woo, Young Sup; Rosenblat, Joshua D.; Kakar, Ron; Bahk, Won-Myong; McIntyre, Roger S.

2016-01-01

Cognitive deficits in major depressive disorder (MDD) patients have been described in numerous studies. However, few reports have aimed to describe cognitive deficits in the remitted state of MDD and the mediational effect of cognitive deficits on occupational outcome. The aim of the current review is to synthesize the literature on the mediating and moderating effects of specific domains of cognition on occupational impairment among people with remitted MDD. In addition, predictors of cognitive deficits found to be vocationally important will be examined. Upon examination of the extant literature, attention, executive function and verbal memory are areas of consistent impairment in remitted MDD patients. Cognitive domains shown to have considerable impact on vocational functioning include deficits in memory, attention, learning and executive function. Factors that adversely affect cognitive function related to occupational accommodation include higher age, late age at onset, residual depressive symptoms, history of melancholic/psychotic depression, and physical/psychiatric comorbidity, whereas higher levels of education showed a protective effect against cognitive deficit. Cognitive deficits are a principal mediator of occupational impairment in remitted MDD patients. Therapeutic interventions specifically targeting cognitive deficits in MDD are needed, even in the remitted state, to improve functional recovery, especially in patients who have a higher risk of cognitive deficit. PMID:26792035

Correlation between the Quality of Attention and Cognitive Competence with Motor Action in Stroke Patients

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S. Arsic

2015-01-01

Full Text Available It is considered that cognitive function and attention could affect walking, motion control, and proper conduct during the walk. To determine whether there is a difference in the quality of attention and cognitive ability in stroke patients and patients without neurological damage of similar age and education and to determine whether the connection of attention and cognition affects motor skills, the sample consisted of 50 stroke patients tested with hemiparesis, involved in the process of rehabilitation, and 50 persons, randomly chosen, without neurological damage. The survey used the following tests: Trail Making (TMT A B test for assessing the flexibility of attention; Mini-Mental State Examination (MMSE for cognitive status; Functional Ambulation Category (FAC test to assess the functional status and parameters of walk: speed, frequency, and length of stride; STEP test for assessing the precision of movement and balance. With stroke patients, relationship between age and performance on the MMSE test was marginally significant. The ratio of performance to TMT A B test and years does not indicate statistical significance, while statistical significance between the MMSE test performance and education exists. In stroke patients, performance on MMSE test is correlated with the frequency and length of stride walk. The quality of cognitive function and attention is associated with motor skills but differs in stroke patients and people without neurological damage of similar age. The significance of this correlation can supplement research in neurorehabilitation, improve the quality of medical rehabilitation, and contribute to efficient recovery of these patients.

Correlation between the Quality of Attention and Cognitive Competence with Motor Action in Stroke Patients.

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Arsic, S; Konstantinovic, Lj; Eminovic, F; Pavlovic, D; Popovic, M B; Arsic, V

2015-01-01

It is considered that cognitive function and attention could affect walking, motion control, and proper conduct during the walk. To determine whether there is a difference in the quality of attention and cognitive ability in stroke patients and patients without neurological damage of similar age and education and to determine whether the connection of attention and cognition affects motor skills, the sample consisted of 50 stroke patients tested with hemiparesis, involved in the process of rehabilitation, and 50 persons, randomly chosen, without neurological damage. The survey used the following tests: Trail Making (TMT A B) test for assessing the flexibility of attention; Mini-Mental State Examination (MMSE) for cognitive status; Functional Ambulation Category (FAC) test to assess the functional status and parameters of walk: speed, frequency, and length of stride; STEP test for assessing the precision of movement and balance. With stroke patients, relationship between age and performance on the MMSE test was marginally significant. The ratio of performance to TMT A B test and years does not indicate statistical significance, while statistical significance between the MMSE test performance and education exists. In stroke patients, performance on MMSE test is correlated with the frequency and length of stride walk. The quality of cognitive function and attention is associated with motor skills but differs in stroke patients and people without neurological damage of similar age. The significance of this correlation can supplement research in neurorehabilitation, improve the quality of medical rehabilitation, and contribute to efficient recovery of these patients.

Penicillin for Education: How Cognitive Science Can Contribute to Education.

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Bruer, John T.

1995-01-01

Education can benefit from knowledge derived from cognitive and developmental psychology. Family demographics have actually improved between 1970 and 90 and so have NAEP scores. Three innovative programs demonstrating cognitive science applications include the Teaching Number Sense elementary math program, reciprocal teaching (reading strategy),…

IMPROVEMENT OF EDUCATIONAL COGNITIVE ACTIVITY STUDENTS IN THE PROFESSIONAL EDUCATIONAL ORGANIZATION ON THE BASIS OF VISUALIZATION TECHNOLOGY OF EDUCATIONAL INFORMATION

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Liliya A. Kolmakova

2015-01-01

Full Text Available The aim of the study is to consider the problem of improving the quality of education in the professional educational organizations.Methods. The scientific and pedagogical analyses of the concepts forming a terminological field of a problem are used. The system, competence-based and personal approaches are used for development of models of cognitive visualization. Questioning of students was carried out to establish the level of development of their informative activity.Results. The constituent parts of the modern educational process and the need to create specific conditions for its implementation are identified and described. The author gives a generalized characteristic of visualization technology of educational information. The application of cognitive visualization models using information and communication technologies are proved. The results showing the evolution of motivational indicators of students’ activity before and after application of LSM and the «Metaplan» in the educational process are presented.Scientific novelty. The pedagogical conditions that allow using information and communication technologies as means of the trainees’ educational informative activity improvement in the professional educational organization are defined. Features of the directed application of methods of cognitive visualization of educational information, both for improvement of educational cognitive activity, and for formation of professional competences of students by profession «A chef, a confectioner» are noted.Practical importance. Use of methods of cognitive visualization in educational process on the example of studying of Chemistry and Biology in the professional educational organization is considered in details. The teaching package providing application of methods of cognitive visualization of educational information for the purpose of improvement of educational cognitive activity of students in the professional educational organization

Cognitive Impairment in Patients with Chronic Neuropathic or Radicular Pain: An Interaction of Pain and Age

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Orla Moriarty

2017-06-01

Full Text Available A growing body of empirical research has confirmed an association between chronic pain and cognitive dysfunction. The aim of the present study was to determine whether cognitive function is affected in patients with a diagnosis of chronic neuropathic or radicular pain relative to healthy control participants matched by age, gender, and years of education. We also examined the interaction of pain with age in terms of cognitive performance. Some limitations of previous clinical research investigating the effects of chronic pain on cognitive function include differences in the pain and cognitive scale materials used, and the heterogeneity of patient participants, both in terms of their demographics and pathological conditions. To address these potential confounds, we have used a relatively homogenous patient group and included both experimental and statistical controls. We have also specifically investigated the interaction effect of pain and age on cognitive performance. Patients (n = 38 and controls (n = 38 were administered a battery of cognitive tests measuring IQ, spatial and verbal memory, attention, and executive function. Educational level, depressive symptoms, and state anxiety were assessed as were medication usage, caffeine, and nicotine consumption to control for possible confounding effects. Both the level of depressive symptoms and the state anxiety score were higher in chronic pain patients than in matched control participants. Chronic pain patients had a lower estimated IQ than controls, and showed impairments on measures of spatial and verbal memory. Attentional responding was altered in the patient group, possibly indicative of impaired inhibitory control. There were significant interactions between chronic pain condition and age on a number of cognitive outcome variables, such that older patients with chronic pain were more impaired than both age-matched controls and younger patients with chronic pain. Chronic pain did not appear

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

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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.

An Analysis, Using Concept Mapping, of Diabetic Patients' Knowledge, before and after Patient Education.

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Marchand, C.; d'Ivernois, J. F.; Assal, J. P.; Slama, G.; Hivon, R.

2002-01-01

Assesses whether concept maps used with diabetic patients could describe their cognitive structure, before and after having followed an educational program. Involves 10 diabetic patients and shows that concept maps can be a suitable technique to explore the type and organization of the patients' prior knowledge and to visualize what they have…

Effectiveness of Cognitive Behavioral Therapy Techniques on Anxiety and Depression in Cancer Patients

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Cem Soylu

2015-04-01

Full Text Available Depression and anxiety are generally considered to be the most important psychopathological comorbidities of cancer patients and experienced by approximately one-third of cancer patients. In the literature, studies have reported that patient characteristics such as gender, age, education level and disease characteristics such as recurrence, stage of cancer and metestazis are associated with anxiety and depression among cancer patients. Cognitive Behavioral Therapy (CBT and techniques are one of the most frequently used approach in studying the effects of psychological intervention on anxiety and depression in cancer patients and its value has been demonstrated in reducing distress with diverse cancer populations. The aim of cognitive-behavioral interventions is to change particular thoughts and behaviors and teach specific coping skills, such as cognitive restructuring, behavior modification, relaxation training and activity plan by using specific techniques. Cognitive restructing, stress management and desensitization, relaxation and activity scheduling with use of diary sheet are most used among CBT techniques. This review summarizes the diagnosis, prevalence, risk factors and treatment of depression and anxiety in patients with cancer and CBT techniques applied to these symptoms and study findings related to treatment. [JCBPR 2015; 4(1.000: 54-63

Cognitive compensatory processes of older, clinically fit patients with hematologic malignancies undergoing chemotherapy: A longitudinal cohort study.

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Libert, Yves; Borghgraef, Cindy; Beguin, Yves; Delvaux, Nicole; Devos, Martine; Doyen, Chantal; Dubruille, Stéphanie; Etienne, Anne-Marie; Liénard, Aurore; Merckaert, Isabelle; Reynaert, Christine; Slachmuylder, Jean-Louis; Straetmans, Nicole; Van Den Neste, Eric; Bron, Dominique; Razavi, Darius

2017-12-01

Despite the well-known negative impacts of cancer and anticancer therapies on cognitive performance, little is known about the cognitive compensatory processes of older patients with cancer. This study was designed to investigate the cognitive compensatory processes of older, clinically fit patients with hematologic malignancies undergoing chemotherapy. We assessed 89 consecutive patients (age ≥ 65 y) without severe cognitive impairment and 89 age-, sex-, and education level-matched healthy controls. Cognitive compensatory processes were investigated by (1) comparing cognitive performance of patients and healthy controls in novel (first exposure to cognitive tasks) and non-novel (second exposure to the same cognitive tasks) contexts, and (2) assessing psychological factors that may facilitate or inhibit cognitive performance, such as motivation, psychological distress, and perceived cognitive performance. We assessed cognitive performance with the Trail-Making, Digit Span and FCSR-IR tests, psychological distress with the Hospital Anxiety and Depression Scale, and perceived cognitive performance with the FACT-Cog questionnaire. In novel and non-novel contexts, average cognitive performances of healthy controls were higher than those of patients and were associated with motivation. Cognitive performance of patients was not associated with investigated psychological factors in the novel context but was associated with motivation and psychological distress in the non-novel context. Older, clinically fit patients with hematologic malignancies undergoing chemotherapy demonstrated lower cognitive compensatory processes compared to healthy controls. Reducing distress and increasing motivation may improve cognitive compensatory processes of patients in non-novel contexts. Copyright © 2017 John Wiley & Sons, Ltd.

Cognitive impairment of patients with chronic renal disease on hemodialysis and its relationship with sociodemographic and clinical characteristics

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Gabriela Dutra Gesualdo

Full Text Available ABSTRACT Cognitive impairment and dementia commonly occur in individuals with chronic kidney disease, especially in advanced stages, but are still poorly diagnosed. OBJECTIVE: To evaluate the cognitive ability of patients with chronic kidney disease on hemodialysis and its relationship with sociodemographic and clinical characteristics. METHODS: A cross-sectional study was carried out in a Renal Replacement Therapy Unit in the interior of the State of São Paulo involving 99 patients. The data were collected through an individual interview, using the Sociodemographic and Clinical Characterization questionnaires and the Addenbrooke's Cognitive Examination – Revised (ACE-R questionnaire. RESULTS: Participants were predominantly male, with a mean age of 54.68 years. The mean ACE-R score was 64.26 points, and 76.76% of patients had lower-than-expected scores, suggesting the presence of cognitive impairment. A moderate, negative correlation was found between total score on the ACE-R and age (r= –0.38, p≤0.001, a moderate positive correlation with years of education (r=0.52, p≤0.001, and a weak positive correlation of total score with hemodialysis time (r=0.26, p≤0.001. CONCLUSION: A relationship was found between cognitive ability and age, years of education and hemodialysis time, suggesting that individuals who were older, had less education and longer hemodialysis time presented greater cognitive impairment.

Cognitive impairment of patients with chronic renal disease on hemodialysis and its relationship with sociodemographic and clinical characteristics

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Gesualdo, Gabriela Dutra; Duarte, Juliana Gomes; Zazzetta, Marisa Silvana; Kusumota, Luciana; Say, Karina Gramani; Pavarini, Sofia Cristina Iost; Orlandi, Fabiana de Souza

2017-01-01

ABSTRACT Cognitive impairment and dementia commonly occur in individuals with chronic kidney disease, especially in advanced stages, but are still poorly diagnosed. OBJECTIVE: To evaluate the cognitive ability of patients with chronic kidney disease on hemodialysis and its relationship with sociodemographic and clinical characteristics. METHODS: A cross-sectional study was carried out in a Renal Replacement Therapy Unit in the interior of the State of São Paulo involving 99 patients. The data were collected through an individual interview, using the Sociodemographic and Clinical Characterization questionnaires and the Addenbrooke's Cognitive Examination – Revised (ACE-R) questionnaire. RESULTS: Participants were predominantly male, with a mean age of 54.68 years. The mean ACE-R score was 64.26 points, and 76.76% of patients had lower-than-expected scores, suggesting the presence of cognitive impairment. A moderate, negative correlation was found between total score on the ACE-R and age (r= –0.38, p≤0.001), a moderate positive correlation with years of education (r=0.52, p≤0.001), and a weak positive correlation of total score with hemodialysis time (r=0.26, p≤0.001). CONCLUSION: A relationship was found between cognitive ability and age, years of education and hemodialysis time, suggesting that individuals who were older, had less education and longer hemodialysis time presented greater cognitive impairment. PMID:29213518

Cognitive impairments in patients with low grade gliomas and high grade gliomas

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Eliane C. Miotto

2011-08-01

Full Text Available OBJECTIVE: The relationship between brain tumors and cognitive deficits is well established in the literature. However, studies investigating the cognitive status in low and high-grade gliomas patients are scarce, particularly in patients with average or lower educational level. This study aimed at investigating the cognitive functioning in a sample of patients with low and high-grade gliomas before surgical intervention. METHOD: The low-grade (G1, n=19 and high-grade glioma (G2, n=8 patients underwent a detailed neuropsychological assessment of memory, executive functions, visuo-perceptive and visuo-spatial abilities, intellectual level and language. RESULTS: There was a significant impairment on verbal and visual episodic memory, executive functions including mental flexibility, nominal and categorical verbal fluency and speed of information processing in G2. G1 showed only specific deficits on verbal and visual memory recall, mental flexibility and processing speed. CONCLUSION: These findings demonstrated different levels of impairments in the executive and memory domains in patients with low and high grade gliomas.

Cognitive dysfunction among newly diagnosed older patients with hematological malignancy: frequency, clinical indicators and predictors.

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Aiki, Sayo; Okuyama, Toru; Sugano, Koji; Kubota, Yosuke; Imai, Fuminobu; Nishioka, Masahiro; Ito, Yoshinori; Iida, Shinsuke; Komatsu, Hirokazu; Ishida, Takashi; Kusumoto, Shigeru; Akechi, Tatsuo

2018-01-01

Medical staff often overlook or underestimate the presence or severity of cognitive dysfunction. The purpose of this study was to clarify the frequency, clinical indicators and predictors of cognitive dysfunction among newly diagnosed older patients with hematologic malignancy receiving first-line chemotherapy. Patients aged 65 years or over with a primary diagnosis of malignant lymphoma or multiple myeloma were consecutively recruited. Cognitive dysfunction was evaluated using the Mini-Mental State Examination (MMSE) twice: before starting chemotherapy (T1) and 1 month later (T2). Participants also underwent a comprehensive geriatric assessment at T1. Potential clinical indicators that were associated with cognitive dysfunction were explored via cross-sectional analysis at T1. Predictors of cognitive dysfunction at T2 were also investigated among patients without cognitive dysfunction at T1. A total of 145 participants participated in the study; cognitive dysfunction at T1 was present in 20%. Multivariate analysis demonstrated that lower educational attainment and poorer instrumental activities of daily living were significant clinical indicators of cognitive dysfunction. Among 99 patients who did not have cognitive dysfunction at T1 and underwent cognitive assessment at T2, 7% developed dysfunction. Subjective perception of difficulty remembering at T1 was the only factor which significantly predicted new-onset cognitive dysfunction at T2. The prevalence rate of cognitive dysfunction was non-negligible among older patients with hematologic malignancy before and immediately after initial chemotherapy. Attention to the clinical indicators and predictors found in this study may provide facilitate the identification of cognitive dysfunction in patients with cancer. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Education attenuates the negative impact of traumatic brain injury on cognitive status.

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Sumowski, James F; Chiaravalloti, Nancy; Krch, Denise; Paxton, Jessica; Deluca, John

2013-12-01

To investigate whether the cognitive reserve hypothesis helps to explain differential cognitive impairment among survivors of traumatic brain injury (TBI), whereby survivors with greater intellectual enrichment (estimated with education) are less vulnerable to cognitive impairment. Cross-sectional study. Medical rehabilitation research center. Survivors of moderate or severe TBI (n=44) and healthy controls (n=36). Not applicable. Intellectual enrichment was estimated with educational attainment. Group was defined as TBI or healthy control. Current cognitive status (processing speed, working memory, episodic memory) was evaluated with neuropsychological tasks. TBI survivors exhibited worse cognitive status than healthy persons (Peducation was positively correlated with cognitive status in TBI survivors (r=.54, Peducation (R(2) change=.036, P=.004), whereas higher education attenuated the negative impact of TBI on cognitive status. TBI survivors with lower education performed much worse than matched healthy persons, but this TBI-related performance discrepancy was attenuated at higher levels of education. Higher intellectual enrichment (estimated with education) reduces the negative effect of TBI on cognitive outcomes, thereby supporting the cognitive reserve hypothesis in persons with TBI. Future work is necessary to investigate whether intellectual enrichment can build cognitive reserve as a rehabilitative intervention in survivors of TBI. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Gray matter morphological anomalies in the cerebellar vermis in first-episode schizophrenia patients with cognitive deficits.

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Wang, Jingjuan; Zhou, Li; Cui, Chunlei; Liu, Zhening; Lu, Jie

2017-11-22

Cognitive deficits are a core feature of early schizophrenia. However, the pathological foundations underlying cognitive deficits are still unknown. The present study examined the association between gray matter density and cognitive deficits in first-episode schizophrenia. Structural magnetic resonance imaging of the brain was performed in 34 first-episode schizophrenia patients and 21 healthy controls. Patients were divided into two subgroups according to working memory task performance. The three groups were well matched for age, gender, and education, and the two patient groups were also further matched for diagnosis, duration of illness, and antipsychotic treatment. Voxel-based morphometric analysis was performed to estimate changes in gray matter density in first-episode schizophrenia patients with cognitive deficits. The relationships between gray matter density and clinical outcomes were explored. Patients with cognitive deficits were found to have reduced gray matter density in the vermis and tonsil of cerebellum compared with patients without cognitive deficits and healthy controls, decreased gray matter density in left supplementary motor area, bilateral precentral gyrus compared with patients without cognitive deficits. Classifier results showed GMD in cerebellar vermis tonsil cluster could differentiate SZ-CD from controls, left supplementary motor area cluster could differentiate SZ-CD from SZ-NCD. Gray matter density values of the cerebellar vermis cluster in patients groups were positively correlated with cognitive severity. Decreased gray matter density in the vermis and tonsil of cerebellum may underlie early psychosis and serve as a candidate biomarker for schizophrenia with cognitive deficits.

Engaging in cultural activities compensates for educational differences in cognitive abilities.

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Soubelet, Andrea

2011-09-01

The goal of the current project was to examine whether engagement in intellectual/cultural activities explains the long-term effects of education on cognitive abilities throughout adulthood, and whether it compensates for educational differences in cognitive abilities throughout adulthood. Participants between 18 and 96 years of age completed a comprehensive questionnaire about intellectual/cultural activities that they participated in and performed a wide variety of cognitive tests. There were no mediation effects of engagement in intellectual/cultural activities on the relationship between education and cognitive functioning. In contrast, engagement in intellectual/cultural activities was found to moderate the relations between education and the level of fluid ability, working memory, speed of processing, and episodic memory. Findings suggest that the risk of cognitive decline in people with less education can be reduced via engagement in intellectual and cultural activities throughout adulthood.

Perceived stress and reported cognitive symptoms among Georgia patients with systemic lupus erythematosus.

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Plantinga, L; Lim, S S; Bowling, C B; Drenkard, C

2017-09-01

Objective To examine associations of perceived stress with cognitive symptoms among adults with systemic lupus erythematosus (SLE). Methods Among 777 adult (≥18 years) SLE patients, the association of Perceived Stress Scale (PSS) scores with two self-reported cognitive symptoms was examined: forgetfulness (severe/moderate vs. mild/none; from the Systemic Lupus Activity Questionnaire) and difficulty concentrating (all/most vs. some/little/none of the time; from the Lupus Impact Tracker). The study used multivariable logistic regression to estimate the odds ratios (ORs) per minimal important difference (MID = 0.5*SD) of PSS score and cognitive symptoms. Results Forgetfulness and difficulty concentrating were reported by 41.7% and 29.5%, respectively. Women and those with less education and high disease activity had higher PSS scores and were more likely to report cognitive symptoms than their counterparts. With adjustment for age, race, sex, education, and disease activity, each MID increase in PSS score was associated with higher prevalence of forgetfulness (OR = 1.43, 95% CI 1.29-1.47) and difficulty concentrating (OR = 2.19, 95% CI 1.90-2.52). No substantial differences in this association by age, race, sex, or disease activity were noted. Conclusions SLE patients, particularly those with high disease activity, report a high burden of cognitive symptoms, for which stress may be a modifiable risk factor.

Assessment of cognitive impairment in patients with Parkinson's disease: prevalence and risk factors

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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

Association of quality of sleep with cognitive decline among the patients of chronic kidney disease undergoing haemodialysis

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Zubair, U.B.; Butt, B.

2017-01-01

This study was conducted to determine the association between the subjective quality of sleep and cognitive decline among the patients of chronic kidney disease (CKD) undergoing haemodialysis. Methods: In this cross-sectional study 106 patients of chronic kidney disease (CKD) undergoing haemodialysis at a tertiary care hospital in Rawalpindi, Pakistan were included in the final analysis. Cognitive decline was measured by British Columbia Cognitive Complaints Inventory (BC-CCI). Sleep quality was measured by using the Pittsburgh Sleep Quality Index (PSQI). Relationship of age, gender, marital status, education, occupation, BMI, duration of dialysis, dialysis count per week, family income, tobacco smoking and use of naswar was assessed with the cognitive decline. Results: Out of 106 patients screened through BC-CCI and PSQI, 13.1% had no cognitive decline while 86.9% had significant cognitive decline. Relationship between quality of sleep and cognitive decline was significant on binary logistic regression. Conclusion: This study showed significant relationship between the sleep quality and cognitive decline among the patients of CKD undergoing haemodialysis. The findings of our study also call for a greater degree of understanding of the physical and psychological state of patients of CKD undergoing haemodialysis. (author)

Individualized Special Education with Cognitive Skill Assessment.

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Kurhila, Jaakko; Laine, Tei

2000-01-01

Describes AHMED (Adaptive and Assistive Hypermedia in Education), a computer learning environment which supports the evaluation of disabled children's cognitive skills in addition to supporting openness in learning materials and adaptivity in learning events. Discusses cognitive modeling and compares it to previous intelligent tutoring systems.…

Cognitive performance in patients with COPD

NARCIS (Netherlands)

Liesker, JJW; Postma, DS; Beukema, RJ; ten Hacken, NHT; van der Molen, T; Riemersma, RA; van Zomeren, EH; Kerstjens, HAM

Background: Hypoxemic patients with Chronic Obstructive Pulmonary Disease (COPD) have impaired cognitive performance. These neuropsychological impairments are related to the degree of hypoxemia. So far, cognitive performance has not been tested in non-hypoxemic patients with COPD. Methods: We

Cognitive Perspectives on Educational Administration: An Introduction.

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Leithwood, Kenneth A.; Hallinger, Philip

1993-01-01

Cognitive perspectives offer important, unique insights about the nature of expert administrative practice, how it develops, and what can be done to assist that development. The five articles making up this issue address cognitive perspectives on educational administration based on three areas of inquiry: human thought and problem-solving…

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

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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. 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. PMID:29213570

Indicators of childhood quality of education in relation to cognitive function in older adulthood.

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Crowe, Michael; Clay, Olivio J; Martin, Roy C; Howard, Virginia J; Wadley, Virginia G; Sawyer, Patricia; Allman, Richard M

2013-02-01

The association between years of education and cognitive function in older adults has been studied extensively, but the role of quality of education is unknown. We examined indicators of childhood educational quality as predictors of cognitive performance and decline in later life. Participants included 433 older adults (52% African American) who reported living in Alabama during childhood and completed in-home assessments of cognitive function at baseline and 4 years later. Reports of residence during school years were matched to county-level data from the 1935 Alabama Department of Education report for school funding (per student), student-teacher ratio, and school year length. A composite measure of global cognitive function was utilized in analyses. Multilevel mixed effects models accounted for clustering of educational data within counties in examining the association between cognitive function and the educational quality indices. Higher student-teacher ratio was associated with worse cognitive function and greater school year length was associated with better cognitive function. These associations remained statistically significant in models adjusted for education level, age, race, gender, income, reading ability, vascular risk factors, and health behaviors. The observed associations were stronger in those with lower levels of education (≤12 years), but none of the education quality measures were related to 4-year change in cognitive function. Educational factors other than years of schooling may influence cognitive performance in later life. Understanding the role of education in cognitive aging has substantial implications for prevention efforts as well as accurate identification of older adults with cognitive impairment.

Cognitive-behavioral therapy for sleep disturbance decreases inflammatory cytokines and oxidative stress in hemodialysis patients.

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Chen, Hung-Yuan; Cheng, I-Chih; Pan, Yi-Ju; Chiu, Yen-Ling; Hsu, Shih-Ping; Pai, Mei-Fen; Yang, Ju-Yeh; Peng, Yu-Sen; Tsai, Tun-Jun; Wu, Kwan-Dun

2011-08-01

Sleep disturbance is common in dialysis patients and is associated with the development of enhanced inflammatory responses. Cognitive-behavioral therapy is effective for sleep disturbance and reduces inflammation experienced by peritoneal dialysis patients; however, this has not been studied in hemodialysis patients. To determine whether alleviation of sleep disturbance in hemodialysis patients also leads to less inflammation, we conducted a randomized controlled interventional study of 72 sleep-disturbed hemodialysis patients. Within this patient cohort, 37 received tri-weekly cognitive-behavioral therapy lasting 6 weeks and the remaining 35, who received sleep hygiene education, served as controls. The adjusted post-trial primary outcome scores of the Pittsburgh Sleep Quality Index, the Fatigue Severity Scale, the Beck Depression Inventory, and the Beck Anxiety Inventory were all significantly improved from baseline by therapy compared with the control group. The post-trial secondary outcomes of high-sensitive C-reactive protein, IL-18, and oxidized low-density lipoprotein levels significantly declined with cognitive-behavioral therapy in comparison with the control group. Thus, our results suggest that cognitive-behavioral therapy is effective for correcting disorganized sleep patterns, and for reducing inflammation and oxidative stress in hemodialysis patients.

Benefits of educational attainment on adult fluid cognition: international evidence from three birth cohorts

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Clouston, Sean AP; Kuh, Diana; Herd, Pamela; Elliott, Jane; Richards, Marcus; Hofer, Scott M

2012-01-01

Background Educational attainment is highly correlated with social inequalities in adult cognitive health; however, the nature of this correlation is in dispute. Recently, researchers have argued that educational inequalities are an artefact of selection by individual differences in prior cognitive ability, which both drives educational attainment and tracks across the rest of the life course. Although few would deny that educational attainment is at least partly determined by prior cognitive ability, a complementary, yet controversial, view is that education has a direct causal and lasting benefit on cognitive development. Methods We use observational data from three birth cohorts, with cognition measured in adolescence and adulthood. Ordinary least squares regression was used to model the relationship between adolescent cognition and adult fluid cognition and to test the sensitivity of our analyses to sample selection, projection and backdoor biases using propensity score matching. Results We find that having a university education is correlated with higher fluid cognition in adulthood, after adjustment for adolescent cognition. We do not find that adolescent cognition, gender or parental social class consistently modify this effect; however, women benefited more in the 1946 sample from Great Britain. Conclusions In all three birth cohorts, substantial educational benefit remained after adjustment for adolescent cognition and parental social class, offsetting an effect equivalent of 0.5 to 1.5 standard deviations lower adolescent cognition. We also find that the likelihood of earning a university degree depends in part on adolescent cognition, gender and parental social class. We conclude that inequalities in adult cognition derive in part from educational experiences after adolescence. PMID:23108707

Benefits of educational attainment on adult fluid cognition: international evidence from three birth cohorts.

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Clouston, Sean A P; Kuh, Diana; Herd, Pamela; Elliott, Jane; Richards, Marcus; Hofer, Scott M

2012-12-01

Educational attainment is highly correlated with social inequalities in adult cognitive health; however, the nature of this correlation is in dispute. Recently, researchers have argued that educational inequalities are an artefact of selection by individual differences in prior cognitive ability, which both drives educational attainment and tracks across the rest of the life course. Although few would deny that educational attainment is at least partly determined by prior cognitive ability, a complementary, yet controversial, view is that education has a direct causal and lasting benefit on cognitive development. We use observational data from three birth cohorts, with cognition measured in adolescence and adulthood. Ordinary least squares regression was used to model the relationship between adolescent cognition and adult fluid cognition and to test the sensitivity of our analyses to sample selection, projection and backdoor biases using propensity score matching. We find that having a university education is correlated with higher fluid cognition in adulthood, after adjustment for adolescent cognition. We do not find that adolescent cognition, gender or parental social class consistently modify this effect; however, women benefited more in the 1946 sample from Great Britain. In all three birth cohorts, substantial educational benefit remained after adjustment for adolescent cognition and parental social class, offsetting an effect equivalent of 0.5 to 1.5 standard deviations lower adolescent cognition. We also find that the likelihood of earning a university degree depends in part on adolescent cognition, gender and parental social class. We conclude that inequalities in adult cognition derive in part from educational experiences after adolescence.

Embedding Patient Education in Mobile Platform for Patients With Heart Failure: Theory-Based Development and Beta Testing.

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Athilingam, Ponrathi; Osorio, Richard E; Kaplan, Howard; Oliver, Drew; O'neachtain, Tara; Rogal, Philip J

2016-02-01

Health education is an important component of multidisciplinary disease management of heart failure. The educational information given at the time of discharge after hospitalization or at initial diagnosis is often overwhelming to patients and is often lost or never consulted again. Therefore, the aim of this developmental project was to embed interactive heart failure education in a mobile platform. A patient-centered approach, grounded on several learning theories including Mayer's Cognitive Theory of Multimedia Learning, Sweller's Cognitive Load, Instructional Design Approach, and Problem-Based Learning, was utilized to develop and test the mobile app. Ten heart failure patients, who attended an outpatient heart failure clinic, completed beta testing. A validated self-confidence questionnaire was utilized to assess patients' confidence in using the mobile app. All participants (100%) reported moderate to extreme confidence in using the app, 95% were very likely to use the app, 100% reported the design was easy to navigate, and content on heart failure was appropriate. Having the information accessible on their mobile phone was reported as a positive, like a health coach by all patients. Clinicians and nurses validated the content. Thus, embedding health education in a mobile app is proposed in promoting persistent engagement to improve health outcomes.

Blood Biomarkers Predict the Cognitive Effects of Aripiprazole in Patients with Acute Schizophrenia

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Hikaru Hori

2017-03-01

Full Text Available Aripiprazole has been reported to exert variable effects on cognitive function in patients with schizophrenia. Therefore, in the present study, we evaluated biological markers, clinical data, and psychiatric symptoms in order to identify factors that influence cognitive function in patients with schizophrenia undergoing aripiprazole treatment. We evaluated cognitive function in 51 patients with schizophrenia using Brief Assessment of Cognition in Schizophrenia (BACS, as well as background information, psychiatric symptoms, plasma catecholamine metabolites—homovanillic acid (HVA, 3-methoxy-4-hydroxyphenylglycol (MHPG—, and serum brain-derived neurotrophic factor (BDNF. Multivariate analyses were performed in order to identify factors independently associated with cognitive function. Brain-derived neurotrophic factor levels, number of hospitalizations, and MHPG levels were associated with verbal memory and learning. Total hospitalization period and MHPG levels were associated with working memory. Age at first hospitalization and education were associated with motor speed. The number of hospital admissions, Positive and Negative Syndrome Scale negative subscale scores (PANSS-N, MHPG levels, BDNF levels, and Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS scores were associated with verbal fluency. Homovanillic acid and MHPG levels, duration of illness, and PANSS-N scores were associated with attention and processing speed. Brain-derived neurotrophic factor and MHPG levels were associated with executive function. These results suggest that treatment of psychiatric symptoms and cognitive dysfunction may be improved in patients treated with aripiprazole by controlling for these contributing factors.

An observational study of cognitive function in patients with irritable bowel syndrome and inflammatory bowel disease.

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Berrill, J W; Gallacher, J; Hood, K; Green, J T; Matthews, S B; Campbell, A K; Smith, A

2013-11-01

Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) are associated with several risk factors for developing cognitive impairment. These include altered cytokine levels, concurrent mood disorders, and the presence of chronic pain. This observational study aimed to explore the cognitive profile of patients with these conditions. Participants completed the Cardiff Cognitive Battery, a series of computerized neuropsychological performance tests that examine a range of cognitive function including psychomotor speed, memory, and intelligence. A progressive analysis of covariance model was used with demographic details, anxiety and depression scores entered as covariates. Fecal calprotectin levels were measured in IBD patients to determine disease activity. In total 231 participants were recruited (150 IBD patients, 40 IBS patients, and 41 healthy controls). IBD patients had significantly lower scores on fluid (p = 0.01) and crystalline intelligence tests (p = 0.028) compared to healthy volunteers, however, this reflected differences in concurrent mood disorder and level of education. When these factors were added as covariates, there was no significant difference between the groups. Duration and activity of disease did not affect cognitive function in IBD patients. Severity of symptoms had no impact on cognition in patients with IBS. The results of this observational study do not support the hypothesis that IBS or IBD have an intrinsic disease process that is associated with cognitive dysfunction. It is possible that concurrent mood disorders, in particular depression, may affect the cognitive performance of patients with IBD in specific tasks. © 2013 John Wiley & Sons Ltd.

Cognitive Behavioral Therapy in Cancer Patients

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Cem Soylu

2014-09-01

Full Text Available Cognitive behavioral therapy is one of the structured but flexible psychosocial interventions that could be applied to patients with cancer. In many studies the positive effects of cognitive behavioral therapy in reducing psychological morbidity and improving the quality of life of cancer patients have been shown. In this article, the contents and techniques of adapted cognitive behavioral therapy for patients with cancer and its effectiveness in commonly seen psychiatric disorders have been reviewed. The aim of this article is to contribute positively to physicians and nurses in Turkey for early detection of psychological distress and referral to the therapist that would clearly increase the quality of life of cancer patients. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(3.000: 257-270

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

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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

Cognitive training in Parkinson disease: cognition-specific vs nonspecific computer training.

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Zimmermann, Ronan; Gschwandtner, Ute; Benz, Nina; Hatz, Florian; Schindler, Christian; Taub, Ethan; Fuhr, Peter

2014-04-08

In this study, we compared a cognition-specific computer-based cognitive training program with a motion-controlled computer sports game that is not cognition-specific for their ability to enhance cognitive performance in various cognitive domains in patients with Parkinson disease (PD). Patients with PD were trained with either a computer program designed to enhance cognition (CogniPlus, 19 patients) or a computer sports game with motion-capturing controllers (Nintendo Wii, 20 patients). The effect of training in 5 cognitive domains was measured by neuropsychological testing at baseline and after training. Group differences over all variables were assessed with multivariate analysis of variance, and group differences in single variables were assessed with 95% confidence intervals of mean difference. The groups were similar regarding age, sex, and educational level. Patients with PD who were trained with Wii for 4 weeks performed better in attention (95% confidence interval: -1.49 to -0.11) than patients trained with CogniPlus. In our study, patients with PD derived at least the same degree of cognitive benefit from non-cognition-specific training involving movement as from cognition-specific computerized training. For patients with PD, game consoles may be a less expensive and more entertaining alternative to computer programs specifically designed for cognitive training. This study provides Class III evidence that, in patients with PD, cognition-specific computer-based training is not superior to a motion-controlled computer game in improving cognitive performance.

Plasma brain-derived neurotrophic factor levels, learning capacity and cognition in patients with first episode psychosis

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de Azua Sonia Ruiz

2013-01-01

Full Text Available Abstract Background Cognitive impairments are seen in first psychotic episode (FEP patients. The neurobiological underpinnings that might underlie these changes remain unknown. The aim of this study is to investigate whether Brain Derived Neurotrophic Factor (BDNF levels are associated with cognitive impairment in FEP patients compared with healthy controls. Methods 45 FEP patients and 45 healthy controls matched by age, gender and educational level were selected from the Basque Country area of Spain. Plasma BDNF levels were assessed in healthy controls and in patients. A battery of cognitive tests was applied to both groups, with the patients being assessed at 6 months after the acute episode and only in those with a clinical response to treatment. Results Plasma BDNF levels were altered in patients compared with the control group. In FEP patients, we observed a positive association between BDNF levels at six months and five cognitive domains (learning ability, immediate and delayed memory, abstract thinking and processing speed which persisted after controlling for medications prescribed, drug use, intelligence quotient (IQ and negative symptoms. In the healthy control group, BDNF levels were not associated with cognitive test scores. Conclusion Our results suggest that BDNF is associated with the cognitive impairment seen after a FEP. Further investigations of the role of this neurotrophin in the symptoms associated with psychosis onset are warranted.

The relation of education, occupation, and cognitive activity to cognitive status in old age: the role of physical frailty.

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Ihle, Andreas; Gouveia, Élvio R; Gouveia, Bruna R; Freitas, Duarte L; Jurema, Jefferson; Odim, Angenay P; Kliegel, Matthias

2017-09-01

It remains unclear so far whether the role of cognitive reserve may differ between physically frail compared to less frail individuals. Therefore, the present study set out to investigate the relation of key markers of cognitive reserve to cognitive status in old age and its interplay with physical frailty in a large sample of older adults. We assessed Mini-Mental State Examination (MMSE) in 701 older adults. We measured grip strength as indicator of physical frailty and interviewed individuals on their education, past occupation, and cognitive leisure activity. Greater grip strength, longer education, higher cognitive level of job, and greater engaging in cognitive leisure activity were significantly related to higher MMSE scores. Moderation analyses showed that the relations of education, cognitive level of job, and cognitive leisure activity to MMSE scores were significantly larger in individuals with lower, compared to those with greater grip strength. Cognitive status in old age may more strongly depend on cognitive reserve accumulated during the life course in physically frail (compared to less frail) older adults. These findings may be explained by cross-domain compensation effects in vulnerable individuals.

Formal education level versus self-rated literacy as predictors of cognitive aging.

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Kavé, Gitit; Shrira, Amit; Palgi, Yuval; Spalter, Tal; Ben-Ezra, Menachem; Shmotkin, Dov

2012-11-01

To compare the prediction of cognitive functioning by formal education and self-rated literacy and the differences in prediction across younger and older cohorts. Data on 28,535 respondents were drawn from a cross-sectional representative sample of community-dwelling older individuals (≥50), participating in the Survey of Health, Ageing, and Retirement in Europe. Education level was classified according to the International Standard Classification of Education 1997 (ISCED-1997) self-rated literacy was determined by having respondents rate their reading and writing on 1-5 scales. Cognitive functioning was measured by verbal recall, word fluency, and arithmetic ability. Structural equation modeling demonstrated that self-rated literacy was more strongly associated with cognitive functioning than was education level, with or without additional exogenous variables (age, sex, household income, medical conditions, activities of daily living, reading eyesight, and country). The association between education level and cognitive functioning was weaker in older than in younger age groups, whereas the association between self-rated literacy and cognitive functioning showed the opposite trend. Self-rated literacy was found to be a better predictor of late-life cognitive functioning than was the level of formal education. The results have implications for studies of age-related differences in which education level is taken into account.

Cognitive component of Tolerance in Pedagogic Education

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O. V. Akimova

2013-01-01

Full Text Available The paper looks at one of the urgent educational problems of tolerance development by teachers and students; tolerance being viewed as the openness to the new knowledge acquisition, willingness to understand other people and cooperate with them, and therefore the opportunity for self- development.The paper outlines the ways of tolerant attitudes formation by all the human subjects of educational process; the concept of person oriented teaching is considered to be the basic one for tolerance development. To optimize the specialists’ training for communication at any level of professional environment, the cognitive activity educational model is suggested, providing the ways out of any complicated pedagogical situation. The cognitive psychology concepts give the background for the above model. The education in question promotes the intellectual level of the prospective teachers, intensifies their creative potential, methodological thinking and practical experience, as well as tolerance development in professional communication process. 

Limitations of a Short Demographic Questionnaire for Bedside Estimation of Patients’ Global Cognitive Functioning in Epilepsy Patients

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Iris Gorny

2018-03-01

Full Text Available ObjectivesThe German socio-demographic estimation scale was developed by Jahn et al. (1 to quickly predict premorbid global cognitive functioning in patients. So far, it has been validated in healthy adults and has shown a good correlation with the full and verbal IQ of the Wechsler Adult Intelligence Scale (WAIS in this group. However, there are no data regarding its use as a bedside test in epilepsy patients.MethodsForty native German speaking adult patients with refractory epilepsy were included. They completed a neuropsychological assessment, including a nine scale short form of the German version of the WAIS-III and the German socio-demographic estimation scale by Jahn et al. (1 during their presurgical diagnostic stay in our center. We calculated means, correlations, and the rate of concordance (range ±5 and ±7.5 IQ score points between these two measures for the whole group, and a subsample of 19 patients with a global cognitive functioning level within 1 SD of the mean (IQ score range 85–115 and who had completed their formal education before epilepsy onset.ResultsThe German demographic estimation scale by Jahn et al. (1 showed a significant mean overestimation of the global cognitive functioning level of eight points in the epilepsy patient sample compared with the short form WAIS-III score. The accuracy within a range of ±5 or ±7.5 IQ score points for each patient was similar to that of the healthy controls reported by Jahn et al. (1 in our subsample, but not in our whole sample.ConclusionOur results show that the socio-demographic scale by Jahn et al. (1 is not sufficiently reliable as an estimation tool of global cognitive functioning in epilepsy patients. It can be used to estimate global cognitive functioning in a subset of patients with a normal global cognitive functioning level who have completed their formal education before epilepsy onset, but it does not reliably predict global cognitive functioning in epilepsy patients

[Cognitive function in patients with systemic sclerosis].

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Straszecka, J; Jonderko, G; Kucharz, E J; Brzezińska-Wcisło, L; Kotulska, A; Bogdanowski, T

1997-09-01

Central nervous system involvement is seldom reported in patients with systemic sclerosis (SSc). Cognitive functions were determined in 21 patients with definite SSc and 42 healthy controls. Thyroid function was also measured in order to eliminate the effect of hypothyroidism on cognitive functioning. It was found that the SSc patients with normal thyroid function showed defective long-term and recent memory, learning ability, criticism, perception and visuo-perceptual skills, their simple reaction time was prolonged. Similar but less advanced cognitive defects were shown in the SSc patients with overt or latent hypothyroidism. The obtained results indicate that the central nervous system involvement is more common in patients with SSc than it has been reported earlier.

Motivation and Social Cognition in Patients with Schizophrenia.

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Fervaha, Gagan; Siddiqui, Ishraq; Foussias, George; Agid, Ofer; Remington, Gary

2015-07-01

Social cognition, referring to one's ability to perceive and process social cues, is an important domain in schizophrenia. Numerous studies have demonstrated that patients with schizophrenia have poorer performance on tests assessing social cognition relative to healthy comparison participants. However, whether variables such as motivation are related to performance on these tests in patients with schizophrenia is unclear. One thousand three-hundred and seventy-eight patients with schizophrenia completed the Facial Emotion Discrimination Task as a measure of emotional processing, a key facet of social cognition. Level of motivation was also evaluated in these patients using a derived measure from the Quality of Life Scale. The relationship between motivation and task performance was examined using bivariate correlations and logistic regression modeling, controlling for the impact of age and overall severity of psychopathology, the latter evaluated using the Positive and Negative Syndrome Scale. Motivation was positively related to performance on the social cognition test, and this relationship remained significant after controlling for potential confounding variables such as age and illness severity. Social cognition was also related to functioning, and the relationship was mediated by level of motivation. The present study found a significant relationship between motivation and performance on a test of social cognition in a large sample of patients with schizophrenia. These findings suggest that amotivation undermines task performance, or alternatively that poor social cognitive ability impedes motivation. Future studies evaluating social cognition in patients with schizophrenia should concurrently assess for variables such as effort and motivation.

Cognition and brain abnormalities on MRI in pituitary patients

International Nuclear Information System (INIS)

Brummelman, Pauline; Sattler, Margriet G.A.; Meiners, Linda C.; Berg, Gerrit van den; Klauw, Melanie M. van der; Elderson, Martin F.; Dullaart, Robin P.F.; Koerts, Janneke; Werumeus Buning, Jorien; Tucha, Oliver; Wolffenbuttel, Bruce H.R.; Bergh, Alfons C.M. van den; Beek, André P. van

2015-01-01

Highlights: • Cognitive impairments are frequently observed in treated NFA patients. • NFA patients with cognitive impairments do not show brain abnormalities on MRI more frequently than patients without cognitive impairments. • The absence of brain abnormalities on brain MRI does not exclude impairments of cognition. - Abstract: Purpose: The extent to which cognitive dysfunction is related to specific brain abnormalities in patients treated for pituitary macroadenoma is unclear. Therefore, we compared brain abnormalities seen on Magnetic Resonance Imaging (MRI) in patients treated for nonfunctioning pituitary macroadenoma (NFA) with or without impairments in cognitive functioning. Methods: In this cross-sectional design, a cohort of 43 NFA patients was studied at the University Medical Center Groningen. White matter lesions (WMLs), cerebral atrophy, (silent) brain infarcts and abnormalities of the temporal lobes and hippocampi were assessed on pre-treatment and post-treatment MRI scans. Post-treatment cognitive examinations were performed using a verbal memory and executive functioning test. We compared our patient cohort with large reference populations representative of the Dutch population. Results: One or more impairments on both cognitive tests were frequently observed in treated NFA patients. No treatment effects were found with regard to the comparison between patients with and without impairments in executive functioning. Interestingly, in patients with one or more impairments on verbal memory function, treatment with radiotherapy had been given more frequently (74% in the impaired group versus 40% in the unimpaired group, P = 0.025). Patients with or without any brain abnormality on MRI did not differ in verbal memory or executive functioning. Conclusions: Brain abnormalities on MRI are not observed more frequently in treated NFA patients with impairments compared to NFA patients without impairments in verbal memory or executive functioning

Cognition and brain abnormalities on MRI in pituitary patients

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Brummelman, Pauline [Department of Endocrinology, University of Groningen, University Medical Center Groningen (Netherlands); Sattler, Margriet G.A. [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen (Netherlands); Department of Radiation Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Meiners, Linda C. [Department of Radiology, University of Groningen, University Medical Center Groningen (Netherlands); Berg, Gerrit van den; Klauw, Melanie M. van der [Department of Endocrinology, University of Groningen, University Medical Center Groningen (Netherlands); Elderson, Martin F. [Department of Endocrinology, University of Groningen, University Medical Center Groningen (Netherlands); LifeLines Cohort Study and Biobank, University of Groningen, University Medical Center Groningen (Netherlands); Dullaart, Robin P.F. [Department of Endocrinology, University of Groningen, University Medical Center Groningen (Netherlands); Koerts, Janneke [Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen (Netherlands); Werumeus Buning, Jorien, E-mail: j.werumeus.buning@umcg.nl [Department of Endocrinology, University of Groningen, University Medical Center Groningen (Netherlands); Tucha, Oliver [Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen (Netherlands); Wolffenbuttel, Bruce H.R. [Department of Endocrinology, University of Groningen, University Medical Center Groningen (Netherlands); LifeLines Cohort Study and Biobank, University of Groningen, University Medical Center Groningen (Netherlands); Bergh, Alfons C.M. van den [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen (Netherlands); Beek, André P. van, E-mail: a.p.van.beek@umcg.nl [Department of Endocrinology, University of Groningen, University Medical Center Groningen (Netherlands)

2015-02-15

Highlights: • Cognitive impairments are frequently observed in treated NFA patients. • NFA patients with cognitive impairments do not show brain abnormalities on MRI more frequently than patients without cognitive impairments. • The absence of brain abnormalities on brain MRI does not exclude impairments of cognition. - Abstract: Purpose: The extent to which cognitive dysfunction is related to specific brain abnormalities in patients treated for pituitary macroadenoma is unclear. Therefore, we compared brain abnormalities seen on Magnetic Resonance Imaging (MRI) in patients treated for nonfunctioning pituitary macroadenoma (NFA) with or without impairments in cognitive functioning. Methods: In this cross-sectional design, a cohort of 43 NFA patients was studied at the University Medical Center Groningen. White matter lesions (WMLs), cerebral atrophy, (silent) brain infarcts and abnormalities of the temporal lobes and hippocampi were assessed on pre-treatment and post-treatment MRI scans. Post-treatment cognitive examinations were performed using a verbal memory and executive functioning test. We compared our patient cohort with large reference populations representative of the Dutch population. Results: One or more impairments on both cognitive tests were frequently observed in treated NFA patients. No treatment effects were found with regard to the comparison between patients with and without impairments in executive functioning. Interestingly, in patients with one or more impairments on verbal memory function, treatment with radiotherapy had been given more frequently (74% in the impaired group versus 40% in the unimpaired group, P = 0.025). Patients with or without any brain abnormality on MRI did not differ in verbal memory or executive functioning. Conclusions: Brain abnormalities on MRI are not observed more frequently in treated NFA patients with impairments compared to NFA patients without impairments in verbal memory or executive functioning

EEG markers of cognitive impairments in patients with coronary artery disease

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I. V. Tarasova

2016-01-01

Full Text Available Objective: to identify the indicators of bioelectrical activity of the cerebral cortex, which are associated with cognitive impairments in patients with coronary artery disease (CAD.Patients and methods. The study included 122 male patients aged 45 to 69 years with CAD. Sixty of them were found to have mild cognitive impairments (MCI, their average Mini-Mental State Examination (MMSE score was 26.2±0.90; the other 62 patients had no cognitive impairment; their MMSE score was 28.5±0.86. All the patients underwent clinical and instrumental examinations and computer-based multichannel electroencephalography (EEG. Eyes-closed and eyes-open resting EEG monopolarly recorded in 62 standard leads of the 10-20 system. A binary logistic regression analysis was used to identify EEG predictors of MCI in patients with CAD.Results. The high power values of theta1-rhythm biopotentials with closed eyes in the frontal and occipital areas of the left hemisphere and those of alpha2-rhythm ones with open eyes in the frontal areas of the right hemisphere, and the high theta/alpha EEG power ratio are associated with an increased risk of MCI in CAD patients. The most important clinical and anamnestic factors associated with a decreased risk of MCI were higher education level, the lack of type 2 diabetes, and milder coronary bed lesions according to the SYNTAX scale. There was an association of the power values of the biopotentials and theta/alpha EEG power ratio and the development of MCI in CAD patients.

New directions for situated cognition in mathematics education

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Winbourne, Peter; Winbourne, Peter

2008-01-01

This book draws together a range of papers by experienced writers in mathematics education who have used the concept of situated cognition in their research within recent years. Thus it provides an up-to-date overview of developments and applications to which other researchers can refer and which will inspire future research. It is appropriate to review the field now and collect a range of papers which all relate to situated cognition and show how its application to mathematics education has matured and become usefully embedded in our approach to central issues about learning mathematics.

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

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

2016-01-01

Impaired interpersonal, social, and occupational functioning is very often observed in patients with bipolar disorder, not only at the acute stages of the illness but in remission as well. This finding raises the question of multiple factors that might affect psychosocial functioning in bipolar patients, such as residual subsyndromal symptoms and neuropsychological deficits. Social cognition impairment, especially impaired Theory of Mind (ToM), might also play an important role in bipolar patients' every-day functioning, similarly to what was found in patients with schizophrenia. The present study aimed to investigate the potential effect of clinical and cognitive factors on the psychosocial functioning of patients with bipolar disorder during remission, assessing ToM along with a broad range of basic cognitive functions. Forty-nine patients with bipolar disorder type I in remission and 53 healthy participants were assessed in general intelligence, working memory, attention, speed processing, verbal learning and memory, and executive functions using a comprehensive battery of neuropsychological tests. The Faux Pas Recognition Test was used to assess ToM. The two groups were matched for gender, age and education level. The Hamilton Rating Scale for Depression (HDRS), the Young Mania Rating Scale (YMRS), and the Brief Psychiatric Rating Scale (BPRS) were also administered to the patients. Every-day functioning was assessed with the Global Assessment of Functioning (GAF). In order to examine the contribution of many factors in psychosocial functioning, we used hierarchical multiple regression analysis. Bipolar patients presented significant impairment compared to healthy participants in all the basic cognitive functions tested with the exception of verbal memory. Moreover, patients had significant poorer performance than healthy controls in overall psyand cognitive ToM but not in affective ToM as measured by Faux Pas. Psychosocial functioning in patient group was

Pathways of Intergenerational Transmission of Advantages during Adolescence: Social Background, Cognitive Ability, and Educational Attainment.

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Schulz, Wiebke; Schunck, Reinhard; Diewald, Martin; Johnson, Wendy

2017-10-01

Educational attainment in adolescence is of paramount importance for attaining higher education and for shaping subsequent life chances. Sociological accounts focus on the role of differences in socioeconomic resources in intergenerational reproduction of educational inequalities. These often disregard the intergenerational transmission of cognitive ability and the importance of children's cognitive ability to educational attainment. Psychological perspectives stress the importance of cognitive ability for educational attainment but underemphasize potentially different roles of specific socioeconomic resources in shaping educational outcomes, as well as individual differences in cognitive ability. By integrating two strands of research, a clearer picture of the pathways linking the family of origin, cognitive ability, and early educational outcomes can be reached. Using the population-based TwinLife study in Germany, we investigated multidimensional pathways linking parental socioeconomic position to their children's cognitive ability and academic track attendance in the secondary school. The sample included twins (N = 4008), respectively ages 11 and 17, and siblings (N = 801). We observed strong genetic influences on cognitive ability, whereas shared environmental influences were much more important for academic tracking. In multilevel analyses, separate dimensions of socioeconomic resources influenced child cognitive ability, controlling parental cognitive ability. Controlling adolescent cognitive ability and parental cognitive ability, parental socioeconomic resources also directly affected track attendance. This indicated that it is crucial to investigate the intertwined influences on educational outcomes in adolescence of both cognitive ability and the characteristics of the family of origin.

The effect of cognitive education on the performance of students with neurological developmental disabilities.

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Jepsen, Ruthanne H; VonThaden, Karen

2002-01-01

A cognitive education program was developed to facilitate acquisition of cognitive skills and address the learning deficits of adolescent students with neurological, developmental disabilities, and autism. This study examined the outcomes of incorporating mediated cognitive education into special education classrooms. Cognitive education provided cognitive training utilizing REHABIT materials through mediated teaching. Following a matched pair model, forty-six students were assigned to either a treatment or a control group. All students received weekly instruction in Individual Educational Program (IEP) goals. Curriculum areas included IEP objectives in reading, math, social skills, health, science and social studies. Students in the control group received regular classroom instruction. Students in the treatment group participated in cognitive educated one hour per week replacing thirty minutes of reading and thirty minutes of math. Pre and posttest comparisons on measures of intelligence, achievement and adaptive behavior showed those students in the treatment group attained higher scores across measures.

Does cognitive behavioral therapy alter mental defeat and cognitive flexibility in patients with panic disorder?

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Nagata, Shinobu; Seki, Yoichi; Shibuya, Takayuki; Yokoo, Mizue; Murata, Tomokazu; Hiramatsu, Yoichi; Yamada, Fuminori; Ibuki, Hanae; Minamitani, Noriko; Yoshinaga, Naoki; Kusunoki, Muga; Inada, Yasushi; Kawasoe, Nobuko; Adachi, Soichiro; Oshiro, Keiko; Matsuzawa, Daisuke; Hirano, Yoshiyuki; Yoshimura, Kensuke; Nakazato, Michiko; Iyo, Masaomi; Nakagawa, Akiko; Shimizu, Eiji

2018-01-12

Mental defeat and cognitive flexibility have been studied as explanatory factors for depression and posttraumatic stress disorder. This study examined mental defeat and cognitive flexibility scores in patients with panic disorder (PD) before and after cognitive behavioral therapy (CBT), and compared them to those of a gender- and age-matched healthy control group. Patients with PD (n = 15) received 16 weekly individual CBT sessions, and the control group (n = 35) received no treatment. Patients completed the Mental Defeat Scale and the Cognitive Flexibility Scale before the intervention, following eight CBT sessions, and following 16 CBT sessions, while the control group did so only prior to receiving CBT (baseline). The patients' pre-CBT Mental Defeat and Cognitive Flexibility Scale scores were significantly higher on the Mental Defeat Scale and lower on the Cognitive Flexibility Scale than those of the control group participants were. In addition, the average Mental Defeat Scale scores of the patients decreased significantly, from 22.2 to 12.4, while their average Cognitive Flexibility Scale scores increased significantly, from 42.8 to 49.5. These results suggest that CBT can reduce mental defeat and increase cognitive flexibility in patients with PD Trial registration The study was registered retrospectively in the national UMIN Clinical Trials Registry on June 10, 2016 (registration ID: UMIN000022693).

Postoperative cognitive dysfunction and its relationship to cognitive reserve in elderly total joint replacement patients.

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Scott, J E; Mathias, J L; Kneebone, A C; Krishnan, J

2017-06-01

Whether total joint replacement (TJR) patients are susceptible to postoperative cognitive dysfunction (POCD) remains unclear due to inconsistencies in research methodologies. Moreover, cognitive reserve may moderate the development of POCD after TJR, but has not been investigated in this context. The current study investigated POCD after TJR, and its relationship with cognitive reserve, using a more rigorous methodology than has previously been utilized. Fifty-three older adults (aged 50+) scheduled for TJR were assessed pre and post surgery (6 months). Forty-five healthy controls matched for age, gender, and premorbid IQ were re-assessed after an equivalent interval. Cognition, cognitive reserve, and physical and mental health were all measured. Standardized regression-based methods were used to assess cognitive changes, while controlling for the confounding effect of repeated cognitive testing. TJR patients only demonstrated a significant decline in Trail Making Test Part B (TMT B) performance, compared to controls. Cognitive reserve only predicted change in TMT B scores among a subset of TJR patients. Specifically, patients who showed the most improvement pre to post surgery had significantly higher reserve than those who showed the greatest decline. The current study provides limited evidence of POCD after TJR when examined using a rigorous methodology, which controlled for practice effects. Cognitive reserve only predicted performance within a subset of the TJR sample. However, the role of reserve in more cognitively compromised patients remains to be determined.

Do cognitive leisure activities really matter in the relationship between education and cognition? Evidence from the aging, demographics, and memory study (ADAMS).

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Lee, Yura; Chi, Iris

2016-01-01

Increasing demand for early detection and prevention of dementia has shifted recent attention toward cognitive impairment with no dementia (CIND), which is often considered a possible risk path to dementia. Education and cognitive leisure activities are major predictors featured in dementia studies. However, the definition of cognitive leisure activities often has been inconsistent and diverse. This study explored different domains of these activities and their moderating roles on the relationship between education and cognition. A sample of 704 participants aged 70 or older was drawn from the national Aging, Demographics, and Memory Study. Exploratory factor analysis was conducted to assess two domains from cognitive leisure activities: literacy and visuospatial activities. Multinomial logistic regression tested the main and moderating roles of each domain on cognition categorized as no impairment, CIND, and dementia. Individuals with greater engagement in both literacy and visuospatial activities were more likely to have no cognitive impairment than CIND. Individuals with greater engagement in literacy activities were less likely to have dementia compared to CIND. Literacy activities and education years had a significant interaction effect. Individuals with higher education seem to benefit more by engaging in literacy activities, as evidenced by decreased odds of having dementia. Engagement in cognitive leisure activities for both cognitively intact and impaired older adults is suggested, with more focus on literacy activities for cognitively impaired and highly educated older adults.

Temporal Cerebral Microbleeds Are Associated With Radiation Necrosis and Cognitive Dysfunction in Patients Treated for Nasopharyngeal Carcinoma

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Shen, Qingyu; Lin, Focai; Rong, Xiaoming; Yang, Wuyang; Li, Yi; Cai, Zhaoxi; Xu, Pengfei; Xu, Yongteng; Tang, Yamei

2016-01-01

Purpose: Radiation therapy for patients with nasopharyngeal carcinoma (NPC) may be complicated with radiation-induced brain necrosis (RN), resulting in deteriorated cognitive function. However, the underlying mechanism of this phenomenon remains unclear. This study attempts to elucidate the association between cerebral microbleeds (CMBs) and radiation necrosis and cognitive dysfunction in NPC patients treated with radiation therapy. Methods and Materials: This cross-sectional study included 106 NPC patients who were exposed to radiation therapy (78 patients with RN and 28 without RN). Sixty-six patients without discernable intracranial pathology were included as the control group. CMBs were confirmed using susceptibility-weighted magnetic resonance imaging. Cognitive function was accessed using Montreal Cognitive Assessment. Patients with a total score below 26 were defined as cognitively dysfunction. Results: Seventy-seven patients (98.7%) in the RN group and 12 patients (42.9%) in the non-RN group had at least 1 CMB. In contrast, only 14 patients (21.2%) in the control group had CMBs. In patients with a history of radiation therapy, CMBs most commonly presented in temporal lobes (76.4%) followed by cerebellum (23.7%). Patients with RN had more temporal CMBs than those in the non-RN group (37.7 ± 51.9 vs 3.8 ± 12.6, respectively; P<.001). The number of temporal lobe CMBs was predictive for larger volume of brain necrosis (P<.001) in multivariate linear regression analysis. Although cognitive impairment was diagnosed in 55.1% of RN patients, only 7.1% of non-RN patients sustained cognitive impairment (P<.001). After adjusting for age, sex, education, period after radiation therapy, CMBs in other lobes, and RN volume, the number of temporal CMBs remained an independent risk factor for cognitive dysfunction (odds ratio [OR]: 1.03; 95% confidence interval [CI]: 1.01-1.04; P=.003). Conclusions: CMBs is a common radiological manifestation in NPC patients with RN

Temporal Cerebral Microbleeds Are Associated With Radiation Necrosis and Cognitive Dysfunction in Patients Treated for Nasopharyngeal Carcinoma

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Shen, Qingyu [Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou (China); Department of Neurology, Zengcheng People' s Hospital, Guangzhou (China); Lin, Focai; Rong, Xiaoming [Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou (China); Yang, Wuyang [Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Li, Yi; Cai, Zhaoxi; Xu, Pengfei; Xu, Yongteng [Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou (China); Tang, Yamei, E-mail: yameitang@hotmail.com [Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou (China); Key Laboratory of Malignant Tumor Gene Regulation and Target Therapy of Guangdong Higher Education Institutes, Sun Yat-sen University, Guangzhou (China); Guangdong Province Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong Province (China)

2016-04-01

Purpose: Radiation therapy for patients with nasopharyngeal carcinoma (NPC) may be complicated with radiation-induced brain necrosis (RN), resulting in deteriorated cognitive function. However, the underlying mechanism of this phenomenon remains unclear. This study attempts to elucidate the association between cerebral microbleeds (CMBs) and radiation necrosis and cognitive dysfunction in NPC patients treated with radiation therapy. Methods and Materials: This cross-sectional study included 106 NPC patients who were exposed to radiation therapy (78 patients with RN and 28 without RN). Sixty-six patients without discernable intracranial pathology were included as the control group. CMBs were confirmed using susceptibility-weighted magnetic resonance imaging. Cognitive function was accessed using Montreal Cognitive Assessment. Patients with a total score below 26 were defined as cognitively dysfunction. Results: Seventy-seven patients (98.7%) in the RN group and 12 patients (42.9%) in the non-RN group had at least 1 CMB. In contrast, only 14 patients (21.2%) in the control group had CMBs. In patients with a history of radiation therapy, CMBs most commonly presented in temporal lobes (76.4%) followed by cerebellum (23.7%). Patients with RN had more temporal CMBs than those in the non-RN group (37.7 ± 51.9 vs 3.8 ± 12.6, respectively; P<.001). The number of temporal lobe CMBs was predictive for larger volume of brain necrosis (P<.001) in multivariate linear regression analysis. Although cognitive impairment was diagnosed in 55.1% of RN patients, only 7.1% of non-RN patients sustained cognitive impairment (P<.001). After adjusting for age, sex, education, period after radiation therapy, CMBs in other lobes, and RN volume, the number of temporal CMBs remained an independent risk factor for cognitive dysfunction (odds ratio [OR]: 1.03; 95% confidence interval [CI]: 1.01-1.04; P=.003). Conclusions: CMBs is a common radiological manifestation in NPC patients with RN

Cognitive impairment in heart failure patients

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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

Assessment of Early Cognitive Impairment in Patients with Clinically Isolated Syndromes and Multiple Sclerosis

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Leyla Baysal Kıraç

2014-01-01

Full Text Available Objective. The aim of our study was to investigate the frequency and pattern of cognitive impairment in patients with clinically isolated syndromes and definite diagnosis of multiple sclerosis within the last 2 years. Methods. We assessed the cognitive status of 46 patients aged 18–49 years with clinically isolated syndromes or definite diagnosis of multiple sclerosis who have onset of their symptoms within the last 2 years. Patients were matched with 40 healthy participants for age, sex, and educational level. Neuropsychological assessment was performed by stroop test, paced auditory serial addition test (PASAT, controlled oral word association test (COWAT, clock drawing test, trail making test (TMT, faces symbol test (FST. Hamilton Depression Scale and Modified Fatigue Impact Scale were used to quantify the severity of any depression and fatigue the subjects might suffer. Results. 19.6% of early MS/CIS group failed at 4 and more tests and had significant cognitive impairment focused on attention, executive functions, memory, and learning. No significant relationship was found between cognitive impairment and disability and fatigue scores. Discussion. Cognitive impairment can be present from the earliest stage of multiple sclerosis. It should be considered among the main manifestations of MS even in the earliest stages of the disease.

Cognitive fatigue in patients with myasthenia gravis.

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Jordan, Berit; Schweden, Tabea L K; Mehl, Theresa; Menge, Uwe; Zierz, Stephan

2017-09-01

Cognitive fatigue has frequently been reported in myasthenia gravis (MG). However, objective assessment of cognitive fatigability has never been evaluated. Thirty-three MG patients with stable generalized disease and 17 healthy controls underwent a test battery including repeated testing of attention and concentration (d2-R) and Paced Auditory Serial Addition Test. Fatigability was based on calculation of linear trend (LT) reflecting dynamic performance within subsequent constant time intervals. Additionally, fatigue questionnaires were used. MG patients showed a negative LT in second d2-R testing, indicating cognitive fatigability. This finding significantly differed from stable cognitive performance in controls (P fatigue was significantly higher in MG patients compared with controls (P fatigue is not correlated with objective findings. Muscle Nerve 56: 449-457, 2017. © 2016 Wiley Periodicals, Inc.

Cognitive performance of detoxified alcoholic Korsakoff syndrome patients remains stable over two years.

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Fujiwara, Esther; Brand, Matthias; Borsutzky, Sabine; Steingass, Hans-P; Markowitsch, Hans J

2008-07-01

Excessive alcohol consumption is assumed to promote cognitive decline, eventually increasing the risk of dementia. However, little is known about the time course of cognitive functions in patients with chronic alcoholic Korsakoff syndrome (KS). Therefore, we assessed neuropsychological performance in 20 detoxified chronic KS inpatients at time 1 (T1) with a follow-up after two years (T2). The neuropsychological tests assessed verbal and visual short- and long-term memory, working memory, basic executive functions, language, general knowledge, and visual-spatial abilities. Surveys with caregivers and medical records provided information about current and previous disease-related parameters, drinking history, additional pathologies, as well as psychosocial and cognitive therapy within the two-year period. At both sessions, the majority of the KS patients' results were inferior to those of normal subjects. Comparing T1 and T2 revealed no significant decline in any of the investigated functions. Instead, general knowledge, visual long-term memory, and verbal fluency improved slightly after two years, though they still remained within pathological range. Comparing most improved and most deteriorated patients, better outcome occurred more frequently in men than women and was associated with higher premorbid education and fewer detoxifications in the past. In this sample of detoxified KS patients there was no indication of accelerated cognitive decline or onset of dementia-like symptoms over two years.

Comparison of the montreal cognitive assessment and the mini-mental state examination as screening tests in hemodialysis patients without symptoms.

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Lee, Sun Hwa; Cho, AJin; Min, Yang-Ki; Lee, Young-Ki; Jung, San

2018-11-01

Cognitive impairment in end-stage renal disease patients is associated with an increased risk of mortality. We examined the cognitive function in hemodialysis (HD) patients and compared the Korean versions of the Montreal Cognitive Assessment (K-MoCA) and of the Mini-Mental State Examination (K-MMSE) to identify the better cognitive screening instrument in these patients. Thirty patients undergoing hemodialysis and 30 matched reference group of apparently healthy control were included. All subjects underwent the K-MoCA, K-MMSE and a neuropsychological test battery to measure attention, visuospatial function, language, memory and executive function. All cognitive data were converted to z-scores with appropriate age and education level prior to group comparisons. Cognitive performance 1.0 SD below the mean was defined as modest cognitve impairment while 1.5 below the mean was defined as severe cognitive impairment. Modest cognitive impairment in memory plus other cognitive domains was detected in 27 patients (90%) while severe cognitive impairment in memory plus other cognitive domains was detected in 23 (77%) patients. Total scores in the K-MoCA were significantly lower in HD patients than in the reference group. However, no significant group difference was found in the K-MMSE. The K-MMSE ROC AUC (95% confidence interval) was 0.72 (0.59-0.85) and K-MoCA ROC AUC was 0.77 (0.65-0.89). Cognitive impairment is common but under-diagnosed in this population. The K-MoCA seems to be more sensitive than the K-MMSE in HD patients.

Is Education Associated with Improvements in General Cognitive Ability, or in Specific Skills?

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Ritchie, Stuart J.; Bates, Timothy C.; Deary, Ian J.

2015-01-01

Previous research has indicated that education influences cognitive development, but it is unclear what, precisely, is being improved. Here, we tested whether education is associated with cognitive test score improvements via domain-general effects on general cognitive ability ("g"), or via domain-specific effects on particular cognitive…

[Cognitive deficits in first episode psychosis patients and people at risk for psychosis: from diagnosis to treatment].

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Lecardeur, L; Meunier-Cussac, S; Dollfus, S

2013-05-01

a disruption of the cognitive development and the disturbance of scholarship in young individuals. Considering these results, the treatment of cognitive deficits should be initiated as soon as possible, e.g. in people at risk for psychosis in order to reinforce the normal cognitive development, prevent cognitive decline and to preserve the educational, professional and social status. Since antipsychotic medications do not impact on cognitive functioning, alternative therapeutics should be developed such as cognitive remediation. Several studies and meta-analyses have shown that cognitive remediation programs are particularly efficient in patients with schizophrenia or bipolar disorders. Contrary to antipsychotics, these techniques should be used in patients with a first psychotic episode, but also in individuals with subpsychotic symptoms, subthreshold to the diagnosis of schizophrenia. Copyright © 2013. Published by Elsevier Masson SAS.

Progressively Disrupted Brain Functional Connectivity Network in Subcortical Ischemic Vascular Cognitive Impairment Patients.

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Sang, Linqiong; Chen, Lin; Wang, Li; Zhang, Jingna; Zhang, Ye; Li, Pengyue; Li, Chuanming; Qiu, Mingguo

2018-01-01

Cognitive impairment caused by subcortical ischemic vascular disease (SIVD) has been elucidated by many neuroimaging studies. However, little is known regarding the changes in brain functional connectivity networks in relation to the severity of cognitive impairment in SIVD. In the present study, 20 subcortical ischemic vascular cognitive impairment no dementia patients (SIVCIND) and 20 dementia patients (SIVaD) were enrolled; additionally, 19 normal controls were recruited. Each participant underwent a resting-state functional MRI scan. Whole-brain functional networks were analyzed with graph theory and network-based statistics (NBS) to study the functional organization of networks and find alterations in functional connectivity among brain regions. After adjustments for age, gender, and duration of formal education, there were significant group differences for two network functional organization indices, global efficiency and local efficiency, which decreased (NC > SIVCIND > SIVaD) as cognitive impairment worsened. Between-group differences in functional connectivity (NBS corrected, p  impairment worsened, with an increased number of decreased connections between brain regions. We also observed more reductions in nodal efficiency in the prefrontal and temporal cortices for SIVaD than for SIVCIND. These findings indicated a progressively disrupted pattern of the brain functional connectivity network with increased cognitive impairment and showed promise for the development of reliable biomarkers of network metric changes related to cognitive impairment caused by SIVD.

Turning education into action: Impact of a collective social education approach to improve nurses' ability to recognize and accurately assess delirium in hospitalized older patients.

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Travers, Catherine; Henderson, Amanda; Graham, Fred; Beattie, Elizabeth

2018-03-01

Although cognitive impairment including dementia and delirium is common in older hospital patients, it is not well recognized or managed by hospital staff, potentially resulting in adverse events. This paper describes, and reports on the impact of a collective social education approach to improving both nurses' knowledge of, and screening for delirium. Thirty-four experienced nurses from six hospital wards, became Cognition Champions (CogChamps) to lead their wards in a collective social education process about cognitive impairment and the assessment of delirium. At the outset, the CogChamps were provided with comprehensive education about dementia and delirium from a multidisciplinary team of clinicians. Their knowledge was assessed to ascertain they had the requisite understanding to engage in education as a collective social process, namely, with each other and their local teams. Following this, they developed ward specific Action Plans in collaboration with their teams aimed at educating and evaluating ward nurses' ability to accurately assess and care for patients for delirium. The plans were implemented over five months. The broader nursing teams' knowledge was assessed, together with their ability to accurately assess patients for delirium. Each ward implemented their Action Plan to varying degrees and key achievements included the education of a majority of ward nurses about delirium and the certification of the majority as competent to assess patients for delirium using the Confusion Assessment Method. Two wards collected pre-and post-audit data that demonstrated a substantial improvement in delirium screening rates. The education process led by CogChamps and supported by educators and clinical experts provides an example of successfully educating nurses about delirium and improving screening rates of patients for delirium. ACTRN 12617000563369. Copyright © 2018 Elsevier Ltd. All rights reserved.

Stroke occurring in patients with cognitive impairment or dementia

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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.

Educational Attainment is not a Good Proxy for Cognitive Function in Methamphetamine Dependence

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Dean, Andy C.; Hellemann, Gerhard; Sugar, Catherine A.; London, Edythe D.

2014-01-01

We sought to test the hypothesis that methamphetamine use interferes with both the quantity and quality of one's education, such that the years of education obtained by methamphetamine dependent individuals serves to underestimate general cognitive functioning and overestimate the quality of academic learning. Thirty-six methamphetamine-dependent participants and 42 healthy comparison subjects completed cognitive tests and self-report measures in Los Angeles, California. An overall cognitive battery score was used to assess general cognition, and vocabulary knowledge was used as a proxy for the quality of academic learning. Linear regression procedures were used for analyses. Supporting the hypothesis that methamphetamine use interferes with the quantity of education, we found that a) earlier onset of methamphetamine use was associated with fewer years of education (p battery score (p < .01); and c) greater differences between methamphetamine-dependent participants' predicted and actual educational attainment were associated with an earlier onset of MA use (p ≤ .01). Supporting the hypothesis that methamphetamine use interferes with the quality of education, years of education received prior to the onset of methamphetamine use was a better predictor of a proxy for academic learning, vocabulary knowledge, than was the total years of education obtained. Results support the hypothesis that methamphetamine use interferes with the quantity and quality of educational exposure, leading to under- and overestimation of cognitive function and academic learning, respectively. PMID:22206606

Educational attainment is not a good proxy for cognitive function in methamphetamine dependence.

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Dean, Andy C; Hellemann, Gerhard; Sugar, Catherine A; London, Edythe D

2012-06-01

We sought to test the hypothesis that methamphetamine use interferes with both the quantity and quality of one's education, such that the years of education obtained by methamphetamine dependent individuals serves to underestimate general cognitive functioning and overestimate the quality of academic learning. Thirty-six methamphetamine-dependent participants and 42 healthy comparison subjects completed cognitive tests and self-report measures in Los Angeles, California. An overall cognitive battery score was used to assess general cognition, and vocabulary knowledge was used as a proxy for the quality of academic learning. Linear regression procedures were used for analyses. Supporting the hypothesis that methamphetamine use interferes with the quantity of education, we found that (a) earlier onset of methamphetamine use was associated with fewer years of education (pbattery score (p<.01); and (c) greater differences between methamphetamine-dependent participants' predicted and actual educational attainment were associated with an earlier onset of MA use (p≤.01). Supporting the hypothesis that methamphetamine use interferes with the quality of education, years of education received prior to the onset of methamphetamine use was a better predictor of a proxy for academic learning, vocabulary knowledge, than was the total years of education obtained. Results support the hypothesis that methamphetamine use interferes with the quantity and quality of educational exposure, leading to under- and overestimation of cognitive function and academic learning, respectively. Copyright © 2011. Published by Elsevier Ireland Ltd.

Twenty Five Years of Cognitive Care Education Research: Time for a Revolutionary Change

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Porter, Russell; Berry, Jeremy; Cude, Kellie; Anderson, Stephen; Britt, Sanfrena

2018-01-01

This is the third study of Cognitive Care Education in New York State nursing homes using cross-sectional methods over a 25 year period. The data indicate that the Cognitive Care Education increased at statistically significant levels, albeit by evolutionary means. It is now time for "A Revolutionary Change," for Cognitive Care…

Cognitive visualization as a support instrument by individual education

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V. A. Uglev

2014-01-01

Full Text Available The process of individual education, as the most effective form of gaining domain knowledge can be intensified through the organizational methods (involving a tutor, hardware (using computing technology, and psychological techniques (in particular, applying a cognitive visual representation. Of particular interest is a combination of traditional and computer-aided tutor support for individualized learning approaches based on the specific means of mapping.A tutor is an intermediary between a student (pupil and a teacher or between a student and a knowledge source in case of self-learning to orient the educational process to the student's personal goals and implement the L. S. Vygotsky's mediation principle. Thus, the tutor faces a task to identify the personal learning goals, disclose the learning prospects and its supports, but the student plays a role of a decision-maker. One of the nuclear problems of tutorage is making an individual educational or didactic path, which expects making a kind of distinctive cognition route.An application of cognitive visualization as a tutor's tools, is aimed, primarily, at a comprehensive representation of subjective educational student's space. A student has to be oriented inside this space to reach the denoted goals. In this context it is possible to formulate the navigation problem, which may be solved it in the most rational way by educational space mapping and navigating in it at any moment of the educational process. All three basic qualities of maps (the presence of different spatial objects in the corresponding metric, vector and scale can be usefully applied to support an individualized learning process.The paper shows that personality-resource maps can be used for describing the learning situation and building an individual study program in graphical form when the specifics of direct individualized learning is taken into account. Performing both the implementation function and the signum one, a

Correlation between demographic characteristics, cognitive functioning and functional independence in stroke patients

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Arsić Slađana

2016-01-01

Full Text Available Introduction. It has been assumed that there is causality of the achieved level of functional independence with the degree of preservation of cognitive function in stroke patients. Demographic characteristics may be important for monitoring the achieved level of functional independence. Objective. The aim of this study was to examine the relationship of demographic characteristics and functional independence in regard to the level of cognitive impairment in stroke patients. Methods. The study included 50 stroke patients after rehabilitation, as well as age- and gender-matched 50 subjects selected randomly, according to the demographic characteristics of the studied sample, who in their medical history had no neurological disorders. For the assessment of functional independence, the Functional Independence Measure (FIM test was used. The general cognition was estimated by the Mini-Mental State Examination (MMSE test. The statistical analyses included the Mann-Whitney test, for two independent samples, measures of canonical correlation, and χ2 test. Results. There was a statistically significant difference between the groups in relation to risk factors, hypertension and diabetes mellitus type II (p<0.001; There was a statistically significant difference within the groups in relation to the cognitive impairment in all the examined demographic characteristics (p<0.001; the differences within the groups in relation to the cognitive impairment are present on all subscales of the FIM test (p<0.05; the differences within the groups in relation to handedness, hemiparesis, show that mild cognitive impairment is more common among left hemiparesis, while a more severe one is more common among right-sided hemiparesis (p<0.05; More severe cognitive impairment is common among women, the elderly and in persons with lower education (p<0.05. Conclusion. By prevention of risk factors, and prevention of possible cognitive impairment, consequences of stroke can be

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.

Cognitive function in patients with chronic pain treated with opioids

DEFF Research Database (Denmark)

Kurita, G P; de Mattos Pimenta, C A; Braga, P E

2012-01-01

The paucity of studies regarding cognitive function in patients with chronic pain, and growing evidence regarding the cognitive effects of pain and opioids on cognitive function prompted us to assess cognition via neuropsychological measurement in patients with chronic non-cancer pain treated...

Physics education students’ cognitive and affective domains toward ecological phenomena

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Napitupulu, N. D.; Munandar, A.; Redjeki, S.; Tjasyono, B.

2018-05-01

Environmental education is become prominent in dealing with natural phenomena that occur nowadays. Studying environmental physics will lead students to have conceptual understanding which are importent in enhancing attitudes toward ecological phenomena that link directry to cognitive and affective domains. This research focused on the the relationship of cognitive and affective domains toward ecological phenomena. Thirty-seven Physics Education students participated in this study and validated sources of data were collected to eksplore students’ conceptual understanding as cognitive domain and to investigate students’ attitudes as affective domain. The percentage of cognitive outcome and affective outcome are explore. The features of such approaches to environmental learning are discussion through analysis of contribution of cognitive to develop the attitude ecological as affective outcome. The result shows that cognitive domains do not contribute significantly to affective domain toward ecological henomena as an issue trend in Central Sulawesi although students had passed Environmental Physics instruction for two semester. In fact, inferior knowledge in a way actually contributes to the attitude domain caused by the prior knowledge that students have as ombo as a Kaili local wisdom.

Prevalence of mild cognitive impairment in employable patients after acute coronary event in cardiac rehabilitation

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Salzwedel A

2017-02-01

Full Text Available Annett Salzwedel,1 Maria-Dorothea Heidler,1,2 Kathrin Haubold,1 Martin Schikora,2 Rona Reibis,3 Karl Wegscheider,4 Michael Jöbges,2 Heinz Völler1,5 1Center for Rehabilitation Research, University of Potsdam, Potsdam, 2Brandenburg Klinik, Bernau, 3Cardiological Outpatient Clinic, Am Park Sanssouci, Potsdam, 4Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, 5Klinik am See, Rüdersdorf, Germany Introduction: Adequate cognitive function in patients is a prerequisite for successful implementation of patient education and lifestyle coping in comprehensive cardiac rehabilitation (CR programs. Although the association between cardiovascular diseases and cognitive impairments (CIs is well known, the prevalence particularly of mild CI in CR and the characteristics of affected patients have been insufficiently investigated so far. Methods: In this prospective observational study, 496 patients (54.5 ± 6.2 years, 79.8% men with coronary artery disease following an acute coronary event (ACE were analyzed. Patients were enrolled within 14 days of discharge from the hospital in a 3-week inpatient CR program. Patients were tested for CI using the Montreal Cognitive Assessment (MoCA upon admission to and discharge from CR. Additionally, sociodemographic, clinical, and physiological variables were documented. The data were analyzed descriptively and in a multivariate stepwise backward elimination regression model with respect to CI. Results: At admission to CR, the CI (MoCA score < 26 was determined in 182 patients (36.7%. Significant differences between CI and no CI groups were identified, and CI group was associated with high prevalence of smoking (65.9 vs 56.7%, P = 0.046, heavy (physically demanding workloads (26.4 vs 17.8%, P < 0.001, sick leave longer than 1 month prior to CR (28.6 vs 18.5%, P = 0.026, reduced exercise capacity (102.5 vs 118.8 W, P = 0.006, and a shorter 6-min walking distance

Relating Education, Brain Structure, and Cognition: The Role of Cardiovascular Disease Risk Factors

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Moyra E. Mortby

2014-01-01

Full Text Available The protective effect of education on cognitive and brain health is well established. While the direct effects of individual cardiovascular disease (CVD risk factors (i.e., hypertension, smoking, diabetes, and obesity on cerebral structure have been investigated, little is understood about the possible interaction between the protective effect of education and the deleterious effects of CVD risk factors in predicting brain ageing and cognition. Using data from the PATH Through Life study (N=266, we investigated the protective effect of education on cerebral structure and function and tested a possible mediating role of CVD risk factors. Higher education was associated with larger regional grey/white matter volumes in the prefrontal cortex in men only. The association between education and cognition was mediated by brain volumes but only for grey matter and only in relation to information processing speed. CVD risk factors did not mediate the association between regional volumes and cognition. This study provides additional evidence in support for a protective effect of education on cerebral structures and cognition. However, it does not provide support for a mediating role of CVD risk factors in these associations.

Mathematics Teacher Educators' Perceptions and Use of Cognitive Research

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Laski, Elida V.; Reeves, Todd D.; Ganley, Colleen M.; Mitchell, Rebecca

2013-01-01

Instructors ("N"?=?204) of elementary mathematics methods courses completed a survey assessing the extent to which they value cognitive research and incorporate it into their courses. Instructors' responses indicated that they view cognitive research to be fairly important for mathematics education, particularly studies of domain-specific topics,…

How Do Cognitive Function and Knowledge Affect Heart Failure Self-Care?

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Dickson, Victoria Vaughan; Lee, Christopher S.; Riegel, Barbara

2011-01-01

Despite extensive patient education, few heart failure (HF) patients master self-care. Impaired cognitive function may explain why patient education is ineffective. A concurrent triangulation mixed methods design was used to explore how knowledge and cognitive function influence HF self-care. A total of 41 adults with HF participated in interviews…

Leisure activities, education, and cognitive impairment in Chinese older adults: a population-based longitudinal study.

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Zhu, Xinyi; Qiu, Chengxuan; Zeng, Yi; Li, Juan

2017-05-01

We examine the association between leisure-time activities and the risk of developing cognitive impairment among Chinese older people, and further investigate whether the association varies by educational level. This follow-up study included 6,586 participants (aged 79.5 ± 9.8 years, range 65-105 years, 51.7% female) of the Chinese Longitudinal Healthy Longevity Survey who were aged ≥65 years and were free of cognitive impairment in 2002. Incident cognitive impairment was defined at the 2005 or 2008/2009 survey following an education-based cut-off on the adapted Chinese version of Mini-Mental State Examination (MMSE). Participation in cognitive activities (e.g. reading) and non-exercise physical activity (e.g. housework) was assessed by a self-reported scale. Cox proportional hazard models were employed to examine the association of leisure activities with incident cognitive impairment while controlling for age, gender, education, occupation, residence, physical exercise, smoking, drinking, cardiovascular diseases and risk factors, negative well-being, and physical functioning, and baseline MMSE score. During a five-year follow-up, 1,448 participants developed incident cognitive impairment. Overall, a high level of participation in leisure activities was associated with a 41% decreased risk of cognitive impairment compared to low-level engagement in leisure activities after controlling for age, gender, education, and other confounders. Moreover, there was a significant interaction between leisure activity and educational level, such that the beneficial effect of leisure activities on cognitive function was larger in educated elderly than their uneducated counterparts, and only educated elderly benefited from cognitive activities. Late-life leisure activities protect against cognitive impairment among elderly Chinese people, and the protective effects are more profound for educated elderly.

Cognitive Function Among Obstructive Sleep Apnea Patients in North East Malaysia.

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Yusop, Che Yusfarina Che; Mohamad, Irfan; Mohammad, Wan Mohd Zahiruddin Wan; Abdullah, Baharudin

2017-01-01

Obstructive sleep apnea patients may develop deficits in the cognitive domains of attention, concentration, executive function, verbal and visuospatial memory, constructional abilities, and psychomotor functioning. As cognitive performance will improve with the treatment, early screening for cognitive dysfunction should be done to prevent further deterioration. We aim to evaluate the cognitive function of obstructive sleep apnea patients by using the 'Mini Mental State Examination'. This was a cross sectional study to evaluate the cognitive function of moderate and severe obstructive sleep apnea patients with age ranged from 18 to 60 old who attended our sleep clinic. These patients were confirmed to have moderate and severe obstructive sleep apnea by Type 1 polysomnography (attended full overnight study). The age, gender and ethnicity were noted and other relevant data such as weight, height, body mass index and apnea and hypopnoea index were recorded accordingly. The cognitive function was evaluated using validated Malay version of Mini Mental State Examination which measured 5 areas of cognitive functions comprising orientation, registration, attention and calculation, word recall and language abilities, and visuospatial. A total of 38 patients participated in this study. All 19 patients of moderate group and 14 patients of severe group had normal cognitive function while only 5 patients in severe group had mild cognitive function impairment. There was a statistically significant difference between the moderate group and severe group on cognitive performance (p value = 0.042). Severe obstructive sleep apnea patients may have impaired cognitive function. Mini Mental State Examination is useful in the screening of cognitive function of obstructive sleep apnea patients but in normal score, more sophisticated test batteries are required as it is unable to identify in 'very minimal' or 'extremely severe' cognitive dysfunction. Copyright © 2017 National Medical

Health Literacy and Global Cognitive Function Predict E-Mail but Not Internet Use in Heart Failure Patients

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Jared P. Schprechman

2013-01-01

Full Text Available Background. The internet offers a potential for improving patient knowledge, and e-mail may be used in patient communication with providers. However, barriers to internet and e-mail use, such as low health literacy and cognitive impairment, may prevent patients from using technological resources. Purpose. We investigated whether health literacy, heart failure knowledge, and cognitive function were related to internet and e-mail use in older adults with heart failure (HF. Methods. Older adults (N=119 with heart failure (69.84±9.09 years completed measures of health literacy, heart failure knowledge, cognitive functioning, and internet use in a cross-sectional study. Results. Internet and e-mail use were reported in 78.2% and 71.4% of this sample of patients with HF, respectively. Controlling for age and education, logistic regression analyses indicated that higher health literacy predicted e-mail (P<.05 but not internet use. Global cognitive function predicted e-mail (P<.05 but not internet use. Only 45% used the Internet to obtain information on HF and internet use was not associated with greater HF knowledge. Conclusions. The majority of HF patients use the internet and e-mail, but poor health literacy and cognitive impairment may prevent some patients from accessing these resources. Future studies that examine specific internet and email interventions to increase HF knowledge are needed.

Characteristic patterns of cerebral blood perfusion and cognitive impairment in patients with Parkinsons disease

International Nuclear Information System (INIS)

Jeong, Y. J.; Park, M. J.; Cha, J. G.; Kim, S. H.; Kim, J. W.; Kang, D. Y.

2005-01-01

Parkinsons disease (PD) is a neurodegenerative disorder that represents cognitive impairment as well as motor symptoms. Even in the early stages of PD, cognitive alterations can be demonstrated by careful neuropsychological test. The purposes of this study are to investigate the pattern of cognitive impairment and the regional cerebral blood flow (rCBF) using Tc-99m HMPAO SPECT in patients with PD. One hundred and twenty two patients with PD and 35 control subjects participated in this study. Patients with PD who had dementia clinically or K-MMSE score below 25 points or with severe motor dysfunction to interfere with the tests were also excluded. They were all matched for age (61±10 vs 61±8), education periods (8.8±4.9 vs 8.8±4.5), and K-MMSE score (27±1.6 vs 27±1.5). All subjects were evaluated using the Seoul Neuropsychological Screening Battery (SNSB) and Tc-99m HMPAO SPECT with SPM software to measure rCBF. Patients with PD performed worse in digit span backward, Rey Complex Figure Test, visual memory, semantic fluency, stroop test, and alternating hand movement test(p<0.05) compared with control group. On SNSB test, 100 patients (82.0%) showed some abnormalities. Eighty-six patients (70.5%) showed frontal dysfunction, 47 (38.5%) memory impairment, 33 (27.0%) language dysfunction, 25 (20.5%) attention deficit and 22 (18.3%) visuospatial dysfunction in the order of frequency. Eight patients with PD showed single memory domain MCI and 28 single non-memory domain MCI (20 frontal dysfunction). Multiple domain MCI was found in 64 patients with PD. SPM analysis of the SPECT image revealed multiple perfusion deficit in the both frontal, temporal, both limbic lobes, Lt. parietal and Lt. Putamen. It is concluded that abnormalities of cognitive function be detected very commonly in patients with PD. MCI in PD patients is most frequently involved in the item of frontal lobe function. SPECT image might be helpful to explain cognitive impairment in some PD patients

Characteristic patterns of cerebral blood perfusion and cognitive impairment in patients with Parkinsons disease

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Jeong, Y. J.; Park, M. J.; Cha, J. G.; Kim, S. H.; Kim, J. W.; Kang, D. Y. [Dong-A University College of medicine, Pusan (Korea, Republic of)

2005-07-01

Parkinsons disease (PD) is a neurodegenerative disorder that represents cognitive impairment as well as motor symptoms. Even in the early stages of PD, cognitive alterations can be demonstrated by careful neuropsychological test. The purposes of this study are to investigate the pattern of cognitive impairment and the regional cerebral blood flow (rCBF) using Tc-99m HMPAO SPECT in patients with PD. One hundred and twenty two patients with PD and 35 control subjects participated in this study. Patients with PD who had dementia clinically or K-MMSE score below 25 points or with severe motor dysfunction to interfere with the tests were also excluded. They were all matched for age (61{+-}10 vs 61{+-}8), education periods (8.8{+-}4.9 vs 8.8{+-}4.5), and K-MMSE score (27{+-}1.6 vs 27{+-}1.5). All subjects were evaluated using the Seoul Neuropsychological Screening Battery (SNSB) and Tc-99m HMPAO SPECT with SPM software to measure rCBF. Patients with PD performed worse in digit span backward, Rey Complex Figure Test, visual memory, semantic fluency, stroop test, and alternating hand movement test(p<0.05) compared with control group. On SNSB test, 100 patients (82.0%) showed some abnormalities. Eighty-six patients (70.5%) showed frontal dysfunction, 47 (38.5%) memory impairment, 33 (27.0%) language dysfunction, 25 (20.5%) attention deficit and 22 (18.3%) visuospatial dysfunction in the order of frequency. Eight patients with PD showed single memory domain MCI and 28 single non-memory domain MCI (20 frontal dysfunction). Multiple domain MCI was found in 64 patients with PD. SPM analysis of the SPECT image revealed multiple perfusion deficit in the both frontal, temporal, both limbic lobes, Lt. parietal and Lt. Putamen. It is concluded that abnormalities of cognitive function be detected very commonly in patients with PD. MCI in PD patients is most frequently involved in the item of frontal lobe function. SPECT image might be helpful to explain cognitive impairment in some

Patient education programmes in obstructive airway disease. The Ingelheim Model for promoting health through patient education.

Science.gov (United States)

Klein, K; Troglauer, K G; Ahlstich, G; Schunke, B; Theissen, E; Voss, H W; Clausen, V

1992-06-01

Chronic obstructive airway diseases (COAD) can be regarded as one of the major health problems needing environmental actions and screening programs for early detection and intensive patient education programs to cope with the needs of tertiary prevention. On the basis of our epidemiological study focused on COAD carried out in FRG (sample size August 1988: 63,000 participants) a patient education program has been developed and evaluated. In cooperation with general practitioners and pneumologists the program has been installed at practice and community level. The need for a patient education program has been assessed during the three years of the PNEUMOBIL-Project. It is not just a matter of cutting costs, but to a large extent a matter of the wellbeing of the patients and of reducing side effects to a minimum. The objective of the project can be split into three dimensions: (1) The cognitive aspect. Here significant lack of knowledge has to be overcome. At this point it has to be stated clearly that at the present time the medical community is not able to solve this problem on their own. (2) The psychomotoric aspect. Here the competent use of medication has to be trained. (3) The emotional aspect. The patient has to be motivated and integrated into the therapeutic process in a way that his compliance contributes significantly. The didactical concept consists of modules that can be used in varying sequences according to the needs of the target audience.(ABSTRACT TRUNCATED AT 250 WORDS)

Qualitative analysis of the Clock Drawing Test by educational level and cognitive profile

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Aline Teixeira Fabricio

2014-04-01

Full Text Available The use of a qualitative scale for the Clock Drawing Test (CDT may add information about the pattern of errors committed. Objective: To translate and adapt the Modified Qualitative Error Analysis of Rouleau into Brazilian Portuguese and to examine the pattern of errors according to educational level and cognitive profile. Method: 180 adults (47-82 years completed the CDT. Participants were stratified into age and educational levels and separated between those with and without changes in cognitive screening tests (Mini-Mental State Examination, Verbal Fluency. Results: No significant differences were found in CDT scores among age groups. Among participants without cognitive impairment, those with lower education often presented graphic difficulties, conceptual deficits and spatial deficits. Participants with cognitive deficits, demonstrated more frequently conceptual and spatial errors. Conclusion: The qualitative analysis of the CDT may contribute to the identification of cognitive changes. Education level has to be taken into consideration during the analysis.

The relationship of cognitive impairment with neurological and psychiatric variables in multiple sclerosis patients.

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Karadayi, Husna; Arisoy, Ozden; Altunrende, Burcu; Boztas, Mehmet Hamid; Sercan, Mustafa

2014-01-01

Cognitive impairment (CI) in multiple sclerosis (MS) can develop any time. CI is associated with the degree of neuronal loss, but disease duration, fatigue, comorbid affective disorder, and drug dose may also affect cognition. Our aim was to assess which cognitive domain was disturbed primarily in mild MS patients and to see whether CI was related with clinical and psychiatric features. Neurological and psychiatric evaluation of 31 MS patients and 31 age, sex, and education-matched healthy controls were made with Structured Clinical Interview for Axis I Disorders (SCID-I). Depression, anxiety, functionality, fatigue, and disability scoring were determined with Hamilton Depression-Anxiety scales, Global Assessment of Functionality, Fatigue Severity and Expanded Disability Status Scales. Cognitive functions were assessed using Mini Mental, Serial Digit Learning, Verbal and Nonverbal Cancellation, Stroop and Rey Auditory Verbal Learning tests. Retrieval from long-term memory and psychomotor speed were significantly worse in MS group. CI was correlated with disease duration, number of attacks, and physical disability but not with depression and anxiety severity. Disease duration predicted disturbances in recall and psychomotor speed, whereas fatigue and disability predicted depression. Psychomotor speed and memory were primarily impaired in MS patients, and CI was closely associated with clinical aspects of MS rather than with depression and anxiety.

Cognitive Education in Four Canadian Prisons.

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Volpe, Richard; And Others

1985-01-01

This article reports the evaluation of a cognitive education course designed for inmates in Canadian federal penitentiaries. Reports from school instructors indicate that participating inmates showed improvement in their ability to communicate and discuss ideas and were more able to stop and think before acting on a problem. (Author/CT)

Effect of computerized cognitive rehabilitation program on cognitive function and activities of living in stroke patients

OpenAIRE

Yoo, Chanuk; Yong, Mi-hyun; Chung, Jaeyeop; Yang, Yeongae

2015-01-01

[Purpose] The objective of this study was to examine the effect of cognitive rehabilitation using a computer on cognitive function and activities of daily living in stroke patients presenting impairment of cognitive function. [Subjects] Forty-six stroke patients were divided into two groups (a training group and control group) through random assignment. [Methods] The training group received rehabilitation therapy and an additional computerized cognitive rehabilitation program using The RehaCo...

Mild cognitive deficits in patients with primary adrenal insufficiency.

Science.gov (United States)

Tiemensma, Jitske; Andela, Cornelie D; Biermasz, Nienke R; Romijn, Johannes A; Pereira, Alberto M

2016-01-01

The brain is a major target organ for cortisol considering its high density of glucocorticoid receptors. Several states of hypothalamus-pituitary-adrenal dysregulation point towards impairments in cognitive functioning. However, there is a very limited body of research on the effects of hypocortisolism on cognitive functioning. To evaluate cognitive functioning in patients with hypocortisolism (i.e., primary adrenal insufficiency (PAI)) and to examine the possible effect of postponing early-morning hydrocortisone intake on cognitive functioning. Thirty-one patients with PAI on regular morning hydrocortisone intake and 31 healthy matched controls underwent nine neuropsychological tests, evaluating memory and executive functioning. In addition, the effect of normal timing and postponement of morning hydrocortisone intake on neuropsychological tests were assessed in an additional 29 patients with PAI. Compared to controls, patients with PAI performed worse on auditory and visual memory tasks (all P ≤ 0.024) and executive functioning tasks (all P ≤ 0.012). In contrast, patients performed better on a concentration and an attention task (both Paffect the outcomes of neuropsychological tests. Patients on long-term hydrocortisone replacement for PAI show mild cognitive deficits compared to controls. There was no effect of postponement of regular hydrocortisone intake on cognition. Copyright © 2015 Elsevier Ltd. All rights reserved.

The relationship between clinical characteristics, metacognitive appraisals, and cognitive insight in patients with obsessive-compulsive disorder.

Science.gov (United States)

Ekinci, Okan; Ekinci, Asli

2016-11-01

Cognitive insight, a recently developed insight measure, refers to metacognitive processes of the re-evaluation and correction of distorted beliefs and misinterpretations. However, to the best of the authors' knowledge, no study has specifically examined cognitive insight, demographics, psychopathological variables, and distorted beliefs in OCD. The aim of this research was to examine links between cognitive insight and demographics, clinical factors, and distorted beliefs among patients with OCD. Eighty-four consecutive outpatients with a diagnosis of OCD underwent a detailed clinical assessment for OCD, including the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Beck Cognitive Insight Scale (BCIS), Thought-Action Fusion Scale (TAFS), White Bear Thought Suppression Inventory, Metacognition Questioniarre-30 (MCQ-30), and a sociodemographic questionnaire. In addition, 82 control subjects matched for age, education, and gender were tested. BCIS-self-certainty scores were all substantially higher in subjects with remitted and unremitted OCD than in healthy comparison subjects, while BCIS-composite scores were significantly lower in both patient groups than controls. Obsession and compulsion severity had significant effects on BCIS scores. In addition, it was found that the specific symptoms were linked to self-certainty scores. Self-reflectiveness and composite scores had positive correlations with the sub-scale scores of the MCQ-30, while the TAF-morality score was positively correlated with self-certainty scores. The results demonstrated poor cognitive insight among remitted and unremitted OCD patients. In addition, the present study suggested significant associations between sociodemographic and clinical features and dysfunctional appraisals. Cognitive-behavioural techniques aimed at enhancing cognitive insight may be beneficial for patients with OCD, particularly patients who have prominent dysfunctional beliefs.

EFEKTIFITAS COGNITIVE BEHAVIOURAL EDUCATIONAL INTERVENTION PADA PASIEN POST TRANS URETHERAL RESECTION OF THE PROSTATE DI RS PKU MUHAMMADIYAH BANTUL

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Wantonoro Wantonoro

2016-03-01

Full Text Available This research aimed to show the effectiveness cognitive behavioural educational intervention (CBEI in post trans urethral resection of the prostate in PKU Muhammadiyah Bantul Hospital. The research design used Quasi-eksperiment; posttest only control group. Sample was taken by nonprobability sampling with accidental sampling method (on February-June 2015. There were 20 respondent have TURP procedure and which were divided into two groups. The t-test independent indicated a significant difference in pain respon in two groups (p=0,000. From this study, CBEI was recommended for pain management in patient with TURP.Keywords: cognitive behavioural educational intervention, pain, TURP

Frequent mild cognitive deficits in several functional domains in elderly patients with heart failure without known cognitive disorders.

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Nordlund, Arto; Berggren, Jens; Holmström, Alexandra; Fu, Michael; Wallin, Anders

2015-09-01

The objective of the present study was to investigate whether mild cognitive deficits are present in patients with heart failure (HF) despite absence of any known cognitive disorder. A well defined group of patients (n = 40) with heart failure completed a cognitive screening check list, a depression screening questionnaire, and a battery consisting of neuropsychological tests assessing 5 different cognitive domains: speed/attention, episodic memory, visuospatial functions, language, and executive functions. The neuropsychological results were compared with those from a group of healthy control subjects (n = 41). The patients with HF displayed cognitive impairment compared with the control group within the domains speed and attention, episodic memory, visuospatial functions, and language. Among them, 34 HF patients (85%) could be classified with mild cognitive impairment (MCI), the majority as nonamnestic MCI, ie, with no memory impairment. Considering the high occurrence of mild cognitive deficits among HF patients without known cognitive disorders, closer attention should be paid to their self-care and compliance. Inadequate self-care and compliance could lead to more frequent hospitalizations. Furthermore, the HF patients may be at increased risk of dementia. Copyright © 2015 Elsevier Inc. All rights reserved.

Graduate Social Work Education and Cognitive Complexity: Does Prior Experience Really Matter?

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Simmons, Chris

2014-01-01

This study examined the extent to which age, education, and practice experience among social work graduate students (N = 184) predicted cognitive complexity, an essential aspect of critical thinking. In the regression analysis, education accounted for more of the variance associated with cognitive complexity than age and practice experience. When…

Cognitive flexibility in verbal and nonverbal domains and decision making in anorexia nervosa patients: a pilot study

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Marzola Enrica

2011-10-01

Full Text Available Abstract Background This paper aimed to investigate cognitive rigidity and decision making impairments in patients diagnosed with Anorexia Nervosa Restrictive type (AN-R, assessing also verbal components. Methods Thirty patients with AN-R were compared with thirty age-matched healthy controls (HC. All participants completed a comprehensive neuropsychological battery comprised of the Trail Making Test, Wisconsin Card Sorting Test, Hayling Sentence Completion Task, and the Iowa Gambling Task. The Beck Depression Inventory was administered to evaluate depressive symptomatology. The influence of both illness duration and neuropsychological variables was considered. Body Mass Index (BMI, years of education, and depression severity were considered as covariates in statistical analyses. Results The AN-R group showed poorer performance on all neuropsychological tests. There was a positive correlation between illness duration and the Hayling Sentence Completion Task Net score, and number of completion answers in part B. There was a partial effect of years of education and BMI on neuropsychological test performance. Response inhibition processes and verbal fluency impairment were not associated with BMI and years of education, but were associated with depression severity. Conclusions These data provide evidence that patients with AN-R have cognitive rigidity in both verbal and non-verbal domains. The role of the impairment on verbal domains should be considered in treatment. Further research is warranted to better understand the relationship between illness state and cognitive rigidity and impaired decision-making.

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

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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.

Cognitive and psychosocial impairment in remitted bipolar patients

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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.

Cognitive functions in newly diagnosed patients with HIV infection in a tertiary health facility: Assessment using community screening interview for dementia

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T.A. Sumonu

2017-12-01

Full Text Available Introduction: Neurocognitive dysfunction is a detrimental complication of HIV infection. In this study we attempt to characterize the pattern of cognitive dysfunction in a sample of Nigerian patients with newly diagnosed HIV infection. Methods: We conducted a prospective study in which 50 patients with newly diagnosed HIV infection were studied along with 50 normal control subjects. The participants were evaluated with the medical history, general, physical and neurological examination. Laboratory evaluation and chest X-Ray were done for all patients. The Community Screening Interview for Dementia (CSID questionnaire was administered to all the study participants. Results: About 70% of the patients were in advanced disease stage. The mean age (SD of the patients and controls in years were 36.44±8.22 and 35.40±11.53 respectively. More than half (56% of the patients had secondary level of education (12years of education. About 20% of the patients had severe neurocognitive impairment while 48% had minor neurocognitive disorder. The patients with HIV infection performed poorly in the domains of language, memory, orientation, attention/calculation and praxis relative to controls (p0.05 but the presence of opportunistic infections had negative impact on the performances on orientation and total CSID scores in the patients with HIV infection (p<0.05. Conclusion: Patients with newly diagnosed HIV infection have poor cognitive functions when compared to normal controls and some presence of opportunistic infections in the patient is a significant risk factor for cognitive impairment. Keywords: Human immunodeficiency virus infection, Cognitive functions, Dementia, Nigeria

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

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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.

A study on cognitive impairment and gray matter volume abnormalities in silent cerebral infarction patients

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Luo, Wei; Wei, Xiaofeng; Li, Mengxiong [The First Affiliated Hospital of Yangtze University, Biomedical Engineering Laboratory, Jingzhou, Hubei (China); Jiang, Xun [Renmin Hospital of Wuhan University, Biomedical Engineering Laboratory, Wuhan, Hubei (China); Li, Shanshan [JingZhou City Central Blood Bank, Jingzhou, Hubei (China)

2015-08-15

The relationship between silent cerebral infarction (SCI) and the integrity of cognitive function is unknown. We intended to investigate whether cognitive impairment is associated with gray matter volume (GMV) in the SCI patients. Sixty-two patients with SCI and 62 age- and gender-matched healthy controls (HC) were evaluated with P300 test, Montreal Cognitive Assessment (MoCA) test, Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HDRS). Whole brain high-resolution T1-weighted images were processed with SPM12b software and analyzed by voxel-based morphometry (VBM). Correlation analysis was performed between the GMV and the scores of MoCA Scale, P300 latency, P300 amplitude, HAMA, HDRS, age, and educational level. The brains of the SCI patients have a significant reduction in GMV in the left superior and inferior frontal gyrus, left superior temporal gyrus, right middle temporal gyrus, and bilateral hippocampus gyrus (p < 0.01, FDR correction). No significant increase of GMV was detected. The GMV of their frontal and temporal lobes is positively correlated with the score of MoCA scale and P300 amplitude (r ≥ 0.62, p < 0.01). The GMV of frontal, temporal, and hippocampus is negatively correlated with P300 latency (r ≤ -0.71, p < 0.05). No significant correlation between the GMV of abnormal brain regions and another two clinical characteristics was found. SCI patients have impaired cognitive function and reduced GMV compared to the HC subjects. The neuropathological basis of such cognitive deficits in SCI patients might be a reduced GMV. (orig.)

A study on cognitive impairment and gray matter volume abnormalities in silent cerebral infarction patients

International Nuclear Information System (INIS)

Luo, Wei; Wei, Xiaofeng; Li, Mengxiong; Jiang, Xun; Li, Shanshan

2015-01-01

The relationship between silent cerebral infarction (SCI) and the integrity of cognitive function is unknown. We intended to investigate whether cognitive impairment is associated with gray matter volume (GMV) in the SCI patients. Sixty-two patients with SCI and 62 age- and gender-matched healthy controls (HC) were evaluated with P300 test, Montreal Cognitive Assessment (MoCA) test, Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HDRS). Whole brain high-resolution T1-weighted images were processed with SPM12b software and analyzed by voxel-based morphometry (VBM). Correlation analysis was performed between the GMV and the scores of MoCA Scale, P300 latency, P300 amplitude, HAMA, HDRS, age, and educational level. The brains of the SCI patients have a significant reduction in GMV in the left superior and inferior frontal gyrus, left superior temporal gyrus, right middle temporal gyrus, and bilateral hippocampus gyrus (p < 0.01, FDR correction). No significant increase of GMV was detected. The GMV of their frontal and temporal lobes is positively correlated with the score of MoCA scale and P300 amplitude (r ≥ 0.62, p < 0.01). The GMV of frontal, temporal, and hippocampus is negatively correlated with P300 latency (r ≤ -0.71, p < 0.05). No significant correlation between the GMV of abnormal brain regions and another two clinical characteristics was found. SCI patients have impaired cognitive function and reduced GMV compared to the HC subjects. The neuropathological basis of such cognitive deficits in SCI patients might be a reduced GMV. (orig.)

A consideration of cognitive factors in the learning and education of older adults

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Fry, Prem S.

1992-07-01

The purpose of this paper is to consider the unique cognitive and intellectual factors that influence the learning and education of older adults. With this objective in mind, the paper reviews the empirical literature on patterns of intellectual and cognitive aging, and ends by discussing the implications and applications of these patterns for the practical and effective education of our elderly citizenry. When we consider the aging of intellectual abilities we are concerned with studying the development of fluid, crystallized and practical intelligence and variations in these abilities from adulthood into advanced old age. We are also concerned with looking at changes in cognitive functions such as attention, memory, information retrieval and tolerance for interference in learning capacity. Much recent work has been successful in showing that intellectual and cognitive decline in old age is not necessarily irreversible. While many elderly persons are very able learners, are highly self-directed, and have ample educational and intellectual resources available, others may benefit from assistance or suggestions about how to compensate for some of the cognitive declines in old age. With this objective the implications are discussed for educators and practitioners who must formulate cognitive training programs for older adults.

Effect of Virtual Reality on Cognition in Stroke Patients

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

2011-01-01

Objective To investigate the effect of virtual reality on the recovery of cognitive impairment in stroke patients. Method Twenty-eight patients (11 males and 17 females, mean age 64.2) with cognitive impairment following stroke were recruited for this study. All patients were randomly assigned to one of two groups, the virtual reality (VR) group (n=15) or the control group (n=13). The VR group received both virtual reality training and computer-based cognitive rehabilitation, whereas the cont...

Cognitive rehabilitation training in patients with brain tumor-related epilepsy and cognitive deficits: a pilot study.

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Maschio, Marta; Dinapoli, Loredana; Fabi, Alessandra; Giannarelli, Diana; Cantelmi, Tonino

2015-11-01

The aim of this pilot observational study was to evaluate effect of cognitive rehabilitation training (RehabTr) on cognitive performances in patients with brain tumor-related epilepsy (BTRE) and cognitive disturbances. Medical inclusion criteria: patients (M/F) ≥ 18 years ≤ 75 with symptomatic seizures due to primary brain tumors or brain metastases in stable treatment with antiepileptic drugs; previous surgical resection or biopsy; >70 Karnofsky Performance Status; stable oncological disease. Eligible patients recruited from 100 consecutive patients with BTRE at first visit to our Center from 2011 to 2012. All recruited patients were administered battery of neuropsychological tests exploring various cognitive domains. Patients considered to have a neuropsychological deficit were those with at least one test score for a given domain indicative of impairment. Thirty patients out of 100 showed cognitive deficits, and were offered participation in RehabTr, of which 16 accepted (5 low grade glioma, 4 high grade glioma, 2 glioblastoma, 2 meningioma and 3 metastases) and 14 declined for various reasons. The RehabTr consisted of one weekly individual session of 1 h, for a total of 10 weeks, carried out by a trained psychologist. The functions trained were: memory, attention, visuo-spatial functions, language and reasoning by means of Training NeuroPsicologico (TNP(®)) software. To evaluate the effect of the RehabTr, the same battery of tests was administered directly after cognitive rehabilitation (T1), and at six-month follow-up (T2). Statistical analysis with Student T test for paired data showed that short-term verbal memory, episodic memory, fluency and long term visuo-spatial memory improved immediately after the T1 and remained stable at T2. At final follow-up all patients showed an improvement in at least one domain that had been lower than normal at baseline. Our results demonstrated a positive effect of rehabilitative training at different times, and, for

[Validation of the Hungarian version of Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) in patients with mild cognitive impairment].

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Papp, Edina; Pákáski, Magdolna; Drótos, Gergely; Kálmán, János

2012-01-01

Early recognition of mild cognitive impairment (MCI) has increasing clinical relevance in the treatment process of dementia, since it is considered as prodromal period. A great variety of instruments have been developed for measuring cognitive performance of the demented patients. The cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS-Cog) is one of the most frequently applied instrument to determine the severity of dementia and the efficiency of pharmacotherapy. The aim of this study is to examine the sensitivity parameters of the Hungarian ADAS-Cog in differentiating healthy elderly from MCI patients, furthermore to compare the sociodemographic data of the two groups. Fourty-five patients with MCI and 47 healthy subjects (HS) participated in the study. Their age variated between 52 and 88 years, the mean age was 68.8 (standard deviation=8.6). The mean of the years of education was 11.8 (standard deviation=3.5). Mental state was determined by ADAS-Cog and Mini-Mental State Examination (MMSE) and Beck Depression Inventory (BDI) was used to exclude depression. Data analysis was performed with SPSS 17. There were no significant differences between the two groups considering the sociodemographic data. The total score of ADAS-Cog is the most sensitive index (AUC: 0.875, sensitivity: 95.6%) for determining MCI, although the ratio of false positive cases was very high (specificity: 70.2%). The cut-off scores of the ADAS-Cog in the Hungarian sample were higher than the findings in previous researches. Positive correlation between age and ADAS-Cog total score was only significant in the HS group. On the other hand, negative correlation was found between education and ADAS-Cog total score in the MCI group. These results indicate that the currently used Hungarian ADAS-Cog is able to distinguish between MCI patients and HS groups. However, the adaptation of the Hungarian version will be necessary during the further standardization process including the

Functional Connectivity in Frontoparietal Network: Indicator of Preoperative Cognitive Function and Cognitive Outcome Following Surgery in Patients with Glioma.

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Lang, Stefan; Gaxiola-Valdez, Ismael; Opoku-Darko, Michael; Partlo, Lisa A; Goodyear, Bradley G; Kelly, John J P; Federico, Paolo

2017-09-01

Patients with diffuse glioma are known to have impaired cognitive functions preoperatively. However, the mechanism of these cognitive deficits remains unclear. Resting-state functional connectivity in the frontoparietal network (FPN) is associated with cognitive performance in healthy subjects. For this reason, it was hypothesized that functional connectivity of the FPN would be related to cognitive functioning in patients with glioma. To assess this relationship, preoperative cognitive status was correlated to patient-specific connectivity within the FPN. Further, we assessed whether connectivity could predict neuropsychologic outcome following surgery. Sixteen patients with diffuse glioma underwent neuropsychologic assessment and preoperative functional magnetic resonance imaging using task (n-back) and resting-state scans. Thirteen patients had postoperative cognitive assessment. An index of patient-specific functional connectivity in the FPN was derived by averaging connectivity values between 2 prefrontal and 2 parietal cortex regions defined by activation during the n-back task. The relationship of these indices with cognitive performance was assessed. Higher average connectivity within the FPN is associated with lower composite cognitive scores. Higher connectivity of the parietal region of the tumor-affected hemisphere is associated specifically with lower fluid cognition. Lower connectivity of the parietal region of the nontumor hemisphere is associated with worse neuropsychologic outcome 1 month after surgery. Resting-state functional connectivity between key regions of the FPN is associated with cognitive performance in patients with glioma and is related to cognitive outcome following surgery. Copyright © 2017 Elsevier Inc. All rights reserved.

Assessment of cognitive function in patients with myasthenia gravis

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Sherifa A Hamed

2014-12-01

Full Text Available Aim: During the past decade, there has been an increasing interest in the evaluation of cognitive function in myasthenia gravis (MG, neuromuscular transmission disorder caused by acetylcholine receptor auto-antibodies. However, the results of previous studies on cognition and MG are inconsistent and controversial. This study aimed to evaluate cognition in patients with mild/moderate grades of MG. Methods: This study included 20 patients with MG with a mean age of 28.45 ± 8.89 years and duration of illness of 3.52 ± 1.15 years. Cognition was tested using a sensitive battery of psychometric testing (Mini-mental State Examination [MMSE], Stanford-Binet Intelligence Scale 4 th edition [SBIS] and Wechsler Memory Scale-Revised [WMS-R] and by recording P300 component of event-related potentials (ERPs, a neurophysiological analog for cognitive function. Results: Compared with healthy subjects (n = 20, patients had lower total scores of cognitive testing (MMSE, SBIS and WMS-R (P = 0.001, higher Beck Depression Inventory 2 nd edition scores (P = 0.0001 and prolonged latencies (P = 0.01 and reduced amplitudes (P = 0.001 of P300 component of ERPs. Correlations were identified between total scores of cognitive testing and age (r = -0.470, P = 0.010, duration of illness (r = -0.788, P = 0.001 and depression scores (r = -0.323, P = 0.045. Using linear regression analysis and after controlling for age and depression scores, a significant correlation was identified between total scores of cognitive testing and duration of illness (β = -0.305, P = 0.045. Conclusion: Patients with mild/moderate MG may have cognitive dysfunction. This is important to determine prognosis and managing patients.

Third-person Diagnostic Interview on the Cognitive Insight Level of Psychotic Patients with an Insight at the Denial Level.

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Mehdizadeh, Mahsa; Rezaei, Omid

2016-01-01

According to the previous findings, the third-person technique improved the clinical insight of psychotic patients, therefore the present study aims to examine the effect of a third-person interview compared to a first-person interview on the level of cognitive insight of psychotic patients with an insight at the denial level. In this study, using interviews and questionnaires, a total number of 44 patients of Razi Psychiatric Educational and Treatment Center with an insight at the denial level being assessed using diagnostic interviews were divided randomly into two groups. Then, the two groups of patients' cognitive insights were evaluated using Beck Cognitive Insight Scale. The findings indicated that in psychotic patients with an insight at the denial level, the third-person technique of interview compared to the first-person had little effect on the improvement of overall cognitive insight and its components, including self-reflection and self-assurance; however, this effect was not strong enough to make a significant difference between the two groups of patients. According to the study findings, we can conclude that the third-person interview compared to the first-person interview has no effect on the improvement of the cognitive insight of psychotic patients with an insight at the denial level. This finding is consistent with the previous studies indicating that although the theory of mind has some correlations with the clinical insight of patients, it has no effect on their cognitive insight.

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

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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.

Effects of cognitive remediation on cognitive dysfunction in partially or fully remitted patients with bipolar disorder

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Demant, Kirsa M; Almer, Glennie Marie; Vinberg, Maj

2013-01-01

A large proportion of patients with bipolar disorder experience persistent cognitive dysfunction, such as memory, attention and planning difficulties, even during periods of full remission. The aim of this trial is to investigate whether cognitive remediation, a new psychological treatment......, improves cognitive function and, in turn, psychosocial function in patients with bipolar disorder in partial or full remission....

Educational Inequalities in Health Behaviors at Midlife: Is There a Role for Early-life Cognition?

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Clouston, Sean A P; Richards, Marcus; Cadar, Dorina; Hofer, Scott M

2015-09-01

Education is a fundamental cause of social inequalities in health because it influences the distribution of resources, including money, knowledge, power, prestige, and beneficial social connections, that can be used in situ to influence health. Recent studies have highlighted early-life cognition as commonly indicating the propensity for educational attainment and determining health and age of mortality. Health behaviors provide a plausible mechanism linking both education and cognition to later-life health and mortality. We examine the role of education and cognition in predicting smoking, heavy drinking, and physical inactivity at midlife using data from the Wisconsin Longitudinal Study (N = 10,317), National Survey of Health and Development (N = 5,362), and National Childhood Development Study (N = 16,782). Adolescent cognition was associated with education but was inconsistently associated with health behaviors. Education, however, was robustly associated with improved health behaviors after adjusting for cognition. Analyses highlight structural inequalities over individual capabilities when studying health behaviors. © American Sociological Association 2015.

Cognitive impairments in former patients with work-related stress complaints - one year later.

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Eskildsen, Anita; Andersen, Lars Peter; Pedersen, Anders Degn; Andersen, Johan Hviid

2016-11-01

Patients on sick leave due to work-related stress often present with cognitive impairments. The aim of this prospective cohort study was to examine the long-term consequences of prolonged work-related stress in terms of cognitive functioning one year after initial professional care seeking. We tested a group of patients with work-related stress with a comprehensive neuropsychological test battery at two occasions, one year apart. At both time points, we compared the performance of patients with healthy controls matched pairwise on sex, age and length of education. This paper presents the results from the one-year follow-up. When adjusting for practice effects, patients improved on measures of prospective memory and processing speed. However, patients continued to perform worse than controls on all tests, though only half of the comparisons reached statistical significance. The effect sizes of the differences between the two groups at one-year follow-up were small to medium. In conclusion, former patients with prolonged work-related stress improved, but they continued to perform worse than controls after one year. In the acute phase, the largest impairments were related to executive function and mental speed but at follow-up memory impairments also became apparent.

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

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

The construct of cognition in language teacher education and development

OpenAIRE

Bartels, Nathaniel

2006-01-01

Chapter 1: Central issues in the field of second language teacher education (SLTE) rest on conceptions of human cognition: what knowledge is, how it is acquired, and how it is used. However, human cognition is not a focus of the academic disciplines which usually are in charge of SLTE programs; research and theory on the nature of human cognition is usually not included in debates on SLTE. The purpose of this dissertation is to use a wide range of work on human cognition to address and evalua...

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

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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.

Cognitive Neuroscience and Education: Unravelling the Confusion

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Purdy, Noel; Morrison, Hugh

2009-01-01

This paper critically examines the application of research into cognitive neuroscience to educational contexts. It first considers recent warnings from within the neuroscientific community itself about the limitations of current neuroscientific knowledge and the urgent need to dispel popular "neuromyths" which have become accepted in…

A comparative study of cognitive deficits in patients with delusional disorder and paranoid schizophrenia

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Sandeep Grover

2011-01-01

Full Text Available Background: Very few studies have evaluated the neurocognitive functions of patients with persistent delusional disorder. Aim: To study the neurocognitive profile of patients with delusional disorder and compare it with those of patients with paranoid schizophrenia and healthy control subjects. Materials and Methods: Attention concentration, executive functions, memory, and IQ were assessed in 20 patients with delusional disorder and were compared with 20 patients with paranoid schizophrenia and 20 healthy controls. All three groups were matched on age, sex, and level of education. The two patient groups were also matched on duration of illness. Results: In general, patients with delusional disorder performed worst than healthy controls and patients with paranoid schizophrenia performed in between the other two groups. Compared with healthy controls, both patients with delusional disorder and patients with paranoid schizophrenia were significantly impaired on different tests of attention and visual learning and memory. Compared with patients with paranoid schizophrenia, patients with delusional disorder had more impairment different tests of attention, visual learning and memory, verbal working memory, and executive functions. Conclusion: Patients with delusional disorder exhibit cognitive dysfunctions that are very similar to schizophrenia, but are more severe in intensity. The resemblance of cognitive profiles suggests that the two disorders may have similar etiological basis.

The relation between Internet and social media use and the demographic and clinical parameters, quality of life, depression, cognitive function and sleep quality in hemodialysis patients: social media and hemodialysis.

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Afsar, Baris

2013-01-01

There are very few studies in the literature investigating the Internet use in hemodialysis (HD) patients. However, no study examined the relationship between Internet and social media use and quality of life, depression, cognitive function and sleep problems in HD patients. The study is cross-sectional in design. All patients underwent history taking; physical examination; laboratory analysis and quality of life (by a short form of the Medical Outcomes Study), depression (by the Beck Depression Inventory), cognitive function (by the Standardized Mini Mental State Examination) and sleep problems (by the Pittsburgh Sleep Quality Index) evaluation. In total, 134 HD patients (male/female: 73/61, age: 53.0 ± 13.4 years) were included. Patients with mail, Facebook and Twitter accounts were younger, were less depressive, had better quality of life, had higher cognitive function and were more educated compared to patients who did not have these accounts. Patients with Internet-based research about their disease were less depressive, had better quality of life and sleep quality, had higher cognitive function and were more educated compared to patients who did not have Internet-based research. Internet and social media use was closely related with quality of life, depression, cognitive function and education in HD patients. Studies are needed on whether Internet use under the supervision of health care professionals will improve clinical outcomes, adherence, quality of life, depression and decision making in HD patients. Copyright © 2013 Elsevier Inc. All rights reserved.

Effect of virtual reality on cognition in stroke patients.

Science.gov (United States)

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

2011-08-01

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

Profiling Cognitive Deficits in Intra-Axial and Extra-Axial Tumors Using Addenbrooke's Cognitive Examination as a Screening Tool: An Indian Experience.

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Cherkil, Sandhya; Panikar, Dilip; Soman, Deepak Kuttikkattu

2017-01-01

Tumors of the brain, whether intra- or extra-axial, results in cognitive deficits. The aim of the present study was to profile cognitive deficits using Addenbrooke's Cognitive Examination-Malayalam (ACE-M) as a screen and to determine the sensitivity and specificity of the same. Seventy-four drug naïve patients diagnosed to have brain tumors were assessed for cognitive functioning using ACE-M before surgery. Patients with high-grade intra-axial tumors showed a significant association on the cognitive domains of registration (0.04), recall (0.01), and visuospatial functioning (0.02). Gender showed an association between registration (0.02) and verbal fluency (0.02) with females performing better while education was significantly associated with retrograde or remote memory (0.00) with college-educated sample performing better. Significance was assumed at P cognitive decline on the cognitive domains of attention (0.02), recall (0.05), naming (0.02), and language functions (0.01). College educated group performed better on registration (0.01), recall (0.09), naming (0.00), and visuospatial functioning (0.00). The area under the receiver operating characteristic curve was estimated as 0.75, which indicates fairly good discriminative ability with a cut off of 71/100; sensitivity at 77.3 and specificity fixed at 67. ACE-M is capable of bringing out cognitive deficits along with a number of cognitive domains in patients with intra- and extra-axial tumors in the capacity of a screen, with fairly good levels of sensitivity and specificity.

Perspectives from the Patient and the Healthcare Professional in Multiple Sclerosis: Social Media and Patient Education.

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Kantor, Daniel; Bright, Jeremy R; Burtchell, Jeri

2018-06-01

A diagnosis of multiple sclerosis (MS) is life-altering. Because the course of MS is heterogeneous, patients may face uncertainty in terms of long-term physical and cognitive challenges, potential loss of employment, and the risk of social isolation. Patients often turn to the Internet and social media for information about MS and its management, and to seek out fellow patients and support groups. Here, we examine the use of social media and the Internet among patients with MS, considering its impact on patient education. We consider the access that these conduits provide not only to other patients with MS but also to a wealth of disease-related information online. These themes are further illustrated with first-hand experiences of the patient author and her physician. We also explore the impact of the Internet and social media on the education and support of patients with MS from the healthcare professional's (HCP's) perspective, including opportunities for HCPs to promote disease education among their patients, and the advantages that arise from patients being better informed about their disease. The rise of the Internet and social media has changed the patient experience, helping patients to support each other, to educate themselves proactively about their condition, and to participate more actively in decisions relating to disease management than perhaps was the case historically. Funding Novartis Pharmaceuticals Corporation.

Building Bridges between Neuroscience, Cognition and Education with Predictive Modeling

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Stringer, Steve; Tommerdahl, Jodi

2015-01-01

As the field of Mind, Brain, and Education seeks new ways to credibly bridge the gap between neuroscience, the cognitive sciences, and education, various connections are being developed and tested. This article presents a framework and offers examples of one approach, predictive modeling within a virtual educational system that can include…

Cognitive decline in temporal lobe epilepsy due to unilateral hippocampal sclerosis.

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Marques, Carolina Mattos; Caboclo, Luís Otávio Sales Ferreira; da Silva, Tatiana Indelicato; Noffs, Maria Helena da Silva; Carrete, Henrique; Lin, Katia; Lin, Jaime; Sakamoto, Américo Ceiki; Yacubian, Elza Márcia Targas

2007-05-01

We assessed the cognitive performance of patients with temporal lobe epilepsy (TLE) caused by unilateral hippocampal sclerosis (HS), in comparison with that of matched, healthy controls. We report the relationship between cognitive measures and duration of epilepsy, correlating with hippocampal volumes, and the impact of educational level on cognitive decline. This study involved 61 outpatients (40 with 8 years of formal education) with unilateral HS and 61 controls. Volumetric MRI was performed on all patients and 10 controls. The results (mean, SD) of the neuropsychological tests of healthy subjects and patients were compared using the Student t and Mann-Whitney tests. Patients performed worse than controls in the neuropsychological evaluation. When adjusted z scores were used to calculate the impairment index, patients had a greater percentage of abnormal tests compared with controls. The cognitive decline, assessed through the impairment index, correlated with duration of epilepsy. Higher level of education did not protect against this decline, thus not supporting the hypothesis of cerebral reserve in this population. A significant correlation between hippocampal volumetric measures and duration of epilepsy was observed only in patients with left HS. Patients with TLE caused by HS present with cognitive morbidity that extends beyond memory deficits. Cognitive decline is associated with duration of epilepsy, and in patients with left-sided HS, duration may correlate with volumetric hippocampal loss.

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

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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.

Mini mental state examination and the Addenbrooke's cognitive examination: effect of education and norms for a multicultural population.

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Mathuranath, P S; Cherian, Joseph P; Mathew, Robert; George, Annamma; Alexander, Aley; Sarma, Sankara P

2007-01-01

To derive population norms on the Malayalam adaptation of Addenbrooke's Cognitive Examination (M-ACE) and the inclusive Malayalam mini mental state examination (M-MMSE). Education-stratified norms were obtained on randomly selected cognitively unimpaired community elders (n = 519). Valid data on norms was available on 488 subjects (age 68.5 +/- 7.1 and education 7.9 +/- 5.4). Education and age, but not gender had a significant effect on both M-ACE and M-MMSE. When compared to the effect of age, the effect of education was sevenfold more on the M-ACE and ninefold more on the M-MMSE. The mean composite score on the M-ACE (and the M-MMSE) was 42.8 +/- 9.8 (14.9 +/- 3.1) for those with 0 (n = 72), 55.9 +/- 12.5 (19.7 +/- 4.1) with 1-4 (n = 96), 62.6 +/- 11.4 (21.9 +/- 3.7) with 5-8 (n = 81), 77 +/- 10.2 (25.7 +/- 2.4) with 9-12 (n = 136) and 83.4 +/- 7.2 (26.7 +/- 1.6) with > 12 (n = 103) years of formal education. Education has the most potent effect on performance on both M-ACE and M-MMSE in the Indian cohort. Education-stratified scores on the M-ACE and the M-MMSE, will provide a more appropriate means of establishing the cognitive status of patients. It is also our feeling that these cut-off scores will be useful across India.

The Rationality Debate: Application of Cognitive Psychology to Mathematics Education

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Leron, Uri; Hazzan, Orit

2006-01-01

Research in mathematics education usually attempts to look into students' learning and other mental processes. It could therefore be expected to build on knowledge acquired within the academic discipline of cognitive psychology. Our aim in this paper is to show how some recent developments in cognitive psychology can help interpret empirical…

Cognitive load theory, educational research, and instructional design; some food for thought

NARCIS (Netherlands)

de Jong, Anthonius J.M.

2010-01-01

Cognitive load is a theoretical notion with an increasingly central role in the educational research literature. The basic idea of cognitive load theory is that cognitive capacity in working memory is limited, so that if a learning task requires too much capacity, learning will be hampered. The

Reducing Resistance to Diversity through Cognitive Dissonance Instruction: Implications for Teacher Education.

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McFalls, Elisabeth L.; Cobb-Roberts, Deirdre

2001-01-01

Applied the principals of cognitive dissonance theory to an instructional strategy used to reduce resistance to the idea of white privilege, comparing groups of college students in diversity education courses that did and did not receive supplemental instruction on cognitive dissonance. Incorporating cognitive dissonance theory created an…

Cognitive Educational Approaches as Means of Envisioning and Effecting Worldview Transformation via Theological Education

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Mittwede, Steven K.

2013-01-01

Although much done in the name of discipleship and theological education pronounces lofty goals, such as movement from orthodoxy to orthopraxy, in many cases mere doctrinal assent is assumed to reflect deep change. An analysis of discipleship, worldview theory, and certain cognitive approaches to education suggests that worldview-level…

Cognitive training: How can it be adapted for surgical education?

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Wallace, Lauren; Raison, Nicholas; Ghumman, Faisal; Moran, Aidan; Dasgupta, Prokar; Ahmed, Kamran

2017-08-01

There is a need for new approaches to surgical training in order to cope with the increasing time pressures, ethical constraints, and legal limitations being placed on trainees. One of the most interesting of these new approaches is "cognitive training" or the use of psychological processes to enhance performance of skilled behaviour. Its ability to effectively improve motor skills in sport has raised the question as to whether it could also be used to improve surgical performance. The aim of this review is to provide an overview of the current evidence on the use of cognitive training within surgery, and evaluate the potential role it can play in surgical education. Scientific database searches were conducted to identify studies that investigated the use of cognitive training in surgery. The key studies were selected and grouped according to the type of cognitive training they examined. Available research demonstrated that cognitive training interventions resulted in greater performance benefits when compared to control training. In particular, cognitive training was found to improve surgical motor skills, as well as a number of non-technical outcomes. Unfortunately, key limitations restricting the generalizability of these findings include small sample size and conceptual issues arising from differing definitions of the term 'cognitive training'. When used appropriately, cognitive training can be a highly effective supplementary training tool in the development of technical skills in surgery. Although further studies are needed to refine our understanding, cognitive training should certainly play an important role in future surgical education. Copyright © 2016 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Cognitive performance of patients with chronic heart failure on sacubitril/valsartan : A retrospective cohort study.

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De Vecchis, R; Ariano, C; Di Biase, G; Noutsias, M

2018-02-15

Sacubitril, a neprilysin inhibitor in the combination molecule sacubitril/valsartan, slows down degradation of endogenous natriuretic peptides, thereby enhancing their beneficial cardiovascular effects. However, sacubitril might also promote neuronal dysfunction and cognitive impairment in patients with chronic heart failure (CHF) treated with sacubitril/valsartan, due to possible neprilysin inhibition at the level of Central Nervous System. A retrospective cohort study was undertaken to detect the effects exerted by sacubitril/valsartan on cognitive function in CHF patients. The patients' clinical data were examined for information provided in the Mini-Mental State Examination (MMSE), which was routinely administered during clinical visits at two centers from 15 March to 31 October 2017. Patients in the sacubitril/valsartan group had a clinical history of at least 3 months of continuous sacubitril/valsartan administration. The control group comprised CHF patients on conventional therapy not taking sacubitril/valsartan. In the between-group comparison, patients were matched for mean age, educational level, sex, NYHA class, and comorbidities. In the present retrospective study only patients in NYHA class II-III were enrolled. The mean MMSE score was 22.72 ± 2.68 (mean ± standard deviation [SD]) in the sacubitril/valsartan group (n = 51 patients) vs. 21.96 ± 2.73 (mean ± SD) in the control group (n = 51; p = 0.1572, independent samples t-test). Thus, a similar mild-to-moderate impairment in cognitive performance was found in the comparison between the two groups. In our study, we did not find any evidence of the alleged harmful influence of sacubitril/valsartan on cognitive function. Patients taking sacubitril/valsartan for at least 3 months had similar mean MMSE scores to control subjects.

Cognitive status in patients with multiple sclerosis in Lanzarote.

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Pérez-Martín, María Yaiza; Eguia-Del Río, Pablo; González-Platas, Montserrat; Jiménez-Sosa, Alejandro

2016-01-01

Cognitive impairment is a common feature in multiple sclerosis affecting ~43%-72% of patients, which involves cognitive functions such as memory, processing speed, attention, and executive function. The aim of this study was to describe the extent and pattern of the involvement of cognitive impairment and psychological status in all patients with multiple sclerosis on a small Spanish island. In all, 70 patients and 56 healthy controls were included in the study between February 2013 and May 2013. All participants were assessed using the Brief Repeatable Battery of Neuropsychological Test. The patients also completed instruments to evaluate the presence of fatigue, perceived cognitive dysfunction, and symptoms of anxiety and depression. All procedures were performed in a single session. Cognitive impairment, defined as a score <1.5 standard deviation on two subtests of the battery, was present in 35% of the participants. The most frequently affected domain was working memory, followed by verbal memory and processing speed. Disease duration showed a moderate correlation with visuospatial memory and processing speed. The Expanded Disability Status Scale score correlated with verbal and processing speed. Verbal memory was correlated with depression symptoms and fatigue. Cognitive impairment was present in 35% of the study population. The most affected domains were working memory and verbal memory. Working memory and verbal fluency deficit are independent factors of disease evolution. Cognitive decline is related to clinical variables and psychological measures such as fatigue or depression but not to anxiety.

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

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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.

Cognitive status in patients with multiple sclerosis in Lanzarote

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Pérez-Martín MY

2016-06-01

Full Text Available María Yaiza Pérez-Martín,1 Pablo Eguia-del Río,2 Montserrat González-Platas,1 Alejandro Jiménez-Sosa31Service of Neurology, Complejo Hospitalario Universitario de Canarias, La Laguna, 2Service of Neurology, Doctor José Molina Orosa Hospital, Arrecife, Lanzarote, 3Unit of Research, Complejo Hospitalario Universitario de Canarias, La Laguna, SpainObjectives: Cognitive impairment is a common feature in multiple sclerosis affecting ~43%–72% of patients, which involves cognitive functions such as memory, processing speed, attention, and executive function. The aim of this study was to describe the extent and pattern of the involvement of cognitive impairment and psychological status in all patients with multiple sclerosis on a small Spanish island.Patients and methods: In all, 70 patients and 56 healthy controls were included in the study between February 2013 and May 2013. All participants were assessed using the Brief Repeatable Battery of Neuropsychological Test. The patients also completed instruments to evaluate the presence of fatigue, perceived cognitive dysfunction, and symptoms of anxiety and depression. All procedures were performed in a single session.Results: Cognitive impairment, defined as a score <1.5 standard deviation on two subtests of the battery, was present in 35% of the participants. The most frequently affected domain was working memory, followed by verbal memory and processing speed. Disease duration showed a moderate correlation with visuospatial memory and processing speed. The Expanded Disability Status Scale score correlated with verbal and processing speed. Verbal memory was correlated with depression symptoms and fatigue.Conclusion: Cognitive impairment was present in 35% of the study population. The most affected domains were working memory and verbal memory. Working memory and verbal fluency deficit are independent factors of disease evolution. Cognitive decline is related to clinical variables and

Effects of education and race on cognitive decline: An integrative analysis of generalizability versus study-specific results

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Gross, Alden L.; Mungas, Dan M.; Crane, Paul K.; Gibbons, Laura E.; MacKay-Brandt, Anna; Manly, Jennifer J.; Mukherjee, Shubhabrata; Romero, Heather; Sachs, Bonnie; Thomas, Michael; Potter, Guy G.; Jones, Richard N.

2015-01-01

Objective To examine variability across multiple prospective cohort studies in level and rate of cognitive decline by race/ethnicity and years of education. Method To compare data across studies, we harmonized estimates of common latent factors representing overall or general cognitive performance, memory, and executive function derived from the: 1) Washington Heights, Hamilton Heights, Inwood Columbia Aging Project (N=4,115), 2) Spanish and English Neuropsychological Assessment Scales (N=525), 3) Duke Memory, Health, and Aging study (N=578), and 4) Neurocognitive Outcomes of Depression in the Elderly (N=585). We modeled cognitive change over age for cognitive outcomes by race, education, and study. We adjusted models for sex, dementia status, and study-specific characteristics. Results For baseline levels of overall cognitive performance, memory, and executive function, differences in race and education tended to be larger than between-study differences and consistent across studies. This pattern did not hold for rate of cognitive decline: effects of education and race/ethnicity on cognitive change were not consistently observed across studies, and when present were small, with racial/ethnic minorities and those with lower education declining at faster rates. Discussion In this diverse set of datasets, non-Hispanic whites and those with higher education had substantially higher baseline cognitive test scores. However, differences in the rate of cognitive decline by race/ethnicity and education did not follow this pattern. This study suggests that baseline test scores and longitudinal change have different determinants, and future studies to examine similarities and differences of causes of cognitive decline in racially/ethnically and educationally diverse older groups is needed. PMID:26523693

Interactive Distance Education: A Cognitive Load Perspective

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Kalyuga, Slava

2012-01-01

Evidence-based approaches to the design of the next generation of interactive distance education need to take into account established multimedia learning principles. Cognitive load theory is a theory that has significantly contributed to the development of such principles. It has applied our knowledge of major features and processing limitations…

Screening of cognitive impairment in patients with Parkinson's disease: diagnostic validity of the Brazilian versions of the Montreal Cognitive Assessment and the Addenbrooke's Cognitive Examination-Revised.

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Sobreira, Emmanuelle; Pena-Pereira, Márcio A; Eckeli, Alan L; Sobreira-Neto, Manoel A; Chagas, Marcos H N; Foss, Maria P; Cholerton, Brenna; Zabetian, Cyrus P; Mata, Ignacio F; Tumas, Vitor

2015-11-01

The aim of the present study is to examine the accuracy of the Brazilian versions of the Montreal Cognitive Assessment (MoCA) and the Addenbrooke's Cognitive Examination-Revised (ACE-R) to screen for mild cognitive impairment (PDMCI) and dementia (PDD) in patients with Parkinson's disease (PD). Both scales were administered to a final convenience sample of 79 patients with PD. Patients were evaluated by a neurologist, a psychiatrist and a neuropsychologist using UPDRS, Hoehn and Yahr and Schwab and England scales, global deterioration scale, a psychiatric structured interview, Mattis Dementia Rating Scale and other cognitive tests. There were 32 patients with PDMCI and 17 patients with PDD. The MoCA and the ACE-R were able to discriminate patients with PDD from the others. Both scales showed to be useful to screen for dementia but not for mild cognitive impairment in patients with PD.

Screening of cognitive impairment in patients with Parkinson's disease: diagnostic validity of the Brazilian versions of the Montreal Cognitive Assessment and the Addenbrooke's Cognitive Examination-Revised

Directory of Open Access Journals (Sweden)

Emmanuelle Sobreira

2015-11-01

Full Text Available ABSTRACTObjective The aim of the present study is to examine the accuracy of the Brazilian versions of the Montreal Cognitive Assessment (MoCA and the Addenbrooke's Cognitive Examination-Revised (ACE-R to screen for mild cognitive impairment (PDMCI and dementia (PDD in patients with Parkinson's disease (PD.Method Both scales were administered to a final convenience sample of 79 patients with PD. Patients were evaluated by a neurologist, a psychiatrist and a neuropsychologist using UPDRS, Hoehn and Yahr and Schwab and England scales, global deterioration scale, a psychiatric structured interview, Mattis Dementia Rating Scale and other cognitive tests.Results There were 32 patients with PDMCI and 17 patients with PDD. The MoCA and the ACE-R were able to discriminate patients with PDD from the others.Conclusion Both scales showed to be useful to screen for dementia but not for mild cognitive impairment in patients with PD.

Modeling Enrollment in and Completion of Vocational Education: The role of cognitive and non-cognitive skills by program type

DEFF Research Database (Denmark)

Stratton, Leslie S.; Gupta, Nabanita Datta; Reimer, David

We examine the role of cognitive and non-cognitive skills on enrollment in and completion of three types of vocational training (VET): education/health, technical, and business. Using two nine-year panels of Danish youths, estimation proceeds separately by gender, controlling for selection......, inversely related to completion for technical VET and non-cognitive skills are important only for business VET....

Cardiovascular disease and cognitive function in maintenance hemodialysis patients

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Cardiovascular disease (CVD) and cognitive impairment are common in dialysis patients. Given the proposed role of microvascular disease on cognitive function, particularly cognitive domains that incorporate executive functions, we hypothesized that prevalent systemic CVD would be associated with wor...

Cognitive-Behavioral Interventions for Treatment of Depression in Alzheimer's Patients.

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Teri, Linda; Gallagher-Thompson, Dolores

1991-01-01

Presents two strategies for treating depression in Alzheimer's patients: cognitive therapy for mildly demented adults which challenges patient's negative cognitions to reduce distortions and enable patient to generate more adaptive ways of viewing specific events; and behavioral intervention for moderately or severely demented adults which…

Carotid Atherosclerosis and Cognitive Impairment in Nonstroke Patients

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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.

Cognition As a Therapeutic Target in the Suicidal Patient Approach

Science.gov (United States)

da Silva, Antônio Geraldo; Malloy-Diniz, Leandro Fernandes; Garcia, Marina Saraiva; Figueiredo, Carlos Guilherme Silva; Figueiredo, Renata Nayara; Diaz, Alexandre Paim; Palha, António Pacheco

2018-01-01

The current considerations about completed suicides and suicide attempts in different cultures call the attention of professionals to this serious public health problem. Integrative approaches have shown that the confluence of multiple biological and social factors modulate various psychopathologies and dysfunctional behaviors, such as suicidal behavior. Considering the level of intermediate analysis, personality traits and cognitive functioning are also of great importance for understanding the suicide phenomenon. About cognitive factors, we can group them into cognitive schemas of reality interpretation and underlying cognitive processes. On the other hand, different types of primary cognitive alterations are related to suicidal behavior, especially those resulting from changes in frontostriatal circuits. Among such cognitive mechanisms can be highlighted the attentional bias for environmental cues related to suicide, impulsive behavior, verbal fluency deficits, non-adaptive decision-making, and reduced planning skills. Attentional bias consists in the effect of thoughts and emotions, frequently not conscious, about the perception of environmental stimuli. Suicidal ideation and hopelessness can make the patient unable to find alternative solutions to their problems other than suicide, biasing their attention to environmental cues related to such behavior. Recent research efforts are directed to assess the possible use of attention bias as a therapeutic target in patients presenting suicide behavior. The relationship between impulsivity and suicide has been largely investigated over the last decades, and there is still controversy about the theme. Although there is strong evidence linking impulsivity to suicide attempts. Effective interventions address to reduce impulsivity in clinical populations at higher risk for suicide could help in the prevention. Deficits in problem-solving ability also seem to be distorted in patients who attempt suicide. Understanding

Cognition As a Therapeutic Target in the Suicidal Patient Approach

Directory of Open Access Journals (Sweden)

Antônio Geraldo da Silva

2018-02-01

Full Text Available The current considerations about completed suicides and suicide attempts in different cultures call the attention of professionals to this serious public health problem. Integrative approaches have shown that the confluence of multiple biological and social factors modulate various psychopathologies and dysfunctional behaviors, such as suicidal behavior. Considering the level of intermediate analysis, personality traits and cognitive functioning are also of great importance for understanding the suicide phenomenon. About cognitive factors, we can group them into cognitive schemas of reality interpretation and underlying cognitive processes. On the other hand, different types of primary cognitive alterations are related to suicidal behavior, especially those resulting from changes in frontostriatal circuits. Among such cognitive mechanisms can be highlighted the attentional bias for environmental cues related to suicide, impulsive behavior, verbal fluency deficits, non-adaptive decision-making, and reduced planning skills. Attentional bias consists in the effect of thoughts and emotions, frequently not conscious, about the perception of environmental stimuli. Suicidal ideation and hopelessness can make the patient unable to find alternative solutions to their problems other than suicide, biasing their attention to environmental cues related to such behavior. Recent research efforts are directed to assess the possible use of attention bias as a therapeutic target in patients presenting suicide behavior. The relationship between impulsivity and suicide has been largely investigated over the last decades, and there is still controversy about the theme. Although there is strong evidence linking impulsivity to suicide attempts. Effective interventions address to reduce impulsivity in clinical populations at higher risk for suicide could help in the prevention. Deficits in problem-solving ability also seem to be distorted in patients who attempt

Successful neuropsychological rehabilitation in a patient with Cerebellar Cognitive Affective Syndrome.

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Ruffieux, N; Colombo, F; Gentaz, E; Annoni, J-M; Chouiter, L; Roulin Hefti, S; Ruffieux, A; Bihl, T

2017-01-01

The objective of this case study was to describe the neuropsychological rehabilitation of a 16-year-old patient who presented a Cerebellar Cognitive Affective Syndrome (CCAS) following a bilateral cerebellar hemorrhage. The patient presented severe and diffuse cognitive deficits, massive behavioral disorders, and emotion regulation difficulties. The cognitive rehabilitation was performed in the chronic phase (one year after the onset of the hemorrhage) using a transdisciplinary neurobehavioral approach based on the patient's favorite interest (soccer). A significant behavioral and cognitive improvement was observed. The patient became progressively independent in all activities of daily living and was discharged home. The Functional Independence Measure at discharge was 124/126 (vs. 37/126 at entry). The patient was able to complete his schooling despite the mild cognitive and behavioral sequelae. This first description of the use of neurobehavioral therapy in a case of chronic CCAS suggests that (a) major clinical improvement can occur more than one year after the onset of the CCAS, showing the importance of long-term and intensive neurorehabilitation; and (b) when the cerebellum cannot properly play its regulator role in cognition, neuropsychological intervention through a behavioral and cognitive approach can be of great help by acting as an external modulator to help the patient regain control over himself.

Improving detection of dementia in Asian patients with low education: combining the Mini-Mental State Examination and the Informant Questionnaire on Cognitive Decline in the Elderly.

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Narasimhalu, Kaavya; Lee, June; Auchus, Alexander P; Chen, Christopher P L H

2008-01-01

Previous work combining the Mini-Mental State Examination (MMSE) and Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) has been conducted in western populations. We ascertained, in an Asian population, (1) the best method of combining the tests, (2) the effects of educational level, and (3) the effect of different dementia etiologies. Data from 576 patients were analyzed (407 nondemented controls, 87 Alzheimer's disease and 82 vascular dementia patients). Sensitivity, specificity and AUC values were obtained using three methods, the 'And' rule, the 'Or' rule, and the 'weighted sum' method. The 'weighted sum' rule had statistically superior AUC and specificity results, while the 'Or' rule had the best sensitivity results. The IQCODE outperformed the MMSE in all analyses. Patients with no education benefited more from combined tests. There was no difference between Alzheimer's disease and vascular dementia populations in the predictive value of any of the combined methods. We recommend that the IQCODE be used to supplement the MMSE whenever available and that the 'weighted sum' method be used to combine the MMSE and the IQCODE, particularly in populations with low education. As the study population selected may not be representative of the general population, further studies are required before generalization to nonclinical samples. (c) 2007 S. Karger AG, Basel.

Genetic and environmental transactions linking cognitive ability, physical fitness, and education in late life

DEFF Research Database (Denmark)

Johnson, Wendy; Deary, Ian J; McGue, Matt

2009-01-01

Cognitive ability and physical fitness are important to the ability to live independently in late life. Both are also related to level of attained education, with better educated older adults tending to display better cognitive ability and better late-life physical health. Chronic illnesses...

What Cognitive Neuroscience Tells Us about Creativity Education: A Literature Review

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Zhou, Zai

2018-01-01

Recently, an interest in creativity education has increased globally. Cognitive neuroscience research of creativity has provided possible implications for education, yet few literary reviews that bridge the brain and education studies have been published. This article first introduces the definitions and behavioral measures of creativity from…

Cognitive rehabilitation for patients with schizophrenia in Korea.

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Lee, Won Hye; Lee, Woo Kyeong

2017-02-01

Psychosocial rehabilitation programs received mental health professional support in addition to traditional medication therapy. Many psychosocial programs were developed since the 1990s, including cognitive remediation therapy. In this review, we focus on cognitive remediation therapy in Korea since the 1990s. We review several cognitive rehabilitation programs developed in Korea and their outcome studies and suggest future research directions and prospects. We reviewed cognitive rehabilitation programs including social cognitive training as well as more recent forms of computerized cognitive rehabilitation. Although there are differences in cognitive domains by training targets, almost all neurocognitive remediation trainings in Korea have beneficial effects on early visual processing, various attention types, and executive function. Future studies need to investigate the mechanisms and various mediators underlying the relationships between cognitive functions and functional outcomes. With more comprehensive cognitive and social cognitive programs, we can enhance both cognition and functional outcomes of the patients with schizophrenia. Copyright © 2016 Elsevier B.V. All rights reserved.

the effects of early childhood education attendance on cognitive

African Journals Online (AJOL)

Eyerusalem

children's cognitive development, public investment in this critical stage of education .... characteristics of the parents, shocks household encountered and initial ..... effects, the authors employed OLS, instrumental variables (IV) and matching.

Cognitive Load Theory, Educational Research, and Instructional Design: Some Food for Thought

Science.gov (United States)

de Jong, Ton

2010-01-01

Cognitive load is a theoretical notion with an increasingly central role in the educational research literature. The basic idea of cognitive load theory is that cognitive capacity in working memory is limited, so that if a learning task requires too much capacity, learning will be hampered. The recommended remedy is to design instructional systems…

Association between Primary Caregiver Education and Cognitive and Language Development of Preterm Neonates.

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Asztalos, Elizabeth V; Church, Paige T; Riley, Patricia; Fajardo, Carlos; Shah, Prakesh S

2017-03-01

Objective  This study aims to explore the association between primary caregiver education and cognitive and language composite scores of the Bayley Scales of Infant and Toddler Development, 3rd ed. (Bayley-III) in preterm infants at 18 to 21 months corrected age. Design  An observational study was performed on preterm infants born before 29 weeks' gestation between 2010 and 2011. Primary caregivers were categorized by their highest education level and cognitive and language composite scores of the Bayley-III were compared among infants between these groups with adjustment for perinatal and neonatal factors. Results  In total, 1,525 infants/caregivers were included in the multivariate analysis. Compared with those with less than a high school education, infants with primary caregivers who received partial college/specialized training displayed higher cognitive (adjusted difference [AD]: 4.6, 95% confidence interval [CI]: 1.8-7.4) and language scores (AD: 4.0, 95% CI: 0.8-7.1); infants with primary caregivers with university graduate education or above also demonstrated higher cognitive (AD: 6.4, 95% CI: 2.6-10.1) and language scores (AD: 9.9, 95% CI: 5.7-14.1). Conclusion  Higher levels of education of the primary caregiver were associated with increased cognitive and language composite scores at 18 to 21 months corrected age in preterm infants. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Fine Motor Function Skills in Patients with Parkinson Disease with and without Mild Cognitive Impairment.

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Dahdal, Philippe; Meyer, Antonia; Chaturvedi, Menorca; Nowak, Karolina; Roesch, Anne D; Fuhr, Peter; Gschwandtner, Ute

2016-01-01

The objective of this study was to investigate the relation between impaired fine motor skills in Parkinson disease (PD) patients and their cognitive status, and to determine whether fine motor skills are more impaired in PD patients with mild cognitive impairment (MCI) than in non-MCI patients. Twenty PD MCI and 31 PD non-MCI patients (mean age 66.7 years, range 50-84, 36 males/15 females), all right-handed, took part in a motor performance test battery. Steadiness, precision, dexterity, velocity of arm-hand movements, and velocity of wrist-finger movements were measured and compared across groups and analyzed for confounders (age, sex, education, severity of motor symptoms, and disease duration). Statistical analysis included t tests corrected for multiple testing, and a linear regression with stepwise elimination procedure was used to select significant predictors for fine motor function. PD MCI patients performed significantly worse in precision (p motor function skills were confounded by age. Fine motor skills in PD MCI patients are impaired compared to PD non-MCI patients. Investigating the relation between the fine motor performance and MCI in PD might be a relevant subject for future research. © 2016 S. Karger AG, Basel.

Mindfulness-based cognitive therapy in patients with late-life depression: A case series

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Sonal Mathur

2016-01-01

Full Text Available Depression is the most common mental illness in the elderly, and cost-effective treatments are required. Therefore, this study is aimed at evaluating the effectiveness of a mindfulness-based cognitive therapy (MBCT on depressive symptoms, mindfulness skills, acceptance, and quality of life across four domains in patients with late-onset depression. A single case design with pre- and post-assessment was adopted. Five patients meeting the specified inclusion and exclusion criteria were recruited for the study and assessed on the behavioral analysis pro forma, geriatric depression scale, Hamilton depression rating scale, Kentucky inventory of mindfulness skills, Acceptance and Action Questionnaire II, The World Health Organization quality of life Assessment Brief version (WHOQO-L-BREF. The therapeutic program consisted of education regarding the nature of depression, training in formal and informal mindfulness meditation, and cognitive restructuring. A total of 8 sessions over 8 weeks were conducted for each patient. The results of this study indicate clinically significant improvement in the severity of depression, mindfulness skills, acceptance, and overall quality of life in all 5 patients. Eight-week MBCT program has led to reduction in depression and increased mindfulness skills, acceptance, and overall quality of life in patients with late-life depression.

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

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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.

Effect of Sandplay Therapy on Cognitive Development of Educable Mentally Retarded

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*M. Malekpour

2014-12-01

Full Text Available The purpose of this research was to determine the effect of sandplay therapy on cognitive development of educable mentally disabled children. The statistical population of this study included all children with educable mental disability in preschool and children in grades 1, 2, 3 in city of Isfahan. The sample included 32 children (16 boys and 16 girls who were randomly selected from 2 schools. Then they were randomaly assigned to 2 groups: the experimental and control groups. The material used in this research was: Kay Cognitive Diagnostic Test. A pretest was administered to both the experimental and control groups. Then sandplay therapy employed on experimental group. There post test was administered to both groups at the end of the training. The results analysis of covariance show that sandplay therapy significantly increased cognitive development among the experimental group as compared to the experimental group. The results also showed that there was a significant difference between the mean scores of Kay Cognitive Diagnostic Test of cognitive development in the experimental and the control group in the post test (P<0.001, and that sand play therapy intervention had a significant effect on conceptualization, symbolic thinking, social cognition, visuo_motor perception, attention span and mental_motor speed development (P<0.001.

Self-transcendence and nurse-patient interaction in cognitively intact nursing home patients.

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Haugan, Gørill; Rannestad, Toril; Hanssen, Brith; Espnes, Geir A

2012-12-01

The aim of this study was to test whether nurse-patient interaction affects cognitively intact nursing home patients' interpersonal and intrapersonal self-transcendence, as well as testing the psychometric properties of the Nurse-Patient Interaction Scale (NPIS). Self-transcendence is considered a spiritual developmental process of maturity in adulthood, and a vital resource of well-being at the end of life. The concept of self-transcendence has previously been explored in various populations, yet the nurse-patient interactions' potential influence on self-transcendence in nursing home patients has not been published previously. A cross-sectional design employing the Self-Transcendence Scale and the NPIS was adopted. A sample of 202 cognitively well-functioning nursing home patients in Norway was selected. The statistical analyses were carried out using lisrel 8.8 and structural equation modelling. Structural equation modelling-analysis indicates statistical significant effect of nurse-patient interaction on the patients' self-transcendence. Direct influence on the intrapersonal and indirect influence on the interpersonal self-transcendence aspects was disclosed. Nurse-patient interaction significantly affected both interpersonal and intrapersonal self-transcendence among cognitively intact nursing home patients. Hence, facilitating caring interventions can be significantly beneficial to older patients' self-transcendence and thereby well-being, both emotional and physical. Caring behaviour signifies the vital and ultimate qualitative nursing behaviour, which promotes self-transcendence and thereby well-being. These findings are important for clinical nursing that intends to increase patients' well-being. © 2012 Blackwell Publishing Ltd.

Total Cerebral Small Vessel Disease MRI Score Is Associated With Cognitive Decline In Executive Function In Patients With Hypertension

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Renske Uiterwijk

2016-12-01

Full Text Available Objectives: Hypertension is a major risk factor for white matter hyperintensities, lacunes, cerebral microbleeds and perivascular spaces, which are MRI markers of cerebral small vessel disease (SVD. Studies have shown associations between these individual MRI markers and cognitive functioning and decline. Recently, a total SVD score was proposed in which the different MRI markers were combined into one measure of SVD, to capture total SVD-related brain damage. We investigated if this SVD score was associated with cognitive decline over 4 years in patients with hypertension. Methods: In this longitudinal cohort study, 130 hypertensive patients (91 patients with uncomplicated hypertension and 39 hypertensive patients with a lacunar stroke were included. They underwent a neuropsychological assessment at baseline and after 4 years. The presence of white matter hyperintensities, lacunes, cerebral microbleeds, and perivascular spaces were rated on baseline MRI. Presence of each individual marker was added to calculate the total SVD score (range 0-4 in each patient. Results: Uncorrected linear regression analyses showed associations between SVD score and decline in overall cognition (p=0.017, executive functioning (p<0.001 and information processing speed (p=0.037, but not with memory (p=0.911. The association between SVD score and decline in overall cognition and executive function remained significant after adjustment for age, sex, education, anxiety and depression score, potential vascular risk factors, patient group and baseline cognitive performance.Conclusions: Our study shows that a total SVD score can predict cognitive decline, specifically in executive function, over 4 years in hypertensive patients. This emphasizes the importance of considering total brain damage due to SVD.

Cognitive profiles in Mild Cognitive Impairment (MCI patients associated with Parkinson′s disease and cognitive disorders

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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.

Differences in prefrontal, limbic, and white matter lesion volumes according to cognitive status in elderly patients with first-onset subsyndromal depression.

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Jun-Young Lee

Full Text Available The purpose of this preliminary study was to test the hypothesis that subsyndromal depression is associated with the volume of medial prefrontal regional gray matter and that of white matter lesions (WMLs in the brains of cognitively normal older people. We also explored the relationships between subsyndromal depression and medial prefrontal regional gray matter volume, limbic regional gray matter volume, and lobar WMLs in the brains of patients with mild cognitive impairment (MCI and Alzheimer's disease (AD. We performed a cross-sectional study comparing patients with subsyndromal depression and nondepressed controls with normal cognition (n = 59, MCI (n = 27, and AD (n = 27, adjusting for sex, age, years of education, and results of the Mini-Mental State Examination. Frontal WML volume was greater, and right medial orbitofrontal cortical volume was smaller in cognitively normal participants with subsyndromal depression than in those without subsyndromal depression. No volume differences were observed in medial prefrontal, limbic, or WML volumes according to the presence of subsyndromal depression in cognitively impaired patients. The absence of these changes in patients with MCI and AD suggests that brain changes associated with AD pathology may override the changes associated with subsyndromal depression.

Cognitive Vulnerability in Aging May Be Modulated by Education and Reserve in Healthy People

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María D. Roldán-Tapia

2017-10-01

Full Text Available Aging is related to a deterioration of cognitive performance and to multiple alterations in the brain. Even before the beginning of a noticeable cognitive decline, the framework which holds cognitive function experiences these alterations. From a system-vulnerability point of view of cognition, the deterioration associated with age would be the collection of repercussions during a life. Brain function and structure are modified in a multidimensional way, which could concern different aspects like structural integrity, functional activity, connectivity, or glucose metabolism. From this point of view, the effects of aging could affect the most brain systems and their functional activity. In this study, we analyze the functional development of three cognitive domains in relation to aging, educational level, and cognitive reserve (CR. A total of 172 healthy subjects were divided into two age groups (young and old, and completed a battery of classic neuropsychological tests. The tests were organized and analyzed according to three cognitive domains: working memory and flexibility, visuoconstructive functions, and declarative memory. Subjects also completed a questionnaire on CR. Results showed that the performance in all cognitive domains decreased with age. In particular, tests related to working memory, flexibility, and visuoconstructive abilities were influenced by age. Nevertheless, this effect was attenuated by effects of education, mainly in visuoconstructive domain. Surprisingly, visual as well as verbal memory tests were not affected either by aging, education, or CR. Brain plasticity plays a prominent role in the aging process, but, as other studies have shown, the plasticity mechanism is quite different in healthy vs. pathological brains. Moreover, this plasticity brain mechanism could be modulated by education and CR. Specially, cognitive domains as working memory, some executive functions and the visuoconstructive abilities seem to be

Anatomical correlates of cognitive functions in early Parkinson's disease patients.

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Roberta Biundo

Full Text Available Cognitive deficits may occur early in Parkinson's disease (PD but the extent of cortical involvement associated with cognitive dysfunction needs additional investigations. The aim of our study is to identify the anatomical pattern of cortical thickness alterations in patients with early stage PD and its relationship with cognitive disability.We recruited 29 PD patients and 21 healthy controls. All PD patients performed an extensive neuropsychological examination and 14 were diagnosed with mild cognitive impairment (PD-MCI. Surface-based cortical thickness analysis was applied to investigate the topographical distribution of cortical and subcortical alterations in early PD compared with controls and to assess the relationship between cognition and regional cortical changes in PD-MCI.Overall PD patients showed focal cortical (occipital-parietal areas, orbito-frontal and olfactory areas and subcortical thinning when compared with controls. PD-MCI showed a wide spectrum of cognitive deficits and related significant regional thickening in the right parietal-frontal as well as in the left temporal-occipital areas.Our results confirm the presence of changes in grey matter thickness at relatively early PD stage and support previous studies showing thinning and atrophy in the neocortex and subcortical regions. Relative cortical thickening in PD-MCI may instead express compensatory neuroplasticity. Brain reserve mechanisms might first modulate cognitive decline during the initial stages of PD.

Cognitive rehabilitation in neuro-oncological patients: three case reports

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Chiara Zucchella

2012-06-01

Full Text Available Cognitive impairment is one of the most common neurological disorders in neuro-oncological patients, linked with morbidity, disability, and poor quality of life. As pharmacologic interventions have not yet proven effective in the treatment of cognitive deficits, cognitive rehabilitation could represent an alternative approach. This paper presents three case studies, describing the cognitive intervention and discussing its effectiveness in the light of current evidence.

Neuropsychological profile of patients with juvenile myoclonic epilepsy: a controlled study of 50 patients.

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Pascalicchio, Tatiana Frascareli; de Araujo Filho, Gerardo M; da Silva Noffs, Maria Helena; Lin, Katia; Caboclo, Luís Otávio S F; Vidal-Dourado, Marcos; Ferreira Guilhoto, Laura M F; Yacubian, Elza Márcia Targas

2007-03-01

The purpose of this study was to verify possible cognitive dysfunction in patients with juvenile myoclonic epilepsy (JME) and its relationship to factors related to epilepsy and schooling. Fifty subjects diagnosed with JME and 50 controls underwent neuropsychological assessment evaluating intellectual functions, attention, memory, executive functions, and language. The patients were further divided into two subgroups on the basis of educational level: 11 years of formal education. Participants diagnosed with JME scored significantly below age-, education-, and gender-matched controls on neuropsychological measures of attention, immediate verbal memory, mental flexibility, control of inhibition, working memory, processing speed, verbal delayed memory, visual delayed memory, naming, and verbal fluency. A positive correlation was observed between duration of epilepsy and cognitive decline. However, in the group of patients with >11 years of education, this correlation was not significant. In this series of patients with JME, neuropsychological evaluation suggests widespread cognitive dysfunction outside the limits of the frontal lobes. The duration of epilepsy correlated with cognitive decline, and patients with higher education manifested less progression of deficits.

Unpacking the Complexity of Patient Handoffs Through the Lens of Cognitive Load Theory.

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Young, John Q; Ten Cate, Olle; O'Sullivan, Patricia S; Irby, David M

2016-01-01

The transfer of a patient from one clinician to another is a high-risk event. Errors are common and lead to patient harm. More effective methods for learning how to give and receive sign-out is an important public health priority. Performing a handoff is a complex task. Trainees must simultaneously apply and integrate clinical, communication, and systems skills into one time-limited and highly constrained activity. The task demands can easily exceed the information-processing capacity of the trainee, resulting in impaired learning and performance. Appreciating the limits of working memory can help identify the challenges that instructional techniques and research must then address. Cognitive load theory (CLT) identifies three types of load that impact working memory: intrinsic (task-essential), extraneous (not essential to task), and germane (learning related). The authors generated a list of factors that affect a trainee's learning and performance of a handoff based on CLT. The list was revised based on feedback from experts in medical education and in handoffs. By consensus, the authors associated each factor with the type of cognitive load it primarily effects. The authors used this analysis to build a conceptual model of handoffs through the lens of CLT. The resulting conceptual model unpacks the complexity of handoffs and identifies testable hypotheses for educational research and instructional design. The model identifies features of a handoff that drive extraneous, intrinsic, and germane load for both the sender and the receiver. The model highlights the importance of reducing extraneous load, matching intrinsic load to the developmental stage of the learner and optimizing germane load. Specific CLT-informed instructional techniques for handoffs are explored. Intrinsic and germane load are especially important to address and include factors such as knowledge of the learner, number of patients, time constraints, clinical uncertainties, overall patient

Cognitive behavioural therapy for tinnitus.

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Martinez Devesa, P; Waddell, A; Perera, R; Theodoulou, M

2007-01-24

Tinnitus is an auditory perception that can be described as the experience of sound, in the ear or in the head, in the absence of external acoustic stimulation (not usually audible to anyone else). At present no specific therapy for tinnitus is acknowledged to be satisfactory in all patients. Cognitive behavioural therapy (CBT) uses relaxation, cognitive restructuring of the thoughts and exposure to exacerbating situations in order to promote habituation and may benefit tinnitus patients, as may the treatment of associated psychological conditions. To assess whether cognitive behavioural therapy is effective in the management of patients suffering from tinnitus. Our search included the Cochrane ENT Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2006), MEDLINE and EMBASE. The last search date was June 2006. Randomised controlled trials in which patients with unilateral or bilateral tinnitus as main symptom received cognitive behavioural treatment. One review author (PMD) assessed every report identified by the search strategy. The four review authors assessed the methodological quality, applied inclusion/exclusion criteria and extracted data. Six trials comprising 285 participants were included. 1. subjective tinnitus loudness. CBT compared to a waiting list control group: we found no significant difference (Standardised Mean Difference (SMD) 0.06 (95% CI -0.25 to 0.37)). CBT compared to another intervention (Yoga, Education, Minimal Contact - Education and Education): we found no significant difference (SMD 0.1 (95% CI -0.22 to 0.42)).2. a) Depression. CBT compared to a waiting list control group: we found no significant difference in either group (SMD 0.29 (95%CI -0.04 to 0.63)). CBT compared to another intervention (Yoga, Education and Minimal Contact - Education): we found no significant difference (SMD 0.01 (95% CI -0.43 to 0.45)). b) Quality of life: CBT compared to a waiting list control

Addenbrooke's cognitive examination-revised: normative and accuracy data for seniors with heterogeneous educational level in Brazil.

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César, Karolina G; Yassuda, Mônica S; Porto, Fabio H G; Brucki, Sonia M D; Nitrini, Ricardo

2017-08-01

Several cognitive tools have been developed aiming to diagnose dementia. The cognitive battery Addenbrooke's Cognitive Examination - Revised (ACE-R) has been used to detect cognitive impairment; however, there are few studies including samples with low education. The aim of the study was to provide ACE-R norms for seniors within a lower education, including illiterates. An additional aim was to examine the accuracy of the ACE-R to detect dementia and cognitive impairment no dementia (CIND). Data originated from an epidemiological study conducted in the municipality of Tremembé, Brazil. The Brazilian version of ACE-R was applied as part of the cognitive assessment in all participants. Of the 630 participants, 385 were classified as cognitively normal (CN) and were included in the normative data set, 110 individuals were diagnosed with dementia, and 135 were classified as having CIND. ACE-R norms were provided with the sample stratified into age and education bands. ACE-R total scores varied significantly according to age, education, and sex. To distinguish CN from dementia, a cut-off of 64 points was established (sensitivity 91%, specificity 76%) and to differentiate CN from CIND the best cut-off was 69 points (sensitivity 73%, specificity 65%). Cut-off scores varied according to the educational level. This study offers normative and accuracy parameters for seniors with lower education and it should expand the use of the ACE-R for this population segment.

Total serum homocysteine levels do not identify cognitive dysfunction in multimorbid elderly patients.

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Hengstermann, S; Laemmler, G; Hanemann, A; Schweter, A; Steinhagen-Thiessen, E; Lun, A; Schulz, R-J

2009-02-01

Total blood homocysteine (Hcys) and folate levels have been investigated in association with cognitive dysfunction in healthy but not in multimorbid elderly patients. We hypothesized that total serum Hcys is an adequate marker to identify multimorbid elderly patients with cognitive dysfunction assessed by the Short Cognitive Performance Test (SKT) and Mini-Mental State Examination (MMSE). Cross-sectional study. The study center was an acute geriatric hospital. A total of 189 multimorbid elderly patients were recruited. Cognitive dysfunction was determined according to the SKT and MMSE. Biochemical parameters (Hcys, folate, vitamin B12, hemoglobin), nutritional status (BMI, Mini Nutritional Assessment, nutritional intake), and activities of daily living were assessed. According to the SKT, 25.4% of patients showed no cerebral cognitive dysfunction, 21.2% had suspected incipient cognitive dysfunction, 12.7% showed mild cognitive dysfunction, 9.0% had moderate cognitive dysfunction, and 31.7% of patients were demented. The median plasma Hcys value was elevated by approximately 20% in multimorbid elderly patients, independent of cognitive dysfunction. Serum folate and vitamin B12 concentrations were within normal ranges. We did not find significant differences in nutritional status, activities of daily living, numbers of diseases or medications, or selected biochemical parameters between the SKT groups. Elevated serum Hcys levels with normal plasma folate and vitamin B12 concentrations were observed in multimorbid elderly patients. The plasma Hcys level did not appear to be an important biological risk factor for cognitive dysfunction in multimorbid geriatric patients.

Persons' various experiences of learning processes in patient education for osteoarthritis, a qualitative phenomenographic approach.

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Larsson, Ingalill; Sundén, Anne; Ekvall Hansson, Eva

2018-03-30

Patient education (PE) is a core treatment of osteoarthritis (OA) with the aim to increase persons' knowledge, self-efficacy, and empowerment. To describe person's various experiences of learning processes in PE for OA. Phenomenography. Semi-structured interviews were performed with the same persons, pre- (11) and post- (9) education. Various experiences on learning processes were found and were described in an outcome space. Achieving knowledge describes self-regulated learning and strongly relates to Control, which describes a high order cognitive learning skill, and minor to Confirm, which describes a cognitive learning skill based on recognition and application. Receiving knowledge describes the expectancy of learning regulated from the educator and strongly relates to Comply, which describes a low-order cognitive learning skill, and minor to Confirm. Different experiences of motivation and learning impact on persons' learning processes which, in turn, influence the persons' capability to accomplish self-efficacy and empowerment. The outcome space may serve as a basis for discussions between healthcare educators involved in PE to better understand what learning implies and to develop PE further.

The importance of need for cognition and educational experience in enhanced and standard substance abuse treatment.

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Czuchry, Michael; Dansereau, Donald F

2004-06-01

The current study examined the relationship between need for cognition (i.e., cognitive motivation or "will") and educational experience (i.e., cognitive ability or "skill") to perceived improvements during treatment of probationers receiving residential treatment within the criminal justice system. Probationers were randomly assigned to either receive motivational activities developed by the authors (the "enhanced" condition), or treatment as usual (but with access to general reading materials in lieu of the motivational activities). Need for cognition and educational experience were assessed and used as blocking variables, and ratings of progress were assessed midway and toward the end of treatment. The results indicate that both need for cognition and educational experience are important predictors of improvement during treatment, and that the motivational activities developed by the authors were particularly valuable for clients with lower levels of need for cognition.

Issues in Cognitive Psychology: Implications for Professional Education.

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Regehr, Glenn; Norman, Geoffrey R.

1996-01-01

Research developments in cognitive psychology, and their implications for teaching and learning at the level of professional education, are summarized. Areas discussed include organization of long-term memory, influences on storage and retrieval from memory, problem solving and transfer/use of analogy, concept formation/categorization/pattern…

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

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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.

Association between cognitive deficits and suicidal ideation in patients with major depressive disorder

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Pu, Shenghong; Setoyama, Shiori; Noda, Takamasa

2017-01-01

The role of cognitive function in suicidal ideation in patients with major depressive disorder (MDD) has not been adequately explored. This research sought to measure the relationship between suicidal ideation and cognitive function. Therefore, in this study, the association between cognitive function and suicidal ideation in patients with MDD was assessed. Cognitive function was evaluated in 233 patients with MDD using the Japanese version of the Brief Assessment of Cognition in Schizophreni...

Postoperative cognitive dysfunction in middle-aged patients

NARCIS (Netherlands)

Johnson, T.; Monk, T.; Rasmussen, L.S.; Abildstrom, H.; Houx, P.J.; Korttila, K.; Kuipers, H.M.; Hanning, C.D.; Siersma, V.D.; Kristensen, D.; Canet, J.; Ibanaz, M.T.; Moller, J.T.

2002-01-01

Background: Postoperative cognitive dysfunction (POCD) after noncardiac surgery is strongly associated with increasing age in elderly patients; middle-aged patients (aged 40-60 yr) may be expected to have a lower incidence, although subjective complaints are frequent. Methods: The authors compared

Intelligence and education as predictors of cognitive state in late life: a 50-year follow-up.

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Plassman, B L; Welsh, K A; Helms, M; Brandt, J; Page, W F; Breitner, J C

1995-08-01

We evaluated the relation of education and intelligence in early adult life to cognitive function in a group of elderly male twins. The Army General Classification Test (AGCT) was administered to US armed forces inductees in the early 1940s. Fifty years later, as part of a study of dementia in twins, we tested the cognitive status of 930 of these men using the modified Telephone Interview for Cognitive Status (TICS-m). TICS-m scores obtained in later life were correlated with AGCT scores (r = 0.457) and with years of education (r = 0.408). Thus, in univariate analyses, the AGCT score accounted for 20.6% and education accounted for 16.7% of variance in cognitive status. However, these two effects were not fully independent. A multivariable model using AGCT score, education, and the interaction of the two variables as predictors of the TICS-m score explained 24.8% of the variance, a slightly but significantly greater proportion than was explained by either factor alone. In a separate analysis based on 604 pairs of twins who took the AGCT, heritability of intelligence (estimated by AGCT score) was 0.503. Although this study does not address the issue of education and premorbid IQ as risk factors for dementia, the findings suggest that basic cognitive abilities in late life are related to cognitive performance measures from early adult life (ie, education and IQ).

Does higher education hone cognitive functioning and learning efficacy? Findings from a large and diverse sample.

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Guerra-Carrillo, Belén; Katovich, Kiefer; Bunge, Silvia A

2017-01-01

Attending school is a multifaceted experience. Students are not only exposed to new knowledge but are also immersed in a structured environment in which they need to respond flexibly in accordance with changing task goals, keep relevant information in mind, and constantly tackle novel problems. To quantify the cumulative effect of this experience, we examined retrospectively and prospectively, the relationships between educational attainment and both cognitive performance and learning. We analyzed data from 196,388 subscribers to an online cognitive training program. These subscribers, ages 15-60, had completed eight behavioral assessments of executive functioning and reasoning at least once. Controlling for multiple demographic and engagement variables, we found that higher levels of education predicted better performance across the full age range, and modulated performance in some cognitive domains more than others (e.g., reasoning vs. processing speed). Differences were moderate for Bachelor's degree vs. High School (d = 0.51), and large between Ph.D. vs. Some High School (d = 0.80). Further, the ages of peak cognitive performance for each educational category closely followed the typical range of ages at graduation. This result is consistent with a cumulative effect of recent educational experiences, as well as a decrement in performance as completion of schooling becomes more distant. To begin to characterize the directionality of the relationship between educational attainment and cognitive performance, we conducted a prospective longitudinal analysis. For a subset of 69,202 subscribers who had completed 100 days of cognitive training, we tested whether the degree of novel learning was associated with their level of education. Higher educational attainment predicted bigger gains, but the differences were small (d = 0.04-0.37). Altogether, these results point to the long-lasting trace of an effect of prior cognitive challenges but suggest that new learning

Validity and reliability of The Johns Hopkins Adapted Cognitive Exam for critically ill patients.

Science.gov (United States)

Lewin, John J; LeDroux, Shannon N; Shermock, Kenneth M; Thompson, Carol B; Goodwin, Haley E; Mirski, Erin A; Gill, Randeep S; Mirski, Marek A

2012-01-01

To validate The Johns Hopkins Adapted Cognitive Exam designed to assess and quantify cognition in critically ill patients. Prospective cohort study. Neurosciences, surgical, and medical intensive care units at The Johns Hopkins Hospital. One hundred six adult critically ill patients. One expert neurologic assessment and four measurements of the Adapted Cognitive Exam (all patients). Four measurements of the Folstein Mini-Mental State Examination in nonintubated patients only. Adapted Cognitive Exam and Mini-Mental State Examination were performed by 76 different raters. One hundred six patients were assessed, 46 intubated and 60 nonintubated, resulting in 424 Adapted Cognitive Exam and 240 Mini-Mental State Examination measurements. Criterion validity was assessed by comparing Adapted Cognitive Exam with a neurointensivist's assessment of cognitive status (ρ = 0.83, p validity was assessed by comparing Adapted Cognitive Exam with Mini-Mental State Examination in nonintubated patients (ρ = 0.81, p validity was assessed by surveying raters who used both the Adapted Cognitive Exam and Mini-Mental State Examination and indicated the Adapted Cognitive Exam was an accurate reflection of the patient's cognitive status, more sensitive a marker of cognition than the Mini-Mental State Examination, and easy to use. The Adapted Cognitive Exam demonstrated excellent interrater reliability (intraclass correlation coefficient = 0.997; 95% confidence interval 0.997-0.998) and interitem reliability of each of the five subscales of the Adapted Cognitive Exam and Mini-Mental State Examination (Cronbach's α: range for Adapted Cognitive Exam = 0.83-0.88; range for Mini-Mental State Examination = 0.72-0.81). The Adapted Cognitive Exam is the first valid and reliable examination for the assessment and quantification of cognition in critically ill patients. It provides a useful, objective tool that can be used by any member of the interdisciplinary critical care team to support

Cognitive Mapping Techniques: Implications for Research in Engineering and Technology Education

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Dixon, Raymond A.; Lammi, Matthew

2014-01-01

The primary goal of this paper is to present the theoretical basis and application of two types of cognitive maps, concept map and mind map, and explain how they can be used by educational researchers in engineering design research. Cognitive mapping techniques can be useful to researchers as they study students' problem solving strategies…

Screening of cognitive impairment in patients with Parkinson's disease: diagnostic validity of the Brazilian versions of the Montreal Cognitive Assessment and the Addenbrooke's Cognitive Examination-Revised

OpenAIRE

Emmanuelle Sobreira; Márcio A. Pena-Pereira; Alan L. Eckeli; Manoel A. Sobreira-Neto; Marcos H. N. Chagas; Maria P. Foss; Brenna Cholerton; Cyrus P. Zabetian; Ignacio F. Mata; Vitor Tumas

2015-01-01

ABSTRACTObjective The aim of the present study is to examine the accuracy of the Brazilian versions of the Montreal Cognitive Assessment (MoCA) and the Addenbrooke's Cognitive Examination-Revised (ACE-R) to screen for mild cognitive impairment (PDMCI) and dementia (PDD) in patients with Parkinson's disease (PD).Method Both scales were administered to a final convenience sample of 79 patients with PD. Patients were evaluated by a neurologist, a psychiatrist and a neuropsychologist using UPDRS,...

Vitamin B12 supplementation and cognitive scores in geriatric patients with Mild Cognitive Impairment

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Komal Chauhan

2016-09-01

Full Text Available Background: The Neurodegenerative diseases are increasingly affecting the elderly with a severe impact on their brain health. There is a wide gap in supplementation based studies for increasing the cognition levels of the geriatric population, especially in developing countries like India which are at extreme risk of developing neurological disorders. And recently Vitamin B12 has drawn considerable attention due to its ability to improve the cognitive status. Current literature has linked the possibility of alleviating neurological disorders in the elderly with effective vitamin B12 management. Abundant animal and human models have proved that supplementation of vitamin B12 is beneficial for the restoration of cognitive functions. Objective: To supplement vitamin B12 deficient mild cognitively impaired geriatric patients with injectable doses of vitamin B12 followed by impact evaluation. Methods: Screening of the mild cognitively impaired patients was carried out using the Mini- Mental State Examination and Yamaguchi Fox Pigeon Imitation test. Baseline information was elicited from the patients residing in urban Vadodara (a district in the state of Gujarat, India. This included socio-demographic, medical and drug history, anthropometric and physical activity pattern, in addition to biochemical parameters comprising of serum vitamin B12 and glycated haemoglobin profile. A sub-sample of 60 patients with mild cognitive impairment (MCI demonstrating severe vitamin B12 deficiency were conveniently enrolled for injectable doses of Vitamin B 12 in the dosage of 1,000 µg every day for one week, followed by 1,000 µg every week for 4 weeks & finishing with 1,000 µg for the remaining 4 months. An intervention six- month after the experiment with all the parameters were elicited. Results: Vitamin B12 supplementation resulted in a significant (p<0.001 improvement in the MMSE scores of the patients with a rise of 9.63% in the total patients. Gender

Disrupted white matter structure underlies cognitive deficit in hypertensive patients

International Nuclear Information System (INIS)

Li, Xin; Ma, Chao; Zhang, Junying; Chen, Yaojing; Zhang, Zhanjun; Sun, Xuan; Chen, Kewei

2016-01-01

Hypertension is considered a risk factor of cognitive impairments and could result in white matter changes. Current studies on hypertension-related white matter (WM) changes focus only on regional changes, and the information about global changes in WM structure network is limited. We assessed the cognitive function in 39 hypertensive patients and 37 healthy controls with a battery of neuropsychological tests. The WM structural networks were constructed by utilizing diffusion tensor tractography and calculated topological properties of the networks using a graph theoretical method. The direct and indirect correlations among cognitive impairments, brain WM network disruptions and hypertension were analyzed with structural equation modelling (SEM). Hypertensive patients showed deficits in executive function, memory and attention compared with controls. An aberrant connectivity of WM networks was found in the hypertensive patients (P Eglob = 0.005, P Lp = 0.005), especially in the frontal and parietal regions. Importantly, SEM analysis showed that the decline of executive function resulted from aberrant WM networks in hypertensive patients (p = 0.3788, CFI = 0.99). These results suggest that the cognitive decline in hypertensive patients was due to frontal and parietal WM disconnections. Our findings highlight the importance of brain protection in hypertension patients. (orig.)

Effect of Vinpocetine (Cognitol™) on Cognitive Performances of a ...

African Journals Online (AJOL)

patients compared with age, sex and level of education matched 56 controls. Cognitive ... stigmatized disorder that is often complicated by memory impairments, attention deficits and ..... Selective improvement based on the severity of cognitive ...

Predictors of Cognitive Dysfunction among Patients with Moderate to Severe Chronic Kidney Disease

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Uduak Effiong Williams

2017-04-01

Full Text Available Cognitive dysfunction including dementia is a common complication of chronic kidney disease (CKD that has just been recently appreciated. It has negative outcomes in the management of patients with CKD. This study explored the possible biochemical and clinical features of patients with CKD that can predict the occurrence of cognitive impairment in patients with moderate to severe CKD. We evaluate patients with stages 3-5 CKD for the occurrence and predictors of cognitive impairment. Multiple areas of cognitive function were tested in this single-center study using Community Screening Interview for Dementia (CSID and Trial-Making Test A (TMTA/Trial-Making Test B (TMTB. Cognitive impairment was correlated with patients’ routine biochemical, hematological, and selected clinical parameters. We observed a negative correlation between cognitive impairment and patient’s serum calcium (r = 0.240; p = 0.033 and estimated Glomerular filtration rate (eGFR (r = 0.379; p = 0.0006. Therefore, eGFR is an accurate predictor of cognitive dysfunction in patients with moderate to severe CKD. Early evaluation of cognitive function in CKD is indeed advised for optimal outcome in the management of patients with CKD.

The evolution of cognitive load theory and its application to medical education

NARCIS (Netherlands)

Leppink, Jimmie; van den Heuvel, Angelique

Cognitive Load Theory (CLT) has started to find more applications in medical education research. Unfortunately, misconceptions such as lower cognitive load always being beneficial to learning and the continued use of dated concepts and methods can result in improper applications of CLT principles in

Cognitive Levels Regarding Articulation Marks among Violin Students in Department of Music Education in Gazi University

Science.gov (United States)

Taninmis, Gamze Elif

2016-01-01

The purpose of this study is to determine violin students' cognitive levels about articulation marks in Department of Music Education, Fine Arts Education, Gazi Faculty of Education, Gazi University (GUGEF), and to identify the variables on which the cognitive levels vary. It is a descriptive research considering the study purpose, method and…

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

Science.gov (United States)

Zamarian, Laura; Högl, Birgit; Delazer, Margarete; Hingerl, Katharina; Gabelia, David; Mitterling, Thomas; Brandauer, Elisabeth; Frauscher, Birgit

2015-01-01

Patients with narcolepsy often complain about attention deficits in everyday situations. In comparison with these subjective complaints, deficits in objective testing are subtler. The present study assessed the relationships between subjective complaints, objectively measured cognitive performance, disease-related variables, and mood. A total of 51 patients with narcolepsy and 35 healthy controls responded to questionnaires regarding subjectively perceived attention deficits, sleepiness, anxiety and depression. Moreover, they performed an extensive neuropsychological assessment tapping into attention, executive functions, and memory. Patients rated their level of attention in everyday situations to be relatively poor. In an objective assessment of cognitive functioning, they showed only slight attention and executive function deficits. The subjective ratings of attention deficits significantly correlated with ratings of momentary sleepiness, anxiety, and depression, but not with objectively measured cognitive performance. Momentary sleepiness and depression predicted almost 39% of the variance in the ratings of subjectively perceived attention deficits. The present study showed that sleepiness and depression, more than objective cognitive deficits, might play a role in the subjectively perceived attention deficits of patients with narcolepsy. The results suggested that when counselling and treating patients with narcolepsy, clinicians should pay attention to potential depression because subjective cognitive complaints may not relate to objective cognitive impairments. Copyright © 2014 Elsevier B.V. All rights reserved.

Undetected cognitive impairment and decision-making capacity in patients receiving hospice care.

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Burton, Cynthia Z; Twamley, Elizabeth W; Lee, Lana C; Palmer, Barton W; Jeste, Dilip V; Dunn, Laura B; Irwin, Scott A

2012-04-01

: Cognitive dysfunction is common in patients with advanced, life-threatening illness and can be attributed to a variety of factors (e.g., advanced age, opiate medication). Such dysfunction likely affects decisional capacity, which is a crucial consideration as the end-of-life approaches and patients face multiple choices regarding treatment, family, and estate planning. This study examined the prevalence of cognitive impairment and its impact on decision-making abilities among hospice patients with neither a chart diagnosis of a cognitive disorder nor clinically apparent cognitive impairment (e.g., delirium, unresponsiveness). : A total of 110 participants receiving hospice services completed a 1-hour neuropsychological battery, a measure of decisional capacity, and accompanying interviews. : In general, participants were mildly impaired on measures of verbal learning, verbal memory, and verbal fluency; 54% of the sample was classified as having significant, previously undetected cognitive impairment. These individuals performed significantly worse than the other participants on all neuropsychological and decisional capacity measures, with effect sizes ranging from medium to very large (0.43-2.70). A number of verbal abilities as well as global cognitive functioning significantly predicted decision-making capacity. : Despite an absence of documented or clinically obvious impairment, more than half of the sample had significant cognitive impairments. Assessment of cognition in hospice patients is warranted, including assessment of verbal abilities that may interfere with understanding or reasoning related to treatment decisions. Identification of patients at risk for impaired cognition and decision making may lead to effective interventions to improve decision making and honor the wishes of patients and families.

Distinct Patterns of Cognitive Aging Modified by Education Level and Gender among Adults with Limited or No Formal Education: A Normative Study of the Mini-Mental State Examination.

Science.gov (United States)

Xie, Haiqun; Zhang, Chengguo; Wang, Yukai; Huang, Shuyun; Cui, Wei; Yang, Wenbin; Koski, Lisa; Xu, Xiping; Li, Youbao; Zheng, Meili; He, Mingli; Fu, Jia; Shi, Xiuli; Wang, Kai; Tang, Genfu; Wang, Binyan; Huo, Yong

2016-01-01

Dementia is increasingly prevalent due to rapid aging of the population, but under-recognized among people with low education levels. This is partly due to a lack of appropriate and precise normative data, which underestimates cognitive aging in the use of screening tools for dementia. We aimed to improve the precision of screening for cognitive impairment, by characterizing the patterns of cognitive aging and derived normative data of the Mini-Mental State Examination (MMSE) for illiterate and low-educated populations. This community-based study included data from 2,280 individuals aged 40 years or older from two rural areas. Multiple linear modeling examined the effect of aging on cognition reflected by the MMSE, stratified by education level and gender. Threshold effect of age on cognition was performed using a smoothing function. The majority of participants (60.4%) were illiterate or had attended only primary school (24.6%). The effect of aging on cognition varied by gender and education. Primary-school educated females and males remained cognitively stable up to 62 and 71 years of age, respectively, with MMSE score declining 0.4 and 0.8 points/year in females and males thereafter. Illiterates females scored 2.3 points lower than illiterate males, and scores for both declined 0.2 points/year. According to these results, normative data stratified by age, education and gender was generated. This study suggests gender and educational differences exist in cognitive aging among adults with limited or no formal education. To improve screening precision for cognitive impairment with the use of MMSE in low-educated population, age, gender, and education level should be considered.

Intelligence May Moderate the Cognitive Profile of Patients with ASD.

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Nanda Rommelse

Full Text Available The intelligence of individuals with Autism Spectrum Disorder (ASD varies considerably. The pattern of cognitive deficits associated with ASD may differ depending on intelligence. We aimed to study the absolute and relative severity of cognitive deficits in participants with ASD in relation to IQ.A total of 274 children (M age = 12.1, 68.6% boys participated: 30 ASD and 22 controls in the below average Intelligence Quotient (IQ group (IQ115. Matching for age, sex, Full Scale IQ (FSIQ, Verbal IQ (VIQ, Performance IQ (PIQ and VIQ-PIQ difference was performed. Speed and accuracy of social cognition, executive functioning, visual pattern recognition and basic processing speed were examined per domain and as a composite score.The composite score revealed a trend significant IQ by ASD interaction (significant when excluding the average IQ group. In absolute terms, participants with below average IQs performed poorest (regardless of diagnosis. However, in relative terms, above average intelligent participants with ASD showed the most substantial cognitive problems (particularly for social cognition, visual pattern recognition and verbal working memory since this group differed significantly from the IQ-matched control group (p < .001, whereas this was not the case for below-average intelligence participants with ASD (p = .57.In relative terms, cognitive deficits appear somewhat more severe in individuals with ASD and above average IQs compared to the below average IQ patients with ASD. Even though high IQ ASD individuals enjoy a certain protection from their higher IQ, they clearly demonstrate cognitive impairments that may be targeted in clinical assessment and treatment. Conversely, even though in absolute terms ASD patients with below average IQs were clearly more impaired than ASD patients with average to above average IQs, the differences in cognitive functioning between participants with and without ASD on the lower end of the IQ spectrum were

Validation of the Conversion between the Mini-Mental State Examination and Montreal Cognitive assessment in Korean Patients with Parkinson's Disease.

Science.gov (United States)

Kim, Ryul; Kim, Han-Joon; Kim, Aryun; Jang, Mi-Hee; Kim, Hyun Jeong; Jeon, Beomseok

2018-01-01

Two conversion tables between the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) have recently been established for Parkinson's disease (PD). This study aimed to validate them in Korean patients with PD and to evaluate whether they could be influenced by educational level. A total of 391 patients with PD who undertook both the Korean MMSE and the Korean MoCA during the same session were retrospectively assessed. The mean, median, and root mean squared error (RMSE) of the difference between the true and converted MMSE scores and the intraclass correlation coefficient (ICC) were calculated according to educational level (6 or fewer years, 7-12 years, or 13 or more years). Both conversions had a median value of 0, with a small mean and RMSE of differences, and a high correlation between the true and converted MMSE scores. In the classification according to educational level, all groups had roughly similar values of the median, mean, RMSE, and ICC both within and between the conversions. Our findings suggest that both MMSE-MoCA conversion tables are useful instruments for transforming MoCA scores into converted MMSE scores in Korean patients with PD, regardless of educational level. These will greatly enhance the utility of the existing cognitive data from the Korean PD population in clinical and research settings.

Evaluation of written patient educational materials in the field of diagnostic imaging

International Nuclear Information System (INIS)

Ryhaenen, A.M.; Johansson, K.; Virtanen, H.; Salo, S.; Salanterae, S.; Leino-Kilpi, H.

2009-01-01

Aim: To evaluate the quality of written educational materials for diagnostic imaging (radiological and nuclear medicine) patients. Materials and methods: Written educational materials (n = 70) for diagnostic imaging patients were analysed. The materials were evaluated based on their external appearance (9 criteria), instructiveness (7), content (7), language and structure (8) and readability (1). Deductive content analysis was used. Quantified parts of the analyses were analysed by SAS for Windows. Dependence between criteria (32) was tested by Pearson correlation coefficients. Results: The external appearance fulfilled almost completely the criteria of good written education materials. The instructiveness was addressed clearly, except for the purpose of the material. The contents of materials dealt with bio-physiological, functional and cognitive dimensions of knowledge, while financial dimensions of knowledge were hardly dealt with at all. The language and the structure were reasonably good, but the language was partly in passive voice and the text contained strange words. Most of the education material was moderately easy to read. Conclusions: The results show that the quality of material was quite good in all dimensions. Only a small number of criteria were unsatisfactory. The results can be used to further improve written patient education materials and patient education in the imaging unit.

Cognitive Indicators of Different Levels of Special Educational Support Needs in Autism

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Aljunied, Mariam; Frederickson, Norah

2011-01-01

Potential cognitive indicators of the level of special educational needs (SEN) were investigated in 52 children with autism. Two general indicators (intelligence quotient and cognitive modifiability) and three specific indicators (theory of mind, executive functioning and central coherence) were evaluated for their ability to discriminate three…

Using the Oxford Cognitive Screen to Detect Cognitive Impairment in Stroke Patients: A Comparison with the Mini-Mental State Examination.

Science.gov (United States)

Mancuso, Mauro; Demeyere, Nele; Abbruzzese, Laura; Damora, Alessio; Varalta, Valentina; Pirrotta, Fabio; Antonucci, Gabriella; Matano, Alessandro; Caputo, Marina; Caruso, Maria Giovanna; Pontiggia, Giovanna Teresa; Coccia, Michela; Ciancarelli, Irene; Zoccolotti, Pierluigi

2018-01-01

The Oxford Cognitive Screen (OCS) was recently developed with the aim of describing the cognitive deficits after stroke. The scale consists of 10 tasks encompassing five cognitive domains: attention and executive function, language, memory, number processing, and praxis. OCS was devised to be inclusive and un-confounded by aphasia and neglect. As such, it may have a greater potential to be informative on stroke cognitive deficits of widely used instruments, such as the Mini-Mental State Examination (MMSE) or the Montreal Cognitive Assessment, which were originally devised for demented patients. The present study compared the OCS with the MMSE with regards to their ability to detect cognitive impairments post-stroke. We further aimed to examine performance on the OCS as a function of subtypes of cerebral infarction and clinical severity. 325 first stroke patients were consecutively enrolled in the study over a 9-month period. The OCS and MMSE, as well as the Bamford classification and NIHSS, were given according to standard procedures. About a third of patients (35.3%) had a performance lower than the cutoff (cognitive domains of the OCS. Using the MMSE as a standard of clinical practice, the comparative sensitivity of OCS was 100%. Out of the 208 patients with normal MMSE performance 180 showed impaired performance in at least one domain of the OCS. The discrepancy between OCS and MMSE was particularly strong for patients with milder strokes. As for subtypes of cerebral infarction, fewer patients demonstrated widespread impairments in the OCS in the Posterior Circulation Infarcts category than in the other categories. Overall, the results showed a much higher incidence of cognitive impairment with the OCS than with the MMSE and demonstrated no false negatives for OCS vs MMSE. It is concluded that OCS is a sensitive screen tool for cognitive deficits after stroke. In particular, the OCS detects high incidences of stroke-specific cognitive impairments, not detected

Association between educational attainment and amyloid deposition across the spectrum from normal cognition to dementia: neuroimaging evidence for protection and compensation.

Science.gov (United States)

Arenaza-Urquijo, Eider M; Bejanin, Alexandre; Gonneaud, Julie; Wirth, Miranka; La Joie, Renaud; Mutlu, Justine; Gaubert, Malo; Landeau, Brigitte; de la Sayette, Vincent; Eustache, Francis; Chételat, Gaël

2017-11-01

The brain mechanisms underlying the effect of intellectual enrichment may evolve along the normal aging Alzheimer's disease (AD) cognitive spectrum and may include both protective and compensatory mechanisms. We assessed the association between early intellectual enrichment (education, years) and average cortical florbetapir standardized uptake value ratio as well as performed voxel-wise analyses in a total of 140 participants, including cognitively normal older adults, mild cognitive impairment (MCI), and AD patients. Higher education was associated with lower cortical florbetapir positron emission tomography (florbetapir-PET) uptake, notably in the frontal lobe in normal older adults, but with higher uptake in frontal, temporal, and parietal regions in MCI after controlling for global cognitive status. No association was found in AD. In MCI, we observed an increased fluorodeoxyglucose positron emission tomography (FDG-PET) uptake with education within the regions of higher florbetapir-PET uptake, suggesting a compensatory increase. Early intellectual enrichment may be associated with protection and compensation for amyloid beta (Aβ) deposition later in life, before the onset of dementia. Previous investigations have been controversial as regard to the effects of intellectual enrichment variables on Aβ deposition; the present findings call for approaches aiming to evaluate mechanisms of resilience across disease stages. Copyright © 2017 Elsevier Inc. All rights reserved.

Role of Educational Status in Explaining the Association between Body Mass Index and Cognitive Function.

Science.gov (United States)

Ho, Yi-Te; Kao, Tung-Wei; Peng, Tao-Chun; Liaw, Fang-Yih; Yang, Hui-Fang; Sun, Yu-Shan; Chang, Yaw-Wen; Chen, Wei-Liang

2016-02-01

Preserving physical and cognitive function becomes an important issue as people age. A growing number of studies have found that the correlation between body mass index (BMI) and cognitive function changes in different age groups. It is obvious that higher educational status is linked to higher cognitive function in terms of numerous risk factors that influence cognitive function. This study aimed to investigate the interplay between obesity and cognitive function categorized by different educational status.This study included 5021 participants aged 20 to 59 years who completed 3 neurocognitive function tests, including a simple reaction time test (SRTT), a symbol digit substitution test (SDST), and a serial digit learning test (SDLT) as reported in the National Health and Nutrition Examination Survey (NHANES) III database. The associations between neurocognitive function and BMI were analyzed using multivariate linear regression while controlling for confounders.After adjusting for pertinent covariates in mode 3, the β coefficients in the female participants with more than 12 years of education (interpreted as change of 3 neurocognitive function tests for each increment in BMI) comparing obesity groups to those with normal BMI were 16.2 (P education and female participants with fewer than 12 years of education demonstrated increased impairment as their BMI increased. However, this association was not significant after adjustments.Obese individuals had worse neurocognitive function than those of normal weight or overweight, especially in women with a high educational level.

Impaired cognitive functioning in patients with tyrosinemia type I receiving nitisinone.

Science.gov (United States)

Bendadi, Fatiha; de Koning, Tom J; Visser, Gepke; Prinsen, Hubertus C M T; de Sain, Monique G M; Verhoeven-Duif, Nanda; Sinnema, Gerben; van Spronsen, Francjan J; van Hasselt, Peter M

2014-02-01

To examine cognitive functioning in patients with tyrosinemia type I treated with nitisinone and a protein-restricted diet. We performed a cross-sectional study to establish cognitive functioning in children with tyrosinemia type I compared with their unaffected siblings. Intelligence was measured using age-appropriate Wechsler Scales. To assess cognitive development over time, we retrieved sequential IQ scores in a single-center subset of patients. We also evaluated whether plasma phenylalanine and tyrosine levels during treatment was correlated with cognitive development. Average total IQ score in 10 patients with tyrosinemia type I receiving nitisinone was significantly lower compared with their unaffected siblings (71 ± 13 vs 91 ± 13; P = .008). Both verbal and performance IQ subscores differed (77 ± 14 vs 95 ± 11; P cognitive function despite a protein-restricted diet. Copyright © 2014 Mosby, Inc. All rights reserved.

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 ...

Associations between modifiable lifestyle factors and multidimensional cognitive health among community-dwelling old adults: stratified by educational level.

Science.gov (United States)

Yuan, Manqiong; Chen, Jia; Han, Yaofeng; Wei, Xingliang; Ye, Zirong; Zhang, Liangwen; Hong, Y Alicia; Fang, Ya

2018-02-15

Cognition is multidimensional, and each domain plays a unique and crucial part in successful daily life engagement. However, less attention has been paid to multi-domain cognitive health for the elderly, and the role of lifestyle factors in each domain remains unclear. We conducted a cross-sectional study of 3,230 older adults aged 60+ years in Xiamen, China, in 2016. The Montreal Cognitive Assessment (MoCA) was used to measure general cognition and six specific sub-domains. To account for educational effects, we adjusted the MoCA score and divided respondents into three education-specific groups (low, moderate, and high education groups with ≤5, 6~8, and ≥9 years of education, respectively). A series of proportional odds models were used to detect the associations between two categories of lifestyle factors - substance abuse (cigarette and alcohol) and leisure activity (TV watching, reading, smartphone use, social activity, and exercise) - and general cognition and the six sub-domains in those three groups. Among the 3,230 respondents, 2,617 eligible participants were included with a mean age of 69.05 ± 7.07 years. Previous or current smoking/drinking was not associated with MoCA scores in the whole population, but unexpectedly, the ex-smokers in the low education group performed better in general cognition (OR = 2.22) and attention (OR = 2.05) than their never-smoking counterparts. Modest TV watching, reading, and smartphone use also contributed to better cognition among elderly participants in the low education group. For the highly educated elderly, comparatively longer reading (>3.5 hours/week) was inversely associated with general cognition (OR = 0.53), memory (OR = 0.59), and language (OR = 0.54), while adequate exercise (5~7 days/week) was positively related to these factors with OR = 1.48, OR = 1.49, and OR = 1.53, respectively. For the moderately educated elderly, only modest reading was significantly beneficial. Lifestyle factors play different

Cognitive behavioral program in treating insomnia among elderly patients

OpenAIRE

Richter, Kneginja; Miloseva, Lence; Niklewski, Günter; Piehl, Anja

2015-01-01

Introduction: Insomnia is a most common in elderly patients. World wide experience showed that Cognitive behavioral program in treating insomnia is one of the best effective model. Objectives: The present study aim to present clinical experience from University Clinic Nuremberg, Centre for Sleeping Medicine with application of Cognitive behavioral program in treating insomnia among elderly. Material and Methods: The sample consists of 22 patients with chronic insomnia (10 primary insom...

Using the Oxford Cognitive Screen to Detect Cognitive Impairment in Stroke Patients: A Comparison with the Mini-Mental State Examination

Directory of Open Access Journals (Sweden)

Mauro Mancuso

2018-02-01

Full Text Available BackgroundThe Oxford Cognitive Screen (OCS was recently developed with the aim of describing the cognitive deficits after stroke. The scale consists of 10 tasks encompassing five cognitive domains: attention and executive function, language, memory, number processing, and praxis. OCS was devised to be inclusive and un-confounded by aphasia and neglect. As such, it may have a greater potential to be informative on stroke cognitive deficits of widely used instruments, such as the Mini-Mental State Examination (MMSE or the Montreal Cognitive Assessment, which were originally devised for demented patients.ObjectiveThe present study compared the OCS with the MMSE with regards to their ability to detect cognitive impairments post-stroke. We further aimed to examine performance on the OCS as a function of subtypes of cerebral infarction and clinical severity.Methods325 first stroke patients were consecutively enrolled in the study over a 9-month period. The OCS and MMSE, as well as the Bamford classification and NIHSS, were given according to standard procedures.ResultsAbout a third of patients (35.3% had a performance lower than the cutoff (<22 on the MMSE, whereas 91.6% were impaired in at least one OCS domain, indicating higher incidences of impairment for the OCS. More than 80% of patients showed an impairment in two or more cognitive domains of the OCS. Using the MMSE as a standard of clinical practice, the comparative sensitivity of OCS was 100%. Out of the 208 patients with normal MMSE performance 180 showed impaired performance in at least one domain of the OCS. The discrepancy between OCS and MMSE was particularly strong for patients with milder strokes. As for subtypes of cerebral infarction, fewer patients demonstrated widespread impairments in the OCS in the Posterior Circulation Infarcts category than in the other categories.ConclusionOverall, the results showed a much higher incidence of cognitive impairment with the OCS than with the

Cognitive Reserve in Patients with Mild Cognitive Impairment: The Importance of Occupational Complexity as a Buffer of Declining Cognition in Older Adults

Directory of Open Access Journals (Sweden)

Feldberg Carolina

2016-01-01

Full Text Available Cognitive reserve is the ability to optimize performance through differential recruitment of brain networks, which may reflect the use of alternative cognitive strategies. Work is one of the most important sources of cognitive stimulation during adulthood. Mild cognitive impairment (MCI represents an intermediate status between normal aging and dementia. As a consequence, this is considered a risk group regarding cognition. In order to study the probable association between occupational complexity and cognitive performance in a group of patients with MCI, a non-probabilistic intentional sample was dispensed on a group of 80 patients. Occupational complexity was explored by the Questionnaire on Agency of Labor Activity (CAAL, according to its acronym in Spanish and a set of neuropsychological tests, which assessed cognitive performance in different areas: memory, attention, language and executive function, were administered. Results reveal that occupational complexity is associated to cognitive performance of elderly adults with MCI. With respect to working with Data, an increase in neuropsychological tests that demand high levels of attention and imply processing speed and working memory can be noted. Regarding the complexity of working with People, an association between the level of occupational complexity and an increase in verbal abilities and verbal reasoning can be seen. On the other hand, working with Things could be associated with better performance in specific areas of cognition such as visuospatial abilities. These results add up as empirical evidence to the fields of cognitive neurology and gerontology and to the cognitive reserve hypothesis, showing how complex environments can enhance cognition in old age. It adds evidence that help to understand which psychological, social and labor factors intervene in the cognitive reserve of an elder adult in cognitive risk.

Screening for Cognitive Impairments in Primary Blepharospasm.

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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.

Comparison of the extent and pattern of cognitive impairment among predialysis, dialysis and transplant patients: A cross-sectional study from Australia.

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Lambert, Kelly; Mullan, Judy; Mansfield, Kylie; Lonergan, Maureen

2017-11-01

The aim of this study was to compare the extent of cogntive impairment and the types of cognitive deficits in an Australian cohort of four patient groups with end stage kidney disease. Characteristics predicting the presence of cognitive impairment were also evaluated. Observational cross-sectional study of 155 patients with end stage kidney disease are recruited from a regional Australian renal unit. Eligible participants included those whose estimated Glomerular Filtration Rate was Cognitive Assessment tool was used to screen the study participants for cognitive impairment and evaluate cognitive deficits. Cognitive impairment was defined as a total Montreal Cognitive Assessment tool score ≤24/30. The extent of cognitive impairment varied between the four groups with end stage kidney disease. Factors predicting the presence of cognitive impairment included undertaking dialysis, age ≥65, male gender and the presence of diabetes or cerebrovascular disease. Deficits in executive function, attention, language, visuospatial skills, memory and orientation were common among the study participants, and the extent of these deficits varied between groups. Limitations to the study included the cross-sectional design, and that the presence of confounders like depression were not recorded. The impact of disparities in the cognitive capabilities identified in this study are likely to be far reaching. Tailoring of education and self-management programmes to the cognitive deficits of individuals is required. © 2016 Asian Pacific Society of Nephrology.

Progression of cognitive impairment in stroke/TIA patients over 3 years.

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Sachdev, Perminder S; Lipnicki, Darren M; Crawford, John D; Wen, Wei; Brodaty, Henry

2014-12-01

To examine how cognitive deficits progress in the years following a stroke or transient ischaemic attack (TIA). A follow-up study, with neuropsychological and MRI assessments undertaken 3 years after baseline assessments made 3-6 months poststroke in 183 stroke/TIA patients and 97 healthy controls participating in the Sydney Stroke Study. Additional measures included cardiovascular risk factors and apolipoprotein E (APOE) genotype. Stroke/TIA patients had poorer cognitive function and more vascular risk factors than controls at baseline, but did not show greater decline in cognitive function over 3 years except for verbal memory. Patients with a subsequent stroke/TIA showed greater decline in global cognitive function and a number of domains. Rates of incident dementia were 5.9% per year in patients and 0.4% in controls. Both groups showed increased atrophy of the hippocampus, amygdala and whole brain, and an increase in white matter hyperintensities over 3 years; whole brain atrophy was greater in patients. Cognitive decline was greater in women and in those with smaller hippocampi at baseline. For patients without a subsequent stroke/TIA, those with smaller hippocampi or the APOE ε4 allele had greater global cognitive and verbal memory decline. In poststroke patients, cognitive decline was not greater than in comparison subjects, except for verbal memory, unless they had another stroke/TIA. However, dementia incidence was higher in patients, as might be expected from their poorer baseline cognitive functioning. Smaller hippocampi were associated with an increased risk of decline in memory, and APOE ε4 was a risk factor in those without a subsequent stroke/TIA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

How does coconut oil affect cognitive performance in alzheimer patients?

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De la Rubia Ortí, José Enrique; Sánchez Álvarez, Carmen; Selvi Sabater, Pablo; Bueno Cayo, Alma María; Sancho Castillo, Sandra; Rochina, Mariano Julián; Hu Yang, Iván

2017-03-30

Introduction: Alzheimer’s disease is one of the most prevalent neurodegenerative dementia in developed world. This fact, coupled with the lack cure, makes new no pharmacological therapeutic strategies such as nutrient management to investigate. In this regard, it stresses the possible influence of coconut oil as alternative energy source capable of stopping the progressively neuronal death that occurs in this disease. Objectives: To assess the cognitive impact of coconut oil in Alzheimer’s patients, and specifically in orientation, language-building, fixing, calculation-concentration and memory areas. Methods: Prospective, longitudinal, qualitative, analytical and experimental study through a clinical trial where 44 patients with Alzheimer’s in region of Ribera (Valencia), of which half was selected to receive during 21 days, 40 ml coconut oil daily divided between breakfast (20 ml) and food (20 ml). Before and after administration of the oil, they were evaluated through cognitive test Mini-Mental State Examination to determine possible changes. Results: It was observed in patients who received coconut oil, that cognitive improvement after completion of the intervention, statistically significant improved in the orientation and language-construction areas. Conclusions: Coconut oil appears to improve cognitive abilities of Alzheimer’s patients, with different intensity depending on the cognitive area.

Does higher education hone cognitive functioning and learning efficacy? Findings from a large and diverse sample

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Guerra-Carrillo, Belén; Katovich, Kiefer

2017-01-01

Attending school is a multifaceted experience. Students are not only exposed to new knowledge but are also immersed in a structured environment in which they need to respond flexibly in accordance with changing task goals, keep relevant information in mind, and constantly tackle novel problems. To quantify the cumulative effect of this experience, we examined retrospectively and prospectively, the relationships between educational attainment and both cognitive performance and learning. We analyzed data from 196,388 subscribers to an online cognitive training program. These subscribers, ages 15–60, had completed eight behavioral assessments of executive functioning and reasoning at least once. Controlling for multiple demographic and engagement variables, we found that higher levels of education predicted better performance across the full age range, and modulated performance in some cognitive domains more than others (e.g., reasoning vs. processing speed). Differences were moderate for Bachelor’s degree vs. High School (d = 0.51), and large between Ph.D. vs. Some High School (d = 0.80). Further, the ages of peak cognitive performance for each educational category closely followed the typical range of ages at graduation. This result is consistent with a cumulative effect of recent educational experiences, as well as a decrement in performance as completion of schooling becomes more distant. To begin to characterize the directionality of the relationship between educational attainment and cognitive performance, we conducted a prospective longitudinal analysis. For a subset of 69,202 subscribers who had completed 100 days of cognitive training, we tested whether the degree of novel learning was associated with their level of education. Higher educational attainment predicted bigger gains, but the differences were small (d = 0.04–0.37). Altogether, these results point to the long-lasting trace of an effect of prior cognitive challenges but suggest that new

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...

Cognitive reserve and emotional stimuli in older individuals: level of education moderates the age-related positivity effect.

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Bruno, Davide; Brown, Adam D; Kapucu, Aycan; Marmar, Charles R; Pomara, Nunzio

2014-01-01

BACKGROUND/STUDY CONTEXT: A frequently observed age-related effect is a preference in older individuals for positive stimuli. The cognitive control model proposes that this positivity effect may be mediated by executive functions. We propose that cognitive reserve, operationally defined as years of education, which tempers cognitive decline and has been linked to executive functions, should also influence the age-related positivity effect, especially as age advances. An emotional free recall test was administered to a group of 84 cognitively intact individuals aged 60 to 88, who varied in years of education. As part of a larger test battery, data were obtained on measures of executive functioning and depression. Multiple regression and moderation analyses were performed, controlling for general cognitive function, severity of depressive symptoms, and executive function. In our data, years of education appeared to moderate the effect of age on the positivity effect; age was negatively associated with recall of positive words in participants with fewer years of education, whereas a nonsignificant positive correlation was observed between age and positivity in participants with more education. Cognitive reserve appears to play a role in explaining individual differences in the positivity effect in healthy older individuals. Future studies should investigate whether cognitive reserve is also implicated in the ability to process a wide range of emotional stimuli and whether greater reserve is reflected in improved emotional regulation.

The influence of an introduction to cognitive education on school ...

African Journals Online (AJOL)

paper will interest local and international readers because it highlights both essential content and the ... justification for engaging school leadership with the cognitive education movement. .... process of curricular innovation and change. The.

Face-to-Face or Telematic Cognitive Stimulation in Patients with Multiple Sclerosis and Cognitive Impairment: Why Not Both?

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C. Guijarro-Castro

2017-01-01

Full Text Available Introduction. Cognitive impairment (CI affects 40–65% of patients with multiple sclerosis (MS. Few studies address telematic cognitive stimulation (TCS in MS. The objective of this study is to evaluate the efficacy and impact of telestimulation or distance cognitive stimulation (TCS, with and without the support of face-to-face cognitive stimulation (FCS in cognitive impairment in MS. Methods. Multicentre, prospective, randomised, controlled study. We will include 98 MS patients with EDSS ≤ 6, symbol digit modality test (SDMT ≤ Pc 25, and Multiple Sclerosis Neuropsychological Screening Questionnaire (MSNQ > 26 points. Patients will be randomised into 3 groups, a TCS group, a mixed TCS/FCS group, and a control group. CS is performed 3 days a week for 3 months. Processing speed, memory, attention, and executive functions will be rehabilitated. FCS will include ecological exercises and strategies. EDSS and a cognitive evaluation (SDMT, CTMT, PASAT, and TAVEC, MSNQ, psychological impact scales (MSIS, and depression (BDI will be carried out, baseline, postrehabilitation, and also 6 and 12 months later, to evaluate the effect of CS in the longer term. Conclusion. This study could help to establish the usefulness of TCS or, in its absence, TCS with face-to-face help for CI in MS. The interest lies in the clear benefits of remote rehabilitation in the daily life of patients.

Causal mechanisms of subjective cognitive dysfunction in schizophrenic and depressed patients

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van den Bosch, RJ; Rombouts, RP

We examined causal mechanisms of subjective cognitive (dis)abilities in schizophrenic and depressed patients, and in patient and normal control groups. This exploratory study included objective cognitive performance (Continuous Performance Task) as well as mood and mental effort ratings. Self-report

Mild cognitive impairment: coping with an uncertain label.

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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

Cognitive Remediation for Individuals with Psychosis in a Supported Education Setting: A Pilot Study

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Sean A. Kidd

2012-01-01

Full Text Available Cognitive remediation (CR is a treatment approach that is being increasingly examined as a means through which the cognitive impacts of schizophrenia might be ameliorated. While CR has demonstrated good outcomes when paired with supported employment, little is known regarding how it might be integrated within supported education contexts. In this study CR was examined in a supported education context with 16 individuals with psychosis. The findings indicated that CR aligned well with the academic curriculum with very low attrition, was found useful by students, and showed similar pre-post differences on cognitive measures as those found in previous work.

Semantic memory and depressive symptoms in patients with subjective cognitive decline, mild cognitive impairment, and Alzheimer's disease.

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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.

Aging of theory of mind: the influence of educational level and cognitive processing.

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Li, Xiaoming; Wang, Kai; Wang, Fan; Tao, Qian; Xie, Yu; Cheng, Qi

2013-01-01

Previous studies of theory of mind (ToM) in old age have provided mixed results. We predicted that educational level and cognitive processing are two factors influencing the pattern of the aging of ToM. To test this hypothesis, a younger group who received higher education (mean age 20.46 years), an older group with an education level equal to that of the young group (mean age 76.29 years), and an older group with less education (mean age 73.52 years) were recruited. ToM tasks included the following tests: the second-order false-belief task, the faux-pas task, the eyes test, and tests of fundamental aspects of cognitive function that included two background tests (memory span and processing speed) and three subcomponents of executive function (inhibition, updating, and shifting). We found that the younger group and the older group with equally high education outperformed the older group with less education in false-belief and faux-pas tasks. However, there was no significant difference between the two former groups. The three groups of participants performed equivalently in the eyes test as well as in control tasks (false-belief control question, faux-pas control question, faux-pas control story, and Eyes Test control task). The younger group outperformed the other two groups in the cognitive processing tasks. Mediation analyses showed that difficulties in inhibition, memory span, and processing speed mediated the age differences in false-belief reasoning. Also, the variables of inhibition, updating, memory span, and processing speed mediated age-related variance in faux-pas. Discussion focused on the links between ToM aging, educational level, and cognitive processing. Supported by Chinese National Natural Science Foundation (number: 30870766) and Anhui Province Natural Science Foundation (number: 11040606M166).

Neuropsychological and clinical heterogeneity of cognitive impairment in patients with multiple system atrophy.

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Barcelos, Lorena Broseghini; Saad, Flávia; Giacominelli, Carla; Saba, Roberta Arb; de Carvalho Aguiar, Patrícia Maria; Silva, Sonia Maria Azevedo; Borges, Vanderci; Bertolucci, Paulo Henrique Ferreira; Ferraz, Henrique Ballalai

2018-01-01

We evaluated neuropsychological tests to compare cognitive impairment between two types of multiple system atrophy: predominant parkinsonism (MSA-P) and predominant cerebellar ataxia (MSA-C). This cross-sectional study included 14 patients diagnosed with MSA: four with MSA-C and ten with MSA-P. Presence of motor symptoms was determined by using the Unified Rating MSA Scale (URMSAS). Non-motor symptoms were evaluated by the Short Form Health Survey (SF-36), Scales for Outcomes in Parkinson's disease Autonomic (SCOPA-AUT), Hospital Anxiety and Depression Scale (HADS), and Beck Depression Inventory (BDI). Neuropsychological tests were used to evaluate general cognition, verbal and visual memory, working memory, constructional ability, visuospatial, language, and executive function. The median age of the patients was 62 years, median disease duration was 3.5 years, and median education level was 10 years. The median Mini-Mental State Examination (MMSE) score was 26.5 points, and median Mattis Dementia Rating Scale (MDRS) score was 131.5. We compared the continuous data between the two MSA subtypes and observed that bodily pain reported in the quality of life questionnaire, SF-36, was worse in MSA-P (p<0.05), and attention function evaluated by MDRS was significantly lower in MSA-C than MSA-P (p<0.05). Our comparative study of cognitive impairment in MSA-P and MSA-C showed that both groups had impaired executive and visuospatial functions, while the attention deficit was predominant only in MSA-C. These findings support the concept that cognitive deficit originates from striatofrontal dysfunction and cerebellar degeneration. Our study also suggests that cognitive impairment is relevant in MSA, and clinical neurologists should not neglect evaluation of these aspects in their daily clinical practice. Copyright © 2017. Published by Elsevier B.V.

Evolution of short cognitive test performance in stroke patients with vascular cognitive impairment and vascular dementia: Baseline evaluation and follow-up

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Custodio, Nilton; Montesinos, Rosa; Lira, David; Herrera-Perez, Eder; Bardales, Yadira; Valeriano-Lorenzo, Lucia

2017-01-01

ABSTRACT. There is limited evidence about the progression of cognitive performance during the post-stroke stage. Objective: To assess the evolution of cognitive performance in stroke patients without vascular cognitive impairment (VCI), patients with vascular mild cognitive impairment (MCI), and patients with vascular dementia (VD). Methods: A prospective cohort of stroke outpatients from two secondary medical centers in Lima, Peru was studied. We performed standardized evaluations at definitive diagnosis (baseline evaluation), and control follow-ups at 6 and 12 months, including a battery of short cognitive tests: Clinical Dementia Rating (CDR), Addenbrooke's Cognitive Examination (ACE), and INECO Frontal Screening (IFS). Results: 152 outpatients completed the follow-up, showing progressive increase in mean score on the CDR(0.34 to 0.46), contrary to the pattern observed on the ACE and IFS (78.18 to 76.48 and 23.63 to 22.24). The box plot for the CDR test showed that VCI patients had progressive worsening (0.79 to 0.16). Conversely, this trend was not observed in subjects without VCI. The box plot for the ACE and IFS showed that, for the majority of the differentiated stroke types, both non-VCI and VCI patients had progressive worsening. Conclusion: According to both ACE and IFS results during a 1-year follow-up, the cognitive performance of stroke patients worsened, a trend which was particularly consistent in infarction-type stroke patients. PMID:29354218

Evolution of short cognitive test performance in stroke patients with vascular cognitive impairment and vascular dementia: Baseline evaluation and follow-up

Directory of Open Access Journals (Sweden)

Nilton Custodio

Full Text Available ABSTRACT. There is limited evidence about the progression of cognitive performance during the post-stroke stage. Objective: To assess the evolution of cognitive performance in stroke patients without vascular cognitive impairment (VCI, patients with vascular mild cognitive impairment (MCI, and patients with vascular dementia (VD. Methods: A prospective cohort of stroke outpatients from two secondary medical centers in Lima, Peru was studied. We performed standardized evaluations at definitive diagnosis (baseline evaluation, and control follow-ups at 6 and 12 months, including a battery of short cognitive tests: Clinical Dementia Rating (CDR, Addenbrooke's Cognitive Examination (ACE, and INECO Frontal Screening (IFS. Results: 152 outpatients completed the follow-up, showing progressive increase in mean score on the CDR(0.34 to 0.46, contrary to the pattern observed on the ACE and IFS (78.18 to 76.48 and 23.63 to 22.24. The box plot for the CDR test showed that VCI patients had progressive worsening (0.79 to 0.16. Conversely, this trend was not observed in subjects without VCI. The box plot for the ACE and IFS showed that, for the majority of the differentiated stroke types, both non-VCI and VCI patients had progressive worsening. Conclusion: According to both ACE and IFS results during a 1-year follow-up, the cognitive performance of stroke patients worsened, a trend which was particularly consistent in infarction-type stroke patients.

Rehabilitation for improved cognition in patients with stress-related exhaustion disorder

DEFF Research Database (Denmark)

Malmberg Gavelin, Hanna; Eskilsson, Therese; Boraxbekk, Carl-Johan

2018-01-01

Stress-related exhaustion has been associated with selective and enduring cognitive impairments. However, little is known about how to address cognitive deficits in stress rehabilitation and how this influences stress recovery over time. The aim of this open-label, parallel randomized controlled...... trial (ClinicalTrials.gov: NCT03073772) was to investigate the long-term effects of 12 weeks cognitive or aerobic training on cognitive function, psychological health, and work ability for patients diagnosed with exhaustion disorder (ED). One-hundred-and-thirty-two patients (111 women) participating...... in multimodal stress rehabilitation were randomized to receive additional cognitive training (n = 44), additional aerobic training (n = 47), or no additional training (n = 41). Treatment effects were assessed before, immediately after and one-year post intervention. The primary outcome was global cognitive...

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.

Breastfeeding, Maternal Education and Cognitive Function: A Prospective Study in Twins

NARCIS (Netherlands)

Bartels, M.; van Beijsterveldt, C.E.M.; Boomsma, D.I.

2009-01-01

The effect of breastfeeding on cognitive abilities is examined in the offspring of highly educated women and compared to the effects in women with low or middle educational attainment. All offspring consisted of 12-year old mono- or dizygotic twins and this made it possible to study the effect of

Does cognitive decline decrease health utility value in older adult patients with cancer?

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Akechi, Tatsuo; Aiki, Sayo; Sugano, Koji; Uchida, Megumi; Yamada, Atsuro; Komatsu, Hirokazu; Ishida, Takashi; Kusumoto, Shigeru; Iida, Shinsuke; Okuyama, Toru

2017-05-01

Cognitive decline is common among older adults with cancer. The present study aimed to investigate the impact of cognitive decline on health utility value in older adults suffering from cancer. Consecutive patients aged 65 years or older with a primary diagnosis of malignant lymphoma or multiple myeloma were recruited. Patients were asked to complete the EuroQoL-5 (EQ-5D) scale to measure health utility and the Mini-Mental State Examination to assess cognitive decline. The potential impact of cognitive decline was investigated with univariate analysis. A multivariate regression analysis was conducted to control for potential confounding factors. Complete data were obtained from 87 patients, 29% of whom had cognitive decline. The mean ± SE EQ-5D score for patients with cognitive decline was significantly lower than that for those without cognitive decline (0.67 ± 0.04 vs 0.79 ± 0.03, t = 2.38, P = 0.02). However, multiple regression analysis showed that cognitive decline was not significantly associated with EQ-5D scores. Female sex and lower performance scores (worse physical condition) were significantly associated with EQ-5D scores. Cognitive decline may be involved in decreased health utility value in older adult patients with cancer. However, this effect does not seem to be independent, and the patient's physical condition may be a relevant confounding factor. © 2016 The Authors. Psychogeriatrics © 2016 Japanese Psychogeriatric Society.

The effect of cognitive behavior therapy in patients with rheumatoid arthritis

NARCIS (Netherlands)

Kraaimaat, F. W.; Brons, M. R.; Geenen, R.; Bijlsma, J. W.

1995-01-01

In order to examine the effectiveness of cognitive behavioral therapy for patients with rheumatoid arthritis (RA) three patients groups were studied: a cognitive behavioral therapy group (CBT), an occupational therapy group (OT), and a waiting-list control group. The CBT received a comprehensive,

Cognitive reserve and patient-reported outcomes in multiple sclerosis.

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Schwartz, Carolyn E; Snook, Erin; Quaranto, Brian; Benedict, Ralph H B; Vollmer, Timothy

2013-01-01

Adaptation and compensation in the face of changing pathology may be better understood by considering the concept of cognitive reserve, which may protect against disability in multiple sclerosis (MS). The present work investigates the relationship between cognitive reserve and demographic characteristics, health behaviors, and patient-reported outcomes (PROs). Cross-sectional data (n=1142) were drawn from the North American Research Committee on MS (NARCOMS) Registry, from whom additional survey data were collected. Cognitive reserve was measured using the Stern and Sole-Padulles measures, the O*NET occupational classification system, and the Godin Leisure-Time Exercise Questionnaire. PROs were assessed using generic (SF -12v2, Perceived Deficits Questionnaire, Ryff Psychological Well-Being, Diener Satisfaction with Life Scale) and disease-specific (Patient-Determined Disease Steps, Performance Scales) measures. Psychometric analysis created unidimensional cognitive reserve subscales. Regression models examined relationships between cognitive reserve, demographic characteristics, and PROs. The cognitive reserve measures assessed distinct but related constructs. Individuals with high cognitive reserve were more likely to report lower levels of perceived disability and perceived cognitive deficits, and higher levels of physical health, mental health, and well-being. Both active and passive reserve are associated with better outcomes, independent of demographic factors, and these associations apply to both generic and disease-specific outcomes. This expanded measurement of cognitive reserve captures both the passive and active aspects of the construct, and there is a consistent and substantial relationship with PROs. Individuals with high passive and/or active reserve are healthier and experience higher levels of well-being.

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

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.

Validation of the Conversion between the Mini-Mental State Examination and Montreal Cognitive assessment in Korean Patients with Parkinson’s Disease

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Kim, Ryul; Kim, Han-Joon; Kim, Aryun; Jang, Mi-Hee; Kim, Hyun Jeong; Jeon, Beomseok

2018-01-01

Objective Two conversion tables between the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) have recently been established for Parkinson’s disease (PD). This study aimed to validate them in Korean patients with PD and to evaluate whether they could be influenced by educational level. Methods A total of 391 patients with PD who undertook both the Korean MMSE and the Korean MoCA during the same session were retrospectively assessed. The mean, median, and root mean squared error (RMSE) of the difference between the true and converted MMSE scores and the intraclass correlation coefficient (ICC) were calculated according to educational level (6 or fewer years, 7–12 years, or 13 or more years). Results Both conversions had a median value of 0, with a small mean and RMSE of differences, and a high correlation between the true and converted MMSE scores. In the classification according to educational level, all groups had roughly similar values of the median, mean, RMSE, and ICC both within and between the conversions. Conclusion Our findings suggest that both MMSE-MoCA conversion tables are useful instruments for transforming MoCA scores into converted MMSE scores in Korean patients with PD, regardless of educational level. These will greatly enhance the utility of the existing cognitive data from the Korean PD population in clinical and research settings. PMID:29316782

Cognitive-Behavioral-Based Physical Therapy for Patients With Chronic Pain Undergoing Lumbar Spine Surgery: A Randomized Controlled Trial.

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Archer, Kristin R; Devin, Clinton J; Vanston, Susan W; Koyama, Tatsuki; Phillips, Sharon E; George, Steven Z; McGirt, Matthew J; Spengler, Dan M; Aaronson, Oran S; Cheng, Joseph S; Wegener, Stephen T

2016-01-01

The purpose of this study was to determine the efficacy of a cognitive-behavioral-based physical therapy (CBPT) program for improving outcomes in patients after lumbar spine surgery. A randomized controlled trial was conducted on 86 adults undergoing a laminectomy with or without arthrodesis for a lumbar degenerative condition. Patients were screened preoperatively for high fear of movement using the Tampa Scale for Kinesiophobia. Randomization to either CBPT or an education program occurred at 6 weeks after surgery. Assessments were completed pretreatment, posttreatment and at 3-month follow-up. The primary outcomes were pain and disability measured by the Brief Pain Inventory and Oswestry Disability Index. Secondary outcomes included general health (SF-12) and performance-based tests (5-Chair Stand, Timed Up and Go, 10-Meter Walk). Multivariable linear regression analyses found that CBPT participants had significantly greater decreases in pain and disability and increases in general health and physical performance compared with the education group at the 3-month follow-up. Results suggest a targeted CBPT program may result in significant and clinically meaningful improvement in postoperative outcomes. CBPT has the potential to be an evidence-based program that clinicians can recommend for patients at risk for poor recovery after spine surgery. This study investigated a targeted cognitive-behavioral-based physical therapy program for patients after lumbar spine surgery. Findings lend support to the hypothesis that incorporating cognitive-behavioral strategies into postoperative physical therapy may address psychosocial risk factors and improve pain, disability, general health, and physical performance outcomes. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

Maternal education, anthropometric markers of malnutrition and cognitive function (ELSA-Brasil).

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Araújo, Larissa Fortunato; Giatti, Luana; Chor, Dora; Passos, Valéria Maria Azeredo; Barreto, Sandhi Maria

2014-07-02

The early exposure to poor social and nutritional conditions may influence cognitive function during adult age. However, the relative impact of these factors has not yet been established and they can vary during the course of life. Analysis of data from 12,997 participants (35-64 years) of the baseline exams (2008-2010) of the Longitudinal Study of Adult Health (ELSA-Brasil), a cohort of Brazilian civil servants. Four cognitive tests were applied: learning, recall and word recognition; semantic and phonemic verbal fluency; trail-making test version B. The markers of early nutritional and social conditions were maternal educational level, birth weight, and length of trunk and leg. The presence of independent association between every early marker and the poor performance in each cognitive test was investigated by multiple logistic regression, after mutual adjustment and considering the effects of gender, age and participant's schooling level. The cut off for poor performance was the worst age-specific percentile of the final score distribution for each test. After full adjustments, lower maternal education increased the chances of poor performance in all cognitive tests, with a dose-response gradient; low birth-weight was related to poor performance in the trail-making test B (OR = 1.63, 95% IC = 1.29-2.06); and greater trunk length decreased the chances of poor performance in the semantic and phonemic verbal fluency (OR = 0.96, 95% IC = 0.94-0.97) and in the trail-making test B (OR = 0.94, 95% IC = 0.92-0.95). Leg length was not associated with any of the tests examined. The associations found were not modified by the educational attainment of the participants. Early exposure to adverse social and nutritional conditions appear detrimental to semantic memory, learning, concentration, executive control and language among adults, independent of adulthood educational achievement.

Regular Latin Dancing and Health Education may Improve Cognition of Late Middle-Aged and Older Latinos

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Marquez, David X.; Wilson, Robert; Aguiñaga, Susan; Vásquez, Priscilla; Fogg, Louis; Yang, Zhi; Wilbur, JoEllen; Hughes, Susan; Spanbauer, Charles

2017-01-01

Disparities exist between Latinos and non-Latino whites in cognitive function. Dance is culturally appropriate and challenges individuals physically and cognitively, yet the impact of regular dancing on cognitive function in older Latinos has not been examined. A two-group pilot trial was employed among inactive, older Latinos. Participants (N = 57) participated in the BAILAMOS© dance program or a health education program. Cognitive test scores were converted to z-scores and measures of global cognition and specific domains (executive function, episodic memory, working memory) were derived. Results revealed a group × time interaction for episodic memory (pdance group showed greater improvement in episodic memory than the health education group. A main effect for time for global cognition (pdance programs can positively influence episodic memory; and participation in structured programs may improve overall cognition among older Latinos. PMID:28095105

Computer-aided cognitive rehabilitation improves cognitive performances and induces brain functional connectivity changes in relapsing remitting multiple sclerosis patients: an exploratory study.

Science.gov (United States)

Bonavita, S; Sacco, R; Della Corte, M; Esposito, S; Sparaco, M; d'Ambrosio, A; Docimo, R; Bisecco, A; Lavorgna, L; Corbo, D; Cirillo, S; Gallo, A; Esposito, F; Tedeschi, G

2015-01-01

To better understand the effects of short-term computer-based cognitive rehabilitation (cCR) on cognitive performances and default mode network (DMN) intrinsic functional connectivity (FC) in cognitively impaired relapsing remitting (RR) multiple sclerosis (MS) patients. Eighteen cognitively impaired RRMS patients underwent neuropsychological evaluation by the Rao's brief repeatable battery and resting-state functional magnetic resonance imaging to evaluate FC of the DMN before and after a short-term (8 weeks, twice a week) cCR. A control group of 14 cognitively impaired RRMS patients was assigned to an aspecific cognitive training (aCT), and underwent the same study protocol. Correlations between DMN and cognitive performances were also tested. After cCR, there was a significant improvement of the following tests: SDMT (p Color-Word Interference Test and FC in the PCC emerged. After aCT, the control group did not show any significant effect either on FC or neuropsychological tests. No significant differences were found in brain volumes and lesion load in both groups when comparing data acquired at baseline and after cCR or aCT. In cognitively impaired RRMS patients, cCR improves cognitive performances (i.e., processing speed and visual and verbal sustained memory), and increases FC in the PCC and IPC of the DMN. This exploratory study suggests that cCR may induce adaptive cortical reorganization favoring better cognitive performances, thus strengthening the value of cognitive exercise in the general perspective of building either cognitive or brain reserve.

Self-reflection and set-shifting mediate awareness in cognitively preserved schizophrenia patients.

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Gilleen, James; David, Anthony; Greenwood, Kathryn

2016-05-01

Poor insight in schizophrenia has been linked to poor cognitive functioning, psychological processes such as denial, or more recently with impaired metacognitive capacity. Few studies, however, have investigated the potential co-dependency of multiple factors in determining level of insight, but such a model is necessary in order to account for patients with good cognitive functioning who have very poor awareness. As evidence suggests that set-shifting and cognitive insight (self-reflection (SR) and self-certainty) are strong predictors of awareness we proposed that these factors are key mediators in the relationship between cognition and awareness. We hypothesised that deficits specifically in SR and set-shifting determine level of awareness in the context of good cognition. Thirty schizophrenia patients were stratified by high and low awareness of illness and executive functioning scores. Cognitive insight, cognition, mood and symptom measures were compared between sub-groups. A low insight/high executive functioning (LI-HE) group, a high insight/high executive functioning (HI-HE) group and a low insight/low executive functioning (LI-LE) group were revealed. As anticipated, the LI-HE patients showed significantly lower capacity for SR and set-shifting than the HI-HE patients. This study indicates that good cognitive functioning is necessary but not sufficient for good awareness; good awareness specifically demands preserved capacity to self-reflect and shift-set. Results support Nelson and Narens' [1990. Metamemory: A theoretical framework and new findings. The Psychology of Learning and Motivation, 26, 125-173] model of metacognition by which awareness is founded on control (set-shifting) and monitoring (SR) processes. These specific factors could be targeted to improve insight in patients with otherwise unimpaired cognitive function.

Guidelines for cognitive behavioral training within doctoral psychology programs in the United States: report of the Inter-organizational Task Force on Cognitive and Behavioral Psychology Doctoral Education.

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Klepac, Robert K; Ronan, George F; Andrasik, Frank; Arnold, Kevin D; Belar, Cynthia D; Berry, Sharon L; Christofff, Karen A; Craighead, Linda W; Dougher, Michael J; Dowd, E Thomas; Herbert, James D; McFarr, Lynn M; Rizvi, Shireen L; Sauer, Eric M; Strauman, Timothy J

2012-12-01

The Association for Behavioral and Cognitive Therapies initiated an interorganizational task force to develop guidelines for integrated education and training in cognitive and behavioral psychology at the doctoral level in the United States. Fifteen task force members representing 16 professional associations participated in a year-long series of conferences, and developed a consensus on optimal doctoral education and training in cognitive and behavioral psychology. The recommendations assume solid foundational training that is typical within applied psychology areas such as clinical and counseling psychology programs located in the United States. This article details the background, assumptions, and resulting recommendations specific to doctoral education and training in cognitive and behavioral psychology, including competencies expected in the areas of ethics, research, and practice. Copyright © 2012. Published by Elsevier Ltd.

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

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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.

Cognitive functions in the euthymic patients with bipolar disorder

International Nuclear Information System (INIS)

Ozdel, O.; Karadag, F.; Atesci, Figen C.; Oguzhanoglu, N.K.; Cabuk, T.

2007-01-01

Recent studies have focused on the nature of dysfunction in bipolar patients. The purpose of the current study was to investigate cognitive performance of individuals with bipolar disorder compared to healthy control subjects during a well-established euthymic period. The sample consisted of 27 bipolar euthymic patients and 21 control subjects. Verbal and visual memory performance, attention, executive functions and psychological functions were evaluated for each participant. Bipolar patients showed significant attentional deficit and executive dysfunction and also poor performance on verbal and visual memory tasks compared to the controls. Illness duration and lifetime total episode number and previous episode with psychotic features was associated with worsened performance on attention, executive and memory tasks. Psychological functioning was not associated with cognitive deficit. The present study showed persistent cognitive impairment on inhibitory control and selective attention as well as poor performance on verbal and visual memory tests in a group of bipolar euthymic patients. The impaired neuropsychological performance was associated with psychotic features. Attentional dysfunction seemed to be a trait abnormality for the sample studied. (author)

Vascular Risk as a Predictor of Cognitive Decline in a Cohort of Elderly Patients with Mild to Moderate Dementia

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Pedro K. Curiati

2014-10-01

Full Text Available Background/Aims: The purpose of our study was to evaluate vascular risk factors and other clinical variables as predictors of cognitive and functional decline in elderly patients with mild to moderate dementia. Methods: The clinical characteristics of 82 elderly patients (mean age 79.0 ± 5.9 years; 67.1% females with mild to moderate dementia were obtained at baseline, including years of education, Framingham Coronary Heart Disease Risk score, Hachinski Ischemic Score (HIS, Clinical Dementia Rating (CDR, Mini-Mental State Examination (MMSE score, Functional Activities Questionnaire (FAQ score, Burden Interview Scale score, and Neuropsychiatric Inventory (NPI score. Changes in MMSE and FAQ scores over time were assessed annually. The association between baseline clinical variables and cognitive and functional decline was investigated during 3 years of follow-up through the use of generalized linear mixed effects models. Results: A trend was found towards steeper cognitive decline in patients with less vascular burden according to the HIS (β = 0.056, p = 0.09, better cognitive performance according to the CDR score (β = 0.313, p = 0.06 and worse caregiver burden according to the Burden Interview Scale score (β = -0.012, p = 0.07 at baseline. Conclusion: Further studies with larger samples are necessary to confirm and expand our findings.

Utility and limitations of Addenbrooke's Cognitive Examination-Revised for detecting mild cognitive impairment in Parkinson's disease.

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Komadina, Natalie C; Terpening, Zoe; Huang, Yue; Halliday, Glenda M; Naismith, Sharon L; Lewis, Simon J G

2011-01-01

To evaluate the utility of the Addenbrooke's Cognitive Examination-Revised (ACE-R) as a screening tool for mild cognitive impairment in Parkinson's disease (PD-MCI). PD patients underwent comprehensive neuropsychological and neurological evaluations and ACE-R assessment. The ACE-R was superior to the Mini-Mental State Exam (MMSE) in detecting PD-MCI, with a cutoff score of ≤93 offering a sensitivity of 61% and a specificity of 64%. The utility of the ACE-R in detecting PD-MCI is largely influenced by the fluency sub-domain score, and has optimal discriminability when utilized in patients with lower levels of education (≤12 years of formal schooling). The ACE-R must be used cautiously as a screening tool for PD-MCI, with results being most influenced by its fluency sub-domain score and patient education levels. Copyright © 2011 S. Karger AG, Basel.

Validity of Addenbrooke's Cognitive Examination to Discriminate between Incipient Dementia and Depression in Elderly Patients of a Private Clinic in Lima, Peru.

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Herrera-Pérez, Eder; Custodio, Nilton; Lira, David; Montesinos, Rosa; Bendezu, Liliana

2013-01-01

Dementia and depression are different clinical conditions, but share common features, and can be indistinguishable in the initial disease stages. We aimed to establish whether the Peruvian version of the Addenbrooke's Cognitive Examination (ACE-Peru) can distinguish between the cognitive profile in patients with incipient dementia and that in patients with depression. This was a cross-sectional study to assess the performance on the ACE-Peru of 193 elderly subjects (102 with dementia, 21 with depression, and 70 healthy controls). Depending on the diagnosis, there were two groups of cognitive impairment (CI) - the primary neurodegenerative (PN-CI) subtype and the secondary to depression (SD-CI) subtype - as well as a non-CI group. The area under the curve (AUC) of the receiver-operating characteristic curve was determined to compare the diagnostic performance, using the diagnosis of CI as the gold standard. In our sample of elderly subjects aged 59-82 years with at least 7 years of education, the ACE-Peru showed a significantly better performance than the MMSE (AUC = 0.997 vs. AUC = 0.887; p cognitive profile in patients with incipient dementia and that in patients with depression.

Reduced prefrontal activation during working and long-term memory tasks and impaired patient-reported cognition among cancer survivors postchemotherapy compared with healthy controls.

Science.gov (United States)

Wang, Lei; Apple, Alexandra C; Schroeder, Matthew P; Ryals, Anthony J; Voss, Joel L; Gitelman, Darren; Sweet, Jerry J; Butt, Zeeshan A; Cella, David; Wagner, Lynne I

2016-01-15

Patients who receive adjuvant chemotherapy have reported cognitive impairments that may last for years after the completion of treatment. Working memory-related and long-term memory-related changes in this population are not well understood. The objective of this study was to demonstrate that cancer-related cognitive impairments are associated with the under recruitment of brain regions involved in working and recognition memory compared with controls. Oncology patients (n = 15) who were receiving adjuvant chemotherapy and had evidence of cognitive impairment according to neuropsychological testing and self-report and a group of age-matched, education group-matched, cognitively normal control participants (n = 14) underwent functional magnetic resonance imaging. During functional magnetic resonance imaging, participants performed a nonverbal n-back working memory task and a visual recognition task. On the working memory task, when 1-back and 2-back data were averaged and contrasted with 0-back data, significantly reduced activation was observed in the right dorsolateral prefrontal cortex for oncology patients versus controls. On the recognition task, oncology patients displayed decreased activity of the left-middle hippocampus compared with controls. Neuroimaging results were not associated with patient-reported cognition. Decreased recruitment of brain regions associated with the encoding of working memory and recognition memory was observed in the oncology patients compared with the control group. These results suggest that there is a reduction in neural functioning postchemotherapy and corroborate patient-reported cognitive difficulties after cancer treatment, although a direct association was not observed. Cancer 2016;122:258-268. © 2015 American Cancer Society. © 2015 American Cancer Society.

Freezing of gait is associated with cognitive impairment in patients with Parkinson disease.

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Yao, Zhiwen; Shao, Yuan; Han, Xiang

2017-08-24

To explore whether the cognitive impairment is correlated with freezing of gait (FOG) in patients with Parkinson disease (PD). A total of 186 patients with Parkinson disease (104 patients with FOG and 82 patients with no clinical history of freezing behavior) and 125 healthy individuals were selected for this study. Neuropsychological assessments, including the scales for outcomes in Parkinson disease cognition, unified Parkinson's disease rating scale, and Hamilton depression/anxiety rating scale etc., were applied to evaluate the patients'cognitive functioning. We found that the scores of Unified Parkinson's Disease Rating Scale (UPDRS) were significantly higher among PD patients with FOG, compared with non-FOG group. We also showed that Mini-Mental State Examination score (MMSE) was lower among subjects with FOG than in patients without FOG. Patients with FOG displayed lower Scales for OUTCOMES: in Parkinson's Disease Cognition (SCOPA-COG) score than non-FOG patients. In addition, significant higher Hamilton Anxiety Rating Scale (HAMD) scores were found in patients with FOG than patients without FOG. Moreover, disease duration, stage of the disease, the severity of motor symptom, increased depressive and anxiety complaints measured by FOG questionnaire were significantly associated with severity of FOG. Meanwhile, we also found that the score of Freezing of Gait Questionnaire (FOGQ) score was negatively correlated with MMSE. Our results demonstrated that FOG is related to impaired cognitive functions in PD patients with FOG. The understanding of impaired cognitive functions in PD patients with FOG can provide evidences for possible therapeutic interventions. Copyright © 2017 Elsevier B.V. All rights reserved.

Improving a newly developed patient-reported outcome for thyroid patients, using cognitive interviewing

DEFF Research Database (Denmark)

Watt, Torquil; Rasmussen, Ase Krogh; Groenvold, Mogens

2008-01-01

Objective To improve a newly developed patient-reported outcome measure for thyroid patients using cognitive interviewing. Methods Thirty-one interviews using immediate retrospective and expansive probing were conducted among patients with non-toxic goiter (n = 4), nodular toxic goiter (n = 5) Gr...

Cognitive factors that influence delayed decision to seek treatment among older patients with acute myocardial infarction in Korea.

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Hwang, Seon Young; Jeong, Myung Ho

2012-06-01

The incidence of acute myocardial infarction (AMI) is rapidly increasing among older adults in Korea. However, the factors associated with a delayed decision to visit a hospital and the reasons for this delay have not been explored adequately among older patients. To determine factors predicting a prehospital delay time of > 6 h and to identify the cognitive barriers in the delayed decision of AMI patients aged ≥ 65 years. This study adopted a mixed methodological approach using quantitative and qualitative analyses. The sample included 94 male and 71 female patients hospitalized for first-time AMI at a university hospital in Korea. Thematic content analysis was used to identify the themes from the qualitative interview data, and multiple logistic regression analysis was used to predict delayed hospital presentation by > 6 h. The median prehospital delay time was 12 h. Low education level, presence of preinfarction angina pain, and attribution of symptoms to a non-cardiac origin were found to be the predicting factors. From the qualitative data, four meaningful themes including 10 subthemes that influenced the delayed decision were identified. Some culturally peculiar themes were found in this Korean sample. Educational strategies that focus on these cognitive decision-making barriers should be planned for elderly Korean at high risk for AMI.

Cognitive remediation therapy for patients with anorexia nervosa: preliminary findings

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Campbell Iain C

2007-06-01

Full Text Available Abstract Background Anorexia nervosa (AN is a severe mental illness. Drug treatments are not effective and there is no established first choice psychological treatment for adults with AN. Neuropsychological studies have shown that patients with AN have difficulties in cognitive flexibility: these laboratory based findings have been used to develop a clinical intervention based on Cognitive Remediation Therapy (CRT which aims to use cognitive exercises to strengthen thinking skills. Aims 1 To conduct a preliminary investigation of CRT in patients with AN 2 to explore whether cognitive training improves performance in set shifting tasks 3 to explore whether CRT exercises are appropriate and acceptable to AN patients 4 to use the data to improve a CRT module for AN patients. Methods Intervention was comprised of ten 45 minute sessions of CRT. Four patients with AN were assessed before and after the ten sessions using five set shifting tests and clinical assessments. At the end, each patient wrote a letter providing feedback on the intervention. Results Post intervention, three of the five set shifting assessments showed a moderate to large effect size in performance and two showed a large effect size in performance, both indicative of improved flexibility. Patients were aware of an improvement in their cognitive flexibility qualitative feedback was generally positive towards CRT. Discussion This preliminary study suggests that CRT changed performance on flexibility tasks and may be beneficial for acute, treatment resistant patients with AN. Feedback gathered from this small case series has enabled modification of the intervention for a future larger study, for example, by linking exercises with real life behavioural tasks and including exercises that encourage global thinking. Conclusion This exploratory study has produced encouraging data supporting the use of CRT in patients with AN: it has also provided insight into how the module should be

Cognitive Training Using a Novel Memory Game on an iPad in Patients with Amnestic Mild Cognitive Impairment (aMCI).

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Savulich, George; Piercy, Thomas; Fox, Chris; Suckling, John; Rowe, James B; O'Brien, John T; Sahakian, Barbara J

2017-08-01

Cognitive training is effective in patients with mild cognitive impairment but does not typically address the motivational deficits associated with older populations with memory difficulties. We conducted a randomized controlled trial of cognitive training using a novel memory game on an iPad in 42 patients with a diagnosis of amnestic mild cognitive impairment assigned to either the cognitive training (n=21; 8 hours of gameplay over 4 weeks) or control (n=21; clinic visits as usual) groups. Significant time-by-pattern-by-group interactions were found for cognitive performance in terms of the number of errors made and trials needed on the Cambridge Neuropsychological Test Automated Battery Paired Associates Learning task (P=.044; P=.027). Significant time-by-group interactions were also found for the Cambridge Neuropsychological Test Automated Battery Paired Associates Learning first trial memory score (P=.002), Mini-Mental State Examination (P=.036), the Brief Visuospatial Memory Test (P=.032), and the Apathy Evaluation Scale (P=.026). Within-group comparisons revealed highly specific effects of cognitive training on episodic memory. The cognitive training group maintained high levels of enjoyment and motivation to continue after each hour of gameplay, with self-confidence and self-rated memory ability improving over time. Episodic memory robustly improved in the cognitive training group. "Gamified" cognitive training may also enhance visuospatial abilities in patients with amnestic mild cognitive impairment. Gamification maximizes engagement with cognitive training by increasing motivation and could complement pharmacological treatments for amnestic mild cognitive impairment and mild Alzheimer's disease. Larger, more controlled trials are needed to replicate and extend these findings. © The Author 2017. Published by Oxford University Press on behalf of CINP.

Gender differences measured by the MATRICS consensus cognitive battery in chronic schizophrenia patients

OpenAIRE

Zhang, Baohua; Han, Mei; Tan, Shuping; De Yang, Fu; Tan, Yunlong; Jiang, Shurong; Zhang, Xiangyang; Huang, Xu-Feng

2017-01-01

Using Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), previous study showed significant gender differences for cognitive deficits in immediate and delayed memory in schizophrenia patients. However, RBANS does not include reasoning and problem solving, and social cognition. These cognitive functions can significantly affect the outcomes and daily life in patients. This study examined the gender differences of cognition using the measurement and treatment research to...

The Neuroscience of Mathematical Cognition and Learning. OECD Education Working Papers, No. 136

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Looi, Chung Yen; Thompson, Jacqueline; Krause, Beatrix; Kadosh, Roi Cohen

2016-01-01

The synergistic potential of cognitive neuroscience and education for efficient learning has attracted considerable interest from the general public, teachers, parents, academics and policymakers alike. This review is aimed at providing 1) an accessible and general overview of the research progress made in cognitive neuroscience research in…

Risk Factors for Postoperative Cognitive Dysfunctions in Elderly Patients

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N. Yu. Ibragimov

2008-01-01

Full Text Available Objective: to study the impact of a wide spectrum of factors on the development of postoperative delirium in elderly patients in relation to the changes in their cognitive functions depending on the type of anesthesia and period after surgery. Subjects and methods. The study covered 100 patients aged 65—90 years who had been electively operated on under general, regional, and combined anesthesia. Their cognitive status was elevated before and 1, 4, and 7 days after surgery, by using the Mini-Mental State Examination (MMSE schedule. The diagnosis was postoperatively established on the basis of interviews, by applying the diagnostic criteria of ICD-10 and DSM-IV (American Psychiatric Association, 1994 and verified by a psychiatrist’s consultation. Results. Seventeen patients developed delirium within the first two days following surgery. Elevated plasma sodium (p<0.000001, leukocytosis (p<0.00002, and postoperative analgesia mode (p<0.02 proved to be statistically significant risk factors for delirium. Worse results of MMSE tests at all postoperative stages than those obtained prior to surgery were significant (p<0.05. Comparing the results obtained on days 1, 4, and 7 showed a significant cognitive improvement. Analysis indicated no significant differences in MMSE changes between the groups of general, regional, and combined anesthesia at all study stages. Conclusion. In elderly patients, surgery and anesthesia lead to a considerable deterioration of cognitive functions even if the development of delirium can be avoided. There is a significant correlation of the development of delirium with leukocytosis, hypernatremia, and postoperative analgesia mode. Key words: anesthesia, postoperative delirium, cognitive status, MMSE, elderly age.

Cognitive functioning in elderly people and the influence of the socio-educative variables - Results from the ELES Study

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Mª Feli González

2013-12-01

Full Text Available Cognitive functioning changes in elderly people. The degree of decline varies across different cognitive abilities and other variables, such as educational level and life-time professional activity, can slow down this process. This study investigates the pattern of cognitive performance in people over 50 years old, taking into account the influence of educational level and profession. Research data were collected during the pilot study of the Longitudinal Aging Study in Spain (ELES in which a representative sample of non-institutionalized Spanish older people was assessed. The following cognitive variables were evaluated: general cognitive functioning, verbal memory, working memory span, visuomotor speed, and language. Differences were found in all cognitive variables in the different age groups, and according to educational level and profession. These differences remained after controlling for the age variable. Population studies provide a global perspective of cognitive performance in older people and help to identify the role of the different associated factors.

Cognitive performance in young adulthood and midlife: Relations with age, sex, and education-The Cardiovascular Risk in Young Finns Study.

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Rovio, Suvi P; Pahkala, Katja; Nevalainen, Jaakko; Juonala, Markus; Salo, Pia; Kähönen, Mika; Hutri-Kähönen, Nina; Lehtimäki, Terho; Jokinen, Eero; Laitinen, Tomi; Taittonen, Leena; Tossavainen, Päivi; Viikari, Jorma; Rinne, Juha O; Raitakari, Olli T

2016-07-01

Age, education, and sex associate with cognitive performance. We investigated associations between age, sex, education, and cognitive performance in young or middle-aged adults and evaluated data reduction methods to optimally capture cognitive performance in our population-based data. This study is part of the Cardiovascular Risk in Young Finns Study. The 3,596 randomly selected subjects (aged 3-18 years in 1980) have been followed up for 30 years. In 2011, a computer-based cognitive testing battery (the Cambridge Neuropsychological Test Automated Battery [CANTAB]) was used to assess several cognitive domains. Principal component analysis, categorical and standardized classifications were applied to the cognitive data. Among 34- to 49-year-old participants, cognitive performance declined with age, while education associated with better cognitive functions in several cognitive domains. Men had higher performance on all cognitive domains except visual or episodic memory, in which women outperformed men. The results were similar regardless of the data reduction method used. The associations between sex, age, education, and cognitive performance are already apparent in young adulthood or middle age. Principal component analyses, categorical and standardized classifications are useful tools to analyze CANTAB cognitive data. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Cognitive deficits in adult patients with brain tumours.

NARCIS (Netherlands)

Taphoorn, M.J.B.; Klein, M.

2004-01-01

Cognitive function, with survival and response on brain imaging, is increasingly regarded as an important outcome measure in patients with brain tumours. This measure provides us with information on a patient's clinical situation and adverse treatment effects. Radiotherapy has been regarded as the

An ethnographic study of the effects of cognitive symptoms in patients with major depressive disorder

DEFF Research Database (Denmark)

Ebert, Bjarke; Miskowiak, Kamilla; Kloster, Morten

2017-01-01

BACKGROUND: The manifestation of major depressive disorder (MDD) may include cognitive symptoms that can precede the onset of MDD and persist beyond the resolution of acute depressive episodes. However, little is known about how cognitive symptoms are experienced by MDD patients and the people...... symptoms in MDD appeared to negatively impact patients' social relationships and patients' ability to handle daily tasks at work and at home; (3) patients' cognitive symptoms also impacted relationships with family members and coworkers; (4) patients' cognitive symptoms increased stress and feelings...... of failure, which in turn seemed to worsen the cognitive symptoms, thereby creating a destructive cycle; and (5) although HCPs recommended that patients re-engage in everyday activities to help overcome their depression, cognitive symptoms seemed to impede such functional recovery. CONCLUSIONS: Taken...

Representational Approach: A Conceptual Framework to Guide Patient Education Research and Practice.

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Arida, Janet A; Sherwood, Paula R; Flannery, Marie; Donovan, Heidi S

2016-11-01

Illness representations are cognitive structures that individuals rely on to understand and explain their illnesses and associated symptoms. The Representational Approach (RA) to patient education offers a theoretically based, clinically useful model that can support oncology nurses to develop a shared understanding of patients' illness representations to collaboratively develop highly personalized plans for symptom management and other important self-management behaviors. This article discusses theoretical underpinnings, practical applications, challenges, and future directions for incorporating illness representations and the RA in clinical and research endeavors.

A systematic review of cognitive performance in patients with childhood craniopharyngioma.

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Özyurt, Jale; Müller, Hermann L; Thiel, Christiane M

2015-10-01

Craniopharyngiomas are rare brain tumors of the sellar/suprasellar region, often adversely affecting patients' physical and psychosocial functioning. Until a few years ago, knowledge on cognitive deficits in craniopharyngioma patients was based on little valid evidence, with considerable inconsistencies across studies. Findings from recent research, with partly larger sample sizes, add to existing evidence to provide a more clear and reliable picture. The current review aims to summarize and systemize current findings on cognitive deficits in childhood craniopharyngioma, taking account of patient- and treatment-related variables where possible. Those studies were included that reported results of childhood craniopharyngioma patients tested with formalized neuropsychological tests (irrespective of their age at study, group size ≥10). A systematic assignment of test results to subcomponents of broader cognitive domains (e.g. to specific memory systems and processes) allows for a first comprehensive overview of patterns of spared and impaired cognitive functions. We show that episodic memory recall in particular is impaired, largely sparing other memory components. In accordance with recent knowledge on mammillary function, patients with hypothalamic involvement appear to be at particular risk. Deficits in higher cognitive processes, relying on the integrity of the prefrontal cortex and its subcortical pathways, may also occur, but results are still inconsistent. To gain deeper insight into the pattern of deficits and their association with patient- and treatment-related variables, further multi-site research with larger cohorts is needed.

Cognitive Function and Serum Hormone Levels Are Associated with Gray Matter Volume Decline in Female Patients with Prolactinomas

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Shun Yao

2018-01-01

Full Text Available Background and objectiveCognitive impairments have been reported in patients with hyperprolactinemia; however, there is a lack of knowledge of brain structure alterations relevant to hyperprolactinemia in prolactinomas. Thus, we aimed to identify changes in brain structure in prolactinomas and to determine whether these changes are related to cognitive performance and clinical characteristics.MethodsParticipants were 32 female patients with prolactinomas and 26 healthy controls (HC matched for age, sex, education, and handedness. All participants underwent magnetic resonance imaging brain scans, neuropsychological assessments, and clinical evaluations. Voxel-based morphometry analysis was used to identify changes in gray matter volume (GMV. Partial correlation analysis and multiple linear regression were performed to determine the relationship between GMV, cognition, and clinical characteristics.ResultsCompared to HC, patients with prolactinomas demonstrated a decrease in GMV in the left hippocampus, left orbitofrontal cortex, right middle frontal cortex (MFC, and right inferior frontal cortex (IFC. In addition, patients performed worse than controls on tests for verbal memory and executive function, and this was significantly related to the GMV of the left hippocampus and right MFC, respectively. Moreover, in the patients, we found a negative relationship between serum prolactin levels and the GMV of the left hippocampus and right IFC, whereas a positive relationship was found between the GMV of the left hippocampus and serum levels of estradiol and luteinizing hormone.ConclusionIn patients with prolactinomas, specific brain structure abnormalities have been identified and are associated with cognitive impairments and dysfunctional hormones. This study enhances our understanding of brain structure changes that may occur with prolactinomas and provides novel and fundamental evidence for previous behavioral findings relevant to hyperprolactinemia.

Medications Used for Cognitive Enhancement in Patients With Schizophrenia, Bipolar Disorder, Alzheimer's Disease, and Parkinson's Disease.

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Hsu, Wen-Yu; Lane, Hsien-Yuan; Lin, Chieh-Hsin

2018-01-01

Cognitive impairment, which frequently occurs in patients with schizophrenia, bipolar disorder, Alzheimer's disease, and Parkinson's disease, has a significant impact on the daily lives of both patients and their family. Furthermore, since the medications used for cognitive enhancement have limited efficacy, the issue of cognitive enhancement still remains a clinically unsolved challenge. We reviewed the clinical studies (published between 2007 and 2017) that focused on the efficacy of medications used for enhancing cognition in patients with schizophrenia, bipolar disorder, Alzheimer's disease, and Parkinson's disease. Acetylcholinesterase inhibitors and memantine are the standard treatments for Alzheimer's disease and Parkinson's disease. Some studies have reported selective cognitive improvement in patients with schizophrenia following galantamine treatment. Newer antipsychotics, including paliperidone, lurasidone, aripiprazole, ziprasidone, and BL-1020, have also been reported to exert cognitive benefits in patients with schizophrenia. Dopaminergic medications were found to improve language function in patients with Parkinson's disease. However, no beneficial effects on cognitive function were observed with dopamine agonists in patients with schizophrenia. The efficacies of nicotine and its receptor modulators in cognitive improvement remain controversial, with the majority of studies showing that varenicline significantly improved the cognitive function in schizophrenic patients. Several studies have reported that N -methyl-d-aspartate glutamate receptor (NMDAR) enhancers improved the cognitive function in patients with chronic schizophrenia. NMDAR enhancers might also have cognitive benefits in patients with Alzheimer's disease or Parkinson's disease. Raloxifene, a selective estrogen receptor modulator, has also been demonstrated to have beneficial effects on attention, processing speed, and memory in female patients with schizophrenia. Clinical trials with

Boosting Cognition With Music in Patients With Disorders of Consciousness.

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Castro, Maïté; Tillmann, Barbara; Luauté, Jacques; Corneyllie, Alexandra; Dailler, Frédéric; André-Obadia, Nathalie; Perrin, Fabien

2015-09-01

Music listening conveys beneficial effects on cognitive processes in both normal and pathologic cerebral functioning. Surprisingly, no quantitative study has evaluated the potential effects of music on cognition and consciousness in patients with disorders of consciousness. The aim of the present study was to evaluate the effect of music on cerebral processing in patients with disorders of consciousness. Using bedside electroencephalographic recording, we acquired in 13 patients with disorders of consciousness event-related potentials to the patient's first name after either an excerpt of the patient's preferred music (music condition) or a continuous sound (control condition). The cerebral response to the patient's first name was more often observed in the music condition, than in the control condition. Furthermore, the presence or absence of a discriminative response in the music condition seemed to be associated with a favorable or unfavorable outcome, respectively. These findings demonstrate for the first time that music has a beneficial effect on cognitive processes of patients with disorders of consciousness. The autobiographical characteristics of music, that is, its emotional and personal relevance, probably increase arousal and/or awareness. © The Author(s) 2015.

Role of Educational Status in Explaining the Association between Body Mass Index and Cognitive Function

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Ho, Yi-Te; Kao, Tung-Wei; Peng, Tao-Chun; Liaw, Fang-Yih; Yang, Hui-Fang; Sun, Yu-Shan; Chang, Yaw-Wen; Chen, Wei-Liang

2016-01-01

Abstract Preserving physical and cognitive function becomes an important issue as people age. A growing number of studies have found that the correlation between body mass index (BMI) and cognitive function changes in different age groups. It is obvious that higher educational status is linked to higher cognitive function in terms of numerous risk factors that influence cognitive function. This study aimed to investigate the interplay between obesity and cognitive function categorized by diff...

Educational needs for improving self-care in heart failure patients with diabetes.

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Cha, EunSeok; Clark, Patricia C; Reilly, Carolyn Miller; Higgins, Melinda; Lobb, Maureen; Smith, Andrew L; Dunbar, Sandra B

2012-01-01

To explore the need for self-monitoring and self-care education in heart failure patients with diabetes (HF- DM patients) by describing cognitive and affective factors to provide guidance in developing effective self-management education. A cross-sectional correlation design was employed using baseline patient data from a study testing a 12-week patient and family dyad intervention to improve dietary and medication-taking self-management behaviors in HF patients. Data from 116 participants recruited from metropolitan Atlanta area were used. Demographic and comorbidities, physical function, psychological distress, relationship with health care provider, self-efficacy (medication taking and low sodium diet), and behavioral outcomes (medications, dietary habits) were assessed. Descriptive statistics and a series of chi-square tests, t tests, or Mann-Whitney tests were performed to compare HF patients with and without DM. HF-DM patients were older and heavier, had more comorbidities, and took more daily medications than HF patients. High self-efficacy on medication and low-sodium diet was reported in both groups with no significant difference. Although HF-DM patients took more daily medications than HF, both groups exhibited high HF medication-taking behaviors. The HF-DM patients consumed significantly lower total sugar than HF patients but clinically higher levels of sodium. Diabetes educators need to be aware of potential conflicts of treatment regimens to manage 2 chronic diseases. Special and integrated diabetes self-management education programs that incorporate principles of HF self-management should be developed to improve self-management behavior in HF-DM patients.

Progression and effect of cognitive-behavioral changes in patients with amyotrophic lateral sclerosis.

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Bock, Meredith; Duong, Y-Nhy; Kim, Anthony; Allen, Isabel; Murphy, Jennifer; Lomen-Hoerth, Catherine

2017-12-01

To prospectively evaluate the progression of cognitive-behavioral function in amyotrophic lateral sclerosis (ALS) and examine the association of cognitive-behavioral deficits with disease progression, patient quality of life (QOL), and caregiver burden. We evaluated cognitive-behavioral function using the Amyotrophic Lateral Sclerosis Cognitive Behavioral Screen at enrollment and after 7 months in a cohort of patients with ALS. Paired t tests were used to evaluate the change in the 2 assessments. Linear regression and Kruskal-Wallis tests were applied to investigate how initial cognitive or behavioral status related to outcomes. The mean test-retest interval was 6.8 months (SD 1.6). Cognitive status of the study population (n = 49) overall did not change over the study period ( p = 0.06) despite progression of motor weakness ( p cognitive change. Patients initially classified as behaviorally normal showed increased behavioral problems over time ( t = -2.8, p = 0.009). Decline in cognitive (β = -1.3, p = 0.03) and behavioral (β = -0.76, p = 0.002) status predicted increasing caregiver burden. Behavioral abnormalities predicted decline in forced vital capacity and ALS Functional Rating Scale-Revised score ( p = 0.008, 0.012) in the study population and patient QOL in the most severely affected group ( t = 4.3, p = 0.003). Cognitive-behavioral change is a key aspect of disease heterogeneity in ALS. Executive function in ALS overall remains stable over 7 months as detected by an administered screening tool. However, patients may develop caregiver-reported behavioral symptoms in that time period. Screening for caregiver-reported symptoms has a particular utility in predicting future clinical decline, increased caregiver burden, and worsening patient QOL.

Active videogames and cognition. Educational proposals in adolescents