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Sample records for early cognitive impairment

  1. Relation between cognitive impairment and early death in the elderly.

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    Eagles, J M; Beattie, J A; Restall, D B; Rawlinson, F; Hagen, S; Ashcroft, G W

    1990-01-01

    STUDY OBJECTIVE--To study the association between cognitive impairment and early death in elderly patients living in the community. DESIGN--Case-control study of 410 patients assessed by the mental status questionnaire and followed up after three years. SETTING--A general practice in Inverurie, Aberdeenshire, with 14,000 patients. PATIENTS--205 Patients aged greater than or equal to 65 with cognitive impairment according to the mental status questionnaire (score less than or equal to 8) and 205 patients scoring greater than 8 on the questionnaire matched for age and sex. MAIN OUTCOME MEASURE--Death. RESULTS--The relative risk of death in the cognitively impaired patients overall was 3.5. Those patients who scored less than or equal to 7 on the mental status questionnaire were five times more likely to die than their controls. There was no difference in risk of death between those with severe or moderate cognitive impairment. CONCLUSIONS--Cognitive impairment is associated with early death. PMID:2106935

  2. Variability in performance: Identifying early signs of future cognitive impairment

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    Gamaldo, Alyssa A.; An, Yang; Allaire, Jason C.; Kitner-Triolo, Melissa H.; Zonderman, Alan B.

    2012-01-01

    Objective The current study examined whether year-to-year variability in cognitive performance differ between individuals cognitively unimpaired and individuals who subsequently develop dementia. Method Analyses included a case-control sample of Baltimore Longitudinal Study of Aging (BLSA; M age = 69.90, SD = 8.92) participants. One hundred and thirty five clinically diagnosed demented participants were matched with 135 non-demented participants based on age at initial testing and sex. Cognitive performance was examined using measures of memory, executive function, attention, language, and global mental status performance. Cognitive performance was examined from baseline to 5 years before cognitive impairment (mean assessments = 3.03, SD = 2.80). Results Compared to unimpaired individuals, individuals diagnosed with dementia had greater variability on measures of attention, executive function, language, and semantic memory at least 5 years before the estimated onset of cognitive impairment, which may be indicative of maladaptive cognitive functioning. The dementia cases, however, had less variability on visual memory than the unimpaired group, which may suggest that these cases had more difficulty learning. Conclusions These results demonstrate that performance variability indexed over annual or biennial visits may be useful in identifying early signs of subsequent cognitive impairment. PMID:22746310

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

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

    2016-10-01

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

  4. Cognitive impairment in school-aged children with early trauma.

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    Bücker, Joana; Kapczinski, Flavio; Post, Robert; Ceresér, Keila M; Szobot, Claudia; Yatham, Lakshmi N; Kapczinski, Natalia S; Kauer-Sant'Anna, Márcia

    2012-08-01

    Exposure to traumatic events during childhood is often associated with the development of psychiatric disorders, cognitive impairment, and poor functioning in adulthood. However, few studies have examined cognitive function, including executive function, memory, and attention, in school-aged children with early trauma compared with age- and sex-matched controls. We recruited 30 medication-naive children between 5 and 12 years of age with a history of early severe trauma from a foster care home, along with 30 age- and sex-matched controls. Psychiatric diagnoses were based on Kiddie Schedule for Affective Disorders and Schizophrenia Epidemiologic Version (K-SADS-E) for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria and were confirmed with a clinical interview. The neuropsychologic battery was tailored to assess broad cognitive domains such as learning/working memory, executive function, attention, verbal/premorbid intellectual functioning, and impulsivity. There was a higher prevalence of subsyndromal symptoms in children with a history of childhood trauma, although they rarely met all of the diagnostic criteria for a disorder. Moreover, lower estimated intellectual functioning scores were associated with subsyndromal symptoms in children with a history of trauma, and they performed more poorly on the Digits Span Test of the Wechsler Intelligence Scale for Children-III Edition, suggesting attention impairment. There is a high prevalence of subsyndromal symptoms in school-aged children with trauma and an attention impairment, which may contribute to a cumulative deficit early in cognitive development. These findings further support the need for early interventions that can prevent cognitive impairment when childhood trauma occurs.

  5. The Early Indicators of Functional Decrease in Mild Cognitive Impairment

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    Kubicki, Alexandre; Fautrelle, Lilian; Bourrelier, Julien; Rouaud, Olivier; Mourey, France

    2016-01-01

    Objectives: Motor deficiency is associated with cognitive frailty in patients with Mild Cognitive Impairments (MCI). In this study we aimed to test the integrity in muscle synergies involved in an arm-pointing movement in functionally unimpaired MCI patients. We hypothesized that early motor indicators exist in this population at a preclinical level. Methods: Electromyographic signals were collected for 11 muscles in 3 groups: Young Adults (YA), Older Adults (OA), and MCI patients. The OA and MCI groups presented the same functional status. Each subject performed 20 arm-pointing movements from a standing position. Results: The main differences were (1) an earlier activation of the left Obliquus internus in MCI compared with OA group, (2) an earlier activation for the MCI compared with both OA and YA. The temporal differences in muscle synergies between MCI and OA groups were linked with executive functions of MCI patients, assessed by the trail making test. Moreover, the results show a delayed activation of the right Biceps Femoris and the right Erector Spinae at l3 in MCI and OA compared with YA. Interpretation: The motor program changes highlighted in our patient MCI group suggest that discrete modifications of the motor command seem to exist even in the absence of functional impairment. Instead of showing an indication of delayed muscle activation in the MCI patients, our results highlight some early activation of several trunk muscles. PMID:27570509

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

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

    2010-01-01

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

  7. Early Functional Limitations in Cognitively Normal Older Adults Predict Diagnostic Conversion to Mild Cognitive Impairment.

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    Farias, Sarah Tomaszewski; Lau, Karen; Harvey, Danielle; Denny, Katherine G; Barba, Cheyanne; Mefford, Anthony N

    2017-06-01

    To examine whether specific types of early functional limitations in cognitively normal older adults are associated with subsequent development of mild cognitive impairment (MCI), as well as the relative predictive value of self versus informant report in predicting diagnostic conversion to MCI. As a part of a longitudinal study design, participants underwent baseline and annual multidisciplinary clinical evaluations, including a physical and neurological examination, imaging, laboratory work, and neuropsychological testing. Data used in this study were collected as part of longitudinal research at the University of California, Davis Alzheimer's Disease Center. Individuals diagnosed as having normal cognition at study baseline who had an informant who could complete informant-based ratings and at least one follow-up visit (N = 324). Participants and informants each completed the Everyday Cognition Scale (ECog), an instrument designed to measure everyday function in six cognitively relevant domains. Self- and informant-reported functional limitations on the ECog were associated with significantly greater risk of diagnostic conversion to MCI (informant: hazard ratio (HR) = 2.0, 95% confidence interval (CI) = 1.3-3.2, P = .002), with self-report having a slightly higher hazard (HR = 2.3, 95% CI = 1.4-3.6, P cognitive abilities, the effect remained significant for self- and informant-reported functional limitations. Deficits in everyday memory and executive function domains were the strongest predictors of diagnostic conversion to MCI. Detection of early functional limitations may be clinically useful in assessing the future risk of developing cognitive impairment in cognitively normal older adults. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  8. The Dissociation between Polarity, Semantic Orientation, and Emotional Tone as an Early Indicator of Cognitive Impairment

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    Arias Tapia, Susana A.; Martínez-Tomás, Rafael; Gómez, Héctor F.; Hernández del Salto, Víctor; Sánchez Guerrero, Javier; Mocha-Bonilla, J. A.; Barbosa Corbacho, José; Khan, Azizudin; Chicaiza Redin, Veronica

    2016-01-01

    The present study aims to identify early cognitive impairment through the efficient use of therapies that can improve the quality of daily life and prevent disease progress. We propose a methodology based on the hypothesis that the dissociation between oral semantic expression and the physical expressions, facial gestures, or emotions transmitted in a person's tone of voice is a possible indicator of cognitive impairment. Experiments were carried out with phrases, analyzing the semantics of the message, and the tone of the voice of patients through unstructured interviews in healthy people and patients at an early Alzheimer's stage. The results show that the dissociation in cognitive impairment was an effective indicator, arising from patterns of inconsistency between the analyzed elements. Although the results of our study are encouraging, we believe that further studies are necessary to confirm that this dissociation is a probable indicator of cognitive impairment. PMID:27683555

  9. Cognitive impairment in early-stage non-demented Parkinson's disease patients

    DEFF Research Database (Denmark)

    Pfeiffer, Helle Cecilie Viekilde; Løkkegaard, A; Zoetmulder, Marielle

    2013-01-01

    In Parkinson's disease (PD), Parkinson's disease dementia (PDD) and Parkinson's disease-mild cognitive impairment (PD-MCI) are common. PD-MCI is a risk factor for developing PDD. Knowledge of cognition in early-stages PD is essential in understanding and predicting the dementia process....

  10. Predictors of Mild Cognitive Impairment in Early-Stage Parkinson's Disease

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    Brenda Hanna-Pladdy

    2013-05-01

    Full Text Available Aim: The aim of this study was to identify mild cognitive deficits in Parkinson's disease (PD prior to extensive neurodegeneration and to evaluate the extent to which dopamine depletion and other disease-related predictors can explain cognitive profiles. Methods: Neuropsychological performances of 40 nondemented early-stage PD patients and 42 healthy controls were compared across on or off dopaminergic medications. Stepwise regression evaluated cognitive predictors of early-stage PD and disease-related predictors of PD cognition (levodopa dose, disease duration, Unified Parkinson's Disease Rating Scale score, sleep, quality of life, and mood across on and off states. Results: Neuropsychological performance was lower in PD patients across cognitive domains with significant memory, naming, visuomotor, and complex attention/executive deficits, but with intact visuospatial, simple attention, and phonemic fluency functions. However, medication effects were absent except for simple attention. Regression analyses revealed age, working memory, and memory recall to be the best cognitive predictors of PD, while age, quality of life, disease duration, and anxiety predicted PD cognition in the off state. Conclusion: Nondemented early-stage PD patients presented with extensive mild cognitive deficits including prominent memory impairment. The profile was inconsistent with expected isolated frontostriatal dysfunction previously attributed to dopamine depletion and this highlights the need to further characterize extranigral sources of mild cognitive impairment in PD.

  11. MRI techniques and cognitive impairment in the early phase of relapsing-remitting multiple sclerosis

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    Zivadinov, R.; De Masi, R.; Nasuelli, D.; Monti Bragadin, L.; Cazzato, G.; Zorzon, M. [Neurological Clinic, Cattinara Hospital, Trieste (Italy); Ukmar, M.; Pozzi-Mucelli, R.S. [Dept. of Radiology, University of Trieste (Italy); Grop, A. [Dept. of Electrical, Electronics and Computer Science, University of Trieste (Italy)

    2001-04-01

    Correlation studies between various conventional and non-conventional MRI parameters and cognitive impairment in the early stages of multiple sclerosis (MS) are lacking, although it is known that a number of patients with early MS have mild cognitive impairment. Our aim was to explore whether this cognitive impairment is dependent on the extent and severity of the burden of disease, diffuse microscopic brain damage or both. We studied 63 patients with clinically definite relapsing-remitting (RR) MS, duration of disease 1-10 years and Expanded disability status scale scores {<=} 5.0. Mean age was 35.4 years, mean duration of disease 5.8 years and median EDSS score 1.5. Neuropsychological performance, psychological function, neurological impairment and disability were assessed. The patients also underwent MRI, including magnetisation-transfer (MT) studies. We quantified the lesion load on T2- and T1-weighted images, the magnetisation transfer ratio (MTR) of normal-appearing brain tissue (NABT) and the brain parenchymal fraction (BPF). No significant difference was found between lesion loads in patients with and without cognitive impairment. In 15 patients (23.8 %) with overall cognitive impairment, median BPF and average NABT MTR were significantly lower than those in patients without cognitive impairment (0.868 vs 0.892, P = 0.02 and 28.3 vs 29.7 P = 0.046, respectively). Multiple regression analysis models demonstrated that the only variables independently correlated with cognitive impairment were: BPF (R = 0.89, P = 0.001) and average NABT MTR (R = 0.76, P = 0.012). Our findings support the hypothesis that, cognitive decline in patients with MS, a low disability score and short duration of disease is directly associated with the extent and severity of diffuse brain damage. The loss of brain parenchyma did not correlate with the severity of microscopic damage in the NABT, indicating that the two processes could be distinct in the early stages of the disease. (orig.)

  12. Early development in Dravet syndrome; visual function impairment precedes cognitive decline.

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    Chieffo, Daniela; Ricci, Daniela; Baranello, Giovanni; Martinelli, Diego; Veredice, Chiara; Lettori, Donatella; Battaglia, Domenica; Dravet, Charlotte; Mercuri, Eugenio; Guzzetta, Francesco

    2011-01-01

    Aim of the study was to describe prospectively the early neuropsychological evolution including the first pre-cognitive stages of the Severe Myoclonic Epilepsy in Infancy (SMEI) or Dravet syndrome. Five cases, four of whom since before a diagnostic evidence of the Dravet syndrome, were followed up. Full clinical assessment including developmental, visual function and behaviour assessments were serially performed. In four cases, a variable onset age of cognitive decline assessed with developmental scales was preceded some months before by an impairment of visual function; the remaining patient during all the course of follow-up till 51 months of age showed a normal development without visual impairment. A cognitive decline with variable onset was generally confirmed in Dravet syndrome. The previous early impairment of visual function seems to herald the cognitive decline and provides useful prognostic information; furthermore, it possibly suggests some clues for a better understanding of the mechanisms of cognitive deterioration in this syndrome. 2010 Elsevier B.V. All rights reserved.

  13. Early treatment of minocycline alleviates white matter and cognitive impairments after chronic cerebral hypoperfusion.

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    Ma, Jing; Zhang, Jing; Hou, Wei Wei; Wu, Xiao Hua; Liao, Ru Jia; Chen, Ying; Wang, Zhe; Zhang, Xiang Nan; Zhang, Li San; Zhou, Yu Dong; Chen, Zhong; Hu, Wei Wei

    2015-01-01

    Subcortical ischemic vascular dementia (SIVD) caused by chronic cerebral hypoperfusion develops with progressive white matter and cognitive impairments, yet no effective therapy is available. We investigated the temporal effects of minocycline on an experimental SIVD exerted by right unilateral common carotid arteries occlusion (rUCCAO). Minocycline treated at the early stage (day 0-3), but not the late stage after rUCCAO (day 4-32) alleviated the white matter and cognitive impairments, and promoted remyelination. The actions of minocycline may not involve the inhibition of microglia activation, based on the effects after the application of a microglial activation inhibitor, macrophage migration inhibitory factor, and co-treatment with lipopolysaccharides. Furthermore, minocycline treatment at the early stage promoted the proliferation of oligodendrocyte progenitor cells (OPCs) in subventricular zone, increased OPC number and alleviated apoptosis of mature oligodendrocytes in white matter. In vitro, minocycline promoted OPC proliferation and increased the percentage of OPCs in S and G2/M phases. We provided direct evidence that early treatment is critical for minocycline to alleviate white matter and cognitive impairments after chronic cerebral hypoperfusion, which may be due to its robust effects on OPC proliferation and mature oligodendrocyte loss. So, early therapeutic time window may be crucial for its application in SIVD.

  14. [Working memory for music in patients with mild cognitive impairment and early stage Alzheimer's disease].

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    Kerer, Manuela; Marksteiner, Josef; Hinterhuber, Hartmann; Mazzola, Guerino; Kemmler, Georg; Bliem, Harald R; Weiss, Elisabeth M

    2013-01-01

    A variety of studies demonstrated that some forms of memory for music are spared in dementia, but only few studies have investigated patients with early stages of dementia. In this pilot-study we tested working memory for music in patients with mild cognitive impairment (MCI) and early stage Alzheimer's disease (AD) with a newly created test. The test probed working memory using 7 gradually elongated tone-lines and 6 chords which were each followed by 3 similar items and 1 identical item. The participants of the study, namely 10 patients with MCI, 10 patients with early stage AD and 23 healthy subjects were instructed to select the identical tone-line or chord. Subjects with MCI and early AD showed significantly reduced performance than controls in most of the presented tasks. In recognizing chords MCI- participants surprisingly showed an unimpaired performance. The gradual increase of the impairment during the preclinical phase of AD seems to spare this special ability in MCI.

  15. The Role of Apolipoprotein E (APOE Genotype in Early Mild Cognitive Impairment (E-MCI

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    Shannon L Risacher

    2013-04-01

    Full Text Available Objective: Our goal was to evaluate the association APOE with amyloid deposition, cerebrospinal fluid levels (CSF of Aβ, tau, and p-tau, brain atrophy, cognition and cognitive complaints in E-MCI patients and cognitively healthy older adults (HC in the ADNI-2 cohort. Methods: 209 E-MCI and 123 HC participants from the ADNI-2 cohort were included. We evaluated the impact of diagnostic status (E-MCI vs. HC and APOE ε4 status (ε4 positive vs. ε4 negative on cortical amyloid deposition (AV-45/Florbetapir SUVR PET scans, brain atrophy (structural MRI scans processed using voxel-based morphometry and Freesurfer version 5.1, CSF levels of Aβ, tau, and p-tau, and cognitive performance and complaints. Results: E-MCI participants showed significantly impaired cognition, higher levels of cognitive complaints, greater levels of tau and p-tau, and subcortical and cortical atrophy relative to HC participants (p<0.05. Cortical amyloid deposition and CSF levels of Aβ were significantly associated with APOE ε4 status but not E-MCI diagnosis, with ε4 positive participants showing more amyloid deposition and lower levels of CSF Aβ than ε4 negative participants. Other effects of APOE ε4 status on cognition and CSF tau levels were also observed.Conclusions: APOE ε4 status is associated with amyloid accumulation and lower CSF Aβ, as well as increased CSF tau levels in early prodromal stages of AD (E-MCI and HC. Alternatively, neurodegeneration, cognitive impairment, and increased complaints are primarily associated with a diagnosis of E-MCI. These findings underscore the importance of considering APOE genotype when evaluating biomarkers in early stages of disease.

  16. Early life instruction in foreign language and music and incidence of mild cognitive impairment.

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    Wilson, Robert S; Boyle, Patricia A; Yang, Jingyun; James, Bryan D; Bennett, David A

    2015-03-01

    To test the hypothesis that foreign language and music instruction in early life are associated with lower incidence of mild cognitive impairment (MCI) and slower rate of cognitive decline in old age. At enrollment in a longitudinal cohort study, 964 older persons without cognitive impairment estimated years of foreign language and music instruction by age 18. Annually thereafter they completed clinical evaluations that included cognitive testing and clinical classification of MCI. There were 264 persons with no foreign language instruction, 576 with 1-4 years, and 124 with > 4 years; 346 persons with no music instruction, 360 with 1-4 years, and 258 with > 4 years. During a mean of 5.8 years of observation, 396 participants (41.1%) developed MCI. In a proportional hazards model adjusted for age, sex, and education, higher levels (> 4 years) of foreign language (hazard ratio [HR] = 0.687, 95% confidence interval [CI] [0.482, 0.961]) and music (HR = 0.708, 95% CI [0.539, 0.930]) instruction by the age of 18 were each associated with reduced risk of MCI. The association persisted after adjustment for other early life indicators of an enriched cognitive environment, and it was stronger for nonamnestic than amnestic MCI. Both foreign language and music instruction were associated with higher initial level of cognitive function, but neither instruction measure was associated with cognitive decline. Higher levels of foreign language and music instruction during childhood and adolescence are associated in old age with lower risk of developing MCI but not with rate of cognitive decline. PsycINFO Database Record (c) 2015 APA, all rights reserved.

  17. Elman neural network for the early identification of cognitive impairment in Alzheimer’s disease

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    Bertè, Francesco; Lamponi, Giuseppe; Calabrò, Rocco Salvatore; Bramanti, Placido

    2014-01-01

    Early detection of dementia can be useful to delay progression of the disease and to raise awareness of the condition. Alterations in temporal and spatial EEG markers have been found in patients with Alzheimer’s disease (AD) and mild cognitive impairment (MCI). Herein, we propose an automatic recognition method of cognitive impairment evaluation based on EEG analysis using an artificial neural network (ANN) combined with a genetic algorithm (GA). The EEGs of 43 AD and MCI patients (aged between 62 and 88 years) were recorded, analyzed and correlated with their MMSE scores. Quantitative EEGs were calculated using discrete wavelet transform. The data obtained were analyzed by the means of the combined use of ANN and GA to determine the degree of cognitive impairment. The good recognition rate of ANN fed with these inputs suggests that the combined GA/ANN approach may be useful for early detection of AD and could be a valuable tool to support physicians in clinical practice. PMID:25014050

  18. Aberrant cerebral network topology and mild cognitive impairment in early Parkinson's disease.

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    Pereira, Joana B; Aarsland, Dag; Ginestet, Cedric E; Lebedev, Alexander V; Wahlund, Lars-Olof; Simmons, Andrew; Volpe, Giovanni; Westman, Eric

    2015-08-01

    The aim of this study was to assess whether mild cognitive impairment (MCI) is associated with disruption in large-scale structural networks in newly diagnosed, drug-naïve patients with Parkinson's disease (PD). Graph theoretical analyses were applied to 3T MRI data from 123 PD patients and 56 controls from the Parkinson's progression markers initiative (PPMI). Thirty-three patients were classified as having Parkinson's disease with mild cognitive impairment (PD-MCI) using the Movement Disorders Society Task Force criteria, while the remaining 90 PD patients were classified as cognitively normal (PD-CN). Global measures (clustering coefficient, characteristic path length, global efficiency, small-worldness) and regional measures (regional clustering coefficient, regional efficiency, hubs) were assessed in the structural networks that were constructed based on cortical thickness and subcortical volume data. PD-MCI patients showed a marked reduction in the average correlation strength between cortical and subcortical regions compared with controls. These patients had a larger characteristic path length and reduced global efficiency in addition to a lower regional efficiency in frontal and parietal regions compared with PD-CN patients and controls. A reorganization of the highly connected regions in the network was observed in both groups of patients. This study shows that the earliest stages of cognitive decline in PD are associated with a disruption in the large-scale coordination of the brain network and with a decrease of the efficiency of parallel information processing. These changes are likely to signal further cognitive decline and provide support to the role of aberrant network topology in cognitive impairment in patients with early PD.

  19. Depression and Cognitive Impairment in Disability-Free Early Multiple Sclerosis

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    Claus G. Haase

    2003-01-01

    Full Text Available Cognitive and emotional capabilities were evaluated in 73 female patients with stable relapsing-remitting definite, and/or laboratory-supported multiple sclerosis (MS and were compared with 32 matched healthy controls. Patients were categorized according to their score in the expanded disability status scale (EDSS to either no (EDSS 0, n = 33 or few clinical signs (EDSS 1–2, n = 40 of MS without physical disability. Patients with EDSS > 0 were characterized by significantly (p These results indicate that depression may present as an early sign in MS followed by cognitive impairment, in particular visuo-spatial short-term memory, before physical disability appears. Neuropsychological tests as mentioned here could serve as early diagnostic tools to detect subtle disease progression and to initiate and monitor disease modifying therapies.

  20. Quality of life and mild cognitive impairment in early Parkinson's disease: does subtype matter?

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    Lawson, Rachael A; Yarnall, Alison J; Duncan, Gordon W; Khoo, Tien K; Breen, David P; Barker, Roger A; Collerton, Daniel; Taylor, John-Paul; Burn, David J

    2014-01-01

    We evaluated the association between mild cognitive impairment (MCI) subtypes and quality of life (QoL) in 219 newly diagnosed Parkinson's disease (PD) patients without dementia. Participants completed neuropsychological tests of attention, executive function, visuospatial function, memory, and language, and reported QoL using the Parkinson's Disease Questionnaire. Impairments were most common in executive function, memory and attention. MCI subtypes were classified according to Movement Disorder Society Task Force criteria. More severe cognitive impairment was associated with poorer quality of life (p = 0.01), but subtype of impairment was not (p > 0.10), suggesting that the nature of cognitive impairment is less significant than its severity.

  1. Microstructural white matter changes, not hippocampal atrophy, detect early amnestic mild cognitive impairment.

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    Lin Zhuang

    Full Text Available BACKGROUND: Alzheimer's disease (AD is generally considered to be characterized by pathology in gray matter of the brain, but convergent evidence suggests that white matter degradation also plays a vital role in its pathogenesis. The evolution of white matter deterioration and its relationship with gray matter atrophy remains elusive in amnestic mild cognitive impairment (aMCI, a prodromal stage of AD. METHODS: We studied 155 cognitively normal (CN and 27 'late' aMCI individuals with stable diagnosis over 2 years, and 39 'early' aMCI individuals who had converted from CN to aMCI at 2-year follow up. Diffusion tensor imaging (DTI tractography was used to reconstruct six white matter tracts three limbic tracts critical for episodic memory function - the fornix, the parahippocampal cingulum, and the uncinate fasciculus; two cortico-cortical association fiber tracts - superior longitudinal fasciculus and inferior longitudinal fasciculus; and one projection fiber tract - corticospinal tract. Microstructural integrity as measured by fractional anisotropy (FA, mean diffusivity (MD, radial diffusivity (RD and axial diffusivity (AxD was assessed for these tracts. RESULTS: Compared with CN, late aMCI had lower white matter integrity in the fornix, the parahippocampal cingulum, and the uncinate fasciculus, while early aMCI showed white matter damage in the fornix. In addition, fornical measures were correlated with hippocampal atrophy in late aMCI, whereas abnormality of the fornix in early aMCI occurred in the absence of hippocampal atrophy and did not correlate with hippocampal volumes. CONCLUSIONS: Limbic white matter tracts are preferentially affected in the early stages of cognitive dysfunction. Microstructural degradation of the fornix preceding hippocampal atrophy may serve as a novel imaging marker for aMCI at an early stage.

  2. Vocabulary Size in Speech May Be an Early Indicator of Cognitive Impairment.

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    Eiji Aramaki

    Full Text Available Little is known about the relationship between mild cognitive impairment (MCI and changes to language abilities. Here, we used the revised Hasegawa Dementia Scale (HDS-R to identify suspected MCI in elderly individuals. We then analyzed written and spoken narratives to compare the language abilities between study participants with and without MCI in order to explore the relationship between cognitive and language abilities, and to identify a possible indicator for the early detection of MCI and dementia. We recruited 22 people aged 74 to 86 years (mean: 78.32 years; standard deviation: 3.36. The participants were requested to write and talk about one of the happiest events in their lives. Based on HDS-R scores, we divided the participants into 2 groups: the MCI Group comprised 8 participants with a score of 26 or lower, while the Healthy Group comprised 14 participants with a score of 27 or higher. The transcriptions of both written and spoken samples for each participant were used in the measurement of NLP-based language ability scores. Our analysis showed no significant differences in writing abilities between the 2 groups in any of the language ability scores. However, analysis of the spoken narrative showed that the MCI Group had a significantly larger vocabulary size. In addition, analysis of a metric that signified the gap in content between the spoken and written narratives also revealed a larger vocabulary size in the MCI Group. Individuals with early-stage MCI may be engaging in behavior to conceal their deteriorating cognition, thereby leading to a temporary increase in their active spoken vocabulary. These results indicate the possible detection of early stages of reduced cognition before dementia onset through the analysis of spoken narratives.

  3. Vocabulary Size in Speech May Be an Early Indicator of Cognitive Impairment.

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    Aramaki, Eiji; Shikata, Shuko; Miyabe, Mai; Kinoshita, Ayae

    2016-01-01

    Little is known about the relationship between mild cognitive impairment (MCI) and changes to language abilities. Here, we used the revised Hasegawa Dementia Scale (HDS-R) to identify suspected MCI in elderly individuals. We then analyzed written and spoken narratives to compare the language abilities between study participants with and without MCI in order to explore the relationship between cognitive and language abilities, and to identify a possible indicator for the early detection of MCI and dementia. We recruited 22 people aged 74 to 86 years (mean: 78.32 years; standard deviation: 3.36). The participants were requested to write and talk about one of the happiest events in their lives. Based on HDS-R scores, we divided the participants into 2 groups: the MCI Group comprised 8 participants with a score of 26 or lower, while the Healthy Group comprised 14 participants with a score of 27 or higher. The transcriptions of both written and spoken samples for each participant were used in the measurement of NLP-based language ability scores. Our analysis showed no significant differences in writing abilities between the 2 groups in any of the language ability scores. However, analysis of the spoken narrative showed that the MCI Group had a significantly larger vocabulary size. In addition, analysis of a metric that signified the gap in content between the spoken and written narratives also revealed a larger vocabulary size in the MCI Group. Individuals with early-stage MCI may be engaging in behavior to conceal their deteriorating cognition, thereby leading to a temporary increase in their active spoken vocabulary. These results indicate the possible detection of early stages of reduced cognition before dementia onset through the analysis of spoken narratives.

  4. Differences in the prevalence of dementia and mild cognitive impairment and cognitive functions between early and delayed responders in a community-based study of the elderly.

    Science.gov (United States)

    Noguchi-Shinohara, Moeko; Yuki, Sohshi; Dohmoto, Chiaki; Ikeda, Yoshihisa; Samuraki, Miharu; Iwasa, Kazuo; Yokogawa, Masami; Asai, Kimiko; Komai, Kiyonobu; Nakamura, Hiroyuki; Yamada, Masahito

    2013-01-01

    Significant differences exist in demographic characteristics between responders and non-responders in population-based studies on mental health and cognitive status, but much less is known regarding differences in the prevalence of dementia and cognitive dysfunction between them. Here we compared the prevalence of dementia and mild cognitive impairment between early responders of a mass brain function examination and delayed responders (non-responders of the mass brain function examination) in a survey of elderly Japanese citizens (≥65 years) to evaluate non-responder bias. All residents in an area of Nakajima, Japan, were considered as potential candidates (n = 783). Participants of a mass brain function examination were considered as "early responders." The cognitive functions of delayed responders were assessed by home visits. To assess the correlation between sociodemographic characteristics and cognitive functions, the early and delayed responders completed the same questionnaires and neuropsychological tests. Delayed responders (n = 320) were significantly older and less educated than the early responders (n = 307). The delayed responders also exhibited a higher frequency of dementia and mild cognitive impairment than the early responders, even when the groups were restricted to the age group 65-89 years. Our results suggest that population-based studies likely underestimate the prevalence of dementia and mild cognitive impairment, especially if the participation rate is low.

  5. Vascular Cognitive Impairment.

    Science.gov (United States)

    Dichgans, Martin; Leys, Didier

    2017-02-03

    Cerebrovascular disease typically manifests with stroke, cognitive impairment, or both. Vascular cognitive impairment refers to all forms of cognitive disorder associated with cerebrovascular disease, regardless of the specific mechanisms involved. It encompasses the full range of cognitive deficits from mild cognitive impairment to dementia. In principle, any of the multiple causes of clinical stroke can cause vascular cognitive impairment. Recent work further highlights a role of microinfarcts, microhemorrhages, strategic white matter tracts, loss of microstructural tissue integrity, and secondary neurodegeneration. Vascular brain injury results in loss of structural and functional connectivity and, hence, compromise of functional networks within the brain. Vascular cognitive impairment is common both after stroke and in stroke-free individuals presenting to dementia clinics, and vascular pathology frequently coexists with neurodegenerative pathology, resulting in mixed forms of mild cognitive impairment or dementia. Vascular dementia is now recognized as the second most common form of dementia after Alzheimer's disease, and there is increasing awareness that targeting vascular risk may help to prevent dementia, even of the Alzheimer type. Recent advances in neuroimaging, neuropathology, epidemiology, and genetics have led to a deeper understanding of how vascular disease affects cognition. These new findings provide an opportunity for the present reappraisal of vascular cognitive impairment. We further briefly address current therapeutic concepts.

  6. Late-Onset Cognitive Impairments after Early-Life Stress Are Shaped by Inherited Differences in Stress Reactivity

    Science.gov (United States)

    McIlwrick, Silja; Pohl, Tobias; Chen, Alon; Touma, Chadi

    2017-01-01

    Early-life stress (ELS) has been associated with lasting cognitive impairments and with an increased risk for affective disorders. A dysregulation of the hypothalamus-pituitary-adrenal (HPA) axis, the body’s main stress response system, is critically involved in mediating these long-term consequences of adverse early-life experience. It remains unclear to what extent an inherited predisposition for HPA axis sensitivity or resilience influences the relationship between ELS and cognitive impairments, and which neuroendocrine and molecular mechanisms may be involved. To investigate this, we exposed animals of the stress reactivity mouse model, consisting of three independent lines selectively bred for high (HR), intermediate (IR), or low (LR) HPA axis reactivity to a stressor, to ELS and assessed their cognitive performance, neuroendocrine function and hippocampal gene expression in early and in late adulthood. Our results show that HR animals that were exposed to ELS exhibited an HPA axis hyper-reactivity in early and late adulthood, associated with cognitive impairments in hippocampus-dependent tasks, as well as molecular changes in transcript levels involved in the regulation of HPA axis activity (Crh) and in neurotrophic action (Bdnf). In contrast, LR animals showed intact cognitive function across adulthood, with no change in stress reactivity. Intriguingly, LR animals that were exposed to ELS even showed significant signs of enhanced cognitive performance in late adulthood, which may be related to late-onset changes observed in the expression of Crh and Crhr1 in the dorsal hippocampus of these animals. Collectively, our findings demonstrate that the lasting consequences of ELS at the level of cognition differ as a function of inherited predispositions and suggest that an innate tendency for low stress reactivity may be protective against late-onset cognitive impairments after ELS. PMID:28261058

  7. Network analysis in detection of early-stage mild cognitive impairment

    Science.gov (United States)

    Ni, Huangjing; Qin, Jiaolong; Zhou, Luping; Zhao, Zhigen; Wang, Jun; Hou, Fengzhen

    2017-07-01

    The detection and intervention for early-stage mild cognitive impairment (EMCI) is of vital importance However, the pathology of EMCI remains largely unknown, making it be challenge to the clinical diagnosis. In this paper, the resting-state functional magnetic resonance imaging (rs-fMRI) data derived from EMCI patients and normal controls are analyzed using the complex network theory. We construct the functional connectivity (FC) networks and employ the local false discovery rate approach to successfully detect the abnormal functional connectivities appeared in the EMCI patients. Our results demonstrate the abnormal functional connectivities have appeared in the EMCI patients, and the affected brain regions are mainly distributed in the frontal and temporal lobes In addition, to quantitatively characterize the statistical properties of FCs in the complex network, we herein employ the entropy of the degree distribution (EDD) index and some other well-established measures, i.e., clustering coefficient (CC) and the efficiency of graph (EG). Eventually, we found that the EDD index, better than the widely used CC and EG measures, may serve as an assistant and potential marker for the detection of EMCI.

  8. APOE and COMT polymorphisms are complementary biomarkers of status, stability, and transitions in normal aging and early mild cognitive impairment

    Directory of Open Access Journals (Sweden)

    Roger A Dixon

    2014-09-01

    Full Text Available Objective: Research has reported associations among selected genetic susceptibility biomarkers and risk of (a normal cognitive aging decrements, (b established mild cognitive impairment (MCI, and (c sporadic Alzheimer’s disease (AD. In focusing on the transitional normal-to-early MCI phase, we examine associations among three theoretically relevant polymorphisms (APOE [rs429358, rs7412], BDNF [rs6265], COMT [rs4680] and both baseline cognitive status (MCI versus normal aging and two-wave (four-year longitudinal stability or change profiles. The latter included three profiles: (a stable as normal aging, (b stable or chronic impairment (MCI-to-MCI, and (c emergence of impairment (normal-to-MCI. Method: Genotyped older adults (n = 237 at baseline; age range = 64-91; 62% women from the Victoria Longitudinal Study were examined for (a independent and interactive associations of three genetic polymorphisms with (b two objectively classified cognitive status groups (not-impaired controls (NIC and MCI at (c both baseline and across a two-wave (four-year longitudinal interval. Results: First, logistic regression revealed that the presence of at least one APOE ε4 allele (the risk factor for AD was linked to greater baseline risk of objective MCI. Second, multinomial logistic regression revealed that (a the presence of an APOE ε4 allele was associated with an increased risk of 4-year MCI status stability (chronicity, and (b the COMT homozygous risk genotype (G/G or Val/Val was associated with an increased risk of both MCI-to-MCI stability (chronicity and emerging NIC-to-MCI conversion. Discussion: Both chronicity and emergence of objectively classified early cognitive impairment may be genetically heterogeneous phenomena, with influences from a panel of both normal cognitive aging (COMT and AD-related (APOE polymorphisms.

  9. Diagnostic Accuracy and Confidence in the Clinical Detection of Cognitive Impairment in Early-Stage Parkinson Disease.

    Science.gov (United States)

    Wyman-Chick, Kathryn A; Martin, Phillip K; Barrett, Matthew J; Manning, Carol A; Sperling, Scott A

    2017-05-01

    Mild cognitive impairment (MCI) is present in up to 34% of patients with early-stage Parkinson disease (PD); however, it is difficult to detect subtle impairment without objective cognitive testing. Data were obtained from the Parkinson Progression Marker Initiative. All 341 participants were administered the Montreal Cognitive Assessment (MoCA) and a brief neuropsychological battery. Participants were classified as PD-MCI if MoCA was <26 or if they scored ≥1 standard deviation below the normative mean in 2 or more domains, based upon established criteria. The sensitivity/specificity for the clinical detection of PD-MCI was determined. Overall accuracy for clinical detection of PD-MCI was 67.4%. Although clinical determination was highly specific (96.3%; 95% confidence interval [CI]: 0.92-0.98), sensitivity was poor (32.0%; 95% CI: 0.25-0.40). Identifying MCI in early-stage PD based on clinical interview alone appears to be insufficient. The inclusion of objective cognitive tests allowing for normative sample comparisons is needed to increase the detection of cognitive impairment in this population.

  10. Mild Cognitive Impairment (MCI)

    Science.gov (United States)

    ... stage between the expected cognitive decline of normal aging and the more-serious decline of dementia. It can involve problems with memory, language, thinking and judgment that are greater than normal age-related changes. If you have mild cognitive impairment, you may ...

  11. Perceived social determinants of health among older, rural-dwelling adults with early-stage cognitive impairment.

    Science.gov (United States)

    Mattos, Meghan K; Burke, Lora E; Baernholdt, Marianne; Hu, Lu; Nilsen, Marci L; Lingler, Jennifer H

    2017-01-01

    Limited access to resources and delayed detection of subtle cognitive changes may negatively impact the long-term cognitive health of rural-dwelling adults. This study explored perceived social determinants of health among older, rural-dwelling adults with early-stage cognitive impairment. Semi-structured interviews were conducted with older, rural-dwelling adults with early-stage cognitive impairment and their care partners. Thematic content analysis was performed. Participants ( n = 9) were 73.7 ± 6.0 years of age with 14.2 ± 3.1 years of education; care partners ( n = 10) were 70.9 ± 7.4 years of age with 15.6 ± 2.3 years of education. Data analysis revealed six themes: Staying active, Eating well, Living with cognitive changes, Living rural, Connecting with neighbors and community, and Relying on children. Dyads' depictions of perceived social determinants of health focused on the adoption of a healthy lifestyle, description of relationships, and advantages of living in a rural area. Emergent themes may be used to promote adoption of self-management and prevention behaviors, particularly lifestyle changes.

  12. Impairment in Proverb Interpretation as an Executive Function Deficit in Patients with Amnestic Mild Cognitive Impairment and Early Alzheimer’s Disease

    Directory of Open Access Journals (Sweden)

    Thomas Leyhe

    2011-01-01

    Full Text Available Background/Aims: Proverb interpretation is assumed to reflect executive functions. We hypothesized that proverb interpretation is impaired in patients with amnestic mild cognitive impairment (aMCI diagnosed as single-domain impairment by common neuropsychological testing. Methods: We compared performance in a proverb interpretation test in single-domain aMCI patients and patients with early Alzheimer’s disease (EAD. Results: The groups with aMCI and EAD performed significantly worse than healthy controls. Both patient groups gave concrete answers with a similar frequency. However, patients with EAD tended to give senseless answers more frequently. Conclusions: Our data suggest that in patients diagnosed as single-domain aMCI, deterioration of executive functions is detectable with subtle and appropriate neuropsychological testing. Implementation of these procedures may improve the early prediction of AD.

  13. Is cognitive impairment following early life stress in severe mental disorders based on specific or general cognitive functioning?

    Science.gov (United States)

    Aas, Monica; Steen, Nils E; Agartz, Ingrid; Aminoff, Sofie R; Lorentzen, Steinar; Sundet, Kjetil; Andreassen, Ole A; Melle, Ingrid

    2012-08-15

    Schizophrenia spectrum and bipolar disorder are characterized by high levels of childhood trauma as well as of cognitive dysfunction. Our aim is to investigate the association between these two factors in the largest study in the literature so far. A total of 406 patients with schizophrenia spectrum- or bipolar disorders were recruited from a catchment area based organization in Oslo, Norway. Information about early life stress was obtained using the Childhood Trauma Questionnaire (CTQ). Cognitive function was assessed through a comprehensive and standardized neuropsychological test battery. Physical abuse, sexual abuse and physical neglect were significantly associated with reduced scores on working memory and executive function scales (p=0.04 to pIntelligence (WASI) (p=0.059 to pdisorders, in particular working memory and executive function as well as general cognition. Moreover, these dysfunctions seem to be driven by underlying deficits in general cognitive tasks as measured by the WASI.

  14. Intracellular Aβ pathology and early cognitive impairments in a transgenic rat overexpressing human amyloid precursor protein: a multidimensional study.

    Science.gov (United States)

    Iulita, M Florencia; Allard, Simon; Richter, Luise; Munter, Lisa-Marie; Ducatenzeiler, Adriana; Weise, Christoph; Do Carmo, Sonia; Klein, William L; Multhaup, Gerhard; Cuello, A Claudio

    2014-06-05

    Numerous studies have implicated the abnormal accumulation of intraneuronal amyloid-β (Aβ) as an important contributor to Alzheimer's disease (AD) pathology, capable of triggering neuroinflammation, tau hyperphosphorylation and cognitive deficits. However, the occurrence and pathological relevance of intracellular Aβ remain a matter of controversial debate. In this study, we have used a multidimensional approach including high-magnification and super-resolution microscopy, cerebro-spinal fluid (CSF) mass spectrometry analysis and ELISA to investigate the Aβ pathology and its associated cognitive impairments, in a novel transgenic rat model overexpressing human APP. Our microscopy studies with quantitative co-localization analysis revealed the presence of intraneuronal Aβ in transgenic rats, with an immunological signal that was clearly distinguished from that of the amyloid precursor protein (APP) and its C-terminal fragments (CTFs). The early intraneuronal pathology was accompanied by a significant elevation of soluble Aβ42 peptides that paralleled the presence and progression of early cognitive deficits, several months prior to amyloid plaque deposition. Aβ38, Aβ39, Aβ40 and Aβ42 peptides were detected in the rat CSF by MALDI-MS analysis even at the plaque-free stages; suggesting that a combination of intracellular and soluble extracellular Aβ may be responsible for impairing cognition at early time points. Taken together, our results demonstrate that the intraneuronal development of AD-like amyloid pathology includes a mixture of molecular species (Aβ, APP and CTFs) of which a considerable component is Aβ; and that the early presence of these species within neurons has deleterious effects in the CNS, even before the development of full-blown AD-like pathology.

  15. Self-report of cognitive impairment and Mini-Mental State Exam performance in PRKN, LRRK2, and GBA carriers with early onset Parkinson’s disease

    Science.gov (United States)

    Alcalay, Roy N.; Mejia-Santana, Helen; Tang, Ming X.; Rakitin, Brian; Rosado, Llency; Ross, Barbara; Verbitsky, Miguel; Kisselev, Sergey; Louis, Elan D.; Comella, Cynthia; Colcher, Amy; Jennings, Danna; Nance, Martha; Bressman, Susan; Scott, William K.; Tanner, Caroline; Mickel, Susan; Andrews, Howard; Waters, Cheryl; Fahn, Stanley; Cote, Lucien; Frucht, Steven; Ford, Blair; Rezak, Michael; Novak, Kevin; Friedman, Joseph; Pfeiffer, Ronald; Marsh, Laura; Hiner, Bradley; Siderowf, Andrew; Ottman, Ruth; Clark, Lorraine; Marder, Karen; Caccappolo, Elise

    2010-01-01

    While little is known about risk factors for cognitive impairment in early onset Parkinson disease (EOPD), postmortem studies have shown an association between dementia with Lewy bodies (DLB) and glucocerebrosidase (GBA) mutation. We compared Mini-Mental State Examination (MMSE) performance and self-reported cognitive impairment in 699 EOPD participants genotyped for mutations in parkin (PRKN), leucine-rich repeat kinase-2 (LRRK2), and GBA. Logistic regression was used to assess the association between reported cognitive impairment and MMSE score, as well as between GBA group membership and self-reported impairment and MMSE. GBA carriers reported more impairment, but MMSE performance did not differ among genetic groups. Detailed neuropsychological testing is required to explore the association between cognitive impairment and GBA mutations. PMID:20182943

  16. DNA Methylation Signatures of Early Childhood Malnutrition Associated With Impairments in Attention and Cognition.

    Science.gov (United States)

    Peter, Cyril J; Fischer, Laura K; Kundakovic, Marija; Garg, Paras; Jakovcevski, Mira; Dincer, Aslihan; Amaral, Ana C; Ginns, Edward I; Galdzicka, Marzena; Bryce, Cyralene P; Ratner, Chana; Waber, Deborah P; Mokler, David; Medford, Gayle; Champagne, Frances A; Rosene, Douglas L; McGaughy, Jill A; Sharp, Andrew J; Galler, Janina R; Akbarian, Schahram

    2016-11-15

    Early childhood malnutrition affects 113 million children worldwide, impacting health and increasing vulnerability for cognitive and behavioral disorders later in life. Molecular signatures after childhood malnutrition, including the potential for intergenerational transmission, remain unexplored. We surveyed blood DNA methylomes (~483,000 individual CpG sites) in 168 subjects across two generations, including 50 generation 1 individuals hospitalized during the first year of life for moderate to severe protein-energy malnutrition, then followed up to 48 years in the Barbados Nutrition Study. Attention deficits and cognitive performance were evaluated with the Connors Adult Attention Rating Scale and Wechsler Abbreviated Scale of Intelligence. Expression of nutrition-sensitive genes was explored by quantitative reverse transcriptase polymerase chain reaction in rat prefrontal cortex. We identified 134 nutrition-sensitive, differentially methylated genomic regions, with most (87%) specific for generation 1. Multiple neuropsychiatric risk genes, including COMT, IFNG, MIR200B, SYNGAP1, and VIPR2 showed associations of specific methyl-CpGs with attention and IQ. IFNG expression was decreased in prefrontal cortex of rats showing attention deficits after developmental malnutrition. Early childhood malnutrition entails long-lasting epigenetic signatures associated with liability for attention and cognition, and limited potential for intergenerational transmission. Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  17. Synaptosomal bioenergetic defects are associated with cognitive impairment in a transgenic rat model of early Alzheimer's disease.

    Science.gov (United States)

    Martino Adami, Pamela V; Quijano, Celia; Magnani, Natalia; Galeano, Pablo; Evelson, Pablo; Cassina, Adriana; Do Carmo, Sonia; Leal, María C; Castaño, Eduardo M; Cuello, A Claudio; Morelli, Laura

    2017-01-01

    Synaptic bioenergetic deficiencies may be associated with early Alzheimer's disease (AD). To explore this concept, we assessed pre-synaptic mitochondrial function in hemizygous (+/-)TgMcGill-R-Thy1-APP rats. The low burden of Aβ and the wide array of behavioral and cognitive impairments described in 6-month-old hemizygous TgMcGill-R-Thy1-APP rats (Tg(+/-)) support their use to investigate synaptic bioenergetics deficiencies described in subjects with early Alzheimer's disease (AD). In this report, we show that pre-synaptic mitochondria from Tg(+/-) rats evidence a decreased respiratory control ratio and spare respiratory capacity associated with deficits in complex I enzymatic activity. Cognitive impairments were prevented and bioenergetic deficits partially reversed when Tg(+/-) rats were fed a nutritionally complete diet from weaning to 6-month-old supplemented with pyrroloquinoline quinone, a mitochondrial biogenesis stimulator with antioxidant and neuroprotective effects. These results provide evidence that, as described in AD brain and not proven in Tg mice models with AD-like phenotype, the mitochondrial bioenergetic capacity of synaptosomes is not conserved in the Tg(+/-) rats. This animal model may be suitable for understanding the basic biochemical mechanisms involved in early AD.

  18. Optimizing the diagnosis of early Alzheimer's disease in mild cognitive impairment subjects

    DEFF Research Database (Denmark)

    Mattila, Jussi; Soininen, Hilkka; Koikkalainen, Juha

    2012-01-01

    of the disease. Several studies have analyzed data of mild cognitive impairment (MCI) subjects, showing that conversion from MCI to AD can be predicted with a classification accuracy of 60-80%. This accuracy may not be high enough for influencing diagnostic decisions. In this work, the prediction problem...... is approached differently; a target prediction accuracy is defined first and is then used for identifying MCI patients for whom the required accuracy can be reached. The process uses a novel disease state index method in which patient data are statistically compared to a high number of previously diagnosed...... cases. It is shown that the disease index values derived from heterogeneous patient data can be used for identifying groups of patients for whom the prediction accuracy reaches the previously set target level. The results also show that 12 months before receiving clinical AD diagnoses, approximately...

  19. Self-report of cognitive impairment and Mini-Mental State Exam performance in PRKN, LRRK2, and GBA carriers with early onset Parkinson’s disease

    OpenAIRE

    Alcalay, Roy N.; Mejia-Santana, Helen; Tang, Ming X.; Rakitin, Brian; Rosado, Llency; Ross, Barbara; Verbitsky, Miguel; Kisselev, Sergey; Louis, Elan D.; Comella, Cynthia; Colcher, Amy; Jennings, Danna; Nance, Martha; Bressman, Susan; William K Scott

    2010-01-01

    While little is known about risk factors for cognitive impairment in early onset Parkinson disease (EOPD), postmortem studies have shown an association between dementia with Lewy bodies (DLB) and glucocerebrosidase (GBA) mutation. We compared Mini-Mental State Examination (MMSE) performance and self-reported cognitive impairment in 699 EOPD participants genotyped for mutations in parkin (PRKN), leucine-rich repeat kinase-2 (LRRK2), and GBA. Logistic regression was used to assess the associati...

  20. Mild cognitive impairment

    Directory of Open Access Journals (Sweden)

    Pavlović Dragan M.

    2009-01-01

    Full Text Available Mild cognitive impairment (MCI is a syndrome that spans the area between normal ageing and dementia. It is classified into amnestic and non-amnestic types, both with two subtypes: single domain and multiple domains. Prevalence of MCI depends on criteria and population and can vary from 0.1 to 42% persons of older age. In contrast to dementia, cognitive deterioration is less severe and activities of daily living are preserved. Most impaired higher cognitive functions in MCI are memory, executive functions, language, visuospatial functions, attention etc. Also there are depression, apathy or psychomotor agitation, and signs of psychosis. Aetiology of MCI is multiple, mostly neurodegenerative, vascular, psychiatric, internistic, neurological, traumatic and iatrogenic. Persons with amnestic MCI are at a higher risk of converting to Alzheimer's disease, while those with a single non-memory domain are at risk of developing frontotemporal dementia. Some MCI patients also progress to other dementia types, vascular among others. In contrast, some patients have a stationary course, some improve, while others even normalize. Every suspicion of MCI warrants a detailed clinical exploration to discover underlying aetiology, laboratory analyses, neuroimaging methods and some cases require a detailed neuropsychological assessment. At the present time there is no efficacious therapy for cognitive decline in MCI or the one that could postpone conversion to dementia. The treatment of curable causes, application of preventive measures and risk factor control are reasonable measures in the absence of specific therapy.

  1. A multicenter study of the early detection of synaptic dysfunction in Mild Cognitive Impairment using Magnetoencephalography-derived functional connectivity.

    Science.gov (United States)

    Maestú, Fernando; Peña, Jose-Maria; Garcés, Pilar; González, Santiago; Bajo, Ricardo; Bagic, Anto; Cuesta, Pablo; Funke, Michael; Mäkelä, Jyrki P; Menasalvas, Ernestina; Nakamura, Akinori; Parkkonen, Lauri; López, Maria E; Del Pozo, Francisco; Sudre, Gustavo; Zamrini, Edward; Pekkonen, Eero; Henson, Richard N; Becker, James T

    2015-01-01

    Synaptic disruption is an early pathological sign of the neurodegeneration of Dementia of the Alzheimer's type (DAT). The changes in network synchronization are evident in patients with Mild Cognitive Impairment (MCI) at the group level, but there are very few Magnetoencephalography (MEG) studies regarding discrimination at the individual level. In an international multicenter study, we used MEG and functional connectivity metrics to discriminate MCI from normal aging at the individual person level. A labeled sample of features (links) that distinguished MCI patients from controls in a training dataset was used to classify MCI subjects in two testing datasets from four other MEG centers. We identified a pattern of neuronal hypersynchronization in MCI, in which the features that best discriminated MCI were fronto-parietal and interhemispheric links. The hypersynchronization pattern found in the MCI patients was stable across the five different centers, and may be considered an early sign of synaptic disruption and a possible preclinical biomarker for MCI/DAT.

  2. Validation of the Argentine version of the Memory Binding Test (MBT for Early Detection of Mild Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Fabian Roman

    Full Text Available ABSTRACT Background: "Forgetfulness" is frequent in normal aging and characteristic of the early stages of dementia syndromes. The episodic memory test is central for detecting amnestic mild cognitive impairment (MCI. The Memory Binding Test (MBT is a simple, easy and brief memory test to detect the early stage of episodic memory impairment. Objective: To validate the Argentine version of the MBT in a Latin American population and to estimate the diagnostic accuracy as a tool for early detection of MCI. Methods: 88 subjects (46 healthy controls and 42 patients with amnestic MCI matched for age and educational level were evaluated by an extensive neuropsychological battery and the memory binding test. Results: A significantly better performance was detected in the control group; all MBT scales were predictive of MCI diagnosis (p<.01. The MBT showed high sensitivity (69% and high specificity (88%, with a PPV of 93% and a NPV of 55% for associative paired recall. A statistically significant difference (c2=14,164, p<.001 was obtained when comparing the area under the curve (AUC of the MBT (0.88 and the MMSE (0.70. Conclusion: The Argentine version of the MBT correlated significantly with the MMSE and the memory battery and is a useful tool in the detection of MCI. The operating characteristics of the MBT are well suited, surpassing other tests commonly used for detecting MCI.

  3. Cognitive Impairment and Tramadol Dependence.

    Science.gov (United States)

    Bassiony, Medhat M; Youssef, Usama M; Hassan, Mervat S; Salah El-Deen, Ghada M; El-Gohari, Hayam; Abdelghani, Mohamed; Abdalla, Ahmed; Ibrahim, Dalia H

    2017-02-01

    Cognitive impairment is one of the consequences of substance abuse. Tramadol abuse is a public health problem in Egypt. The objective of this study was to estimate the prevalence and correlates of cognitive impairment among tramadol-abuse patients and control subjects. This study included 100 patients with tramadol abuse and 100 control subjects (matched for age, sex, and education) who were recruited from Zagazig University Hospital, Egypt. Patients were divided into 2 groups: patients who used tramadol only (tramadol-alone group) and patients who used tramadol and other substances (polysubstance group). The participants were interviewed using Montreal Cognitive Assessment test and had urine screening for drugs. Twenty-four percent of the cases used tramadol alone, whereas the remaining used tramadol and other substances, mainly cannabis (66%) and benzodiazepines (27%). Tramadol-abuse patients were about 3 times more likely to have cognitive impairment than control subjects (81% vs 28%). Tramadol-alone patients were more than 2 times more likely to have cognitive impairment than control subjects (67% vs 28%). Cognitive impairment was significantly associated with polysubstance abuse. There was no association between cognitive impairment and sociodemographic or clinical factors. Cognitive impairment occurs commonly among tramadol-abuse patients. Memory impairment is the most common cognitive domain to be affected. There is a significant association between cognitive impairment and polysubstance abuse.

  4. Increased Brain Connectivity In Early Postmenopausal Women with Subjective Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Jennifer N Vega

    2016-09-01

    Full Text Available Cognitive changes after menopause are a common complaint, especially as the loss of estradiol at menopause has been hypothesized to contribute to the higher rates of dementia in women. To explore the neural processes related to subjective cognitive complaints, this study examined resting state functional connectivity in 31 postmenopausal women (aged 50-60 in relationship to cognitive complaints following menopause. A cognitive complaint index was calculated using responses to a 120-item questionnaire. Seed regions were identified for resting state brain networks important for higher-order cognitive processes and for areas that have shown differences in volume and functional activity associated with cognitive complaints in prior studies. Results indicated a positive correlation between the executive control network and cognitive complaint score, weaker negative functional connectivity within the frontal cortex, and stronger positive connectivity within the right middle temporal gyrus in postmenopausal women who report more cognitive complaints. While longitudinal studies are needed to confirm this hypothesis, these data are consistent with previous findings suggesting that high levels of cognitive complaints may reflect changes in brain connectivity and may be a potential marker for the risk of late-life cognitive dysfunction in postmenopausal women with otherwise normal cognitive performance.

  5. Explicit (semantic) memory for music in patients with mild cognitive impairment and early-stage Alzheimer's disease.

    Science.gov (United States)

    Kerer, Manuela; Marksteiner, Josef; Hinterhuber, Hartmann; Mazzola, Guerino; Kemmler, Georg; Bliem, Harald R; Weiss, Elisabeth M

    2013-01-01

    BACKGROUND/STUDY CONTEXT: Explicit memory for music was investigated by using a new test with 24 existing and 3 newly composed pieces. Ten patients with mild cognitive impairment (MCI) and 10 patients with early stage of Alzheimer's disease (AD) were compared with 23 healthy subjects, in terms of verbal memory of music by the identification of familiar music excerpts and the discrimination of distortion and original timbre of musical excerpts. MCI and Alzheimer's patients showed significantly poorer performances in tasks requiring verbal memory of musical excerpts than the healthy participants. For discrimination of musical excerpts, MCI and AD patients surprisingly performed significantly better than the healthy comparison subjects. Our results support the notion of a specialized memory system for music.

  6. The relation of regional cerebral perfusion and atrophy in mild cognitive impairment (MCI) and early Alzheimer's dementia.

    Science.gov (United States)

    Luckhaus, Christian; Cohnen, Mathias; Flüss, Michael Oliver; Jänner, Michaela; Grass-Kapanke, Brigitte; Teipel, Stefan J; Grothe, Michel; Hampel, Harald; Peters, Oliver; Kornhuber, Johannes; Maier, Wolfgang; Supprian, Tillmann; Gaebel, Wolfgang; Mödder, Ulrich; Wittsack, Hans-Jörg

    2010-07-30

    The spatial and temporal relations between regional cerebral blood flow (rCBF) and brain volume (rVOL) changes in incipient and early Alzheimer's dementia (AD) are not fully understood. The participants comprised 30 subjects with mild cognitive impairment (MCI) and 15 with mild AD who were examined using structural and perfusion-weighted magnetic resonance imaging (MRI) at 1.5 Tesla. Hippocampus and amygdala volumes were measured by manual volumetry. A region-of-interest co-localisation method was used to calculate rCBF values. DNA samples were genotyped for apolipoprotein E (APO E). In comparisons of AD with MCI, rCBF was reduced in the posterior cingulum only, while profound rVOL reductions occurred in both right and left amygdala and in the right hippocampus, and as a trend, in the left hippocampus. Brain volumes of the hippocampus and the amygdala were uncorrelated with the respective rCBF variables in both MCI and AD. Hippocampal but not amygdalar volumes were associated with presence of one or two APOE epsilon4 alleles in MCI and mild AD, while there was no association of APOE epsilon4 allele with rCBF. These data support earlier indications that rCBF and rVOL changes are at least partly dissociated in the early pathogenesis of AD and heterogeneously associated with the APOE risk allele. The data also support the concept of functional compensatory brain activation and the diaschisis hypothesis as relevant in incipient and early AD.

  7. Intracerebral hemorrhage and cognitive impairment.

    Science.gov (United States)

    Xiong, Li; Reijmer, Yael D; Charidimou, Andreas; Cordonnier, Charlotte; Viswanathan, Anand

    2016-05-01

    Vascular cognitive impairment and vascular dementia are composed of cognitive deficits resulted from a range of vascular lesions and pathologies, including both ischemic and hemorrhagic. However the contribution of spontaneous intracerebral hemorrhage presumed due to small vessel diseases on cognitive impairment is underestimated, in contrast to the numerous studies about the role of ischemic vascular disorders on cognition. In this review we summarize recent findings from clinical studies and appropriate basic science research to better elucidate the role and possible mechanisms of intracerebral hemorrhage in cognitive impairment and dementia. This article is part of a Special Issue entitled: Vascular Contributions to Cognitive Impairment and Dementia edited by M. Paul Murphy, Roderick A. Corriveau and Donna M. Wilcock.

  8. Studies of Implicit Prototype Extraction in Patients with Mild Cognitive Impairment and Early Alzheimer's Disease

    Science.gov (United States)

    Nosofsky, Robert M.; Denton, Stephen E.; Zaki, Safa R.; Murphy-Knudsen, Anne F.; Unverzagt, Frederick W.

    2012-01-01

    Studies of incidental category learning support the hypothesis of an implicit prototype-extraction system that is distinct from explicit memory (Smith, 2008). In those studies, patients with explicit-memory impairments due to damage to the medial-temporal lobe performed normally in implicit categorization tasks (Bozoki, Grossman, & Smith, 2006;…

  9. Nutritional status and cognitive impairment in elderly.

    Science.gov (United States)

    Daradkeh, Ghazi; Essa, Musthafa M; Al-Adawi, S Samir; Koshy, Roopa P; Al-Asmi, Abdullah; Waly, Mostafa I

    2014-10-01

    The elderly population is increasing worldwide and it has been suggested that senior citizens will continue to constitute the bulk of the population in many countries. Nutritional status of senior citizens are adversely affected by their frailty, chronic condition and declining cognitive functioning. Conversely, malnourished elderly further deteriorate their frailty, chronic disease and cognitive functioning. The aim of this review article is to recognize the importance of nutritional assessment of elderly population particularly those with cognitive impairment. First part is to highlight characteristic cognitive impairment among senior citizens and the second one highlight t he background in which malnutrition is a factor that leads to increased risk of morbidity and mortality in the elderly. This review also highlight salgorithms for safeguarding nutritional status among senior citizen and focuses on importance of nutritional screening, assessment and early intervention for safeguarding further deterioration of elderly who are likely to prone to cognitive impairment.

  10. A multicenter study of the early detection of synaptic dysfunction in Mild Cognitive Impairment using Magnetoencephalography-derived functional connectivity

    Directory of Open Access Journals (Sweden)

    Fernando Maestú, PhD

    2015-01-01

    Full Text Available Synaptic disruption is an early pathological sign of the neurodegeneration of Dementia of the Alzheimer's type (DAT. The changes in network synchronization are evident in patients with Mild Cognitive Impairment (MCI at the group level, but there are very few Magnetoencephalography (MEG studies regarding discrimination at the individual level. In an international multicenter study, we used MEG and functional connectivity metrics to discriminate MCI from normal aging at the individual person level. A labeled sample of features (links that distinguished MCI patients from controls in a training dataset was used to classify MCI subjects in two testing datasets from four other MEG centers. We identified a pattern of neuronal hypersynchronization in MCI, in which the features that best discriminated MCI were fronto-parietal and interhemispheric links. The hypersynchronization pattern found in the MCI patients was stable across the five different centers, and may be considered an early sign of synaptic disruption and a possible preclinical biomarker for MCI/DAT.

  11. Single-subject gray matter graph properties and their relationship with cognitive impairment in early- and late-onset Alzheimer's disease.

    Science.gov (United States)

    Tijms, Betty M; Yeung, Hiu M; Sikkes, Sietske A M; Möller, Christiane; Smits, Lieke L; Stam, Cornelis J; Scheltens, Philip; van der Flier, Wiesje M; Barkhof, Frederik

    2014-06-01

    Abstract We investigated the relationships between gray matter graph properties and cognitive impairment in a sample of 215 patients with Alzheimer's disease (AD) and also whether age of disease onset modifies such relationships. We expected that more severe cognitive impairment in AD would be related to more random graph topologies. Single-subject gray matter graphs were constructed from T1-weighted magnetic resonance imaging scans. The following global and local graph properties were calculated: betweenness centrality, normalized clustering coefficient γ, and normalized path length λ. Local clustering, path length, and betweenness centrality measures were determined for 90 anatomically defined areas. Regression models with as interaction term age of onset (i.e., early onset when patients were ≤65 years old and late onset when they were >65 years old at the time of diagnosis)×graph property were used to assess the relationships between cognitive functioning in five domains (memory, language, visuospatial, attention, and executive). Worse cognitive impairment was associated with more random graphs, as indicated by low γ, λ, and betweenness centrality values. Three interaction effects for age of onset×global graph property were found: Low γ and λ values more strongly related to memory impairment in early-onset patients; low beta values were significantly related to impaired visuospatial functioning in late-onset patients. For the local graph properties, language impairment showed the strongest relationship with decreased clustering coefficient in the left superior temporal gyrus across the entire sample. Our study shows that single-subject gray matter graph properties are associated with individual differences in cognitive impairment.

  12. Repurposing psychiatric medicines to target activated microglia in anxious mild cognitive impairment and early Parkinson’s disease

    Science.gov (United States)

    Lauterbach, Edward C

    2016-01-01

    Anxiety is common in the Mild Cognitive Impairment (MCI) stage of Alzheimer’s disease (AD) and the pre-motor stages of Parkinson’s disease (PD). A concomitant and possible cause of this anxiety is microglial activation, also considered a key promoter of neurodegeneration in MCI and early PD via inflammatory mechanisms and the generation of degenerative proinflammatory cytokines. Psychiatric disorders, prevalent in AD and PD, are often treated with psychiatric drugs (psychotropics), raising the question of whether psychotropics might therapeutically affect microglial activation, MCI, and PD. The literature of common psychotropics used in treating psychiatric disorders was reviewed for preclinical and clinical findings regarding microglial activation. Findings potentially compatible with reduced microglial activation or reduced microglial inflammogen release were evident for: antipsychotics including neuroleptics (chlorpromazine, thioridazine, loxapine) and atypicals (aripiprazole, olanzapine, quetiapine, risperidone, ziprasidone); mood stabilizers (carbamazepine, valproate, lithium); antidepressants including tricyclics (amitriptyline, clomipramine, imipramine, nortriptyline), SSRIs (citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline), venlafaxine, and bupropion; benzodiazepine anxiolytics (clonazepam, diazepam); cognitive enhancers (donepezil, galantamine, memantine); and other drugs (dextromethorphan, quinidine, amantadine). In contrast, pramipexole and methylphenidate might promote microglial activation. The most promising replicated findings of reduced microglial activation are for quetiapine, valproate, lithium, fluoxetine, donepezil, and memantine but further study is needed and translation of their microglial effects to human disease still requires investigation. In AD-relevant models, risperidone, valproate, lithium, fluoxetine, bupropion, donepezil, and memantine have therapeutic microglial effects in need of replication. Limited

  13. Cognitive impairment in Parkinson's disease.

    Science.gov (United States)

    Ransmayr, Gerhard

    2015-12-01

    Parkinson's disease is the second most frequent neurodegenerative disorder. There is significantly elevated risk of cognitive decline and associated neuropsychiatric symptoms. Dementia may develop insidiously several years after manifestation of Parkinson motor symptoms (dementia associated with Parkinson's disease; Parkinson's disease dementia) or in close temporal relationship (within one year) after onset of motor symptoms (Dementia with Lewy bodies). There are clinical, pathophysiological and therapeutic similarities between these two conditions. Men are more frequently affected than women. Risk factor or indicators are advanced age at disease onset, disease duration, rigidity, akinesia and posture and gait impairment and falls as opposed to tremor dominance, and associated neuropsychiatric symptoms (depression, apathy, hallucinosis, delirium). Dementia is treatable with cholinesterase inhibitors (rivastigmine, donepezil), memantine, and adjustment of the pharmacological regimen of parkinsonian motor symptoms. Concomitant autonomic nervous system symptoms and neuropsychiatric complications warrant early clinical awareness and are accessible to pharmacological therapy.

  14. Comparison between the story recall test and the word-list learning test in Korean patients with mild cognitive impairment and early stage of Alzheimer's disease.

    Science.gov (United States)

    Baek, Min Jae; Kim, Hyun Jung; Kim, Sangyun

    2012-01-01

    Among verbal memory tests, two that are commonly used to measure the ability of verbal memory function in cognitive impairment are story recall tests and word-list learning tests. However, research is limited regarding which test might be more sensitive in discriminating between normal cognitive aging and patients with Alzheimer's disease (AD) in the Korean population. The purpose of the current study was to compare the word-list learning test (Seoul Verbal Learning Test; SVLT) and the story recall test (Korean Story Recall Test; KSRT) to determine which test is more sensitive in discriminating between individuals with normal cognitive aging and patients with mild cognitive impairment (MCI) and early stage of AD in Korea. A total of 53 healthy adults, 127 patients with MCI, and 72 patients with early stage of AD participated in this study. The receiver-operating characteristic (ROC) curve and area under the curve (AUC) were evaluated to compare these two tests. The results showed that the AUC of the SVLT was significantly larger than the AUC of the KSRT in all three groups (healthy adults vs. MCI and early stage of AD; healthy adults vs. MCI; healthy adults vs. early stage of AD). However, in comparison of patients with MCI and early stage of AD, the AUC of SVLT and the AUC of KSRT were not significant. The word-list learning test is a more useful tool for examining verbal memory function for older adults in Korea than the story recall test.

  15. Cognitive and Learning Impairments

    Science.gov (United States)

    Lewis, Clayton

    People with cognitive disabilities are gaining in a long struggle for recognition of their right to control their lives. In the information society access to the Web is essential to this control. Cognitive barriers to this access are diverse, reflecting the complexity of human cognitive faculties. These barriers are not well managed in current accessibility practice and policy, in part because cognitive accessibility, like usability, cannot be reduced to a checklist of simple attributes. Advances in representing the meaning as well as the form of information, and in supporting configurable presentation and interaction methods, will yield progress. Increased inclusion of people with cognitive disabilities in the processes of technology development and policy making will also pay off.

  16. Cognitive Impairment in Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Farnaz Etesam

    2014-01-01

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

  17. Cognitive impairment in bipolar disorder.

    Science.gov (United States)

    Latalova, Klara; Prasko, Jan; Diveky, Tomas; Velartova, Hana

    2011-03-01

    Provide an overview of how bipolar disorder affects cognitive function in patients. MEDLINE and PsycInfo data bases were searched for articles indexed by the combinations of MESH term or key word "bipolar disorder" with the following terms: "cognition", "memory", "neuropsychology", "neuropsychological tests", "lithium", "anticonvulsants", "antipsychotics", and "schizophrenia". Constraints limiting time period of publications or their language were not applied. Reference lists of publications identified by these procedures were hand-searched for additional relevant citations. There is evidence of stable and lasting cognitive impairment in all phases of bipolar disorder, including the remission phase, particularly in the following domains: sustained attention, memory and executive functions. But research on the cognitive functions has yielded inconsistent results over recent years. There is a growing need for clarification regarding the magnitude, clinical relevance and confounding variables of cognitive impairment in bipolar patients. The impact of bipolar illness on cognition can be influenced by age of onset, pharmacological treatments, individual response, familial risk factors, and clinical features. In addition to the mood state, cognitive performance in bipolar patients is influenced by seasonality. Previous optimistic assumptions about the prognosis of bipolar disorder were based on the success of the control of mood symptoms by pharmacotherapy. However, it is now clear that the "remitted" euthymic bipolar patients have distinct impairments of executive function, verbal memory, psychomotor speed, and sustained attention. Mood stabilizers and atypical antipsychotics may reduce cognitive deficits in certain domains and may have a positive effect on quality of life and social functioning.

  18. Comparison between mini mental state examination (MMSE) and Montreal cognitive assessment Indonesian version (MoCA-Ina) as an early detection of cognitive impairments in post-stroke patients

    Science.gov (United States)

    Lestari, S.; Mistivani, I.; Rumende, C. M.; Kusumaningsih, W.

    2017-08-01

    Mild cognitive impairment (MCI) is defined as cognitive impairment that may never develop into dementia. Cognitive impairment is one long-term complication of a stroke. The Mini Mental State Examination (MMSE), which is commonly used as a screening tool for cognitive impairment, has a low sensitivity to detect cognitive impairment, especially MCI. Alternatively, the Montreal Cognitive Assessment Indonesian version (MoCA-Ina) has been reported to have a higher sensitivity than the MMSE. The aim of this study was to compare the proportion of MCI identified between the MMSE and MoCA-Ina in stroke patients. This was a cross-sectional study of stroke outpatients who attended the Polyclinic Neuromuscular Division, Rehabilitation Department, and Polyclinic Stroke, Neurology Department Cipto Mangunkusumo General Hospital, Jakarta. The proportion of MCI identified using the MMSE was 31.03% compared to 72.41% when using the MoCA-Ina. This difference was statistically significant (Fisher’s exact test, p = 0.033). The proportion of MCI in stroke patients was higher when using the MoCA-Ina compared to the MMSE. The MoCA-Ina should be used as an alternative in the early detection of MCI in stroke patients, especially those undergoing rehabilitation.

  19. Memory Alteration Test to Detect Amnestic Mild Cognitive Impairment and Early Alzheimer’s Dementia in Population with Low Educational Level

    Directory of Open Access Journals (Sweden)

    Nilton Custodio

    2017-08-01

    Full Text Available Background/Aims: Short tests to early detection of the cognitive impairment are necessary in primary care setting, particularly in populations with low educational level. The aim of this study was to assess the performance of Memory Alteration Test (M@T to discriminate controls, patients with amnestic Mild Cognitive Impairment (aMCI and patients with early Alzheimer’s Dementia (AD in a sample of individuals with low level of education.Methods: Cross-sectional study to assess the performance of the M@T (study test, compared to the neuropsychological evaluation (gold standard test scores in 247 elderly subjects with low education level from Lima-Peru. The cognitive evaluation included three sequential stages: (1 screening (to detect cases with cognitive impairment; (2 nosological diagnosis (to determinate specific disease; and (3 classification (to differentiate disease subtypes. The subjects with negative results for all stages were considered as cognitively normal (controls. The test performance was assessed by means of area under the receiver operating characteristic (ROC curve. We calculated validity measures (sensitivity, specificity and correctly classified percentage, the internal consistency (Cronbach’s alpha coefficient, and concurrent validity (Pearson’s ratio coefficient between the M@T and Clinical Dementia Rating (CDR scores.Results: The Cronbach’s alpha coefficient was 0.79 and Pearson’s ratio coefficient was 0.79 (p < 0.01. The AUC of M@T to discriminate between early AD and aMCI was 99.60% (sensitivity = 100.00%, specificity = 97.53% and correctly classified = 98.41% and to discriminate between aMCI and controls was 99.56% (sensitivity = 99.17%, specificity = 91.11%, and correctly classified = 96.99%.Conclusions: The M@T is a short test with a good performance to discriminate controls, aMCI and early AD in individuals with low level of education from urban settings.

  20. Memory Alteration Test to Detect Amnestic Mild Cognitive Impairment and Early Alzheimer’s Dementia in Population with Low Educational Level

    Science.gov (United States)

    Custodio, Nilton; Lira, David; Herrera-Perez, Eder; Montesinos, Rosa; Castro-Suarez, Sheila; Cuenca-Alfaro, José; Valeriano-Lorenzo, Lucía

    2017-01-01

    Background/Aims: Short tests to early detection of the cognitive impairment are necessary in primary care setting, particularly in populations with low educational level. The aim of this study was to assess the performance of Memory Alteration Test (M@T) to discriminate controls, patients with amnestic Mild Cognitive Impairment (aMCI) and patients with early Alzheimer’s Dementia (AD) in a sample of individuals with low level of education. Methods: Cross-sectional study to assess the performance of the M@T (study test), compared to the neuropsychological evaluation (gold standard test) scores in 247 elderly subjects with low education level from Lima-Peru. The cognitive evaluation included three sequential stages: (1) screening (to detect cases with cognitive impairment); (2) nosological diagnosis (to determinate specific disease); and (3) classification (to differentiate disease subtypes). The subjects with negative results for all stages were considered as cognitively normal (controls). The test performance was assessed by means of area under the receiver operating characteristic (ROC) curve. We calculated validity measures (sensitivity, specificity and correctly classified percentage), the internal consistency (Cronbach’s alpha coefficient), and concurrent validity (Pearson’s ratio coefficient between the M@T and Clinical Dementia Rating (CDR) scores). Results: The Cronbach’s alpha coefficient was 0.79 and Pearson’s ratio coefficient was 0.79 (p < 0.01). The AUC of M@T to discriminate between early AD and aMCI was 99.60% (sensitivity = 100.00%, specificity = 97.53% and correctly classified = 98.41%) and to discriminate between aMCI and controls was 99.56% (sensitivity = 99.17%, specificity = 91.11%, and correctly classified = 96.99%). Conclusions: The M@T is a short test with a good performance to discriminate controls, aMCI and early AD in individuals with low level of education from urban settings. PMID:28878665

  1. Mild cognitive impairment (MCI) - the novel trend of targeting Alzheimer's disease in its early stages - methodological considerations.

    Science.gov (United States)

    Pater, C

    2011-11-01

    While much uncertainty exists in the estimates of the global burden of Alzheimer's disease and about the potential impact of various interventions, there is a widespread acceptance of the fact that the steady increase in the incidence and prevalence of the condition worldwide is becoming a massive public health problem as well as a huge economic burden for all healthcare systems and societies. These heavy demands are further compounded by the poor quality of life of the affected individuals, of their families and of their caregivers. The epidemic proportion of Alzheimer's disease has triggered relentless attempts for development of treatment approaches during the past two decades by a multitude of pharmaceuticals and biotech companies. Commercial development of the acetylcholinesterase inhibitors has, until recently, virtually dominated the field and, although efficacy has been demonstrated for five different products, the longterm clinical results suggested that alternate approaches were warranted. Disease modifying strategies targeting the β- amyloid plaques (e.g., decreasing β-amyloid formation through β- and γ-secretase inhibition, diminishing β-amyloid aggregation through anti-aggregants or enhancement of β-amyloid clearance through active/passive immunization), targeting the neurofibrillary tangles through inhibition of tau protein hyperphosphorilation or, more recently, by increasing mitochondrial permeability, all these potential treatment modalities are facing major methodological challenges during the conduct of a myriad of clinical trials meant to bring the novel therapies to the market. Failure of more than 400 products tested in more than 800 clinical trials to date, with many of these failures occurring in late stage development (phase III) have triggered a paradigm shift toward targeting of the early stages of cognitive deficiencies (mild cognitive impairment- MCI) and a refinement of the investigative methodologies. The great heterogeneity of

  2. Parkinson's Disease and Cognitive Impairment.

    Science.gov (United States)

    Yang, Yang; Tang, Bei-Sha; Guo, Ji-Feng

    2016-01-01

    Parkinson's disease (PD) is a progressive neurodegenerative disease primarily characterized by the hallmarks of motor symptoms, such as tremor, bradykinesia, rigidity, and postural instability. However, through clinical investigations in patients and experimental findings in animal models of Parkinson's disease for years, it is now well recognized that Parkinson's disease is more than just a motor-deficit disorder. The majority of Parkinson's disease patients suffer from nonmotor disabilities, for instance, cognitive impairment, autonomic dysfunction, sensory dysfunction, and sleep disorder. So far, anti-PD prescriptions and surgical treatments have been mainly focusing on motor dysfunctions, leaving cognitive impairment a marginal clinical field. Within the nonmotor symptoms, cognitive impairment is one of the most common and significant aspects of Parkinson's disease, and cognitive deficits such as dysexecutive syndrome and visuospatial disturbances could seriously affect the quality of life, reduce life expectancy, prolong the duration of hospitalization, and therefore increase burdens of caregiver and medical costs. In this review, we have done a retrospective study of the recent related researches on epidemiology, clinical manifestation and diagnosis, genetics, and potential treatment of cognitive deficits in Parkinson's disease, aiming to provide a summary of cognitive impairment in Parkinson's disease and make it easy for clinicians to tackle this challenging issue in their future practice.

  3. Parkinson's Disease and Cognitive Impairment

    Science.gov (United States)

    Tang, Bei-sha

    2016-01-01

    Parkinson's disease (PD) is a progressive neurodegenerative disease primarily characterized by the hallmarks of motor symptoms, such as tremor, bradykinesia, rigidity, and postural instability. However, through clinical investigations in patients and experimental findings in animal models of Parkinson's disease for years, it is now well recognized that Parkinson's disease is more than just a motor-deficit disorder. The majority of Parkinson's disease patients suffer from nonmotor disabilities, for instance, cognitive impairment, autonomic dysfunction, sensory dysfunction, and sleep disorder. So far, anti-PD prescriptions and surgical treatments have been mainly focusing on motor dysfunctions, leaving cognitive impairment a marginal clinical field. Within the nonmotor symptoms, cognitive impairment is one of the most common and significant aspects of Parkinson's disease, and cognitive deficits such as dysexecutive syndrome and visuospatial disturbances could seriously affect the quality of life, reduce life expectancy, prolong the duration of hospitalization, and therefore increase burdens of caregiver and medical costs. In this review, we have done a retrospective study of the recent related researches on epidemiology, clinical manifestation and diagnosis, genetics, and potential treatment of cognitive deficits in Parkinson's disease, aiming to provide a summary of cognitive impairment in Parkinson's disease and make it easy for clinicians to tackle this challenging issue in their future practice. PMID:28058128

  4. Diabetes mellitus and cognitive impairments

    Institute of Scientific and Technical Information of China (English)

    Elham; Saedi[1; Mohammad; Reza; Gheini[2; Firoozeh; Faiz[3; Mohammad; Ali; Arami[4

    2016-01-01

    There is strong evidence that diabetes mellitus increases the risk of cognitive impairment and dementia. Insulin signaling dysregulation and small vessel disease in the base of diabetes may be important contributing factors in Alzheimer’s disease and vascular dementia pathogenesis, respectively. Optimal glycemic control in type 1 diabetes and identification of diabetic risk factors and prophylactic approach in type 2 diabetes are very important in the prevention of cognitive complications.In addition, hypoglycemic attacks in children and elderly should be avoided. Anti-diabetic medications especially Insulin may have a role in the management of cognitive dysfunction and dementia but further investigation is needed to validate these findings.

  5. Diabetes mellitus and cognitive impairments

    Science.gov (United States)

    Saedi, Elham; Gheini, Mohammad Reza; Faiz, Firoozeh; Arami, Mohammad Ali

    2016-01-01

    There is strong evidence that diabetes mellitus increases the risk of cognitive impairment and dementia. Insulin signaling dysregulation and small vessel disease in the base of diabetes may be important contributing factors in Alzheimer’s disease and vascular dementia pathogenesis, respectively. Optimal glycemic control in type 1 diabetes and identification of diabetic risk factors and prophylactic approach in type 2 diabetes are very important in the prevention of cognitive complications. In addition, hypoglycemic attacks in children and elderly should be avoided. Anti-diabetic medications especially Insulin may have a role in the management of cognitive dysfunction and dementia but further investigation is needed to validate these findings. PMID:27660698

  6. Hippocampal dysfunction and cognitive impairments provoked by chronic early-life stress involve excessive activation of CRH receptors

    OpenAIRE

    Ivy, Autumn S.; Rex, Christopher S.; Chen, Yuncai; Dubé, Céline; Maras, Pamela M.; Grigoriadis, Dimitri E.; Christine M Gall; Lynch, Gary; Baram, Tallie Z.

    2010-01-01

    Chronic stress impairs learning and memory in humans and rodents and disrupts long-term potentiation (LTP) in animal models. These effects are associated with structural changes in hippocampal neurons, including reduced dendritic arborization. Unlike the generally reversible effects of chronic stress on adult rat hippocampus, we have previously found that the effects of early-life stress endure and worsen during adulthood, yet the mechanisms for these clinically important sequelae are poorly ...

  7. The Contribution of Childhood Parental Rejection and Early Androgen Exposure to Impairments in Socio-Cognitive Skills in Intimate Partner Violence Perpetrators with High Alcohol Consumption

    Directory of Open Access Journals (Sweden)

    Luis Moya-Albiol

    2013-08-01

    Full Text Available Alcohol consumption, a larger history of childhood parental rejection, and high prenatal androgen exposure have been linked with facilitation and high risk of recidivism in intimate partner violence (IPV perpetrators. Participants were distributed into two groups according to their alcohol consumption scores as high (HA and low (LA. HA presented a higher history of childhood parental rejection, prenatal masculinization (smaller 2D:4D ratio, and violence-related scores than LA IPV perpetrators. Nonetheless, the former showed poor socio-cognitive skills performance (cognitive flexibility, emotional recognition and cognitive empathy. Particularly in HA IPV perpetrators, the history of childhood parental rejection was associated with high hostile sexism and low cognitive empathy. Moreover, a masculinized 2D:4D ratio was associated with high anger expression and low cognitive empathy. Parental rejection during childhood and early androgen exposure are relevant factors for the development of violence and the lack of adequate empathy in adulthood. Furthermore, alcohol abuse plays a key role in the development of socio-cognitive impairments and in the proneness to violence and its recidivism. These findings contribute to new coadjutant violence intervention programs, focused on the rehabilitation of basic executive functions and emotional decoding processes and on the treatment of alcohol dependence.

  8. Diagnosis advances in vascular cognitive impairment

    Institute of Scientific and Technical Information of China (English)

    Hua Zhou; Zhong Zhao

    2009-01-01

    Vascular cognitive impairment(VCI) encompasses the entire range of cognitive deficits associated with cerebrovascular disease(CVD), from mild deficits with little or no functional impairment, such as vascular cognitive impairment-no dementia(VCIND), to full-blown vascular dementia(VaD). Accurate diagnosis of vascular cognitive impairment is important but may be difficult. In this review we report advances in VCI in the following areas: etiology, subtypes, neuropsychology, biomarkers, neuroimaging, and diagnostic criteria.

  9. Cognitive impairment effects of early life stress in adolescents can be predicted with early biomarkers: Impacts of sex, experience, and cytokines.

    Science.gov (United States)

    Grassi-Oliveira, Rodrigo; Honeycutt, Jennifer A; Holland, Freedom H; Ganguly, Prabarna; Brenhouse, Heather C

    2016-09-01

    Childhood adversity increases vulnerability to psychiatric disorders that emerge in adolescence, in a sex-dependent manner. Early adversity modeled in rodents with maternal separation (MS) affects cognition and medial prefrontal cortex (mPFC) circuitry. Humans and animals exposed to early life adversity also display heightened circulating inflammatory cytokines, however the predictive relationship of these early measures with later behavioral deficits is unknown. Here, male and female rats were exposed to MS or control rearing during the postnatal period (P2-21). Blood samples were taken at distinct developmental time points for analysis of the pro-inflammatory cytokine IL-1β and the anti-inflammatory cytokines IL-4, and IL-10, followed by win-shift cognitive testing and analysis of mPFC parvalbumin (PVB) immunofluorescent interneurons in adolescence. Regression analyses were conducted to explore the relationship between early cytokines and adolescent behavioral measures. We observed sex- and age-dependent effects of MS on circulating cytokines. MS also yielded adolescent decreases in mPFC PVB and cognitive deficits, which were predicted by early cytokine expression in a sex- and experience-dependent manner. Taken together, the present data reveals that circulating cytokines and PVB levels are predictive of adolescent cognitive deficits, and therefore provide compelling evidence for a putative role of early biomarkers in mediating MS-induced behavioral dysfunction. Importantly, predictive relationships often depended on sex and on MS history, suggesting that early life experiences may yield individualistic mechanisms of vulnerability compared to the general population.

  10. Mild cognitive impairment in Parkinson's disease

    Directory of Open Access Journals (Sweden)

    Shu-hua LI

    2016-06-01

    Full Text Available Cognitive dysfunction is common non-motor symptom (NMS in Parkinson's disease (PD, which affects the patients' quality of life and increases the burden of caregivers. Cognitive dysfunction in PD can be mild cognitive impairment (MCI or dementia. MCI presents in the early stage of PD and the incidence rate is increasing with the disease progression. In some cases it can advance to dementia. The diagnosis of MCI in PD includes inclusion criteria, exclusion criteria and damage level evaluation. Non-pharmacological therapy, such as exercise and cognitive behavior therapy (CBT can improve the symptoms of MCI in PD, while the pharmacological treatment remains to be further studied. DOI: 10.3969/j.issn.1672-6731.2016.06.002

  11. The usefulness of olfactory fear conditioning for the study of early emotional and cognitive impairment in reserpine model.

    Science.gov (United States)

    Souza, Rimenez R; França, Sanmara L; Bessa, Marília M; Takahashi, Reinaldo N

    2013-11-01

    Due to the ability for depleting neuronal storages of monoamines, the reserpine model is a suitable approach for the investigation of the neurobiology of neurodegenerative diseases. However, the behavioral effects of low doses of reserpine are not always detected by classic animal tests of cognition, emotion, and sensory ability. In this study, the effects of reserpine (0.5-1.0mg/kg) were evaluated in olfactory fear conditioning, inhibitory avoidance, open-field, elevated plus-maze, and olfactory discrimination. Possible protective effects were also investigated. We found that single administration of reserpine impaired the acquisition of olfactory fear conditioning (in both doses) as well as olfactory discrimination (in the higher dose), while no effects were seen in all other tests. Additionally, we demonstrated that prior exposure to environmental enrichment prevented effects of reserpine in animals tested in olfactory fear conditioning. Altogether, these findings suggest that a combined cognitive, emotional and sensory-dependent task would be more sensitive to the effects of the reserpine model. In addition, the present data support the environmental enrichment as an useful approach for the study of resilience mechanisms in neurodegenerative processes.

  12. Cognitive Impairment in Heart Failure

    Directory of Open Access Journals (Sweden)

    Efthimios Dardiotis

    2012-01-01

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

  13. Cognitive impairment in Wilson's disease

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    Norberto Anizio Ferreira Frota

    Full Text Available Abstract Wilson's disease (WD or hepatolenticular degeneration is a rare, genetic and systemic disease, caused by a deficit in the metabolism of copper, leading to its accumulation in different organs, mainly the liver, followed by the central nervous system, especially the basal ganglia. When symptoms begin between the second and third decades of life, approximately 50% of the patients show neurological symptoms. Although dystonia and dysarthria are the most common neurological signs, cognitive changes have been reported since the first cases were described in 1912. Memory change is one of the most common impairments, but other cognitive changes have been reported, including dementia in untreated cases. In this article we review the cognitive changes in WD patients and the occurrence of dementia.

  14. Early diagnosis of mild cognitive impairment and mild dementia through basic and instrumental activities of daily living: Development of a new evaluation tool

    Science.gov (United States)

    Gorus, Ellen

    2017-01-01

    Background Assessment of activities of daily living (ADL) is paramount to determine impairment in everyday functioning and to ensure accurate early diagnosis of neurocognitive disorders. Unfortunately, most common ADL tools are limited in their use in a diagnostic process. This study developed a new evaluation by adopting the items of the Katz Index (basic [b-] ADL) and Lawton Scale (instrumental [i-] ADL), defining them with the terminology of the International Classification of Human Functioning, Disability and Health (ICF), adding the scoring system of the ICF, and adding the possibility to identify underlying causes of limitations in ADL. Methods and findings The construct validity, interrater reliability, and discriminative validity of this new evaluation were determined. From 2015 until 2016, older persons (65–93 y) with normal cognitive ageing (healthy comparison [HC]) (n = 79), mild cognitive impairment (MCI) (n = 73), and Alzheimer disease (AD) (n = 71) underwent a diagnostic procedure for neurocognitive disorders at the geriatric day hospital of the Universitair Ziekenhuis Brussel (Brussels, Belgium). Additionally, the ICF-based evaluation for b- and i-ADL was carried out. A global disability index (DI), a cognitive DI (CDI), and a physical DI (PDI) were calculated. The i-ADL-CDI showed high accuracy and higher discriminative power than the Lawton Scale in differentiating HC and MCI (area under the curve [AUC] = 0.895, 95% CI .840–.950, p = .002), MCI and AD (AUC = 0.805, 95% CI .805–.734, p = .010), and HC and AD (AUC = 0.990, 95% CI .978–1.000, p < .001). The b-ADL-DI showed significantly better discriminative accuracy than the Katz Index in differentiating HC and AD (AUC = 0.828, 95% CI .759–.897, p = .039). This study was conducted in a clinically relevant sample. However, heterogeneity between HC, MCI, and AD and the use of different methods of reporting ADL might limit this study. Conclusions This evaluation of b- and i-ADL can contribute

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

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    Kuniaki Kiuchi

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

  16. The rationale and design of the antihypertensives and vascular, endothelial, and cognitive function (AVEC trial in elderly hypertensives with early cognitive impairment: Role of the renin angiotensin system inhibition

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    Hart Meaghan

    2009-11-01

    Full Text Available Abstract Background Prior evidence suggests that the renin angiotensin system and antihypertensives that inhibit this system play a role in cognitive, central vascular, and endothelial function. Our objective is to conduct a double-blind randomized controlled clinical trial, the antihypertensives and vascular, endothelial, and cognitive function (AVEC, to compare 1 year treatment of 3 antihypertensives (lisinopril, candesartan, or hydrochlorothiazide in their effect on memory and executive function, cerebral blood flow, and central endothelial function of seniors with hypertension and early objective evidence of executive or memory impairments. Methods/Design The overall experimental design of the AVEC trial is a 3-arm double blind randomized controlled clinical trial. A total of 100 community eligible individuals (60 years or older with hypertension and early cognitive impairment are being recruited from the greater Boston area and randomized to lisinopril, candesartan, or hydrochlorothiazide ("active control" for 12 months. The goal of the intervention is to achieve blood pressure control defined as SBP 20 and without clinical diagnosis of dementia or Alzheimer's disease. Individuals who are currently receiving antihypertensives are eligible to participate if the participants and the primary care providers are willing to taper their antihypertensives. Participants undergo cognitive assessment, measurements of cerebral blood flow using Transcranial Doppler, and central endothelial function by measuring changes in cerebral blood flow in response to changes in end tidal carbon dioxide at baseline (off antihypertensives, 6, and 12 months. Our outcomes are change in cognitive function score (executive and memory, cerebral blood flow, and carbon dioxide cerebral vasoreactivity. Discussion The AVEC trial is the first study to explore impact of antihypertensives in those who are showing early evidence of cognitive difficulties that did not reach the

  17. Living Alone With Cognitive Impairment.

    Science.gov (United States)

    Gibson, Allison K; Richardson, Virginia E

    2017-02-01

    Although most individuals experiencing cognitive impairment (CI) reside with a caregiver, an estimated 800,000 live alone. Such individuals may have an increased risk for injury to self or others through self-neglect as a result of the CI symptoms. While persons living alone with CI have been identified as an important area for needed research, few studies have been able to examine this population due to the challenges of identifying and recruiting study participants. By using the National Health & Aging Trends Study data set, the researchers explored the characteristics to describe this population. The results of this study indicated that the majority of persons living with CI were older, widowed females who were not diagnosed with Alzheimer's or dementia but tested positive on cognitive screening measures. Further, the majority of persons living alone with CI relied on adult children and paid professionals as the primary care providers.

  18. Early identification of mild cognitive impairment using incomplete random forest-robust support vector machine and FDG-PET imaging.

    Science.gov (United States)

    Lu, Shen; Xia, Yong; Cai, Weidong; Fulham, Michael; Feng, David Dagan

    2017-09-01

    Alzheimer's disease (AD) is the most common type of dementia and will be an increasing health problem in society as the population ages. Mild cognitive impairment (MCI) is considered to be a prodromal stage of AD. The ability to identify subjects with MCI will be increasingly important as disease modifying therapies for AD are developed. We propose a semi-supervised learning method based on robust optimization for the identification of MCI from [18F]Fluorodeoxyglucose PET scans. We extracted three groups of spatial features from the cortical and subcortical regions of each FDG-PET image volume. We measured the statistical uncertainty related to these spatial features via transformation using an incomplete random forest and formulated the MCI identification problem under a robust optimization framework. We compared our approach to other state-of-the-art methods in different learning schemas. Our method outperformed the other techniques in the ability to separate MCI from normal controls. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Retinal Vascular Fractals and Cognitive Impairment

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    Yi-Ting Ong

    2014-08-01

    Full Text Available Background: Retinal microvascular network changes have been found in patients with age-related brain diseases such as stroke and dementia including Alzheimer's disease. We examine whether retinal microvascular network changes are also present in preclinical stages of dementia. Methods: This is a cross-sectional study of 300 Chinese participants (age: ≥60 years from the ongoing Epidemiology of Dementia in Singapore study who underwent detailed clinical examinations including retinal photography, brain imaging and neuropsychological testing. Retinal vascular parameters were assessed from optic disc-centered photographs using a semiautomated program. A comprehensive neuropsychological battery was administered, and cognitive function was summarized as composite and domain-specific Z-scores. Cognitive impairment no dementia (CIND and dementia were diagnosed according to standard diagnostic criteria. Results: Among 268 eligible nondemented participants, 78 subjects were categorized as CIND-mild and 69 as CIND-moderate. In multivariable adjusted models, reduced retinal arteriolar and venular fractal dimensions were associated with an increased risk of CIND-mild and CIND-moderate. Reduced fractal dimensions were associated with poorer cognitive performance globally and in the specific domains of verbal memory, visuoconstruction and visuomotor speed. Conclusion: A sparser retinal microvascular network, represented by reduced arteriolar and venular fractal dimensions, was associated with cognitive impairment, suggesting that early microvascular damage may be present in preclinical stages of dementia.

  20. Cognitive impairment and mortality among nonagenarians

    DEFF Research Database (Denmark)

    Andersen, Kjeld; Nybo, Hanne; Gaist, David;

    2002-01-01

    the impact of cognitive impairment on mortality over a 2-year period. No cognitive impairment was defined as a score of 24-30 points on the Mini Mental State Examination, mild cognitive impairment was defined as a score of 18-23 points, and severe impairment was defined as a score of 0-17 points. Cox...... regression analysis was applied to adjust for a number of known and suspected factors known or suspected of being associated with cognition and mortality (e.g. sociodemographic factors, sex, smoking, alcohol consumption, depressive symptoms, and physical abilities), and yielded hazard ratios (95% confidence...

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

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    Clara Zancada-Menéndez

    2013-12-01

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

  2. Regional cerebral blood flow estimated by early PiB uptake is reduced in mild cognitive impairment and associated with age in an amyloid-dependent manner.

    Science.gov (United States)

    Gietl, Anton F; Warnock, Geoffrey; Riese, Florian; Kälin, Andrea M; Saake, Antje; Gruber, Esmeralda; Leh, Sandra E; Unschuld, Paul G; Kuhn, Felix P; Burger, Cyrill; Mu, Linjing; Seifert, Burkhardt; Nitsch, Roger M; Schibli, Roger; Ametamey, Simon M; Buck, Alfred; Hock, Christoph

    2015-04-01

    Early uptake of [(11)C]-Pittsburgh Compound B (ePiB, 0-6 minutes) estimates cerebral blood flow. We studied ePiB in 13 PiB-negative and 10 PiB-positive subjects with mild cognitive impairment (MCI, n = 23) and 11 PiB-positive and 74 PiB-negative cognitively healthy elderly control subjects (HCS, n = 85) in 6 bilateral volumes of interest: posterior cingulate cortex (PCC), hippocampus (hipp), temporoparietal region, superior parietal gyrus, parahippocampal gyrus (parahipp), and inferior frontal gyrus (IFG) for the associations with cognitive status, age, amyloid deposition, and apolipoprotein E ε4-allele. We observed no difference in ePiB between PiB-positive and -negative subjects and carriers and noncarriers. EPiB decreased with age in PiB-positive subjects in bilateral superior parietal gyrus, bilateral temporoparietal region, right IFG, right PCC, and left parahippocampal gyrus but not in PiB-negative subjects. MCI had lower ePiB than HCS (left PCC, left IFG, and left and right hipp). Lowest ePiB values were found in MCI of 70 years and older, who also displayed high cortical PiB binding. This suggests that lowered regional cerebral blood flow indicated by ePiB is associated with age in the presence but not in the absence of amyloid pathology.

  3. Heterogenous mechanisms of mild cognitive impairment in Parkinson's disease.

    Science.gov (United States)

    Jellinger, Kurt

    2012-03-01

    Mild cognitive impairment in Parkinson disease (PD-MCI) shows heterogeneity in the clinical presentation, neuropsychology, neuroimaging, and neuropathology, suggesting abnormal metabolic network activities involving several cortical and subcortical systems. Prospective studies using specific biomarkers, including amyloid imaging and CSF biomarkers are important for the diagnosis and prognostic assessment of early cognitive deficits in PD patients.

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

    Science.gov (United States)

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

    2016-10-01

    To evaluate the associations between sensory impairments and 10-year risk of cognitive impairment. The Epidemiology of Hearing Loss Study (EHLS), a longitudinal, population-based study of aging in the Beaver Dam, Wisconsin community. Baseline examinations were conducted in 1993 and follow-up examinations have been conducted every 5 years. General community. EHLS members without cognitive impairment at EHLS-2 (1998-2000). There were 1,884 participants (mean age 66.7) with complete EHLS-2 sensory data and follow-up information. Cognitive impairment was defined as a Mini-Mental State Examination score of impairment was a pure-tone average of hearing thresholds (0.5, 1, 2, 4 kHz) of >25 dB hearing level in either ear, visual impairment was a Pelli-Robson contrast sensitivity of impairment was a San Diego Odor Identification Test score of visual, and olfactory impairment were independently associated with cognitive impairment risk (hearing: hazard ratio (HR) = 1.90, 95% confidence interval (CI) = 1.11-3.26; vision: HR = 2.05, 95% CI = 1.24-3.38; olfaction: HR = 3.92, 95% CI = 2.45-6.26)). Nevertheless, 85% of participants with hearing impairment, 81% with visual impairment, and 76% with olfactory impairment did not develop cognitive impairment during follow-up. The relationship between sensory impairment and cognitive impairment was not unique to one sensory system, suggesting that sensorineural health may be a marker of brain aging. The development of a combined sensorineurocognitive measure may be useful in uncovering mechanisms of healthy brain aging. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  5. Mild cognitive impairment in Parkinson disease: heterogenous mechanisms.

    Science.gov (United States)

    Jellinger, Kurt A

    2013-01-01

    Cognitive impairment is common in Parkinson disease (PD), with long-term longitudinal studies reporting that most PD patients develop dementia. A high proportion of patients with PD and mild cognitive impairment (MCI) progress to dementia within a short time. Impairments occur in a range of cognitive domains, but single-domain impairment is more common than multiple one, non-amnestic more common than amnestic impairment. Although the term MCI applied to PD (PD-MCI) is not without controversy due to the lack of uniform diagnostic consensus criteria, the biological validity of PD-MCI is supported by many recent studies that show heterogenous mechanisms in the clinical presentation, neuropsychology, neuroimaging, biomarkers, and neuropathology, suggesting abnormal metabolic network activities involving several cortical and subcortical nervous systems. Prospective studies using specific biomarkers, including amyloid imaging, and cerebro-spinal fluid biomarkers are warranted for an exact diagnosis and prognostic assessment of early cognitive deficits in PD patients.

  6. Cognitive impairment in COPD: a systematic review

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    Irene Torres-Sánchez

    2015-04-01

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

  7. Current therapy for cognitive impairments

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    Natalia Vasilyevna Vakhnina

    2011-01-01

    Full Text Available Cognitive impairments (CIs are a highly common type of neurological disorders particularly in elderly patients. Choice of a therapeutic strategy for CI is determined by the etiology of abnormalities and their degree. Measures to prevent CI progression and dementia: adequate treatment of existing cardiovascular diseases, prevention of stroke, balanced nutrition, moderate physical and intellectual exercises, and combatting overweight and low activity are of basic value in treating mild and moderate CIs. According to the data of a number of investigations, the above measures reduce the risk of dementia, including in the genetically predisposed. Pharmacotherapy for mild and moderate CIs generally comprises vasoactive, neurometabolic, and noradrenergic agents. The indication for the use of memantine and/or acetylcholinergic agents, i.e. basic therapy for the most common forms of dementia (Alzheimer's disease, Lewy body dementia, vascular, and mixed dementia, hepatic colics is severe CIs. The long-term use of memantine and/or acetylcholinergic agents alleviates the cognitive and behavioral symptoms of dementia, enhances self-dependence in patients, and prolongs their active lifetime.

  8. Caregivers of older adults with cognitive impairment.

    Science.gov (United States)

    DeFries, Erin L; McGuire, Lisa C; Andresen, Elena M; Brumback, Babette A; Anderson, Lynda A

    2009-04-01

    Because of the growing number of caregivers and the awareness of related health and quality-of-life issues, caregiving has emerged as an important public health issue. We examined the characteristics and caregiving experiences of caregivers of people with and without cognitive impairment. Participants (n = 668) were adults who responded to the 2005 North Carolina Behavioral Risk Factor Surveillance System. Caregivers were people who provided regular care to a family member or friend aged 60 years or older either with or without cognitive impairment (ie, memory loss, confusion, or Alzheimer's disease). Demographic characteristics of caregivers of people with cognitive impairment were similar to those of caregivers of people without cognitive impairment. However, compared with caregivers of people without cognitive impairment, caregivers of people with cognitive impairment reported higher levels of disability, were more likely to be paid, and provided care for a longer duration. Care recipients with cognitive impairment were more likely than care recipients without cognitive impairment to be older, have dementia or confusion, and need assistance with memory and learning. State-level caregiving surveillance is vital in assessing and responding to the needs of the growing number of caregivers.

  9. Cognition and Cognitive Impairment in Older Adults with Cancer.

    Science.gov (United States)

    Magnuson, Allison; Mohile, Supriya; Janelsins, Michelle

    2016-09-01

    Aging is a risk factor for cognitive impairment as well as cancer. However, the interplay between these three entities - aging, cognition and cancer - is not well understood. Mounting evidence indicates that both cancer and cancer therapies, such as chemotherapy, can negatively affect cognition and that older adults with pre-existing cognitive impairment may be more susceptible to cognitive decline with therapy than younger patients. For an older adult, decline in cognition may significantly compromise their ability to remain independent in the community. Pre-existing cognitive impairment, at the time of a cancer diagnosis, may also carry an increased risk of treatment-related adverse events in older adults receiving chemotherapy. Growing research suggests behavioral interventions may be helpful in improving chemotherapy-related cognitive changes; however, these interventions have been mainly evaluated in younger patients in whom pre-existing cognitive impairment is less prevalent. Here we review the studies on: cognitive changes associated with cancer and cancer therapies with an emphasis on studies conducted in older adults, relevant screening tools to evaluate cognition in the geriatric oncology setting, and possible intervention strategies for managing cognitive impairment.

  10. Cognitive impairments in alcohol-dependent subjects

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    Florent eBernardin

    2014-07-01

    Full Text Available Chronic excessive alcohol consumption induces cognitive impairments mainly affecting executive functions, episodic memory, and visuospatial capacities related to multiple brain lesions. These cognitive impairments not only determine everyday management of these patients, but also impact on the efficacy of management and may compromise the abstinence prognosis. Maintenance of lasting abstinence is associated with cognitive recovery in these patients, but some impairments may persist and interfere with the good conduct and the efficacy of management. It therefore appears essential to clearly define neuropsychological management designed to identify and evaluate the type and severity of alcohol-related cognitive impairments. It is also essential to develop cognitive remediation therapy so that the patient can fully benefit from the management proposed in addiction medicine units.

  11. Happy and sad judgements in dependence on mode and note density in patients with mild cognitive impairment and early-stage Alzheimer's disease.

    Science.gov (United States)

    Kerer, Manuela; Marksteiner, Josef; Hinterhuber, Hartmann; Kemmler, Georg; Bliem, Harald R; Weiss, Elisabeth M

    2014-01-01

    In Western cultures it has often been assumed that the experience of happy or sad emotions while listening to music is clearly correlated to the key (mode) and the tempo of the musical piece. Recent studies point towards more complex dependencies, but knowledge in this line of research is still very limited, especially regarding the experience of music for persons with memory-related disorders such as dementia. This pilot study explores the emotional content of music for patients with mild cognitive impairment (MCI) and early-stage Alzheimer's disease (AD) and compares them to healthy subjects. A new test was specifically designed for this study and presented to 10 patients with MCI diagnosis, 10 with AD diagnosis and 23 controls. The test comprised musical stimuli consisting of chords and short musical pieces in major and minor mode with variable note density (number of notes per second). In the current study no significant correlation between key and the attribution of 'happy' or 'sad' judgements to a musical piece could be found in all groups. Note density, however, was shown to exhibit a strong influence on happy/sad judgements in all groups. Our findings indicate that the note density of a musical piece is much more important for happy/sad judgements than the key. Furthermore, the diagnosis MCI and early AD had no influence on the attribution of emotional expressions to musical pieces, corroborating recent findings of spared memory for music in these patient groups.

  12. Cognitive Impairments Associated with CFS and POTS

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    Leonard A. Jason

    2013-05-01

    Full Text Available Chronic fatigue syndrome (CFS is characterized by fatigue, sleep dysfunction, and cognitive deficits (Fukuda et al., 1994. Research surrounding cognitive functioning among patients with CFS has found difficulty with memory, attention, and information processing. A similar disorder, postural tachycardia syndrome (POTS, is characterized by increased heart rate, fatigue, and mental cloudiness (Raj et al., 2009. Potential implications of cognitive deficits for patients with CFS and/or POTS are discussed, including difficulties with school and/or employment. A few biological theories (i.e., kindling, impairments in the central nervous system, and difficulty with blood flow have emerged as potential explanations for the cognitive deficits reported in both CFS and POTS Future research should continue to examine possible explanations for cognitive impairments in CFS and POTS, and ultimately use this information to try and reduce cognitive impairments for these patients.

  13. Mild cognitive impairment in Parkinson's disease

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    LUO Xiao-guang

    2013-08-01

    Full Text Available Cognitive impairment is one of the most common non-motor symptoms of Parkinson's disease (PD and a major influencing factor on patients' daily living ability. Mild cognitive impairment (MCI is a cognitive state between normal aging and dementia, and the living capability of MCI patients relatively remains. MCI often occurs in PD, with its clinical features presenting as the impairment in working memory and (or attention, executive function, language ability, memory and visuospatial function. Here we try to depict the general picture of PD-MCI from the view of epidemiology, pathology, clinical presentation, imaging and diagnostic criteria.

  14. [Non-pharmacological treatment of cognitive impairment].

    Science.gov (United States)

    Ramos Cordero, Primitivo; Yubero, Raquel

    2016-06-01

    This article reviews the effect of non-pharmacological therapies in persons with cognitive impairment, especially treatments aimed at brain stimulation and functional maintenance, since both pharmacological and non-pharmacological therapies affecting the cognitive and psychoaffective domains are reviewed in another article in this supplement. The article also discusses the close and reciprocal relationship between cognitive impairment, diet and nutritional status and describes the main nutritional risk factors and protective factors in cognitive decline. Copyright © 2016 Sociedad Española de Geriatría y Gerontología. Publicado por Elsevier España, S.L.U. All rights reserved.

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

    LENUS (Irish Health Repository)

    O'Caoimh, Rónán

    2012-09-01

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

  16. Association among depression, cognitive impairment and executive dysfunction after stroke

    Directory of Open Access Journals (Sweden)

    Luisa Terroni

    Full Text Available ABSTRACT The relationship between depression and cognitive impairment, frequent after stroke, is complex and has not been sufficiently elucidated. Objective: To review the relationship between post-stroke depression and cognitive impairment. Methods: We performed a PubMed database search spanning the last ten years, using the terms post-stroke depression, cognitive dysfunction, cognitive impairment and neuropsychological tests. Our target studies were original quantitative studies that investigated the relationship between post-stroke depression (PSD and cognitive impairment in stroke patients. Articles published in English, Spanish, Italian and Portuguese were considered. Selection criteria were the use of neuropsychological tests to assess cognitive function, and of either instruments to diagnose major depression, or scales to assess depressive symptoms, within the first three months after stroke. Results: Six original quantitative studies fulfilled the criteria. The prevalence of PSD within the first three months after stroke ranged from 22% to 31%. Incidence ranged from 25% to 27% and was evaluated in only two studies. PSD was associated with increased cognitive impairment. Cognitive impairment was reported in 35.2% to 87% of the patients. Post-stroke cognitive deficits were reported mostly in executive function, memory, language, and speed of processing. Conclusion: Executive dysfunction and depression occur in stroke survivors, are frequently coexistent, and also associated with worse stroke prognosis. Healthcare professionals need to address and provide adequate treatment for depression and executive dysfunctions in stroke patients early in the first three months after stroke. Future studies should evaluate the efficacy of programs evaluating the early detection and treatment of PSD and executive dysfunction in stroke survivors.

  17. Cognitive impairment in multiple sclerosis

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    Kutashov V.A.

    2016-06-01

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

  18. Biomarkers for dementia and mild cognitive impairment in Parkinson's disease.

    Science.gov (United States)

    Delgado-Alvarado, Manuel; Gago, Belén; Navalpotro-Gomez, Irene; Jiménez-Urbieta, Haritz; Rodriguez-Oroz, María C

    2016-06-01

    Cognitive decline is one of the most frequent and disabling nonmotor features of Parkinson's disease. Around 30% of patients with Parkinson's disease experience mild cognitive impairment, a well-established risk factor for the development of dementia. However, mild cognitive impairment in patients with Parkinson's disease is a heterogeneous entity that involves different types and extents of cognitive deficits. Because it is not currently known which type of mild cognitive impairment confers a higher risk of progression to dementia, it would be useful to define biomarkers that could identify these patients to better study disease progression and possible interventions. In this sense, the identification among patients with Parkinson's disease and mild cognitive impairment of biomarkers associated with dementia would allow the early detection of this process. This review summarizes studies from the past 25 years that have assessed the potential biomarkers of dementia and mild cognitive impairment in Parkinson's disease patients. Despite the potential importance, no biomarker has as yet been validated. However, features such as low levels of epidermal and insulin-like growth factors or uric acid in plasma/serum and of Aß in CSF, reduction of cerebral cholinergic innervation and metabolism measured by PET mainly in posterior areas, and hippocampal atrophy in MRI might be indicative of distinct deficits with a distinct risk of dementia in subgroups of patients. Longitudinal studies combining the existing techniques and new approaches are needed to identify patients at higher risk of dementia. © 2016 International Parkinson and Movement Disorder Society.

  19. Increased matrix metalloproteinase 9 activity in mild cognitive impairment.

    Science.gov (United States)

    Bruno, Martin A; Mufson, Elliott J; Wuu, Joanne; Cuello, A Claudio

    2009-12-01

    Nerve growth factor (NGF)-dependent cholinergic basal forebrain neurons degenerate during the progression of Alzheimer disease (AD). Elevated proNGF and reduced levels of the TrkA high-affinity NGF receptor occur in prodromal and advanced stages of AD. We recently described a protease cascade responsible for the conversion of proNGF to mature NGF (mNGF) in which matrix metalloproteinase 9 (MMP-9) degrades mNGF in the extracellular space. To determine whether this proteolytic cascade is altered during the progression of AD, we examined human frontal and parietal cortex tissues from aged subjects with a clinical diagnosis of AD, mild cognitive impairment, or no cognitive impairment. The analysis demonstrated greater MMP-9 activity in both AD and mild cognitive impairment compared with no cognitive impairment brain samples (p < 0.01), which supports the notion that a metabolic failure in the NGF-maturation/degradation pathway may be associated with an exacerbated degradation of mNGF in the cerebral cortex in early AD. Moreover, there were inverse correlations between Global Cognitive Score and Mini-Mental State Examination score and MMP-9 activity. These findings suggest that a reduction in mNGF as a consequence of MMP-9-mediated degradation may in part underlie the pathogenesis of cognitive deficits in mild cognitive impairment and AD.

  20. Hyperhomocysteinemia is associated with cognitive impairment in multiple sclerosis.

    Science.gov (United States)

    Russo, C; Morabito, F; Luise, F; Piromalli, A; Battaglia, L; Vinci, A; Trapani Lombardo, V; de Marco, V; Morabito, P; Condino, F; Quattrone, A; Aguglia, Umberto

    2008-01-01

    Hyperhomocysteinemia (HHcy) has been associated with cognitive impairment in various neurological diseases. Cognitive impairment occurs early in multiple sclerosis (MS). Conflicting data have been reported regarding plasma total homocysteine (tHcy) levels in MS patients, and the impact of HHcy on cognitive impairment in MS is not known. This study investigated whether plasma total homocysteine levels are increased in MS and if HHcy is associated with cognitive impairment in MS. We compared tHcy levels in 94 patients with MS and 53 healthy age-matched controls. We used a neuropsychological test battery that included the Raven's Coloured Progressive Matrices, the Visual Search Test, the Trail Making Test A and B, the Immediate and Delayed Recall of a Short Story, the 30 Paired Word Associates, the Rey-Osterrieth Complex Figure Test, and the Semantic and Verbal Fluency Tests. Clinical (sex, age, type of MS, relapse, disease duration, coexisting disease, smoking habit, and physical disability) and laboratory variables (HHcy, low serum levels of folate and vit.B12, MTHFR genotype) were evaluated for their ability to predict cognitive impairment. The mean tHcy was higher in patients (13.19 micromol/L, SD5.58) than in controls (9.81 micromol/L, SD2.53; p < 0.001). Univariate analysis determined the following factors to be associated with cognitive impairment: higher age at observation, chronic progressive course of disease, longer disease duration,moderate or severe physical disability, and frequency of HHcy. With multivariate regression analysis, there remained a significant association only between frequency of HHcy and cognitive impairment (beta 0.262, p = 0.01). We conclude that tHcy levels are increased in MS and that HHcy is associated with cognitive impairment in this disease.

  1. Screening for Cognitive Impairment in Older Adults

    Science.gov (United States)

    ... evidence to make a recommendation for or against screening all older adults for cognitive impairment. The Task Force recognizes that ... there was not enough evidence to determine whether screening all older adults would be beneficial. It therefore could not recommend ...

  2. Measuring hope among families impacted by cognitive impairment.

    Science.gov (United States)

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

    2016-07-01

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

  3. Measuring and managing cognitive impairment in HIV.

    Science.gov (United States)

    Nightingale, Sam; Winston, Alan

    2017-06-01

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

  4. Early cost-utility analysis of general and cerebrospinal fluid-specific Alzheimer's disease biomarkers for hypothetical disease-modifying treatment decision in mild cognitive impairment

    NARCIS (Netherlands)

    Handels, Ron L. H.; Joore, Manuela A.; Tran-Duy, An; Wimo, Anders; Wolfs, Claire A. G.; Verhey, Frans R. J.; Severens, Johan L.

    2015-01-01

    Introduction: The study aimed to determine the room for improvement of a perfect cerebrospinal fluid (CSF) biomarker and the societal incremental net monetary benefit of CSF in subjects with mild cognitive impairment (MCI) assuming a hypothetical disease-modifying Alzheimer's disease (AD) treatment.

  5. Biomarkers for Early Diagnostic of Mild Cognitive Impairment in Type-2 Diabetes Patients: A Multicentre, Retrospective, Nested Case–Control Study

    Directory of Open Access Journals (Sweden)

    Zhi-Peng Xu

    2016-03-01

    Interpretation: Aging, activation of peripheral circulating GSK-3β, expression of ApoE ε4 and increase of olfactory score are diagnostic for the mild cognitive impairment in T2DM patients, and combination of these biomarkers can improve the diagnostic accuracy.

  6. Cognitive impairment and stroke in elderly patients

    Directory of Open Access Journals (Sweden)

    Lo Coco D

    2016-03-01

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

  7. Cognitive function following stroke and vascular cognitive impairment

    NARCIS (Netherlands)

    de Haan, Edward H.; Nys, Gudrun M.; Van Zandvoort, Martine J.

    2006-01-01

    Purpose of review This review of the cognitive status following stroke and vascular cognitive impairment starts by questioning the concept of vascular dementia and related concepts. Our position is that in many cases these labels promote a superficial conceptualization of an inherently complex and h

  8. Cognitive impairment and preferences for current health

    Directory of Open Access Journals (Sweden)

    Tsevat Joel

    2009-01-01

    Full Text Available Abstract Background We assessed preferences for current health using the visual analogue scale (VAS, standard gamble (SG, time trade-off (TTO, and willingness to pay (WTP in patients with cerebral aneurysms, a population vulnerable to cognitive deficits related to aneurysm bleeding or treatment. Methods We measured VAS, SG, TTO, and WTP values for current health in 165 outpatients with cerebral aneurysms. We assessed cognitive impairment with the Mini Mental State Examination (MMSE; scores Results Eleven patients (7% had MMSE scores Conclusion Cognitive impairment is associated with lower preferences for current health in patients with cerebral aneurysms. Cognitively impaired patients have poor inter-preference test correlations and different response distributions compared to unimpaired patients.

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

    Directory of Open Access Journals (Sweden)

    Anabel Chade

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

  10. Parkinson’s Disease and Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Yang Yang

    2016-01-01

    Full Text Available Parkinson’s disease (PD is a progressive neurodegenerative disease primarily characterized by the hallmarks of motor symptoms, such as tremor, bradykinesia, rigidity, and postural instability. However, through clinical investigations in patients and experimental findings in animal models of Parkinson’s disease for years, it is now well recognized that Parkinson’s disease is more than just a motor-deficit disorder. The majority of Parkinson’s disease patients suffer from nonmotor disabilities, for instance, cognitive impairment, autonomic dysfunction, sensory dysfunction, and sleep disorder. So far, anti-PD prescriptions and surgical treatments have been mainly focusing on motor dysfunctions, leaving cognitive impairment a marginal clinical field. Within the nonmotor symptoms, cognitive impairment is one of the most common and significant aspects of Parkinson’s disease, and cognitive deficits such as dysexecutive syndrome and visuospatial disturbances could seriously affect the quality of life, reduce life expectancy, prolong the duration of hospitalization, and therefore increase burdens of caregiver and medical costs. In this review, we have done a retrospective study of the recent related researches on epidemiology, clinical manifestation and diagnosis, genetics, and potential treatment of cognitive deficits in Parkinson’s disease, aiming to provide a summary of cognitive impairment in Parkinson’s disease and make it easy for clinicians to tackle this challenging issue in their future practice.

  11. Cognitive Impairment in Rural Elderly Population in Ecuador

    Science.gov (United States)

    Wong-Achi, Xavier; Egas, Gabriela; Cabrera, Dayana

    2017-01-01

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

  12. Vascular cognitive impairment: Current concepts and Indian perspective

    Directory of Open Access Journals (Sweden)

    Alladi Suvarna

    2010-10-01

    Full Text Available Cognitive impairment due to cerebrovascular disease is termed "Vascular Cognitive Impairment" (VCI and forms a spectrum that includes Vascular Dementia (VaD and milder forms of cognitive impairment referred to as Vascular Mild Cognitive Impairment (VaMCI. VCI represents a complex neurological disorder that occurs as a result of interaction between vascular risk factors such as hypertension, diabetes, obesity, dyslipidemia, and brain parenchymal changes such as macro and micro infarcts, haemorrhages, white matter changes, and brain atrophy occurring in an ageing brain. Mixed degenerative and vascular pathologies are increasingly being recognised and an interaction between the AD pathology, vascular risk factors, and strokes is now proposed. The high cardiovascular disease burden in India, increasing stroke incidence, and ageing population have contributed to large numbers of patients with VCI in India. Inadequate resources coupled with low awareness make it a problem that needs urgent attention, it is important identify patients at early stages of cognitive impairment, to treat appropriately and prevent progression to frank dementia.

  13. Cognitive impairment in rural elderly population in ecuador

    Directory of Open Access Journals (Sweden)

    Xavier Wong-Achi

    2017-01-01

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

  14. [Cognitive rehabilitation in early stage Alzheimer's disease].

    Science.gov (United States)

    Kasper, E; Thöne-Otto, A; Bürger, K; Schröder, S G; Hoffmann, W; Schneider, W; Teipel, S

    2016-07-01

    Dementia impairs the coping with routine daily tasks and social relationships due to an increasing degeneration of cognitive abilities. An appropriate treatment must adequately consider the effects of declined cognitive abilities on patients and their environment. Therefore, in recent times, integrative procedures for cognitive rehabilitation (CR) have become increasingly important for the therapy of patients with mild cognitive impairment (MCI) and mild dementia (MD). CR approaches provide compensatory possibilities for clearly defined routine challenges and the individual needs of those affected. This overview article in the form of a selective review elaborates factors for the effectiveness of CR on the basis of the currently available literature: 1) individuality - consideration of personal needs and targets, 2) compensation - mediation of skills and strategies to compensate for cognitive impairments, 3) interaction - inclusion of relatives and environmental conditions and 4) integration - integration of various therapeutic disciplines and methods. On the basis of this assessment with regards to the content, a critical analysis of the methods of short and long-term therapeutic effects on MCD and MD was carried out. Although the resulting factors were of high long-term relevance for the improvement of depression and quality of life, effects on cognition were more pronounced for MCI than for MD, which emphasizes the importance of beginning therapy as early as possible. The results show that future studies on effectiveness must employ endpoints relevant for routine daily life, and that the possibility of an implementation of therapeutic concepts in a healthcare system should be considered as an essential criterion.

  15. Sexual Behavior Among Persons With Cognitive Impairments.

    Science.gov (United States)

    Thom, Robyn P; Grudzinskas, Albert J; Saleh, Fabian M

    2017-05-01

    Although the cognitively impaired are frequently included in heterogeneous studies of problematic sexual behavior, the epidemiology, etiology, and approach to assessment and treatment of persons with dementia and intellectual disability are distinct from those of the general population. The incidence of inappropriate sexual behavior among the intellectually disabled is 15-33%; however, the nature tends to be more socially inappropriate than with violative intent. Limited sociosexual education is a large contributor, and better addressing this area offers a target for prevention and treatment. A thorough clinical assessment of problematic sexual behaviors in the cognitively impaired requires understanding the patient's internal experience, which can be challenging. Assessment tools validated for the general population have not been validated for this population. Very few studies have assessed treatment approaches specifically among the cognitively impaired; however, research does suggest utility in habilitative, psychotherapeutic, and pharmacologic approaches which have been validated among the general population.

  16. Early impairment of cognitive functions in Parkinson's disease Comprometimento precoce das funções cognitivas na doença de Parkinson

    Directory of Open Access Journals (Sweden)

    Florindo Stella

    2007-06-01

    Full Text Available BACKGROUND: Impairment in non-motor functions such as disturbances of some executive functions are also common events in Parkinson's disease patients. OBJECTIVE: To verify the performance of Parkinson's disease patients in activities requiring visuoconstructive and visuospatial skills. METHOD: Thirty elderly patients with mild or moderate stages of Parkinson's disease were studied. The assessment of the clinical condition was based on the unified Parkinson's disease rating scale (56.28; SD=33.48, Hoehn and Yahr (2.2; SD=0.83, Schwab and England (78.93%, clock drawing test (7.36; SD=2.51, and mini-mental state examination (26.48; SD=10.11. Pearson's correlation and stepwise multiple regression were used for statistical analyses. RESULTS: The patients presented deterioration in visuospatial and visuoconstructive skills. CONCLUSION: The clock drawing test proved to be a useful predictive tool for identifying early cognitive impairment in thesbe individuals.CONTEXTO: Comprometimento em funções não-motoras como perturbações em algumas funções executivas são também eventos comuns em pacientes com doença de Parkinson. OBJETIVO: Verificar as performances de pacientes com doença de Parkinson em atividades que requerem habilidades visuo-construtivas e visuo-espaciais. MÉTODO: Pacientes idosos (n=30 nos estágios leve ou moderado da doença de Parkinson foram estudados. O diagnóstico da condição clínica foi realizado por meio de: unified Parkinson's disease rating scale (56,28; SD=33,48, Hoehn e Yahr (2,2; SD=0,83, Schwab e England (78,93%, teste do desenho do relógio (7,36; SD=2,51, e mini-exame do estado mental (26,48; SD=10,11. A correlação de Pearson e a análise de regressão múltipla foram empregadas na análise estatística. RESULTADOS: Os pacientes apresentaram deterioração nas habilidades vísuo-espaciais e visuoconstrutivas. CONCLUSÃO: O teste do desenho do relógio provou ser uma ferramenta útil e preditiva para

  17. [Functional impairment associated with cognitive impairment in hospitalised elderly].

    Science.gov (United States)

    Ocampo-Chaparro, José Mauricio; Mosquera-Jiménez, José Ignacio; Davis, Annabelle S; Reyes-Ortiz, Carlos A

    2017-06-24

    The aim of this study was to analyse the effect of cognitive impairment on functional decline in hospitalised patients aged ≥60 years. Measurements at admission included demographic data, Charlson's comorbidity index, and cognitive impairment (according to education level). Data were also collected on hospital length of stay, depression, and delirium developed during hospitalisation. The outcome, Barthel Index (BI), was measured at admission, discharge, and 1-month post-discharge. Patients with BI≤75 at admission (n=54) or with a missing BI value were excluded (n=1). Multivariate logistic regression analyses were conducted to explore predictive factors with functional decline (BI≤75) from admission to discharge, and 1-month later. Of the 133 patients included, 24.8% and 19.6% had a BI≤75 at discharge and at 1-month, respectively. Compared with men, women had more than double risk for functional decline at discharge and 1-month (P<.05). Compared with those without delirium and without cognitive impairment, those with delirium and cognitive impairment had an increased risk for functional decline (BI≤75) at discharge (OR 5.15, 95% CI; 1.94-13.67), and at 1-month (OR 6.26, 95% CI; 2.30-17.03). Similarly, those with comorbidity (≥2) had increased functional decline at discharge (OR 2.36, 95% CI; 1.14-4.87), and at 1-month after discharge (OR 2.71, 95% CI; 1.25-5.89). Delirium during hospitalisation, together with cognitive impairment on admission, was a strong predictor of functional decline. Copyright © 2017 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Polypharmacy Cutoff for Gait and Cognitive Impairments

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    Antoine Langeard

    2016-08-01

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

  19. Mild cognitive impairment: safe to drive?

    Science.gov (United States)

    Olsen, Kirsty; Taylor, John-Paul; Thomas, Alan

    2014-06-01

    Driving is an important aspect of daily living and for many older people provides autonomy and psycho-social benefits. Cognitive impairment has been found to impact driving skills at the level of dementia, however, uncertainty remains around the impact of a diagnosis of the pre-dementia condition mild cognitive impairment. Current official guidelines are unclear, and assessment of fitness to drive can be problematical. This editorial examines current official guidance available to the clinician and problems with existing assessment as well as the current position of research specifically into MCI and driving, and considers future direction for research in this field.

  20. Brain imaging of mild cognitive impairment and Alzheimer's disease

    Institute of Scientific and Technical Information of China (English)

    Changhao Yin; Siou Li; Weina Zhao; Jiachun Feng

    2013-01-01

    The rapidly increasing prevalence of cognitive impairment and Alzheimer's disease has the potential to create a major worldwide healthcare crisis. Structural MRI studies in patients with Alzheimer's disease and mild cognitive impairment are currently attracting considerable interest. It is extremely important to study early structural and metabolic changes, such as those in the hippocampus, entorhinal cortex, and gray matter structures in the medial temporal lobe, to allow the early detection of mild cognitive impairment and Alzheimer's disease. The microstructural integrity of white matter can be studied with diffusion tensor imaging. Increased mean diffusivity and decreased fractional anisotropy are found in subjects with white matter damage. Functional imaging studies with positron emission tomography tracer compounds enable detection of amyloid plaques in the living brain in patients with Alzheimer's disease. In this review, we will focus on key findings from brain imaging studies in mild cognitive impairment and Alzheimer's disease, including structural brain changes studied with MRI and white matter changes seen with diffusion tensor imaging, and other specific imaging methodologies will also be discussed.

  1. Charles Bonnet syndrome and cognitive impairment: a systematic review.

    Science.gov (United States)

    Russell, Gregor; Burns, Alistair

    2014-05-22

    ABSTRACT Background: Charles Bonnet syndrome (CBS) is defined as complex persistent visual hallucinations in the absence of mental disorder. It is common in conditions causing significant visual impairment. Many authors advise reassurance, considering the condition benign. However, others have suggested that CBS may in some patients represent the early stages of dementia. This review seeks to systematically examine the evidence for any link between CBS and cognitive impairment. Methods: Literature search using OVID Medline, PsychINFO, and Embase. Results: Three studies where cognitive functioning was the primary focus of the research were found. All were small, did not properly apply diagnostic criteria, and reported conflicting results. Eight other studies commented on cognitive functioning, but none used tests sufficiently sensitive to detect changes seen in early dementia. One hundred and thirty four case reports were scrutinized, and reports found of 16 patients with CBS where dementia emerged. High rates of partial insight at diagnosis of CBS were seen in these patients. Conclusions: There have been no adequately powered studies, using accepted diagnostic criteria, where changes in cognitive functioning were the primary outcome. Existing studies are of limited methodological quality and allow no conclusion regarding a relationship between cognitive impairment and CBS to be reached. Numerous case reports of dementia developing in patients with CBS and partial insight raise the possibility of a link between these conditions. There is a clear need for properly constructed studies to investigate this.

  2. Cognitive impairment in heart failure patients

    Institute of Scientific and Technical Information of China (English)

    Laura Leto; Mauro Feola

    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, altera-tions of cerebrovascular reactivity and modification of blood pressure levels are the main features involved in the etiopathogenetic mecha-nisms 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 avail-able data pointing out assured information and discussing possible areas of research development.

  3. Persistent cognitive impairment after transient ischemic attack

    NARCIS (Netherlands)

    Rooij, F.G. van; Schaapsmeerders, P.; Maaijwee, N.A.; Duijnhoven, D.A. van; Leeuw, F.E. de; Kessels, R.P.; Dijk, E.J. van

    2014-01-01

    BACKGROUND AND PURPOSE: By definition, the symptoms of a transient ischemic attack (TIA) subside completely within 24 hours. Imaging studies show signs of persistent ischemic tissue damage in a substantial amount of patients with TIA. Cerebral infarction can cause permanent cognitive impairment. Whe

  4. Persistent Cognitive Impairment After Transient Ischemic Attack

    NARCIS (Netherlands)

    Rooij, F.G. van; Schaapsmeerders, P.; Maaijwee, N.A.M.M.; Duijnhoven, D.A. van; de Leeuw, F.E.; Kessels, R.P.C.; Dijk, E.J. van

    2014-01-01

    Background and Purpose—By definition, the symptoms of a transient ischemic attack (TIA) subside completely within 24 hours. Imaging studies show signs of persistent ischemic tissue damage in a substantial amount of patients with TIA. Cerebral infarction can cause permanent cognitive impairment. Whet

  5. Cognitive impairment in relapsing remitting Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Saška Roškar

    2003-06-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  7. Piracetam treatment in patients with cognitive impairment.

    Science.gov (United States)

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

    2013-01-01

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

  8. Pro-inflammatory S100A9 Protein as a Robust Biomarker Differentiating Early Stages of Cognitive Impairment in Alzheimer's Disease.

    Science.gov (United States)

    Horvath, Istvan; Jia, Xueen; Johansson, Per; Wang, Chao; Moskalenko, Roman; Steinau, Andreas; Forsgren, Lars; Wågberg, Thomas; Svensson, Johan; Zetterberg, Henrik; Morozova-Roche, Ludmilla A

    2016-01-20

    Pro-inflammatory protein S100A9 was established as a biomarker of dementia progression and compared with others such as Aβ(1-42) and tau-proteins. CSF samples from 104 stringently diagnosed individuals divided into five subgroups were analyzed, including nondemented controls, stable mild cognitive impairment (SMCI), mild cognitive impairment due to Alzheimer's disease (MCI-AD), Alzheimer's disease (AD), and vascular dementia (VaD) patients. ELISA, dot-blotting, and electrochemical impedance spectroscopy were used as research methods. The S100A9 and Aβ(1-42) levels correlated with each other: their CSF content decreased already at the SMCI stage and declined further under MCI-AD, AD, and VaD conditions. Immunohistochemical analysis also revealed involvement of both Aβ(1-42) and S100A9 in the amyloid-neuroinflammatory cascade already during SMCI. Tau proteins were not yet altered in SMCI; however their contents increased during MCI-AD and AD, diagnosing later dementia stages. Thus, four biomarkers together, reflecting different underlying pathological causes, can accurately differentiate dementia progression and also distinguish AD from VaD.

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

    Science.gov (United States)

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

    2014-06-01

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

  10. Quantitative analysis of brain metabolites in patients,with non-dementia vascular cognitive impairment and mild cognitive impairment

    Institute of Scientific and Technical Information of China (English)

    刘艳艳

    2013-01-01

    Objective To investigate metabolite changes in the brain of patients with non-dementia vascular cognitive impairment(VCIND) and mild cognitive impairment(MCI) using magnetic resonance spectroscopy(MRS)

  11. Cognitive Impairment: An Increasingly Important Complication of Type 2 Diabetes

    National Research Council Canada - National Science Library

    Saczynski, Jane S; Jónsdóttir, María K; Garcia, Melissa E; Jonsson, Palmi V; Peila, Rita; Eiriksdottir, Gudny; Olafsdottir, Elin; Harris, Tamara B; Gudnason, Vilmundur; Launer, Lenore J

    2008-01-01

    Persons with type 2 diabetes are at increased risk of cognitive dysfunction. Less is known about which cognitive abilities are affected and how undiagnosed diabetes and impaired fasting glucose relate to cognitive performance...

  12. White Matter Damage in the Cholinergic System Contributes to Cognitive Impairment in Subcortical Vascular Cognitive Impairment, No Dementia

    Science.gov (United States)

    Liu, Qing; Zhu, Zude; Teipel, Stefan J.; Yang, Jianwei; Xing, Yi; Tang, Yi; Jia, Jianping

    2017-01-01

    Cholinergic deficiency has been implicated in the pathogenesis of vascular cognitive impairment (VCI), but the extent of involvement and underlying mechanism remain unclear. In this study, targeting the early stage of VCI, we determined regional atrophy within the basal forebrain and deficiency in cholinergic pathways in 25 patients with vascular cognitive impairment no dementia (VCIND) compared to 24 healthy elderly subjects. By applying stereotaxic cytoarchitectonic maps of the nucleus basalis of Meynert (NbM), no significant atrophy was identified in VCIND. Using probabilistic tractography analysis, our study tracked the two major white matter tracks which map to cholinergic pathways. We identified significantly lower fractional anisotropy (FA) in VCIND. Mediation analysis demonstrated that FA in the tracked pathways could fully account for the executive dysfunction, and partly mediate the memory and global cognition impairment. Our study suggests that the fibers mapped to the cholinergic pathways, but not the NbM, are significantly impaired in VCIND. MRI-based in vivo tracking of cholinergic pathways together with NbM measurement may become a valuable in vivo marker for evaluating the cholinergic system in cognitive disorders. PMID:28289381

  13. Electronic reminding technology for cognitive impairment.

    Science.gov (United States)

    Mason, Sarah; Craig, David; O'Neill, Sonia; Donnelly, Mark; Nugent, Chris

    Demographic changes highlight the need to address disabilities associated with the costly morbidities of old age, such as dementia. Memory impairment associated with dementia represents a significant challenge for many older people. Difficulties occur in carrying out activities in their entirety or in commencing them at all. Technology has the potential to help individuals overcome the barriers created by cognitive disability in terms of performing activities of daily living and therefore help to maintain independence and enhance quality of life (Czaja, 2005). This literature review examines the current reported research, which employs electronic reminding technology to support individuals with cognitive impairment. These devices range from everyday technologies, such as phones, to sophisticated interactive devices with specifically designed software. A summary of the current evidence base is presented and recommendations for future practice are made.

  14. Cognitive impairment after sudden cardiac arrest

    OpenAIRE

    Jaszke-Psonka, Magdalena; Piegza, Magdalena; Ścisło, Piotr; Pudlo, Robert; Piegza, Jacek; Badura-Brzoza, Karina; Leksowska, Aleksandra; Hese, Robert T.; Gorczyca, Piotr W.

    2016-01-01

    Aim To evaluate the incidence and severity of the impairment of selected cognitive functions in patients after sudden cardiac arrest (SCA) in comparison to patients after myocardial infarction without SCA and healthy subjects and to analyze the influence of sociodemographic and clinical parameters and the duration of cardiac arrest on the presence and severity of the described disorders. Material and methods The study group comprised 30 cardiac arrest survivors, the reference group comprised ...

  15. Cognitive Training in Older Adults with Mild Cognitive Impairment

    Institute of Scientific and Technical Information of China (English)

    LIU Xin Yan; LI Li; XIAO Jia Qing; HE Chang Zhi; LYU Xiu Lin; GAO Lei; YANG Xiao Wei; CUI Xin Gang; FAN Li Hua

    2016-01-01

    ObjectiveWe investigated the feasibility and efficacy of cognitive training for older adults in rural settings and with low education levels, who have mild cognitive impairment (MCI). MethodsForty-five older adults (ages >65 years) with MCI were assigned to treatment or control groups, at a 2:1 ratio. Cognitivetraining occurred in the treatment group for 2 months. The cognitive abilities of the participants were assessed at pre-training, metaphase, and post-training time points, using the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), and Hamilton Depression Scale (HAM-D). ResultsFollowing training, cognitive abilities improved in the treatment group, based on the total scores of all 4 measures, as well as specifically on the MoCA and LOTCA. There were differences in the main effects of group and time point on some subscales, but these differences had little, if any, effect on the overall analyses. ConclusionThe present study demonstrated that cognitive training has beneficial effects on attention, language, orientation, visual perception, organization of visual movement, and logical questioning in patients with MCI. Furthermore, the observed effects are long-term changes.

  16. Differences in cognitive impairment between schizophrenia and bipolar disorder: Considering the role of heterogeneity.

    Science.gov (United States)

    Bora, Emre

    2016-10-01

    Schizophrenia is associated with significant cognitive impairment. Bipolar disorder (BD) also presents with cognitive deficits that are similar to, albeit less severe, than those reported in schizophrenia. There has been controversy over whether selective deficits in social cognition or developmental trajectory of cognitive deficits can distinguish schizophrenia from BD. Also, available studies have not generally considered the potential effect of cognitive heterogeneity within the two disorders on between-group differences. The current review examines the evidence on the specificity of social cognitive deficits and early neurocognitive impairment to schizophrenia and explores the overall outcome of studies investigating within and cross-diagnosis cognitive heterogeneity in schizophrenia and BD. Current evidence does not support the specificity of social cognitive impairment to schizophrenia. Available studies also suggest that cognitive impairment in premorbid and early stages is evident not only in schizophrenia but also in many BD patients. Both schizophrenia and BD have a number of cognitive subgroups, including severe impairment, good functioning, and one or more selective or modest impairment clusters. While both disorders are represented in each cognitive subgroup, there are significant cross-diagnostic differences regarding prevalences of individuals belonging to the severe impairment and good functioning subgroups. Individuals with schizophrenia are much more likely to exhibit severe cognitive impairment than individuals with BD and good cognitive functioning is more often observed in BD patients than schizophrenia patients. Further identification of the neurobiological and genetic characteristics of the cognitive subgroups in major psychoses can improve the validity of diagnostic systems and can advance the development of personalized management approaches, including cognitive remediation.

  17. Cognitive reserve and cognitive impairments: drug and nondrug treatments

    Directory of Open Access Journals (Sweden)

    E.I. Dainikova

    2014-01-01

    Full Text Available The paper discusses concepts, such as cognitive reserve (CR and cognitive impairments (CI. It presents the controlled and uncorrectable factors that influence CR and considers the factors of increasing CR and reducing the risk of dementia. The mechanisms responsible for the development of vascular CIs and the role of vascular factor in the occurrence of neurodegenerative disease, primarily Alzheimer's disease and Parkinson's disease, are covered. The issues of correcting CIs in cerebrovascular and neurodegenerative diseases are discussed. The conception of CR is shown to be of value in the planning of management tactics for each patient to prevent dementia by drug and non-drug treatments.

  18. The concept of vascular cognitive impairment.

    Science.gov (United States)

    Bowler, J V

    2002-11-15

    Vascular dementia (VaD) is increasingly recognised to reflect an outmoded concept in that it identifies cases too late for preventive therapy to have an opportunity to prevent the development of dementia and uses a cognitive paradigm inappropriately based on Alzheimer's disease. A replacement is urgently required and a new concept, that of vascular cognitive impairment (VCI), has been proposed to meet this need. It is imperative that criteria for VCI are developed on the basis of knowledge and data rather than supposition and assumption, as was the case for VaD. This review details the state of knowledge that we have now reached concerning the fundamental points of severity and cognitive paradigm and also covers a number of other imaging-related essential points embracing atrophy, leukoaraiosis, infarct volume and infarct location. Finally, the increasingly important concept of mixed dementia (co-existent Alzheimer's disease and VCI) is discussed.

  19. CSF cortisol in Alzheimer's disease and mild cognitive impairment.

    Science.gov (United States)

    Popp, Julius; Schaper, Karsten; Kölsch, Heike; Cvetanovska, Gabriela; Rommel, Fatima; Klingmüller, Dietrich; Dodel, Richard; Wüllner, Ullrich; Jessen, Frank

    2009-03-01

    Hypercortisolaemia occurs in Alzheimer's disease (AD) and may be involved in the AD related neurodegenerative process. In order to determine whether brain structures are exposed to high cortisol concentrations early in AD, we measured cerebrospinal fluid (CSF) cortisol in 66 subjects with AD, 33 subjects with mild cognitive impairment (MCI) and 34 control subjects. CSF cortisol concentrations were higher in AD subjects compared to controls (pcortisol in MCI subjects compared with controls suggesting that the increase of CSF cortisol is not an early event in the course of AD.

  20. Brain Health: The Importance of Recognizing Cognitive Impairment: An IAGG Consensus Conference

    Science.gov (United States)

    Morley, John E.; Morris, John C.; Berg-Weger, Marla; Borson, Soo; Carpenter, Brian D.; del Campo, Natalia; Dubois, Bruno; Fargo, Keith; Fitten, L. Jaime; Flaherty, Joseph H.; Ganguli, Mary; Grossberg, George T.; Malmstrom, Theodore K.; Petersen, Ronald D.; Rodriguez, Carroll; Saykin, Andrew J.; Scheltens, Philip; Tangalos, Eric G.; Verghese, Joe; Wilcock, Gordon; Winblad, Bengt; Woo, Jean; Vellas, Bruno

    2016-01-01

    Cognitive impairment creates significant challenges for patients, their families and friends, and clinicians who provide their health care. Early recognition allows for diagnosis and appropriate treatment, education, psychosocial support, and engagement in shared decision-making regarding life planning, health care, involvement in research, and financial matters. An IAGG-GARN consensus panel examined the importance of early recognition of impaired cognitive health. Their major conclusion was that case-finding by physicians and health professionals is an important step toward enhancing brain health for aging populations throughout the world. This conclusion is in keeping with the position of the United States’ Centers for Medicare and Medicaid Services that reimburses for detection of cognitive impairment as part the of Medicare Annual Wellness Visit and with the international call for early detection of cognitive impairment as a patient’s right. The panel agreed on the following specific findings: (1) validated screening tests are available that take 3 to 7 minutes to administer; (2) a combination of patient- and informant-based screens is the most appropriate approach for identifying early cognitive impairment; (3) early cognitive impairment may have treatable components; and (4) emerging data support a combination of medical and lifestyle interventions as a potential way to delay or reduce cognitive decline. PMID:26315321

  1. A Behavioural Approach to Helping an Older Adult with a Learning Disability and Mild Cognitive Impairment Overcome Depression

    Science.gov (United States)

    Green, Paul

    2017-01-01

    Background: There is a considerable body of evidence to suggest that behavioural activation for depression is an equally effective but less complex treatment than cognitive behavioural therapy. It may therefore be more suitable for those who are cognitively impaired (i.e. early-stage dementia or mild cognitive impairment) or have a learning…

  2. A Behavioural Approach to Helping an Older Adult with a Learning Disability and Mild Cognitive Impairment Overcome Depression

    Science.gov (United States)

    Green, Paul

    2017-01-01

    Background: There is a considerable body of evidence to suggest that behavioural activation for depression is an equally effective but less complex treatment than cognitive behavioural therapy. It may therefore be more suitable for those who are cognitively impaired (i.e. early-stage dementia or mild cognitive impairment) or have a learning…

  3. Probabilistic Sequence Learning in Mild Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Dezso eNemeth

    2013-07-01

    Full Text Available Mild Cognitive Impairment (MCI causes slight but noticeable disruption in cognitive systems, primarily executive and memory functions. However, it is not clear if the development of sequence learning is affected by an impaired cognitive system and, if so, how. The goal of our study was to investigate the development of probabilistic sequence learning, from the initial acquisition to consolidation, in MCI and healthy elderly control groups. We used the Alternating Serial Reaction Time task (ASRT to measure probabilistic sequence learning. Individuals with MCI showed weaker learning performance than the healthy elderly group. However, using the reaction times only from the second half of each learning block – after the reactivation phase - we found intact learning in MCI. Based on the assumption that the first part of each learning block is related to reactivation/recall processes, we suggest that these processes are affected in MCI. The 24-hour offline period showed no effect on sequence-specific learning in either group but did on general skill learning: the healthy elderly group showed offline improvement in general reaction times while individuals with MCI did not. Our findings deepen our understanding regarding the underlying mechanisms and time course of sequence acquisition and consolidation.

  4. Cognitive Impairment Involving Social Cognition in SPG4 Hereditary Spastic Paraplegia

    Directory of Open Access Journals (Sweden)

    Ludivine Chamard

    2016-01-01

    Full Text Available Objectives. To describe cognitive assessment including social cognition in SPG4 patients. Methods. We reported a series of nine patients with SPG4 mutation with an extensive neuropsychological examination including social cognition assessment. Results. None of our patients presented with mental retardation or dementia. All presented with mild cognitive impairment with a high frequency of attention deficit (100%, executive disorders (89%, and social cognition impairment (78%. An asymptomatic patient for motor skills presented with the same cognitive profile. No correlation was found in this small sample between cognitive impairment and motor impairment, age at disease onset, or disease duration. Conclusions. SPG4 phenotypes share some cognitive features of frontotemporal lobar degeneration and amyotrophic lateral sclerosis. Cognitive disorders including executive disorders and social cognition impairment are frequent in SPG4 patients and might sometimes occur before motor disorders. Therefore, cognitive functions including social cognition should be systematically assessed in order to improve the clinical management of this population.

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

    LENUS (Irish Health Repository)

    O'Caoimh, Rónán

    2013-05-01

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

  6. Social cognitive impairment and autism: what are we trying to explain?

    Science.gov (United States)

    Leekam, Susan

    2016-01-19

    Early psychological theories of autism explained the clinical features of this condition in terms of perceptual and sensory processing impairments. The arrival of domain-specific social cognitive theories changed this focus, postulating a 'primary' and specific psychological impairment of social cognition. Across the years, evidence has been growing in support of social cognitive and social attention explanations in autism. However, there has also been evidence for general non-social cognitive impairments in representational understanding, attention allocation and sensory processing. Here, I review recent findings and consider the case for the specificity and primacy of the social cognitive impairment, proposing that we should focus more explicitly on clinically valid features for insights on the integration of 'social' and 'non-social' cognition.

  7. Cognitive impairments in patients with brain injury

    Directory of Open Access Journals (Sweden)

    Vladimir Vladimirovich Zakharov

    2013-01-01

    Full Text Available The paper gives the data of Russian and foreign authors and the results of this paper authors’ investigation of higher cerebral functions in patients who have sustained brain injury (BI. It shows their high prevalence, the predominance of cognitive impairments (CI over neurological disorders in patients with mild and moderate injury, presents their quantitative and qualitative features (a preponderance of focal symptoms in severe injury and neurodynamic disorders in mild injury, describes the predictors of their course and prognosis (the degree of injury is one of the most important predictors, and discusses current trends in the medical correction of detected abnormalities.

  8. Hypersexuality among cognitively impaired older adults.

    Science.gov (United States)

    Wallace, Meredith; Safer, Meredith

    2009-01-01

    Hypersexuality, also referred to in the literature as sexually inappropriate behavior and sexual disinhibition, involves persistent, uninhibited sexual behaviors directed at oneself or at others. For older adults, the literature generally attributes the behavior to biochemical or physiological changes that accompany cognitive impairment-specifically, dementia. Although less common than other behavioral issues, such as aggression and agitation, hypersexuality presents complex logistical and ethical problems for caregivers. This article reviews the current literature on hypersexual behavior. Assessment essentials as well as nonpharmacological and pharmacological treatment approaches are discussed, identifying the need for standardization as well as caregiver education and training.

  9. Vascular cognitive impairments in chronic kidney disease

    Directory of Open Access Journals (Sweden)

    I. V. Rogova

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Helmut Hildebrandt

    2013-04-01

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

  11. White matter hyperintensities, executive function and global cognitive performance in vascular mild cognitive impairment

    Directory of Open Access Journals (Sweden)

    Felipe Kenji Sudo

    2013-07-01

    Full Text Available Vascular mild cognitive impairment (VaMCI represents an early symptomatic stage of vascular cognitive impairment and might be associated to fronto-executive dysfunction. Methods Twenty-six individuals (age: 73.11±7.90 years; 65.4% female; schooling: 9.84±3.61 years were selected through neuropsychological assessment and neuroimaging. Clinical and neuroimaging data of VaMCI individuals (n=15 were compared to normal controls (NC, n=11 and correlated with Fazekas scale. Results VaMCI performed significantly worse than NC in Trail-Making Test (TMT B, errors in TMT B, difference TMT B-A and Cambridge Cognitive Examination (CAMCOG final scores. Correlations were found among scores in modified Fazekas scale and performances in TMT B (time to complete and errors, difference TMT B-A and CAMCOG total score. Conclusion Extension of white matter hyperintensities might be correlated to poorer global cognition and impairments in a set of fronto-executive functions, such as cognitive speed, set shifting and inhibitory control in VaMCI.

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

    Directory of Open Access Journals (Sweden)

    Indra F. Willers

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

  13. Neuroimaging correlates of cognitive impairment and dementia in Parkinson's disease.

    Science.gov (United States)

    Mak, Elijah; Su, Li; Williams, Guy B; O'Brien, John T

    2015-08-01

    There has been a gradual shift in the definition of Parkinson's disease, from a movement disorder to a neurodegenerative condition affecting multiple cognitive domains. Mild cognitive impairment (PD-MCI) is a frequent comorbidity in PD that is associated with progression to dementia (PDD) and debilitating consequences for patients and caregivers. At present, the pathophysiology underpinning cognitive impairment in PD is not established, although emerging evidence has suggested that multi-modal imaging biomarkers could be useful in the early diagnosis of PD-MCI and PDD, thereby identifying at-risk patients to enable treatment at the earliest stage possible. Structural MRI studies have revealed prominent grey matter atrophy and disruptions of white matter tracts in PDD, although findings in non-demented PD have been more variable. There is a need for further longitudinal studies to clarify the spatial and temporal progression of morphological changes in PD, as well as to assess their underlying involvement in the evolution of cognitive deficits. In this review, we discuss the aetiology and neuropsychological profiles of PD-MCI and PDD, summarize the putative imaging substrates in light of evidence from multi-modal neuroimaging studies, highlight limitations in the present literature, and suggest recommendations for future research.

  14. Increased Matrix Metalloproteinase-9 Activity in Mild Cognitive Impairment

    Science.gov (United States)

    Bruno, Martin A.; Mufson, Elliott J.; Wuu, Joanne; Cuello, A. Claudio

    2010-01-01

    Nerve growth factor (NGF)-dependent cholinergic basal forebrain neurons degenerate during the progression of Alzheimer disease (AD). Elevated proNGF and reduced levels of the TrkA high-affinity NGF receptor occur in prodromal and advanced stages of AD. We recently described a protease cascade responsible for the conversion of proNGF to mature NGF (mNGF) in which matrix metalloproteinase 9 (MMP-9) degrades mNGF in the extracellular space. To determine whether this proteolytic cascade is altered during the progression of AD, we examined human frontal and parietal cortex tissue from aged subjects with a clinical diagnosis of AD, mild cognitive impairment (MCI) or no cognitive impairment (NCI). The analysis demonstrated greater MMP-9 activity in both AD and MCI compared to NCI brain samples (p < 0.01), which supports the notion that a metabolic failure in the NGF-maturation/degradation pathway may be associated with an exacerbated degradation of mNGF in the cerebral cortex in early AD. Moreover, there were inverse correlations between Global Cognitive Score and Mini-Mental State Examination score and MMP-9 activity. These findings suggest that a reduction in mNGF as a consequence of MMP-9-mediated degradation may in part underlie the pathogenesis of cognitive deficits in MCI and AD. PMID:19915485

  15. Cognitive impairment in human chronic Chagas' disease

    Directory of Open Access Journals (Sweden)

    C.A. Mangone

    1994-06-01

    Full Text Available We proposed to investigate subclinical cognitive impairment secondary to chronic Chagas' disease (CCD. No similar study was previously done. The neuropsychological performance of 45 chronic Chagasic patients and 26 matched controls (age, education place and years of residency in endemic area was compared using the Mini Mental State Exam (MMSE, Weschler Memory Scale (WMS and the Weschler Adult Intelligent Scale (WAIS. Non-parametric tests and Chi2 were used to compare group means and multivariate statistics in two way frequency tables for measures of independence and association of categorical variables with the disease. Results: Chagasic patients showed lower MMSE scores (p<004, poor orientation (p<.004, and attention (p<.007. Lower WMS MQ were associated with CCD (Chi2 5.9; p<.01; Fisher test p<.02. Lower WAIS IQ were associated with CCD (Chi2 6.3, p<.01; Fisher test p<.01 being the digit symbol (p<.03, picture completion (p<.03, picture arrangement (p<.01 and object assembly (p<.03 subtests the most affected. The impairment in non-verbal reasoning, speed of information processing, problem solving, learning and sequencing observed in chronic Chagas disease patients resembles the cognitive dysfunction associated with white matter disease.

  16. Cognitive Impairment and Disability in Older Japanese Adults

    OpenAIRE

    Hiroyuki Shimada; Hyuma Makizako; Takehiko Doi; Kota Tsutsumimoto; Sangyoon Lee; Takao Suzuki

    2016-01-01

    The prevalence of disability is increasing due to an expanding aging population and an increasing incidence of chronic health problems. Cognitive impairment may predict the development of disability in older adults. Therefore, we examined the association of mild cognitive impairment (MCI) and/or general cognitive impairment (GCI, defined as a Mini Mental State Examination [MMSE] score of 20-23) with the development of disability in a cohort of Japanese community-dwelling older adults. A total...

  17. The Experience of Cognitive Impairment in People with Psychosis.

    Science.gov (United States)

    Wood, Helen; Cupitt, Caroline; Lavender, Tony

    2015-01-01

    Cognitive impairment has been widely studied in people with psychosis. However, research is lacking into the subjective experience of cognitive impairment, its impact and ways in which individuals cope. This study aimed to provide an account of the experience of cognitive impairment in people with a diagnosis of schizophrenia, including what difficulties people experience, how these difficulties are understood, how people respond to these difficulties and how they perceive others' views of these difficulties. A semi-structured interview was carried out with eight participants with a diagnosis of schizophrenia focusing on participants' experiences of difficulties with cognitive functioning. Interpretative phenomenological analysis was used to analyse interview transcripts. Experience of cognitive impairment was understood in terms of six master themes: impaired controlled thinking, physical sensations and impaired movement, explanations for the impairment and comparisons to the past, managing the impairment, how others see the impairment and anticipating the future. This study is the first rigorous qualitative study of the subjective experience of cognitive impairment in people with psychosis, and it provides greater context for empirical findings. The results have significant implications for clinical psychology, including education about cognitive difficulties and the importance of cognitive functioning to formulation. New areas for research include coping strategies in relation to functioning and future perspectives, ascertaining staff understanding of cognitive impairment, and reflective conversation style as an intervention for metacognitive difficulties. Key Practitioner Message Difficulties with cognitive functioning should be considered in clinical practitioners' formulations of clients' difficulties in the context of psychosis. Services should consider providing service user and carer education about cognitive impairment in psychosis. Staff may need further

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

    Science.gov (United States)

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

    2016-09-01

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

  19. Greater cortical thinning in normal older adults predicts later cognitive impairment

    Science.gov (United States)

    Pacheco, Jennifer; Goh, Joshua O.; Kraut, Michael A.; Ferrucci, Luigi; Resnick, Susan M.

    2014-01-01

    Cross-sectional studies have shown regional differences in cortical thickness between healthy older adults and patients with Alzheimer’s disease (AD) or mild cognitive impairment (MCI). We now demonstrate that participants who subsequently develop cognitive impairment leading to a diagnosis of MCI or AD (n=25) experience greater cortical thinning in specific neuroanatomical regions compared to control participants who remained cognitively normal (n=96). Based on 8 years of annual MRI scans beginning an average of 11 years prior to onset of cognitive impairment, participants who developed cognitive impairment subsequent to the scanning period had greater longitudinal cortical thinning in the temporal poles and left medial temporal lobe compared to controls. No significant regional cortical thickness differences were found at baseline between the two study groups indicating that we are capturing a critical time when brain changes occur before behavioral manifestations of impairment are detectable. Our findings suggest that early events of the pathway that leads to cognitive impairment may involve the temporal lobe, and that this increased atrophy could be considered an early biomarker of neurodegeneration predictive of cognitive impairment years later. PMID:25311277

  20. Greater cortical thinning in normal older adults predicts later cognitive impairment.

    Science.gov (United States)

    Pacheco, Jennifer; Goh, Joshua O; Kraut, Michael A; Ferrucci, Luigi; Resnick, Susan M

    2015-02-01

    Cross-sectional studies have shown regional differences in cortical thickness between healthy older adults and patients with Alzheimer's disease (AD) or mild cognitive impairment (MCI). We now demonstrate that participants who subsequently develop cognitive impairment leading to a diagnosis of MCI or AD (n = 25) experience greater cortical thinning in specific neuroanatomic regions compared with control participants who remained cognitively normal (n = 96). Based on 8 years of annual magnetic resonance imaging scans beginning an average of 11 years before onset of cognitive impairment, participants who developed cognitive impairment subsequent to the scanning period had greater longitudinal cortical thinning in the temporal poles and left medial temporal lobe compared with controls. No significant regional cortical thickness differences were found at baseline between the 2 study groups indicating that we are capturing a critical time when brain changes occur before behavioral manifestations of impairment are detectable. Our findings suggest that early events of the pathway that leads to cognitive impairment may involve the temporal lobe and that this increased atrophy could be considered an early biomarker of neurodegeneration predictive of cognitive impairment years later.

  1. Cognitive-Behavioral Group Therapy: Applications with Adolescents Who Are Cognitively Impaired and Sexually Acting Out.

    Science.gov (United States)

    Butler, Scott F.; Fontenelle, Scuddy F., III

    1995-01-01

    Measured the effect of cognitive-behavioral group therapy used to decrease inappropriate sexual behaviors among male adolescents in a residential treatment program who are mildly and moderately cognitively impaired. Findings indicated that with adolescents who are cognitively impaired, group and cognitive-behavioral approaches that specifically…

  2. Diabetes and microvascular disease in Vascular Cognitive Impairment

    NARCIS (Netherlands)

    Brundel, M.

    2014-01-01

    The contribution of cerebrovascular disease in the development of cognitive dysfunction and dementia is increasingly recognized. Cerebrovascular damage is heterogeneous, ranging from a clinical stroke to more insidious brain changes. The term vascular cognitive impairment (VCI) has been introduced,

  3. Relatedl factors of cognitive impairment after stroke

    Institute of Scientific and Technical Information of China (English)

    Xiaofang Chen; Yueji Sun; Haiyan Liu; Yunqiao Ding; Shujuan Liu; Jinghua Chen; Xueying Wang; Zhenpeng Han; Fang Qu

    2006-01-01

    BACKGROUND: Cognitive impairment after stroke associates with various factors, such as age, educational years, etc. Besides concerning about the recovery of limb function after stroke, we should also focus on the rehabilitation of cognition. Moreover, we'd better pay attention to the control of all the risk factors of stroke, and improve the quality of life in stroke patients.OBJECTIVE: To analyze the factors that affect cognitive impairment after stroke.DESIGN: A related factors analysis.SET-FINGS: Department of Neurology of Dalian Port Hospital and Dalian Second People's Hospital.PARTICIPANTS: Totally 148 stroke inpatients were selected from Department of Neurology, Dalian Port Hospital and Dalian Second People's Hospital from April 2004 to December 2005, including 100 males and 48females, aging 45-75 years with an average age of (67±8) years; Their educational years ranged 2-10 years with an average of (6.1 ±3.7) years; The disease course ranged 15-30 days; All were right-handed. Inclusive criteria: All were accorded with the diagnostic standard set by the Fourth National Academic Meeting for Cerebrovascular Disease; Confirmed by CT or MRI; Informed consents were obtained from all the subjects.METHODS: After the disease conditions were stable, the patients were assessed with Wechsler memory scale (WMS) and Wisconsin card sorting test (WCST). WMS included forward and backward recitation of numbers and short-term memory (verbal memory, visual recognition). The number of times for correct and wrong classifications in WCST and the time to complete the trail making tests A and B were recorded. The focal volume, area and layer were recorded at 24 hours after admission. The general data of the patients were recorded, including name, sex, age, educational years, history of hypertension, history of diabetes mellitus.Electroencepalograph (EEC) was examined to record the wave shape, blood lipids were detected, and the cognition related indexes were analyzed with the

  4. Research progress of MRI for cognitive impairment in multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Xiao-fei ZHANG

    2016-04-01

    Full Text Available Multiple sclerosis (MS is a common inflammatory demyelinating disease that affects the central nervous system (CNS. It may be accompanied by cognitive impairment, however, the mechanism for cognitive impairment in multiple sclerosis is still unknown. More and more MRI techniques are used to improve the understanding on pathogenetic mechanism of cognitive impairment in multiple sclerosis. This paper summarizes MRI measures currently available to explain the possible mechanism for cognitive impairment of multiple sclerosis. DOI: 10.3969/j.issn.1672-6731.2016.04.012

  5. Parkinson's disease mild cognitive impairment: application and validation of the criteria

    NARCIS (Netherlands)

    Geurtsen, G.J.; Hoogland, J.; Goldman, J.G.; Schmand, B.A.; Tröster, A.I.; Burn, D.J.; Litvan, I.

    2014-01-01

    Dementia in Parkinson's disease (PD) is a serious health issue and a major concern for many patients. In most cases mild cognitive impairment (MCI) is considered a transitional stage between normal cognitive functioning and dementia which is of potential importance in the early identification of pat

  6. A clinical classification acknowledging neuropsychiatric and cognitive impairment in Huntingtons disease

    DEFF Research Database (Denmark)

    Vinther-Jensen, Tua; Larsen, Ida U; Hjermind, Lena E

    2014-01-01

    BackgroundInvoluntary movements, neuropsychiatric symptoms, and cognitive impairment are all part of the symptom triad in Huntington¿s disease (HD). Despite the fact that neuropsychiatric symptoms and cognitive decline may be early manifestations of HD, the clinical diagnosis is conventionally...

  7. Late life depression with cognitive impairment: Evaluation and treatment

    Directory of Open Access Journals (Sweden)

    Consuelo H Wilkins

    2008-09-01

    Full Text Available Consuelo H Wilkins1,2, Jose Mathews2, Yvette I Sheline21Department of Medicine (Division of Geriatrics and Nutritional Science; 2Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USAAbstract: Older adults with depression often present with signs and symptoms indicative of functional or cognitive impairment. These somatic symptoms make evaluating and treating depression in older adults more complex. Late life depression (LLD, depression in adults over the age of 65, is more frequently associated with cognitive changes. Cognitive impairment in LLD may be a result of the depressive disorder or an underlying dementing condition. Memory complaints are also common in older adults with depression. There is a wide range of cognitive impairment in LLD including decreased central processing speed, executive dysfunction, and impaired short-term memory. The etiology of cognitive impairment in LLD may include cerebrovascular disease, a significant risk factor for LLD, which likely interrupts key pathways between frontal white matter and subcortical structures important in mood regulation. Because depressive symptoms often coexist with dementia, it is important to determine the temporal relationship between depressive symptoms and cognitive change. If depressive symptoms pre-date the cognitive impairment and cognitive symptoms are mild and temporary, LLD is the likely etiology of the cognitive impairment. If cognitive changes appear prior to depressive symptoms and persist after LLD is successfully treated, an underlying dementia is more likely. Clinicians should be exclude common conditions such as thyroid disease which can contribute to depressive symptoms and cognitive impairment prior to treating LLD. Both antidepressants and psychotherapy can be effective in treating LLD. Subsequent evaluations following treatment should also reassess cognition.Keywords: late life depression, cognitive impairment, diagnosis, treatment

  8. Grey matter changes in cognitively impaired Parkinson's disease patients.

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    Irena Rektorova

    Full Text Available BACKGROUND: Cortical changes associated with cognitive decline in Parkinson's disease (PD are not fully explored and require investigations with established diagnostic classification criteria. OBJECTIVE: We used MRI source-based morphometry to evaluate specific differences in grey matter volume patterns across 4 groups of subjects: healthy controls (HC, PD with normal cognition (PD-NC, PD with mild cognitive impairment (MCI-PD and PD with dementia (PDD. METHODS: We examined 151 consecutive subjects: 25 HC, 75 PD-NC, 29 MCI-PD, and 22 PDD at an Italian and Czech movement disorder centre. Operational diagnostic criteria were applied to classify MCI-PD and PDD. All structural MRI images were processed together in the Czech centre. The spatial independent component analysis was used to assess group differences of local grey matter volume. RESULTS: We identified two independent patterns of grey matter volume deviations: a Reductions in the hippocampus and temporal lobes; b Decreases in fronto-parietal regions and increases in the midbrain/cerebellum. Both patterns differentiated PDD from all other groups and correlated with visuospatial deficits and letter verbal fluency, respectively. Only the second pattern additionally differentiated PD-NC from HC. CONCLUSION: Grey matter changes in PDD involve areas associated with Alzheimer-like pathology while fronto-parietal abnormalities are possibly an early marker of PD cognitive decline. These findings are consistent with a non-linear cognitive progression in PD.

  9. Abnormal organization of white matter networks in patients with subjective cognitive decline and mild cognitive impairment

    Science.gov (United States)

    Chen, Guan-Qun; Zhang, Yi-He; Li, Xuan-Yu; Hao, Xu-Yang; Yu, Yang; Zhang, Meng; Sheng, Can; Li, Yu-Xia; Sun, Yu; Li, Hong-Yan; Song, Yang; Li, Kun-Cheng; Yan, Tian-Yi; Tang, Xiao-Ying; Han, Ying

    2016-01-01

    Network analysis has been widely used in studying Alzheimer's disease (AD). However, how the white matter network changes in cognitive impaired patients with subjective cognitive decline (SCD) (a symptom emerging during early stage of AD) and amnestic mild cognitive impairment (aMCI) (a pre-dementia stage of AD) is still unclear. Here, structural networks were constructed respectively based on FA and FN for 36 normal controls, 21 SCD patients, and 33 aMCI patients by diffusion tensor imaging and graph theory. Significantly lower efficiency was found in aMCI patients than normal controls (NC). Though not significant, the values in those with SCD were intermediate between aMCI and NC. In addition, our results showed significantly altered betweenness centrality located in right precuneus, calcarine, putamen, and left anterior cingulate in aMCI patients. Furthermore, association was found between network metrics and cognitive impairment. Our study suggests that the structural network properties might be preserved in SCD stage and disrupted in aMCI stage, which may provide novel insights into pathological mechanisms of AD. PMID:27418146

  10. CURRENT PROBLEMS OF DIAGNOSIS AND TREATMENT OF MILD COGNITIVE IMPAIRMENTS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    G.A. Karkashadze

    2011-01-01

    Full Text Available In practical pediatrics specialists paid wrongly little attention to identification and treatment of cognitive disorders in children. At the same time it is difficult to overestimate the influence of cognitive functions on the formation of human personality and social maladjustment in this part of population. The paper is devoted to the diagnosis and treatment of cognitive impairments. In addition, the classification of this pathology, highlighting aetiopathogenetic factors, prognosis are showed. One of the important problems of early revealing of cognitive impairments and appropriate management of children with this pathology according to the authors opinion are the following: the deficiency of educational programs for training specialists in neurology, lack of knowledge concerning the possibilities of psychological-pedagogical correction, inefficient system of neurological techniques for primary care. Key words: cognitive function, mild cognitive impairment, classification, diagnosis, treatment, prognosis, social maladjustment, psychopedagogical support, children. (Pediatric Pharmacology. — 2011; 8 (5: 37–41.

  11. Mild Cognitive Impairment Status and Mobility Performance

    DEFF Research Database (Denmark)

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

    2014-01-01

    BACKGROUND: The prevalence of mild cognitive impairment (MCI) and mobility limitations is high among older adults. The aim of this study was to investigate the association between MCI status and both performance-based and self-report measures of mobility in community-dwelling older adults. METHODS......MCI), nonmemory domains (naMCI), and multiple domains (mdMCI). Linear regression models were used to assess the association between MCI status and mobility performance in the Habitual Gait Speed, Figure of 8 Walk, Short Physical Performance Battery, and self-reported Late Life Function and Disability Instrument......). All MCI subtypes performed significantly worse than No-MCI on all mobility measures (p Figure of 8 Walk (p = .054) and Basic Lower Extremity (p = .11). Moreover, compared with aMCI, mdMCI manifested worse performance on the Figure of 8 Walk and Short...

  12. Cognitive Impairment in Parkinson's Disease: The Dual Syndrome Hypothesis

    Science.gov (United States)

    Kehagia, Angie A.; Barker, Roger A.; Robbins, Trevor W.

    2012-01-01

    Research into the heterogeneous nature of cognitive impairment documented in patients with Parkinson's disease (PD) has focused on disentangling deficits that vary between individuals, evolve and respond differentially to pharmacological treatments, and relate differentially to PD dementia (PDD). We summarise studies conducted in our laboratory over the last 2 decades, outlining the incremental development of our hypotheses, the starting point for which is our early work on executive deficits mirroring fronto-striatal dysfunction. We present subsequent findings linking these deficits to a model of dopaminergic function that conforms to an inverted curvilinear function. We review studies that investigated the range of dopamine-independent attentional and visuospatial memory deficits seen in PD, demonstrating that abnormalities in these domains more accurately predict PDD. We conclude with an exposition of the dual syndrome hypothesis, which distinguishes between dopaminergically mediated fronto-striatal executive impairments and a dementia syndrome with distinctive prodromal visuospatial deficits in which cholinergic treatments offer some clinical benefits. PMID:23038420

  13. Untangling the Gordian knot of HIV, stress, and cognitive impairment

    Directory of Open Access Journals (Sweden)

    Arielle N. Valdez

    2016-10-01

    Full Text Available As individuals live longer with HIV, this “graying of the HIV epidemic” has introduced a new set of challenges including a growing number of age and inflammation-related diseases such as cardiovascular disease, type II diabetes, cancer, and dementia. The biological underpinnings of these complex and co-morbid diseases are not fully understood and become very difficult to disentangle in the context of HIV and aging. In the current review we examine the contributions and interactions of HIV, stress, and cognitive impairment and query the extent to which inflammation is the linchpin in these dynamic interactions. Given the inter-relatedness of stress, inflammatory mechanisms, HIV, and cognitive impairment, future work will either need to address multiple dimensions simultaneously or embrace the philosophy that breaking the aberrant cycle at any one point will subsequently remedy the other related systems and processes. Such a single-point intervention may be effective in early disease states, but after perpetuation of an aberrant cycle, adaptations in an attempt to internally resolve the issue will likely lead to the need for multifaceted interventions. Acknowledging that HIV, inflammation, and stress may interact with one another and collectively impact cognitive ability is an important step in fully understanding an individual's complete clinical picture and moving towards personalized medicine.

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

    DEFF Research Database (Denmark)

    Vogel, Asmus; Stokholm, Jette; Gade, Anders

    2004-01-01

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

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

    Science.gov (United States)

    Dittrich, Kerstin; Stahl, Christoph

    2012-01-01

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

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

    DEFF Research Database (Denmark)

    Vogel, Asmus; Stokholm, Jette; Gade, Anders

    2004-01-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

  18. Cognitive impairment in affective psychoses: a meta-analysis.

    Science.gov (United States)

    Bora, Emre; Yücel, Murat; Pantelis, Christos

    2010-01-01

    It has recently been suggested that cognitive impairment should be included in the diagnostic criteria of schizophrenia. One of the main arguments in support of this suggestion has been the hope that cognitive impairment can help distinguish schizophrenia from bipolar disorder (BD). However, recent evidence shows that cognitive deficits occur in BD and persist beyond euthymia. Further, mood disorders with psychotic features might be expected to manifest greater cognitive impairment, which further complicates the potential to differentiate these disorders. The goal of the current meta-analysis was to examine the magnitude and characteristics of cognitive impairments in affective psychoses (AP). A systematic search of the existing literature sourced 27 studies that met the inclusion criteria. These studies compared cognitive performances of 763 patients with AP (550 BD and 213 major depressive disorder) and 1823 healthy controls. Meta-regression and subgroup analyses were used to examine the effects of moderator variables. Meta-analyses of these studies showed that patients with AP were impaired in all 15 cognitive tasks with large effect sizes for most measures. There were no significant differences between the magnitude of impairments between the BD and major depressive disorder groups. The largest effect size was found for symbol coding, stroop task, verbal learning, and category fluency, reflecting impairments in elementary and complex aspects of attentional processing, as well as learning and memory. In general, the pattern of cognitive impairments in AP was similar to reported findings in euthymic patients with BD, but relatively more pronounced.

  19. Parental Cognitive Impairment and Child Maltreatment in Canada

    Science.gov (United States)

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

    2011-01-01

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

  20. Observation of curative effect of early intervention for children with cerebral palsy of cognitive impairment%脑瘫儿童认知障碍早期干预的疗效观察

    Institute of Scientific and Technical Information of China (English)

    靳玉洁; 黄茂; 杨路平; 李小平

    2014-01-01

    Objective:To explore the curative effect of early intervention for children with cerebral palsy of cognitive impairment. Methods:121 children with cerebral palsy combined with speech disorder were selected from December 2010 to December 2012. They were randomLy divided into the treatment group with 64 cases and the control group with 57 cases.The control group were given basic treatment and speech training.The treatment group were given acupuncture therapy based on the treatment in control group.We compared the therapeutic effect of 2 groups.Results:In the two group,there was significant difference in efficacy of patients aged from 1 to 3 years old and from 3 to 6 years old(P<0.05).Conclusion:The curative effect of early intervention for children with cerebral palsy of cognitive impairment is significant.%目的:探讨脑瘫儿童认知障碍早期干预的疗效。方法:2010年12月-2012年12月收治脑瘫合并言语障碍患儿121例,随机分为治疗组64例和对照组57例,对照组做基础治疗和言语训练,治疗组在对照组治疗基础上加做头针治疗,比较两组的治疗效果。结果:两组中1~3岁与3~6岁患儿疗效差异有统计学意义(P<0.05)。结论:脑瘫儿童认知障碍早期干预疗效显著。

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

    Directory of Open Access Journals (Sweden)

    Gates N

    2014-05-01

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

  2. Diabetes cognitive impairments and the effect of traditional chinese herbs.

    Science.gov (United States)

    Xu, Xiaohan; Guo, Leilei; Tian, Guoqing

    2013-01-01

    The problem of cognitive impairment resulting from diabetes is gaining more acceptance and attention. Both type 1 and type 2 diabetes mellitus have been proved to be associated with reduced performance on numerous domains of cognitive function. Although the exact mechanisms of cognitive impairments in diabetes have not been completely understood, hyperglycemia and insulin resistance seem to play significant roles. And other possible risk factors such as hypoglycemia, insulin deficiency, vascular risk factors, hyperactive HPA axis, depression, and altered neurotransmitters will also be examined. In the meanwhile, this review analyzed the role of the active ingredient of Chinese herbal medicine in the treatment of diabetes cognitive impairments.

  3. Diabetes Cognitive Impairments and the Effect of Traditional Chinese Herbs

    Directory of Open Access Journals (Sweden)

    Xiaohan Xu

    2013-01-01

    Full Text Available The problem of cognitive impairment resulting from diabetes is gaining more acceptance and attention. Both type 1 and type 2 diabetes mellitus have been proved to be associated with reduced performance on numerous domains of cognitive function. Although the exact mechanisms of cognitive impairments in diabetes have not been completely understood, hyperglycemia and insulin resistance seem to play significant roles. And other possible risk factors such as hypoglycemia, insulin deficiency, vascular risk factors, hyperactive HPA axis, depression, and altered neurotransmitters will also be examined. In the meanwhile, this review analyzed the role of the active ingredient of Chinese herbal medicine in the treatment of diabetes cognitive impairments.

  4. Markers of neurodevelopmental impairments in early-onset psychosis

    Directory of Open Access Journals (Sweden)

    Petruzzelli MG

    2015-07-01

    Full Text Available Maria Giuseppina Petruzzelli,1 Lucia Margari,1 Francesco Craig,1 Maria Gloria Campa,1 Domenico Martinelli,2 Adriana Pastore,3 Marta Simone,1 Francesco Margari3 1Child and Adolescence Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University “Aldo Moro” of Bari, 2Department of Medical and Surgical Sciences; University of Foggia, Foggia, 3Psychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organ, University “Aldo Moro” of Bari, Bari, Italy Background: The aim of this study was to assess the association between the clinical and neurobiological markers of neurodevelopmental impairments and early-onset schizophrenia spectrum psychosis. Methods: A sample of 36 patients with early-onset schizophrenia spectrum psychosis was compared to a control sample of 36 patients with migraine. We assessed early childhood neurodevelopmental milestones using a modified version of the General Developmental Scale, general intellectual ability using the Wechsler Intelligence Scale for Children–Revised or Leiter International Performance Scale–Revised for patients with speech and language abnormalities, and neurological soft signs with specific regard to subtle motor impairment. Results: Subjects with early-onset psychosis had a higher rate of impaired social development (P=0.001, learning difficulties (P=0.04, enuresis (P=0.0008, a lower intelligence quotient (P<0.001, and subtle motor impairments (P=0.005 than control subjects. Conclusion: We suggest that neurodevelopment in early-onset psychosis is characterized by a global impairment of functional and adaptive skills that manifests from early childhood, rather than a delay or limitation in language and motor development. The current evidence is based on a small sample and should be investigated in larger samples in future research. Keywords: early-onset psychosis, early-onset schizophrenia, neurodevelopment, social cognition

  5. Alteration of mTOR signaling occurs early in the progression of Alzheimer disease (AD): analysis of brain from subjects with pre-clinical AD, amnestic mild cognitive impairment and late-stage AD.

    Science.gov (United States)

    Tramutola, Antonella; Triplett, Judy C; Di Domenico, Fabio; Niedowicz, Dana M; Murphy, Michael P; Coccia, Raffaella; Perluigi, Marzia; Butterfield, D Allan

    2015-06-01

    The clinical symptoms of Alzheimer disease (AD) include a gradual memory loss and subsequent dementia, and neuropathological deposition of senile plaques and neurofibrillary tangles. At the molecular level, AD subjects present overt amyloid β (Aβ) production and tau hyperphosphorylation. Aβ species have been proposed to overactivate the phosphoinositide3-kinase (PI3K)/Akt/mammalian target of rapamycin (mTOR) axis, which plays a central role in proteostasis. The current study investigated the status of the PI3K/Akt/mTOR pathway in post-mortem tissue from the inferior parietal lobule (IPL) at three different stages of AD: late AD, amnestic mild cognitive impairment (MCI) and pre-clinical AD (PCAD). Our findings suggest that the alteration of mTOR signaling and autophagy occurs at early stages of AD. We found a significant increase in Aβ (1-42) levels, associated with reduction in autophagy (Beclin-1 and LC-3) observed in PCAD, MCI, and AD subjects. Related to the autophagy impairment, we found a hyperactivation of PI3K/Akt/mTOR pathway in IPL of MCI and AD subjects, but not in PCAD, along with a significant decrease in phosphatase and tensin homolog. An increase in two mTOR downstream targets, p70S6K and 4EBP1, occurred in AD and MCI subjects. Both AD and MCI subjects showed increased, insulin receptor substrate 1, a candidate biomarker of brain insulin resistance, and GSK-3β, a kinase targeting tau phosphorylation. Nevertheless, tau phosphorylation was increased in the clinical groups. The results hint at a link between Aβ and the PI3K/Akt/mTOR axis and provide further insights into the relationship between AD pathology and insulin resistance. In addition, we speculate that the alteration of mTOR signaling in the IPL of AD and MCI subjects, but not in PCAD, is due to the lack of substantial increase in oxidative stress. The figure represents the three different stages of Alzheimer Disease: Preclinical Alzheimer Disease (PCAD), Mild cognitive impairment (MCI

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

    Science.gov (United States)

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

    2017-03-01

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

  7. Effects of Computer Cognitive Training on Depression in Cognitively Impaired Seniors

    Science.gov (United States)

    Allen, Nara L.

    2016-01-01

    The aim of the present study was to investigate the effects of a computer cognitive training program on depression levels in older mildly cognitive impaired individuals. Peterson et al. (1999), defines mild cognitive impairment (MCI) as a transitional stage in which an individual's memory deteriorates and his likelihood of developing Alzheimer's…

  8. Effects of Computer Cognitive Training on Depression in Cognitively Impaired Seniors

    Science.gov (United States)

    Allen, Nara L.

    2016-01-01

    The aim of the present study was to investigate the effects of a computer cognitive training program on depression levels in older mildly cognitive impaired individuals. Peterson et al. (1999), defines mild cognitive impairment (MCI) as a transitional stage in which an individual's memory deteriorates and his likelihood of developing Alzheimer's…

  9. Interventions to reduce cognitive impairments following critical illness

    DEFF Research Database (Denmark)

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

    2016-01-01

    BACKGROUND: Critical illness is associated with cognitive impairments. Effective treatment or prevention has not been established. The aim of this review was to create a systematic summary of the current evidence concerning clinical interventions during intensive care admission to reduce cognitive...... and sleep quality improvement. Data were synthesized to provide an overview of interventions, quality, follow-up assessments and neuropsychological outcomes. CONCLUSION: None of the interventions had significant positive effects on cognitive impairments following critical illness. Quality was negatively...

  10. Diabetes Cognitive Impairments and the Effect of Traditional Chinese Herbs

    OpenAIRE

    Xiaohan Xu; Leilei Guo; Guoqing Tian

    2013-01-01

    The problem of cognitive impairment resulting from diabetes is gaining more acceptance and attention. Both type 1 and type 2 diabetes mellitus have been proved to be associated with reduced performance on numerous domains of cognitive function. Although the exact mechanisms of cognitive impairments in diabetes have not been completely understood, hyperglycemia and insulin resistance seem to play significant roles. And other possible risk factors such as hypoglycemia, insulin deficiency, vascu...

  11. An evaluation of screening measures for cognitive impairment after stroke

    OpenAIRE

    Blake, Holly; McKinney, Michelle; Treece, Karen; Lee, Elizabeth; Lincoln, Nadina B.

    2002-01-01

    Objectives: to assess the sensitivity and specificity of a screening battery for detecting cognitive impairment after stroke. Design: a randomized controlled trial. Methods: stroke patients were recruited from hospitals in three centres. Patients were screened for cognitive impairment on the Mini‐Mental State Examination, the Sheffield Screening Test for Acquired Language Disorders and Raven's Coloured Progressive Matrices and received a further battery of assessments of cognitive f...

  12. Diagnosis of vascular cognitive impairment and its main categories.

    Science.gov (United States)

    Rodríguez García, P L; Rodríguez García, D

    2015-05-01

    A review of current criteria for the diagnosis of categories related with vascular cognitive impairment, in particular the nomenclature, diagnostic criteria, and differential clinical-radiological findings. The criteria for the diagnosis of vascular cognitive impairment have evolved, but available criteria were designed basically for differentiating between vascular dementia and dementia due to Alzheimer disease, and for research purposes. Nevertheless, in clinical practice precise elements are required for: 1) Clinical diagnosis of dementia and mild cognitive impairment; 2) Clinical and neuroimaging criteria for identification of the various cerebrovascular lesions associated with cognitive dysfunction, and 3) A formulation of the aetiogenic-pathogenic relationship between cognitive impairment and cerebrovascular lesions. For this reason, a review was carried out on the diagnostic elements of vascular cognitive impairment categories, classification, and their most relevant characteristics. It highlights the characteristic for the diagnosis of multi-infarction dementia, strategic single infarct dementia, small vessel disease with dementia, mixed dementia, and vascular mild cognitive impairment. Standardisation is required, by a multidisciplinary expert team, as regards nomenclature and criteria for the diagnosis of the full spectrum associated with vascular cognitive impairment and especially for vascular dementia and its categories. Copyright © 2011 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  13. Does cerebral large-artery disease contribute to cognitive impairment?

    Directory of Open Access Journals (Sweden)

    Satoshi Kimura

    2017-09-01

    Conclusion: Impaired cognition was observed in some of the non-demented patients with CLAD. Older age, drinking habit, severe PVH and decreased cerebral perfusion contributed to their poor cognitive performance. Strict treatment of atherosclerosis and intervention for CLAD might be necessary to prevent cognitive decline in these patients.

  14. Lesion-symptom mapping in vascular cognitive impairment

    NARCIS (Netherlands)

    Biesbroek, J.M.

    2016-01-01

    Cerebral vascular disease (CVD) is an important cause of cognitive decline and dementia, either alone or in combination with neurodegenerative diseases, such as Alzheimer's Disease (AD). The contribution of CVD to cognitive decline and dementia is referred to as Vascular Cognitive Impairment (VCI).

  15. Drug therapy and cognitive stimulation in patients with poststroke cognitive impairments

    Directory of Open Access Journals (Sweden)

    D.R. Khasanova

    2014-01-01

    Full Text Available Objective: to compare a multimodal drug approach to treating poststroke cognitive impairments (CI.Patients and methods. Eighty patients with postroke CI in the early recovery period were examined. They were allocated to 4 groups:1 secondary stroke prevention only (a comparison nontreatment group; 2 actovegin infusions; 3 cerebrolysin infusions; 4 drug therapy in combination with non-drug cognitive training using the standard procedure. Follow-ups and neuropsychological assessments were made at the inclusion in the study and 3 and 6 months after stroke. The state of cognitive functions 6 months after stroke was considered to be an endpoint of the study.Results and discussion. At the inclusion in the study, the mini-mental state examination and the frontal lobe dysfunction scale showed no statistical differences in cognitive functions in different patient groups. At a 3-month follow-up, the cognitive status in the neuronal plasticity stimulation groups was significantly better than in the comparison group (p≤0.05. At a 6-month follow-up, there was a significant cognitive improvement in the combined stimulation group versus the drug-therapy and comparison groups (p≤0.05. Day-to-day activities and independent functioning also improved significantly more promptly in the patients receiving drug or combined therapies. More complex instrumental activities of daily living recovered significantly better during combined cognitive function stimulation than during pharmacological stimulation only. There was evidence that the drugs with proven stimulating effects on neuronal plasticity and nondrug cognitive training were effective in treating CI in the early recovery period of stroke. The combined drug and nondrug poststroke CI treatments reflecting the multimodal approach versus drug therapy were found to be most effective in these patients.

  16. Generalized Linear Models of home activity for automatic detection of mild cognitive impairment in older adults.

    Science.gov (United States)

    Akl, Ahmad; Snoek, Jasper; Mihailidis, Alex

    2014-01-01

    With a globally aging population, the burden of care of cognitively impaired older adults is becoming increasingly concerning. Instances of Alzheimer's disease and other forms of dementia are becoming ever more frequent. Earlier detection of cognitive impairment offers significant benefits, but remains difficult to do in practice. In this paper, we develop statistical models of the behavior of older adults within their homes using sensor data in order to detect the early onset of cognitive decline. Specifically, we use inhomogenous Poisson processes to model the presence of subjects within different rooms throughout the day in the home using unobtrusive sensing technologies. We compare the distributions learned from cognitively intact and impaired subjects using information theoretic tools and observe statistical differences between the two populations which we believe can be used to help detect the onset of cognitive decline.

  17. Evaluation of postural balance in mild cognitive impairment through a three-dimensional electromagnetic system.

    Science.gov (United States)

    Borges, Ana Paula Oliveira; Carneiro, José Ailton Oliveira; Zaia, José Eduardo; Carneiro, Antonio Adilton Oliveira; Takayanagui, Osvaldo Massaiti

    2016-01-01

    Elderly people with cognitive impairment are at greater risk for falls; thus, an understanding of the earliest stages of cognitive decline is necessary. To compare postural balance between elderly people with and without mild cognitive impairment using a three-dimensional system. Thirty elderly people with mild cognitive impairment and thirty healthy elderly subjects were selected. Static posturography was performed using three-dimensional electromagnetic equipment and the following parameters were evaluated: maximum displacement, mean speed and total trajectory. Open- and closed-eye stabilometric variable comparisons between groups and within each group were carried out, and a relationship between the Mini Mental State Examination and the total trajectory of all elderly subjects was determined. The analysis among open- and closed-eye conditions showed a significant difference in maximum anteroposterior displacement in the control group and a significant difference in all stabilometric variables in the mild cognitive impairment group. A significant difference between the groups in all variables in the closed-eye condition was observed. There was a strong correlation between cognitive performance and total trajectory. Evaluations showed decrease in balance in elderly people with mild cognitive impairment. Presence of anteroposterior displacement can be an early sign of postural control impairment, and the evaluation with visual restriction can be useful in detecting small postural instabilities. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  18. The effects of cognitive intervention on cognitive impairments after intensive care unit admission.

    Science.gov (United States)

    Zhao, Jingjing; Yao, Li; Wang, Changqing; Sun, Yun; Sun, Zhongwu

    2017-04-01

    Patients who survive critical illness commonly suffer cognitive impairments. We aimed to study the effects of cognitive intervention to treat the long-term impairments observed among different populations of intensive care unit (ICU) survivors. The results showed that the intervention significantly suppressed the deterioration of cognitive function in these patients. Medical and neurological ICU survivors were more susceptible than post-anaesthesia ICU patients to severe cognitive damage. In the former, the deterioration of impairments can be slowed by cognitive intervention. In comparison, intervention exerted significantly positive effects on the recovery of the cognitive functions of post-anaesthesia care unit patients. Furthermore, young populations were more likely than older populations to recover from acute cognitive impairments, and the impairment observed among the older population seemed to be multi-factorial and irreversible.

  19. Callosal degeneration topographically correlated with cognitive function in amnestic mild cognitive impairment and Alzheimer's disease dementia.

    Science.gov (United States)

    Wang, Pei-Ning; Chou, Kun-Hsien; Chang, Ni-Jung; Lin, Ker-Neng; Chen, Wei-Ta; Lan, Gong-Yau; Lin, Ching-Po; Lirng, Jiing-Feng

    2014-04-01

    Degeneration of the corpus callosum (CC) is evident in the pathogenesis of Alzheimer's disease (AD). However, the correlation of microstructural damage in the CC on the cognitive performance of patients with amnestic mild cognitive impairment (aMCI) and AD dementia is undetermined. We enrolled 26 normal controls, 24 patients with AD dementia, and 40 single-domain aMCI patients with at least grade 1 hippocampal atrophy and isolated memory impairment. Diffusion tensor imaging (DTI) with fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (DA), and radial diffusivity (DR) were measured. The entire CC was parcellated based on fiber trajectories to specific cortical Brodmann areas using a probabilistic tractography method. The relationship between the DTI measures in the subregions of the CC and cognitive performance was examined. Although the callosal degeneration in the patients with aMCI was less extended than in the patients with AD dementia, degeneration was already exhibited in several subregions of the CC at the aMCI stage. Scores of various neuropsychological tests were correlated to the severity of microstructural changes in the subregional CC connecting to functionally corresponding cortical regions. Our results confirm that CC degeneration is noticeable as early as the aMCI stage of AD and the disconnection of the CC subregional fibers to the corresponding Brodmann areas has an apparent impact on the related cognitive performance. Copyright © 2013 Wiley Periodicals, Inc.

  20. Atrial fibrillation and prestroke cognitive impairment in stroke.

    Science.gov (United States)

    Horstmann, Solveig; Rizos, Timolaos; Rauch, Geraldine; Fuchs, Maximilian; Arden, Cathrin; Veltkamp, Roland

    2014-03-01

    Dementia and atrial fibrillation (AF) are common comorbidities in stroke patients. The potential role of AF in cognitive impairment prior to a first stroke has yet not been characterized. The aim of our study was to evaluate the prevalence of prestroke cognitive impairment in stroke patients, and to identify whether AF is associated with prestroke cognitive impairment. In this prospective, single-center, explorative, observational study, consecutive patients with first ever transient ischemic attack (TIA), ischemic (IS) or hemorrhagic stroke (ICH) were included. For each patient cardiovascular risk factors and the National Institutes of Health Stroke Scale were recorded. Cognitive status prior to the stroke/TIA was assessed using the informant questionnaire on cognitive decline in the elderly (IQCODE). AF was diagnosed according to a standardised procedure that included the documented medical history, ECG upon admission, 24-h Holter-ECG, continuos ECG monitoring, and was categorized into paroxysmal and persistent. Logistic regression analysis was used to evaluate association of AF and prestroke cognitive impairment. A total of 788 patients were enrolled in our study. Of these, 548 (69.5 %) had an IS, TIA was present in 168 (21.3 %) and ICH in 72 (9.1 %) patients. Mean IQCODE was 3.1 (SD 0.4). Prestroke cognitive impairment (IQCODE ≥3.44) was detected in 96 (12.5 %) patients. Of these, 33 patients (4.3 %) were demented before the actual stroke event. AF was independently associated with prestroke cognitive impairment. Patients with an acute stroke frequently show a history of cognitive impairment before the event. AF is independently associated with prestroke cognitive impairment.

  1. Amnestic mild cognitive impairment with low myocardial metaiodobenzylguanidine uptake

    Science.gov (United States)

    Sakakibara, Ryuji; Ogata, Takeshi; Haruta, Masayuki; Kishi, Masahiko; Tsuyusaki, Yohei; Tateno, Akihiko; Tateno, Fuyuki; Mouri, Takayuki

    2012-01-01

    Objectives: We reported cases of amnestic mild cognitive impairment (MCI) without the core clinical features of dementia with Lewy bodies (DLB) (dementia and spontaneous parkinsonism) with low uptake in 123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy. Methods: During a 3-year period at a university clinic, we had 254 patients with memory complaints; 106 men, 148 women; mean age 72.5 years (48-95 years). In all patients we performed neurologic examination; memory tests including the MMSE, ADAScog, FAB and additional WMS-R; and imaging tests including brain MRI, SPECT and MIBG scintigraphy. Results: The criteria of amnestic MCI were fulfilled in 44 patients; and 13 of them (30%) showed low MIBG uptake. They had the following: uniformly elderly, with an equal sex ratio, have relatively slow progression, preserved general cognitive function (MMSE 24.8/30). In addition to memory impairment, they commonly showed low frontal function by FAB (12.5/18) and some had mild visual hallucination (5). Other than memory disorder, they had autonomic disorder (nocturia in 7, constipation in 2, postural hypotension in one), REM sleep behavioral disorder (in 3) and occipital hypoperfusion by SPECT (in 5). Conclusion: This cohort of multidomain amnestic MCI cases may present with early stage DLB because of the presence of low MIBG uptake. Clinically, they commonly have low FAB, and may have visual hallucination, autonomic and sleep disorders. PMID:23383388

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

    Directory of Open Access Journals (Sweden)

    José Ibiapina Siqueira- Neto

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

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

    Science.gov (United States)

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

    2016-07-19

    Subjective age is a biopsychosocial marker of aging associated with a range of outcomes in old age. In the domain of cognition, feeling older than one's chronological age is related to lower cognitive performance and steeper cognitive decline among older adults. The present study examines whether an older subjective age is associated with the risk of incident cognitive impairment and dementia. Participants were 5,748 individuals aged 65 years and older drawn from the Health and Retirement Study. Measures of subjective age, cognition, and covariates were obtained at baseline, and follow-up cognition was assessed over a 2- to 4-year period. Only participants without cognitive impairment were included at baseline. At follow-up, participants were classified into one of the three categories: normal functioning, cognitive impairment without dementia (CIND), and dementia. An older subjective age at baseline was associated with higher likelihood of CIND (odds ratio [OR] = 1.18; 1.09-1.28) and dementia (OR = 1.29; 1.02-1.63) at follow-up, controlling for chronological age, other demographic factors, and baseline cognition. Physical inactivity and depressive symptoms partly accounted for these associations. An older subjective age is a marker of individuals' risk of subsequent cognitive impairment and dementia. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. (11)C-PIB-PET for the early diagnosis of Alzheimer's disease dementia and other dementias in people with mild cognitive impairment (MCI).

    Science.gov (United States)

    Zhang, Shuo; Smailagic, Nadja; Hyde, Chris; Noel-Storr, Anna H; Takwoingi, Yemisi; McShane, Rupert; Feng, Juan

    2014-07-23

    According to the latest revised National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (now known as the Alzheimer's Association) (NINCDS-ADRDA) diagnostic criteria for Alzheimer's disease dementia, the confidence in diagnosing mild cognitive impairment (MCI) due to Alzheimer's disease dementia is raised with the application of imaging biomarkers. These tests, added to core clinical criteria, might increase the sensitivity or specificity of a testing strategy. However, the accuracy of biomarkers in the diagnosis of Alzheimer's disease dementia and other dementias has not yet been systematically evaluated. A formal systematic evaluation of the sensitivity, specificity, and other properties of positron emission tomography (PET) imaging with the (11)C-labelled Pittsburgh Compound-B ((11)C-PIB) ligand was performed. To determine the diagnostic accuracy of the (11)C- PIB-PET scan for detecting participants with MCI at baseline who will clinically convert to Alzheimer's disease dementia or other forms of dementia over a period of time. The most recent search for this review was performed on 12 January 2013. We searched MEDLINE (OvidSP), EMBASE (OvidSP), BIOSIS Previews (ISI Web of Knowledge), Web of Science and Conference Proceedings (ISI Web of Knowledge), PsycINFO (OvidSP), and LILACS (BIREME). We also requested a search of the Cochrane Register of Diagnostic Test Accuracy Studies (managed by the Cochrane Renal Group).No language or date restrictions were applied to the electronic searches and methodological filters were not used so as to maximise sensitivity. We selected studies that had prospectively defined cohorts with any accepted definition of MCI with baseline (11)C-PIB-PET scan. In addition, we only selected studies that applied a reference standard for Alzheimer's dementia diagnosis for example NINCDS-ADRDA or Diagnostic and Statistical Manual of Mental Disorders-IV (DSM

  5. Effect of Cognitive Impairment on Driving-Relevant Cognition in Older Persons

    Institute of Scientific and Technical Information of China (English)

    Rahel Bieri[1; Michael Jager[1; Nora Bethencourt[1; Urs Peter Mosimann[1,2; Rene Martin Mari[1,3; Tobias Nef[3,4

    2014-01-01

    Intact cognitive abilities are fundamental for driving. Driving-relevant cognition may be affected in older drivers due to aging or cognitive impairment. The aim of this study was to investigate the effects of cognitive impairment on driving-relevant cognition in older persons. Performance in selective and divided attention, eye-hand-coordination, executive functions and the ability to regulate distance and speed of 18 older persons with CI-Group (cognitive impairment group) was compared to performance of older control group (18 age and gender-matched cognitively normal subjects) and young control group (18 gender-matched young subjects). The CI-Group showed poorer performance than the other two control groups in all cognitive tasks (significance level (p) 〈 0.001, effect size (partial r/e) = 0.63). Differences between cognitively impaired and cognitively normal subjects were still significant after controlling for age (effect sizes from 0.14 to 0.28). Dual tasking affected performance of cognitively impaired subjects more than performance of the other two groups (p = 0.016, partial η2 = 0.14). Results show that cognitive impairment has age-independent detrimental effects on selective and divided attention, eye-hand-coordination, executive functions and the ability to regulate distance and speed. Largest effect sizes are found for reaction times in attention tasks.

  6. Separating mood disturbance from mild cognitive impairment in geriatric depression.

    Science.gov (United States)

    Steffens, David C

    2008-08-01

    Disentangling depression from dementia remains one of the most difficult clinical challenges for psychiatrists caring for older adults. The relationship between geriatric depression and dementia is complex for several reasons. First, cognitive impairment is often a prominent feature of depression in the elderly. Cognition may improve with successful treatment of depression but it may not normalize. Indeed, marked memory impairment in older depressed individuals may indicate a prodromal state of dementia. This review will examine issues related to depression and cognitive disorder in the elderly. The author will provide an evidence-based approach to separate mood disorder from cognitive disorder among older adults.

  7. Phase Measurement of Cognitive Impairment Specific to Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-07-01

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

  8. Dietary early-life exposure to contaminated eels does not impair spatial cognitive performances in adult offspring mice as assessed in the Y-maze and the Morris water maze.

    Science.gov (United States)

    Dridi, Imen; Leroy, Delphine; Guignard, Cédric; Scholl, Georges; Bohn, Torsten; Landoulsi, Ahmed; Thomé, Jean-Pierre; Eppe, Gauthier; Soulimani, Rachid; Bouayed, Jaouad

    2014-12-01

    Many environmental contaminants are introduced via the diet and may act as neurotoxins and endocrine disrupters, especially influencing growing organisms in early life. The purpose of this study was to examine whether dietary exposure of dams to fish naturally contaminated with xenobiotics, especially with polychlorinated biphenyls (PCBs) and heavy metals (e.g., mercury and lead), resulted in cognitive function deficits in adult offspring mice. Daily, four groups of dams (n = 10/group) ingested standard diet plus paste with/without eels, during gestation and lactation, from gestational day (GD) six until post natal day (PND) 21 (weaning). Dams orally ingested a standardized amount of eel (0.8 mg kg(-1) d(-1)) containing the six non-dioxin-like (NDL) PCBs (Σ6 NDL-PCBs: 28, 52, 101, 138, 153, and 180) at 0, 85, 216, and 400 ng kg(-1) d(-1). Results showed that early-life exposure to contaminated eels did not (compared to non-exposed controls) impair immediate working memory in the Y-maze in the offspring assessed at PND 38. Furthermore, it did not significantly impact spatial learning and retention memory as measured in the Morris water maze in adult offspring mice (PND 120-123). Our results suggest that perinatal exposure to contaminated eels does not affect spatial cognitive performances, as assessed by the Y-maze and Morris water maze at adult age. Adverse effects of xenobiotics reported earlier might be camouflaged by beneficial eel constituents, such as n-3 fatty acids. However, additional studies are needed to differentiate between potential positive and negative effects following consumption of food items both rich in nutrients and contaminants.

  9. Correlative factors of cognitive impairment in patients with lacunar infarcts

    Institute of Scientific and Technical Information of China (English)

    Zhang Qiujuan; Yao Xiaoxin; Guo Youmin; Zhang Gejuan; Yang Junle

    2007-01-01

    Objective To study the relationships between cognitive impairment in patients with lacunar infarcts and quantitative CT measures and to determine the independent correlative factors of cognitive impairment. Methods Neuropsychological examination was conducted for 128 patients with acute lacunar infarct. Number, location, and volume of infarcts, cerebral atrophy index and severity of white matter lesions (WMLs) were measured and recorded. Results The number of lacunar infarcts in cognitive impairment (CI) group was significantly larger than that in cognitive normal (CN) group. Mean width of sulcus and sylvian fissure, index of frontal horn and ventricular-brain ratio (VBR) were significantly different in both groups. There were more patients with 3 grades or 4 grades WMLs in CI group (62%) than those in CN group (22%). The total volume of lacunar infarcts showed no statistically significant difference. Logistic regression analysis indicated that the number of lacunar infarcts in frontal subcortex and thalamus, the volume of infarcts in anterior periventricular white matter, width of cerebral sulcus and sylvian fissure were correlated with cognitive impairment respectively. Additionally, age and education were correlative factors of cognitive impairment in patients with lacunar infarct. Conclusion Correlative factors of cognitive impairment in patients with lacunar infarct are not merely one feature, but a combination of infarct features (number, location, and volume), cortical atrophy and host factors (age and education).

  10. From mild cognitive impairment to subjective cognitive decline: conceptual and methodological evolution

    Science.gov (United States)

    Cheng, Yu-Wen; Chen, Ta-Fu; Chiu, Ming-Jang

    2017-01-01

    Identification of subjects at the early stages of Alzheimer’s disease (AD) is fundamental for drug development and possible intervention or prevention of cognitive decline. The concept of mild cognitive impairment (MCI) evolved during the past two decades to define subjects at the transitional stage between normal aging and dementia. Evidence from cross-sectional and longitudinal studies has shown that MCI is associated with an increased risk of positive AD biomarkers and an increased annual conversion rate of 5%–17% to AD. The presence of AD biomarkers in subjects with MCI was associated with an even higher risk of progression to dementia. However, earlier clinical trials for pharmacotherapy in subjects with MCI were disappointing. To extend the spectrum of AD to an earlier stage before MCI, subjective cognitive decline (SCD) was introduced and was defined as self-reported cognitive decline before the deficits could be detected by cognitive tests. Subjects with SCD have an increased risk of underlying AD pathology. However, SCD can also develop secondary to other heterogeneous etiologies, including other neurodegenerative and psychiatric diseases, personality traits, physical conditions, and medication use. Several clinical and biomarker features were proposed to predict risk of conversion to AD in subjects with SCD. Further longitudinal studies are needed to support the validity of these high-risk features. PMID:28243102

  11. Automatic Diagnosis of Mild Cognitive Impairment Using Electroencephalogram Spectral Features.

    Science.gov (United States)

    Kashefpoor, Masoud; Rabbani, Hossein; Barekatain, Majid

    2016-01-01

    Alzheimer's disease (AD) is one of the most expensive and fatal diseases in the elderly population. Up to now, no cure have been found for AD, so early stage diagnosis is the only way to control it. Mild cognitive impairment (MCI) usually is the early stage of AD which is defined as decreasing in mental abilities such a cognition, memory, and speech not too severe to interfere daily activities. MCI diagnosis is rather hard and usually assumed as normal consequences of aging. This study proposes an accurate, mobile, and nonexpensive diagnostic approach based on electroencephalogram (EEG) signal. EEG signals were recorded using 19 electrodes positioned according to the 10-20 International system at resting eyes closed state from 16 normal and 11 MCI participants. Nineteen Spectral features are computed for each channel and examined using a correlation based algorithm to select the best discriminative features. Selected features are classified using a combination of neurofuzzy system and k-nearest neighbor classifier. Final results reach 88.89%, 100%, and 83.33% for accuracy, sensitivity, and specificity, respectively, which shows the potential of proposed method to be used as an MCI diagnostic tool, especially for screening a large population.

  12. Hippocampal complex atrophy in poststroke and mild cognitive impairment.

    Science.gov (United States)

    Selnes, Per; Grambaite, Ramune; Rincon, Mariano; Bjørnerud, Atle; Gjerstad, Leif; Hessen, Erik; Auning, Eirik; Johansen, Krisztina; Almdahl, Ina S; Due-Tønnessen, Paulina; Vegge, Kjetil; Bjelke, Börje; Fladby, Tormod

    2015-11-01

    To investigate putative interacting or distinct pathways for hippocampal complex substructure (HCS) atrophy and cognitive affection in early-stage Alzheimer's disease (AD) and cerebrovascular disease (CVD), we recruited healthy controls, patients with mild cognitive impairment (MCI) and poststroke patients. HCSs were segmented, and quantitative white-matter hyperintensity (WMH) load and cerebrospinal fluid (CSF) amyloid-β concentrations were determined. The WMH load was higher poststroke. All examined HCSs were smaller in amyloid-positive MCI than in controls, and the subicular regions were smaller poststroke. Memory was reduced in amyloid-positive MCI, and psychomotor speed and executive function were reduced in poststroke and amyloid-positive MCI. Size of several HCS correlated with WMH load poststroke and with CSF amyloid-β concentrations in MCI. In poststroke and amyloid-positive MCI, neuropsychological function correlated with WMH load and hippocampal volume. There are similar patterns of HCS atrophy in CVD and early-stage AD, but different HCS associations with WMH and CSF biomarkers. WMHs add to hippocampal atrophy and the archetypal AD deficit delayed recall. In line with mounting evidence of a mechanistic link between primary AD pathology and CVD, these additive effects suggest interacting pathologic processes.

  13. [Neurophysiology and ageing. Definition and pathophysiological foundations of cognitive impairment].

    Science.gov (United States)

    Borrás Blasco, Consuelo; Viña Ribes, José

    2016-06-01

    Brain ageing is produced by various morphological, biochemical, metabolic and circulatory changes, which are reflected in functional changes, whose impact depends on the presence or absence of cognitive impairment. Because of brain plasticity, together with redundancy of the distinct cerebral circuits, age- related deterioration of the brain at various levels does not always translate into loss of brain function. However, when the damage exceeds certain thresholds, there is age-related cognitive impairment, which increases the risk of developing various neurodegenerative diseases such as Alzheimer disease. Genetics, together with lifestyle, diet, and environmental factors, etc, can trigger the development of these diseases, which provoke cognitive impairment. This article discusses the most important age-related changes in the brain, as well as the pathophysiological foundations of cognitive impairment. Copyright © 2016 Sociedad Española de Geriatría y Gerontología. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Genetic Risk Score Predicts Late-Life Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Mariegold E. Wollam

    2015-01-01

    Full Text Available Introduction. A family history of Alzheimer’s disease is a significant risk factor for its onset, but the genetic risk associated with possessing multiple risk alleles is still poorly understood. Methods. In a sample of 95 older adults (Mean age = 75.1, 64.2% female, we constructed a genetic risk score based on the accumulation of risk alleles in BDNF, COMT, and APOE. A neuropsychological evaluation and consensus determined cognitive status (44 nonimpaired, 51 impaired. Logistic regression was performed to determine whether the genetic risk score predicted cognitive impairment above and beyond that associated with each gene. Results. An increased genetic risk score was associated with a nearly 4-fold increased risk of cognitive impairment (OR = 3.824, P = .013 when including the individual gene polymorphisms as covariates in the model. Discussion. A risk score combining multiple genetic influences may be more useful in predicting late-life cognitive impairment than individual polymorphisms.

  15. [Cryptococcal meningoencephalitis presenting with treatable cognitive impairment and involuntary movement].

    Science.gov (United States)

    Ikumi, Kazuhiro; Yokoi, Katsunori; Ando, Tetsuo

    2016-01-01

    The patient is a 72-year-old Japanese woman. Seven years prior to admission, multiple nodules in her left lung were found. Bronchoscopic biopsy of the nodules did not provide a confirmative diagnosis, and probable diagnosis of cryptococcosis was made. Follow-up CT scan of the chest revealed reduction in size of the lung nodules. She was admitted to our hospital due to progressive cognitive impairment and difficulty in walking that lasted for 5 months. On admission, athetotic involuntary movement was observed in her lower extremities, predominantly in the right side. Blood and cerebrospinal fluid culture of the patient were positive for Cryptococcus neoformans. Antifungal drugs resolved the cognitive impairment, the difficulty in walking, and the involuntary movement. We assessed the cognitive impairment and observed the clinical improvement of the patient, with the use of neuropsychological examinations. To our knowledge, there has been only a few reported case of cryptococcal meningoencephalitis presenting with treatable cognitive impairment and involuntary movement.

  16. Lifetime principal occupation and risk of cognitive impairment among the elderly.

    Science.gov (United States)

    Li, Chung-Yi; Wu, Shwu Chong; Sung, Fung-Chang

    2002-01-01

    We used a nested case-control design with study participants sampled from two cohorts, for a total of 2,198 elderly people 65 years or older and completed cognitive tests between 1993 and 1997, to assess the association between an individual's lifetime principal occupation and the subsequent risk of cognitive impairment. Cases consisted of 290 older adults with impaired cognitive functioning. For each case, two controls with comparable age (within 5 years) and sex frequencies were randomly sampled from the seniors free of cognitive impairment. Occupational data were collected through interviews. Individual's job content was coded into one of the occupational categories or the occupation-based social classes. Compared to those who were former legislators, government administrators, or business executives and managers, a significantly elevated risk of cognitive impairment was estimated for those who were employed as agriculture/animal husbandry/forestry/fishing workers (odds ratio (OR)=3.2), craft and related trades workers (OR=2.2), plant and machine operators and assemblers (OR=14.7), workers of elementary occupations (OR=3.2), or housekeepers (OR=2.6). We also observed health inequalities in the risk of cognitive impairment across social classes with a significant dose-response trend in which unskilled blue-collar workers had the highest risk. After adjustment for education, we still observed an inverse relationship between risk of cognitive impairment and occupational class. This may mean that lifetime longest-held occupation is more intimately involved in the causal pathways leading to cognitive impairment. Further studies that collect information on specific work hazards would help make specific interpretations of the observed effect of lifetime longest-held occupation in early adulthood on risk of cognitive decline in late life.

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

    Directory of Open Access Journals (Sweden)

    Roberta Biundo

    Full Text Available BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.

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

    Science.gov (United States)

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

    2016-12-01

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

  19. Sarcopenia and impairment in cognitive and physical performance

    Directory of Open Access Journals (Sweden)

    Tolea MI

    2015-03-01

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

  20. Exercise-related changes of networks in aging and mild cognitive impairment brain

    Directory of Open Access Journals (Sweden)

    Pei eHuang

    2016-03-01

    Full Text Available Aging and mild cognitive impairment are accompanied by decline of cognitive functions. Meanwhile, the most common form of dementia is Alzheimer’s disease, which is characterized by loss of memory and other intellectual abilities serious to make difficulties for patients in their daily life. Mild cognitive impairment is a transition period between normal aging and dementia, which has been used for early detection of emerging dementia. It converts to dementia with an annual rate of 5-15% as compared to normal aging with 1% rate. Small decreases in the conversion rate of mild cognitive impairment to Alzheimer’s disease might significantly reduce the prevalence of dementia. Thus, it is important to intervene at the preclinical stage. Since there are still no effective drugs to treat Alzheimer’s disease, non-drug intervention is crucial for the prevention and treatment of cognitive decline in aging and mild cognitive impairment populations. Previous studies have found some cognitive brain networks disrupted in aging and mild cognitive impairment population, and physical exercise could effectively remediate the function of these brain networks. Understanding the exercise-related mechanisms is crucial to design efficient and effective physical exercise programs for treatment/intervention of cognitive decline. In this review, we provide an overview of the neuroimaging studies on physical training in normal aging and mild cognitive impairment to identify the potential mechanisms underlying current physical training procedures. Studies of functional magnetic resonance imaging, electroencephalography, magnetoencephalography and positron emission tomography on brain networks were all included. Based on our review, the default mode network, fronto-parietal network and fronto-executive network are probably the three most valuable targets for efficiency evaluation of interventions.

  1. The impact of cognitive impairment at admission on short-term functional outcome of elderly hip fracture patients

    Directory of Open Access Journals (Sweden)

    Dubljanin-Raspopović Emilija

    2010-01-01

    Full Text Available Introduction The number of patents with dementia increases among hip fracture patients. Cognitive dysfunction is defined as a premorbid state which is potentionally negatively related to short-term functional outcome. Objective To assess the relationship between cognitive status on admission and functional gain during an early rehabilitation period in elderly hip fracture patients. Methods Forty-five elderly patients with surgically treated hip fracture were examined. Cognitive status was assessed by the Mini Mental State Examination (MMSE at admission; functional status was assessed by the motor subscale of Functional Independence Measure (FIM at admission and before discharge, while absolute functional gain was determined by the motor FIM gain (FIM discharge - FIM admission. Absolute functional gain was analyzed in respect to cognitive status. Results Both cognitively impaired and cognitively intact hip fracture patients exhibited overall FIM motor improvements, as well as functional gains in specific FIM motor areas (p<0.01. Absolute functional gain, however, was higher in 1 cognitively intact compared to cognitively impaired patients (p<0.01, and 2 cognitively moderately impaired patients compared to severely cognitively impaired patients (p<0.01. No difference in functional gain was detected between the patients with moderately cognitively impaired compared to the cognitive intact patients (p>0.05. Conclusion The systematic use of MMSE identifies cognitively impaired hip fracture patients, and effectively predicts their short-term functional outcome. A higher admission cognitive status is related to a more favorable short term rehabilitation outcome. In spite of cognitive impairment, elderly patients with hip fracture can benefit from participation in rehabilitation programmes. The systematic identification of cognitively impaired hip fracture patients at admission facilitates optimal treatment and rehabilitation, and thus enables the best

  2. Unspeakable motion: Selective action-verb impairments in Parkinson's disease patients without mild cognitive impairment.

    Science.gov (United States)

    Bocanegra, Yamile; García, Adolfo M; Lopera, Francisco; Pineda, David; Baena, Ana; Ospina, Paula; Alzate, Diana; Buriticá, Omar; Moreno, Leonardo; Ibáñez, Agustín; Cuetos, Fernando

    2017-05-01

    Parkinson's disease (PD) patients show marked impairments in processing action verbs, and to a lesser extent, concrete (specially, manipulable) nouns. However, it is still unclear to what extent deficits in each of these categories are influenced by more general cognitive dysfunctions, and whether they are modulated by the words' implied motility. To examine these issues, we evaluated 49 non-demented PD patients and 49 healthy volunteers in an oral production task. The patients were divided into two groups depending on the presence or absence of mild cognitive impairment (PD-MCI and PD-nMCI, respectively). Participants named pictures of actions varying in motion content (low and high) and of objects varying in manipulability (low and high). The PD-MCI group showed deficits across all four categories. However, PD-nMCI patients exhibited a selective difficulty for high-motion action verbs. This finding corroborates and refines previous results suggesting that disturbances of action-related lexico-semantic information in PD constitute a sui generis alteration manifested early in the course of the disease's physiopathology. Moreover, it suggests that the grounding of action verbs on motor circuits could depend on fine-grained intracategorical semantic distinctions.

  3. Cognitive impairment and vitamin B12: a review.

    Science.gov (United States)

    Moore, Eileen; Mander, Alastair; Ames, David; Carne, Ross; Sanders, Kerrie; Watters, David

    2012-04-01

    This review examines the associations between low vitamin B12 levels, neurodegenerative disease, and cognitive impairment. The potential impact of comorbidities and medications associated with vitamin B12 derangements were also investigated. In addition, we reviewed the evidence as to whether vitamin B12 therapy is efficacious for cognitive impairment and dementia. A systematic literature search identified 43 studies investigating the association of vitamin B12 and cognitive impairment or dementia. Seventeen studies reported on the efficacy of vitamin B12 therapy for these conditions. Vitamin B12 levels in the subclinical low-normal range (vitamin B12 levels and may independently increase the risk for cognitive impairment. Vitamin B12 deficiency (Vitamin B12 supplements administered orally or parenterally at high dose (1 mg daily) were effective in correcting biochemical deficiency, but improved cognition only in patients with pre-existing vitamin B12 deficiency (serum vitamin B12 levels 19.9 μmol/L). Low serum vitamin B12 levels are associated with neurodegenerative disease and cognitive impairment. There is a small subset of dementias that are reversible with vitamin B12 therapy and this treatment is inexpensive and safe. Vitamin B12 therapy does not improve cognition in patients without pre-existing deficiency. There is a need for large, well-resourced clinical trials to close the gaps in our current understanding of the nature of the associations of vitamin B12 insufficiency and neurodegenerative disease.

  4. Early Pavlovian conditioning impairs later Pavlovian conditioning.

    Science.gov (United States)

    Lariviere, N A; Spear, N E

    1996-11-01

    Four experiments tested the effects in the rat of very early experience with stimuli to be used later for Pavlovian conditioning. Beginning on postnatal Day 12, prior to the development of substantial detection and effective perception of visual and auditory stimuli, rats were given five daily experiences with either lights or tones and a footshock known to be an effective unconditioned stimulus at these ages. Twenty-four hours after the last of these experiences, pairings of either the light or tone and the unconditioned stimulus were given with parameters established to yield a moderate degree of conditioning in untreated preweanlings (Experiment 1). Experiment 2 determined that early experience with paired or unpaired presentations of either the light or tone and the unconditioned stimulus resulted in a failure to condition to these same lights or tones on postnatal Day 17, although nontreated pups from the same litters conditioned quite effectively. Experiment 3 determined that this early conditioning experience with either paired or unpaired presentations of the lights or tones and the unconditioned stimulus yielded impaired conditioning on postnatal Day 17 in the alternative sensory modality as well, although again nontreated siblings conditioned quite effectively. Experiment 4 replicated the results of each of Experiments 2 and 3 and determined in addition that despite the impairment in conditioning that resulted from early paired or unpaired experience with the stimuli of conditioning, early experience with the individual stimuli of conditioning-with only the CS, the US, or the context-did not result in a similar impairment in conditioning. Although the results were unexpected, they may be understood in part in terms of intersensory competition during development, and there is precedent in the literature for similar interfering effects of early learning on later learning in a variety of species.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    Impaired cognitive function is commonly seen in patients with hepatitis C-virus (HCV). This might be due to a toxic effect of the virus itself or to neuroinflammatory processes with a direct damaging cerebral effect. The symptoms appear in the pre-cirrhotic stage and impair the patient's level...

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

    Science.gov (United States)

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

    2015-01-01

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

  7. Cognitive impairment in transient ischemic attack patients: A systematic review

    NARCIS (Netherlands)

    Rooij, F.G. van; Kessels, R.P.C.; Richard, E.; Leeuw, H.F. de; Dijk, E.J. van

    2016-01-01

    Background: Although by definition a transient ischemic attack (TIA) lasts less than 24 h, many patients experience cognitive complaints beyond focal symptom resolution. However, their prevalence, causes and profile are unclear. We therefore performed a systematic review on cognitive impairment afte

  8. Acute stress impairs cognitive flexibility in men, not women.

    Science.gov (United States)

    Shields, Grant S; Trainor, Brian C; Lam, Jovian C W; Yonelinas, Andrew P

    2016-09-01

    Psychosocial stress influences cognitive abilities, such as long-term memory retrieval. However, less is known about the effects of stress on cognitive flexibility, which is mediated by different neurobiological circuits and could thus be regulated by different neuroendocrine pathways. In this study, we randomly assigned healthy adults to an acute stress induction or control condition and subsequently assessed participants' cognitive flexibility using an open-source version of the Wisconsin Card Sort task. Drawing on work in rodents, we hypothesized that stress would have stronger impairing effects on cognitive flexibility in men than women. As predicted, we found that stress impaired cognitive flexibility in men but did not significantly affect women. Our results thus indicate that stress exerts sex-specific effects on cognitive flexibility in humans and add to the growing body of research highlighting the need to consider sex differences in effects of stress.

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

    Directory of Open Access Journals (Sweden)

    Irena Martinić-Popović

    2012-01-01

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

  10. Emotion recognition deficits exist in mild cognitive impairment, but only in the amnestic subtype.

    Science.gov (United States)

    McCade, Donna; Savage, Greg; Guastella, Adam; Lewis, Simon J G; Naismith, Sharon L

    2013-09-01

    Emotion recognition is impaired in dementia and there is some initial evidence to suggest that milder deficits may be present in Mild Cognitive Impairment (MCI) patients, an "at risk" population for transition to dementia. In this study, we investigated the emotion recognition profile of MCI subgroups. Results show emotion recognition deficits exist for the amnestic subtype with impairment in multiple domains, with an emotion-specific deficit for anger recognition. Impaired emotion recognition in aMCI was independent of patient mood and cognitive deficits. The study is the first to examine the nonamnestic subtype. No emotion recognition deficits were found. This finding is surprising given the association between the nonamnestic subtype and frontal systems dysfunction. Impaired emotion recognition could be related to the selective pathophysiology in neural pathways, particularly the temporal lobe and connected limbic and prefrontal regions, implicated in both aMCI and emotion processing. These findings may have implications for early diagnosis, prognosis, and clinical management.

  11. Classifying cognitive profiles using machine learning with privileged information in Mild Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Hanin Hamdan Alahmadi

    2016-11-01

    Full Text Available Early diagnosis of dementia is critical for assessing disease progression and potential treatment. State-or-the-art machine learning techniques have been increasingly employed to take on this diagnostic task. In this study, we employed Generalised Matrix Learning Vector Quantization (GMLVQ classifiers to discriminate patients with Mild Cognitive Impairment (MCI from healthy controls based on their cognitive skills. Further, we adopted a ``Learning with privileged information'' approach to combine cognitive and fMRI data for the classification task. The resulting classifier operates solely on the cognitive data while it incorporates the fMRI data as privileged information (PI during training. This novel classifier is of practical use as the collection of brain imaging data is not always possible with patients and older participants.MCI patients and healthy age-matched controls were trained to extract structure from temporal sequences. We ask whether machine learning classifiers can be used to discriminate patients from controls based on the learning performance and whether differences between these groups relate to individual cognitive profiles. To this end, we tested participants in four cognitive tasks: working memory, cognitive inhibition, divided attention, and selective attention. We also collected fMRI data before and after training on the learning task and extracted fMRI responses and connectivity as features for machine learning classifiers. Our results show that the PI guided GMLVQ classifiers outperform the baseline classifier that only used the cognitive data. In addition, we found that for the baseline classifier, divided attention is the only relevant cognitive feature. When PI was incorporated, divided attention remained the most relevant feature while cognitive inhibition became also relevant for the task. Interestingly, this analysis for the fMRI GMLVQ classifier suggests that (1 when overall fMRI signal for structured stimuli is

  12. Classifying Cognitive Profiles Using Machine Learning with Privileged Information in Mild Cognitive Impairment

    Science.gov (United States)

    Alahmadi, Hanin H.; Shen, Yuan; Fouad, Shereen; Luft, Caroline Di B.; Bentham, Peter; Kourtzi, Zoe; Tino, Peter

    2016-01-01

    Early diagnosis of dementia is critical for assessing disease progression and potential treatment. State-or-the-art machine learning techniques have been increasingly employed to take on this diagnostic task. In this study, we employed Generalized Matrix Learning Vector Quantization (GMLVQ) classifiers to discriminate patients with Mild Cognitive Impairment (MCI) from healthy controls based on their cognitive skills. Further, we adopted a “Learning with privileged information” approach to combine cognitive and fMRI data for the classification task. The resulting classifier operates solely on the cognitive data while it incorporates the fMRI data as privileged information (PI) during training. This novel classifier is of practical use as the collection of brain imaging data is not always possible with patients and older participants. MCI patients and healthy age-matched controls were trained to extract structure from temporal sequences. We ask whether machine learning classifiers can be used to discriminate patients from controls and whether differences between these groups relate to individual cognitive profiles. To this end, we tested participants in four cognitive tasks: working memory, cognitive inhibition, divided attention, and selective attention. We also collected fMRI data before and after training on a probabilistic sequence learning task and extracted fMRI responses and connectivity as features for machine learning classifiers. Our results show that the PI guided GMLVQ classifiers outperform the baseline classifier that only used the cognitive data. In addition, we found that for the baseline classifier, divided attention is the only relevant cognitive feature. When PI was incorporated, divided attention remained the most relevant feature while cognitive inhibition became also relevant for the task. Interestingly, this analysis for the fMRI GMLVQ classifier suggests that (1) when overall fMRI signal is used as inputs to the classifier, the post

  13. Classifying Cognitive Profiles Using Machine Learning with Privileged Information in Mild Cognitive Impairment.

    Science.gov (United States)

    Alahmadi, Hanin H; Shen, Yuan; Fouad, Shereen; Luft, Caroline Di B; Bentham, Peter; Kourtzi, Zoe; Tino, Peter

    2016-01-01

    Early diagnosis of dementia is critical for assessing disease progression and potential treatment. State-or-the-art machine learning techniques have been increasingly employed to take on this diagnostic task. In this study, we employed Generalized Matrix Learning Vector Quantization (GMLVQ) classifiers to discriminate patients with Mild Cognitive Impairment (MCI) from healthy controls based on their cognitive skills. Further, we adopted a "Learning with privileged information" approach to combine cognitive and fMRI data for the classification task. The resulting classifier operates solely on the cognitive data while it incorporates the fMRI data as privileged information (PI) during training. This novel classifier is of practical use as the collection of brain imaging data is not always possible with patients and older participants. MCI patients and healthy age-matched controls were trained to extract structure from temporal sequences. We ask whether machine learning classifiers can be used to discriminate patients from controls and whether differences between these groups relate to individual cognitive profiles. To this end, we tested participants in four cognitive tasks: working memory, cognitive inhibition, divided attention, and selective attention. We also collected fMRI data before and after training on a probabilistic sequence learning task and extracted fMRI responses and connectivity as features for machine learning classifiers. Our results show that the PI guided GMLVQ classifiers outperform the baseline classifier that only used the cognitive data. In addition, we found that for the baseline classifier, divided attention is the only relevant cognitive feature. When PI was incorporated, divided attention remained the most relevant feature while cognitive inhibition became also relevant for the task. Interestingly, this analysis for the fMRI GMLVQ classifier suggests that (1) when overall fMRI signal is used as inputs to the classifier, the post

  14. Accelerated Age-Dependent Hippocampal Volume Loss in Parkinson Disease With Mild Cognitive Impairment.

    Science.gov (United States)

    Schneider, Christine B; Donix, Markus; Linse, Katharina; Werner, Annett; Fauser, Mareike; Klingelhoefer, Lisa; Löhle, Matthias; von Kummer, Rüdiger; Reichmann, Heinz; Storch, Alexander

    2017-09-01

    Patients with Parkinson disease are at high risk of developing dementia. During the course of the disease, a substantial number of patients will experience a cognitive decline, indicating the dynamics of the underlying neuropathology. Magnetic resonance imaging (MRI) has become increasingly useful for identifying structural characteristics in radiological brain anatomy existing prior to clinical symptoms. Whether these changes reflect pathology, whether they are aging related, or both often remains unclear. We hypothesized that aging-associated brain structural changes would be more pronounced in the hippocampal region among patients with Parkinson disease having mild cognitive deficits relative to cognitively unimpaired patients. Using MRI, we investigated 30 cognitively healthy patients with Parkinson disease and 33 patients with nondemented Parkinson disease having mild cognitive impairment. All participants underwent structural MRI scanning and extensive clinical and neuropsychological assessments. Irrespective of the study participants' cognitive status, older age was associated with reduced cortical thickness in various neocortical regions. Having mild cognitive impairment was not associated with an increased rate of cortical thinning or volume loss in these regions, except in the hippocampus bilaterally. Patients with Parkinson disease having mild cognitive impairment show an accelerated age-dependent hippocampal volume loss when compared with cognitively healthy patients with Parkinson disease. This may indicate pathological processes in a key region for memory functioning in patients with Parkinson disease at risk of developing dementia. Structural MRI of the hippocampal region could potentially contribute to identifying patients who should receive early treatment aimed at delaying the clinical onset of dementia.

  15. Exposure to Mozart music reduces cognitive impairment in pilocarpine-induced status epilepticus rats.

    Science.gov (United States)

    Xing, Yingshou; Qin, Yi; Jing, Wei; Zhang, Yunxiang; Wang, Yanran; Guo, Daqing; Xia, Yang; Yao, Dezhong

    2016-02-01

    Patients with temporal lobe epilepsy (TLE) often display cognitive deficits. However, current epilepsy therapeutic interventions mainly aim at how to reduce the frequency and degree of epileptic seizures. Recovery of cognitive impairment is not attended enough, resulting in the lack of effective approaches in this respect. In the pilocarpine-induced temporal lobe epilepsy rat model, memory impairment has been classically reported. Here we evaluated spatial cognition changes at different epileptogenesis stages in rats of this model and explored the effects of long-term Mozart music exposure on the recovery of cognitive ability. Our results showed that pilocarpine rats suffered persisting cognitive impairment during epileptogenesis. Interestingly, we found that Mozart music exposure can significantly enhance cognitive ability in epileptic rats, and music intervention may be more effective for improving cognitive function during the early stages after Status epilepticus. These findings strongly suggest that Mozart music may help to promote the recovery of cognitive damage due to seizure activities, which provides a novel intervention strategy to diminish cognitive deficits in TLE patients.

  16. Acetylcholinesterase inhibitors in cognitive impairment in Huntington's disease: A brief review.

    Science.gov (United States)

    Vattakatuchery, Joe John; Kurien, Renjith

    2013-09-22

    Huntington's disease (HD) is a neurodegenerative disease associated with cognitive deficits. Cognitive dysfunction may be present in the early stages of the disease, even before the onset of motor symptoms. The cognitive dysfunction includes executive dysfunction, psychomotor symptoms, visuospatial deficits, perceptual deficits, memory loss and difficulty learning new skills. Acetylcholinesterase inhibitors have shown good effect in the treatment of other types of dementia and it is postulated that it might delay cognitive decline in HD. We reviewed the evidence for Acetylcholinesterase inhibitors in the treatment of cognitive decline and dementia associated with Huntington's disease. We identified 6 articles that investigated the role of Acetylcholinesterase inhibitors for treatment of cognitive deficits in Huntington's disease. Following the review, the authors concluded that there is limited evidence for the use of Acetylcholinesterase inhibitors for cognitive impairment in HD.

  17. A clinical classification acknowledging neuropsychiatric and cognitive impairment in Huntington’s disease

    OpenAIRE

    Vinther-Jensen, Tua; Larsen, Ida U.; Hjermind, Lena E.; Budtz-Jørgensen, Esben; Nielsen, Troels T.; Nørremølle, Anne; Jørgen E. Nielsen; Vogel, Asmus

    2014-01-01

    Background Involuntary movements, neuropsychiatric symptoms, and cognitive impairment are all part of the symptom triad in Huntington’s disease (HD). Despite the fact that neuropsychiatric symptoms and cognitive decline may be early manifestations of HD, the clinical diagnosis is conventionally based on the presence of involuntary movements and a positive genetic test for the HD CAG repeat expansion. After investigating the frequencies of the triad manifestations in a large outpatient clinica...

  18. Cognitive impairment in migraine:A systematic review

    Directory of Open Access Journals (Sweden)

    Caroline Martins de Araújo

    Full Text Available ABSTRACT Patients with migraine often report cognitive complaints, especially regarding attention and memory. Objective: To perform a systematic review of the studies available on cognitive evaluation in patients with migraine. Methods: We evaluated all articles containing the key words: "Migraine", "Cognition" and "Cognitive Impairment." Results: The search strategy resulted in 23 articles. Fifteen out of the 23 studies (65.3% retrieved reported abnormalities on neuropsychological tests in migraine patients, notably tests of memory, attention and information processing speed. Most of the studies showing cognitive changes in migraine were carried out in neurological care facilities. Conversely, among community-based studies, migraine patients were less likely to present cognitive changes. Conclusion: Patients with migraine, especially those followed at neurology clinics, show an elevated risk of mild changes in several cognitive domains. Further studies with greater methodological refinement are warranted in order to clearly establish whether this cognitive dysfunction is associated with an underlying migraine pathophysiological process.

  19. Assessing and treating cognitive impairment in schizophrenia: current and future.

    Science.gov (United States)

    Lin, Chun-Yuan; Tsai, Guochuan E; Lane, Hsien-Yuan

    2014-01-01

    Schizophrenia is a serious neuropsychiatric disease characterized by positive symptoms, negative symptoms and cognitive impairment. Evidence have shown that cognitive impairment sustains in every clinical stage, may relate with the liability, may predict functional outcome in schizophrenia and could be the core symptom of schizophrenia. The treatment of cognitive impairment in schizophrenia could alleviate the burden of the illness and has become the subject of intensive research. In this review, we synthesize current advances of assessing strategies, pharmacological and non-pharmacological treatments of cognitive impairment in schizophrenia. According to the registered records of ClinicalTrials.gov, the most widely studied strategies have aimed at modifying neurochemical mechanisms of dopamine metabolism, glutamate metabolism, γ-aminobutyric acid (GABA) metabolism, serotonin metabolism, acetylcholine metabolism, and oxytocin. Despite preclinical data for putative pro-cognitive drugs, their clinical benefits for schizophrenia patients have been limited. The small sample sizes and the short treatment duration could be related with the suboptimal results. Evidence supported the short-term benefits of cognitive remediation therapy on cognitive domains with small to moderate effects; however, the small sample sizes and the characteristics of subjects limited the generalization of the positive results and the long-term functional outcome is not clear. Combination therapy is promising, by integrating pro-cognitive agents and cognitive rehabilitation programs or combining two kinds of pro-cognitive agents via different mechanisms. Future studies should investigate the pro-cognitive drugs' long-term efficacy, rebound deterioration in psychosis/cognition following discontinuation, and related biomarkers of functional outcome.

  20. Early Cognitive Vision as a Frontend for Cognitive Systems

    DEFF Research Database (Denmark)

    Krüger, Norbert; Pugeault, Nicolas; Baseski, Emre

    We discuss the need of an elaborated in-between stage bridging early vision and cognitive vision which we call `Early Cognitive Vision' (ECV). This stage provides semantically rich, disambiguated and largely task independent scene representations which can be used in many contexts. In addition......, the ECV stage is important for generalization processes across objects and actions.We exemplify this at a concrete realisation of an ECV system that has already been used in variety of application domains....

  1. Early Cognitive Vision as a Frontend for Cognitive Systems

    DEFF Research Database (Denmark)

    Krüger, Norbert; Pugeault, Nicolas; Baseski, Emre;

    We discuss the need of an elaborated in-between stage bridging early vision and cognitive vision which we call `Early Cognitive Vision' (ECV). This stage provides semantically rich, disambiguated and largely task independent scene representations which can be used in many contexts. In addition......, the ECV stage is important for generalization processes across objects and actions.We exemplify this at a concrete realisation of an ECV system that has already been used in variety of application domains....

  2. The PACE study: a randomised clinical trial of cognitive activity (CA) for older adults with mild cognitive impairment (MCI)

    National Research Council Canada - National Science Library

    Vidovich, Mandy R; Lautenschlager, Nicola T; Flicker, Leon; Clare, Linda; Almeida, Osvaldo P

    2009-01-01

    .... The Promoting Healthy Ageing with Cognitive Exercise (PACE) study has been designed to determine whether a cognitive activity intervention decreases the rate of cognitive decline amongst older adults with mild cognitive impairment (MCI...

  3. Cognitive impairment and self-care in heart failure

    Directory of Open Access Journals (Sweden)

    Hajduk AM

    2013-10-01

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

  4. Computational cognitive modeling for the diagnosis of Specific Language Impairment.

    Science.gov (United States)

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

    2013-01-01

    Specific Language Impairment (SLI), as many other cognitive deficits, is difficult to diagnose given its heterogeneous profile and its overlap with other impairments. Existing techniques are based on different criteria using behavioral variables on different tasks. In this paper we propose a methodology for the diagnosis of SLI that uses computational cognitive modeling in order to capture the internal mechanisms of the normal and impaired brain. We show that machine learning techniques that use the information of these models perform better than those that only use behavioral variables.

  5. Evaluation of premorbid intelligence in patients with cognitive impairment

    Directory of Open Access Journals (Sweden)

    Yang ZOU

    2016-09-01

    Full Text Available The result of neuropsychological tests is crucial to confirm a diagnosis of dementia or cognitive impairment. It might be improper judging individuals with different basic cognitive function using the same standard. The evaluation of premorbid intelligence is an effective way for error correction, but not enough attention has been paid during clinical practice. Here we present a review of the existing methods of premorbid intelligence evaluation and their application in cognitive impairment. DOI: 10.3969/j.issn.1672-6731.2016.09.016

  6. Brain Substrates of Learning and Retention in Mild Cognitive Impairment Diagnosis and Progression to Alzheimer's Disease

    Science.gov (United States)

    Chang, Yu-Ling; Bondi, Mark W.; Fennema-Notestine, Christine; McEvoy, Linda K.; Hagler, Donald J., Jr.; Jacobson, Mark W.; Dale, Anders M.

    2010-01-01

    Understanding the underlying qualitative features of memory deficits in mild cognitive impairment (MCI) can provide critical information for early detection of Alzheimer's disease (AD). This study sought to investigate the utility of both learning and retention measures in (a) the diagnosis of MCI, (b) predicting progression to AD, and (c)…

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

    Science.gov (United States)

    Mossello, Enrico; Simoni, David

    2016-06-22

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

  8. [Does pre-surgical cognitive impairment affect knee replacement results?].

    Science.gov (United States)

    Jiménez, M; Zorrilla, P; López-Alonso, A; León, A; Salido, J A

    2014-01-01

    To determine the influence of the pre-operative cognitive impairment on results of the total knee arthroplasty according to a doctor and patient perspective. A prospective study was conducted on patient from the surgical waiting list who had undergone a primary total knee arthroplasty. The sample initially included 265 patients, but 50 were subsequently excluded. Cognitive impairment was assessed pre-operatively by the Mini Cognitive Examination (MEC-35). The Visual Analog Scale (VAS), the Knee Society Score (KSS), the Western Ontario and McMaster Osteoarthritis Index (WOMAC), and the Hospital Anxiety and Depression Scale (HADS), were used pre-operatively and one year later post-operatively. A total of 215 patients were assessed (57 men and 158 women). Cognitive impairment had no influence on the results of total knee arthroplasty. In fact, there was no statistical significance in any of the scales analyzed. Preoperatively, and one year later, the patients with cognitive impairment showed higher levels of anxiety and depression, with these differences being statistically significant. All of the patients experienced an improvement in the specific outcomes and quality of life after the total knee arthroplasty procedure, regardless of the presence of preoperative cognitive impairment. Copyright © 2013 SECOT. Published by Elsevier Espana. All rights reserved.

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

    NARCIS (Netherlands)

    Hildebrandt, H.; Fink, F.K.; Kastrup, A.; Haupts, M.; Eling, P.A.T.M.

    2013-01-01

    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

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

    Science.gov (United States)

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

    2017-01-01

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

  11. Electrophysiological biomarkers for improved etiological diagnosis of cognitive impairment

    Directory of Open Access Journals (Sweden)

    Yamasaki T

    2014-07-01

    Full Text Available Takao Yamasaki,1,2 Shozo Tobimatsu1 1Department of Clinical Neurophysiology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; 2Department of Neurology, Minkodo Minohara Hospital, Fukuoka, Japan Abstract: Alzheimer's disease (AD, Lewy body disease (LBD, and frontotemporal lobar degeneration (FTLD are three major types of neurodegenerative dementia. Intervention and treatment differ significantly among these major dementias, necessitating early and accurate diagnosis. Patients with AD, LBD, and FTLD exhibit specific patterns of visual dysfunction as early behavioral signs. These visual impairments are the manifestations of topographic patterns of neuropathology specific to each type of dementia. Electrophysiological measurements, such as visual evoked potentials and event-related potentials, are objective and noninvasive tools that can detect subtle functional changes in human brain. Therefore, with the use of visual evoked potentials and event-related potentials, early detection of specific patterns of visual dysfunction may be useful for differential diagnosis of dementia. In this review, we first summarize current knowledge about the relevant aspects of the human visual system. Second, we outline clinical characteristics, including visual perceptual abnormalities, of each type of degenerative dementia. Finally, we describe the application of visual evoked potential and event-related potential recording techniques to study visual perception in patients with mild cognitive impairment (prodromal stage of dementia. We stress that electrophysiological signals have potential as reliable biomarkers in the diagnosis of different types of dementia, especially in the case of overlapping phenotypes. Keywords: Alzheimer's disease, Lewy body disease, frontotemporal lobar degeneration, visual evoked potentials, event-related potentials, parallel visual pathways

  12. Tau-driven 26S proteasome impairment and cognitive dysfunction can be prevented early in disease by activating cAMP-PKA signaling.

    Science.gov (United States)

    Myeku, Natura; Clelland, Catherine L; Emrani, Sheina; Kukushkin, Nikolay V; Yu, Wai Haung; Goldberg, Alfred L; Duff, Karen E

    2016-01-01

    The ubiquitin proteasome system (UPS) degrades misfolded proteins including those implicated in neurodegenerative diseases. We investigated the effects of tau accumulation on proteasome function in a mouse model of tauopathy and in a cross to a UPS reporter mouse (line Ub-G76V-GFP). Accumulation of insoluble tau was associated with a decrease in the peptidase activity of brain 26S proteasomes, higher levels of ubiquitinated proteins and undegraded Ub-G76V-GFP. 26S proteasomes from mice with tauopathy were physically associated with tau and were less active in hydrolyzing ubiquitinated proteins, small peptides and ATP. 26S proteasomes from normal mice incubated with recombinant oligomers or fibrils also showed lower hydrolyzing capacity in the same assays, implicating tau as a proteotoxin. Administration of an agent that activates cAMP-protein kinase A (PKA) signaling led to attenuation of proteasome dysfunction, probably through proteasome subunit phosphorylation. In vivo, this led to lower levels of aggregated tau and improvements in cognitive performance.

  13. Cognitive Impairment and Disability in Older Japanese Adults.

    Directory of Open Access Journals (Sweden)

    Hiroyuki Shimada

    Full Text Available The prevalence of disability is increasing due to an expanding aging population and an increasing incidence of chronic health problems. Cognitive impairment may predict the development of disability in older adults. Therefore, we examined the association of mild cognitive impairment (MCI and/or general cognitive impairment (GCI, defined as a Mini Mental State Examination [MMSE] score of 20-23 with the development of disability in a cohort of Japanese community-dwelling older adults. A total of 4290 participants (aged ≥65 years enrolled in the Obu Study of Health Promotion for the Elderly were classified according to the presence and degree of cognitive impairment as follows: cognitively healthy, GCI, MCI single domain (MCIs, MCIs with GCI, MCI multiple domain (MCIm, and MCIm with GCI. MMSE scores, risk factors for dementia, and incidences of new disability were recorded. After an average of 29.5 months, 205 participants (4.8% experienced a new onset of disability. All subtypes of cognitive impairment showed significant relationships with disability except for GCI alone. The following hazard ratios (HRs were determined: MCIs (HR, 2.04; 95% CI, 1.39-3.00, MCIs with GCI (HR, 2.10; 95% CI, 1.21-3.62, MCIm (HR, 2.32; 95% CI, 1.39-3.85, and MCIm with GCI (HR, 4.23; 95% CI, 2.73-6.57. These results indicate that cognitive impairment may be related to an increased risk for the development of disability. Healthcare providers should implement global cognitive assessments to identify MCI and GCI and consider preventive interventions for disability, especially in older persons.

  14. Cognitive Impairment and Disability in Older Japanese Adults.

    Science.gov (United States)

    Shimada, Hiroyuki; Makizako, Hyuma; Doi, Takehiko; Tsutsumimoto, Kota; Lee, Sangyoon; Suzuki, Takao

    2016-01-01

    The prevalence of disability is increasing due to an expanding aging population and an increasing incidence of chronic health problems. Cognitive impairment may predict the development of disability in older adults. Therefore, we examined the association of mild cognitive impairment (MCI) and/or general cognitive impairment (GCI, defined as a Mini Mental State Examination [MMSE] score of 20-23) with the development of disability in a cohort of Japanese community-dwelling older adults. A total of 4290 participants (aged ≥65 years) enrolled in the Obu Study of Health Promotion for the Elderly were classified according to the presence and degree of cognitive impairment as follows: cognitively healthy, GCI, MCI single domain (MCIs), MCIs with GCI, MCI multiple domain (MCIm), and MCIm with GCI. MMSE scores, risk factors for dementia, and incidences of new disability were recorded. After an average of 29.5 months, 205 participants (4.8%) experienced a new onset of disability. All subtypes of cognitive impairment showed significant relationships with disability except for GCI alone. The following hazard ratios (HRs) were determined: MCIs (HR, 2.04; 95% CI, 1.39-3.00), MCIs with GCI (HR, 2.10; 95% CI, 1.21-3.62), MCIm (HR, 2.32; 95% CI, 1.39-3.85), and MCIm with GCI (HR, 4.23; 95% CI, 2.73-6.57). These results indicate that cognitive impairment may be related to an increased risk for the development of disability. Healthcare providers should implement global cognitive assessments to identify MCI and GCI and consider preventive interventions for disability, especially in older persons.

  15. Neuropsychiatric symptoms in Vascular Cognitive Impairment: A systematic review

    Directory of Open Access Journals (Sweden)

    Chan Tiel

    Full Text Available Neuropsychiatric symptoms or Behavioral and Psychological Symptoms of Dementia (BPSD are common and invariably appear at some point during the course of the disease, mediated both by cerebrovascular disease and neurodegenerative processes. Few studies have compared the profiles of BPSD in Vascular Cognitive Impairment (VCI of different subtypes (subcortical or cortical and clinical stages (Vascular Cognitive Impairment No Dementia [VaCIND] and Vascular Dementia [VaD].Objective:To review the BPSD associated with different subtypes and stages of VCI using the Neuropsychiatric Inventory (NPI.Methods:Medline, Scielo and Lilacs databases were searched for the period January 2000 to December 2014, with the key words: "BPSD AND Vascular Dementia, "NPI AND Vascular Dementia" and "NPI AND VCI. Qualitative analysis was performed on studies evaluating BPSD in VCI, using the Neuropsychiatric Inventory (NPI.Results:A total of 82 studies were retrieved of which 13 were eligible and thus included. Among the articles selected, 4 compared BPSD in Subcortical Vascular Dementia (SVaD versus Cortical-Subcortical Vascular Dementia (CSVaD, 3 involved comparisons between SVaD and VaCIND, 1 study analyzed differences between CSVaD and VaCIND, while 5 studies assessed BPSD in CSVaD. Subcortical and Cortical-Subcortical VaD were associated predominantly with Apathy and Depression. VaCIND may present fewer behavioral symptoms than VaD.Conclusion:The profile of BPSD differs for different stages of VCI. Determining the most prevalent BPSD in VCI subtypes might be helpful for improving early diagnosis and management of these symptoms.

  16. Cognitive and psychosocial impairment in remitted bipolar patients

    Directory of Open Access Journals (Sweden)

    Flávia Moreira Lima

    2015-07-01

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

  17. Early Bifrontal Brain Injury: Disturbances in Cognitive Function Development

    Directory of Open Access Journals (Sweden)

    Christine Bonnier

    2010-01-01

    Full Text Available We describe six psychomotor, language, and neuropsychological sequential developmental evaluations in a boy who sustained a severe bifrontal traumatic brain injury (TBI at 19 months of age. Visuospatial, drawing, and writing skills failed to develop normally. Gradually increasing difficulties were noted in language leading to reading and spontaneous speech difficulties. The last two evaluations showed executive deficits in inhibition, flexibility, and working memory. Those executive abnormalities seemed to be involved in the other impairments. In conclusion, early frontal brain injury disorganizes the development of cognitive functions, and interactions exist between executive function and other cognitive functions during development.

  18. Emerging Literature on Cognitive Intervention Techniques for Early Stage Dementia

    Directory of Open Access Journals (Sweden)

    John W Den Boer

    2016-10-01

    Full Text Available Dementia is a growing world-wide phenomenon, impacting more than six million people in the United States. Despite its high projected prevalence, it is a significantly under-represented phenomena, with (underestimate ranging from 15-25% of the general population. The effect of the aging of the population and significant increase in life expectancy has combined to catapult dementia into the range of one of most alarming healthcare problems. Diverse and emerging literature in the area of cognitive prevention/intervention for mild cognitive impairment (MCI/early stage dementia will be reviewed. Additionally, future research and clinical directions will be explored.

  19. Cognitive theories of early gender development.

    Science.gov (United States)

    Martin, Carol Lynn; Ruble, Diane N; Szkrybalo, Joel

    2002-11-01

    The contribution of cognitive perspectives (cognitive-developmental theory and gender schema theory) to a contemporary understanding of gender development is evaluated. Recent critiques of cognitive approaches are discussed and empirical evidence is presented to counter these critiques. Because of the centrality of early gender development to the cognitive perspective, the latest research is reviewed on how infants and toddlers discriminate the sexes and learn the attributes correlated with sex. The essence of cognitive approaches--emphasis on motivational consequences of gender concepts; the active, self-initiated view of development; and focus on developmental patterns-is highlighted and contrasted with social-cognitive views. The value of cognitive theories to the field is illustrated, and recommendations are made concerning how to construct comprehensive, integrative perspectives of gender development.

  20. Differential cognitive impairment for diverse forms of multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Borges Monica

    2006-05-01

    Full Text Available Abstract Background Cognitive impairment is a common feature in multiple sclerosis (MS patients and occurs in 60% of all cases. Unfortunately, neurological examination does not always agree with the neuropsychological evaluation in determining the cognitive profile of the patient. On the other hand, psychophysiological techniques such as event-related potentials (ERPs can help in evaluating cognitive impairment in different pathologies. Behavioural responses and EEG signals were recorded during the experiment in three experimental groups: 1 a relapsing-remitting group (RRMS, 2 a benign multiple sclerosis group (BMS and 3 a Control group. The paradigm employed was a spatial attention task with central cues (Posner experiment. The main aim was to observe the differences in the performance (behavioural variables and in the latency and amplitude of the ERP components among these groups. Results Our data indicate that both MS groups showed poorer task performance (longer reaction times and lower percentage of correct responses, a latency delay for the N1 and P300 component, and a different amplitude for the frontal N1. Moreover, the deficit in the BMS group, indexed by behavioural and pyschophysiological variables, was more pronounced compared to the RRMS group. Conclusion The present results suggest a cognitive impairment in the information processing in all of these patients. Comparing both pathological groups, cognitive impairment was more accentuated in the BMS group compared to the RMSS group. This suggests a silent deterioration of cognitive skills for the BMS that is not usually treated with pharmacological or neuropsychological therapy.

  1. Social Support and Cognition: Early Childhood Versus Older Adulthood.

    Science.gov (United States)

    Kang, Duck-Hee; Boss, Lisa; Clowtis, Licia

    2016-12-01

    Cognitive development in early childhood and cognitive preservation in older adulthood are critical for leading healthy life. Social engagement can significantly affect cognition, but their relationships are unclear. The purpose of this review was to synthesize current findings on the relationship between social engagement and cognition in early childhood and older adulthood. PubMed, Web of Science, Ovid Medline, and PsycINFO were searched for studies published in 1995-2015 for a comprehensive review. Included in this review were 42 articles written in English, published in peer-reviewed journals with participants' age being 2 to 6 or ≥65 years, and measurement of social engagement and cognition. Overall, greater social engagement was associated with higher levels of cognition across the life span, association of which seemed more prominent in populations at risk of cognitive impairment. Additional research is needed to elucidate biobehavioral mechanisms underlying these relationships and to test the efficacy of new interventions. © The Author(s) 2016.

  2. Cognitive impairment predicts worse short-term response to spinal tap test in normal pressure hydrocephalus.

    Science.gov (United States)

    Wolfsegger, Thomas; Topakian, Raffi

    2017-08-15

    In patients with idiopathic normal pressure hydrocephalus (iNPH), the spinal tap test (STT) is commonly used to predict ventriculoperitoneal shunt responsiveness. Clinical improvement following STT usually is measured by testing gait function. In our study, we investigated the impact of cognitive impairment on gait improvement after STT. 22 patients with the clinical and radiological diagnosis of iNPH underwent gait analyses (mobile measuring system Medilogic) before and 2-4h after STT in self-paced gait velocity over 7m. Prior to STT, cognition was evaluated by the Mini Mental State Examination (MMSE). MMSESTT vs. after STT were analyzed with ANOVA with repeated measures. 1. Baseline gait parameters did not differ between the two groups: patients with iNPH and normal cognition (n=11) and patients with iNPH-CI (n=11). 2. Following STT, there was significant improvement of gait parameters in patients without cognitive impairment, while patients with iNPH-CI did not benefit from STT. Subjects with iNPH have a higher probability of lack of gait improvement 2-4h following STT, if cognitive impairment is present. Further studies are needed to elucidate the associations of cognitive impairment and quantitative gait parameters measured early and at later time points after STT. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Neuropsychiatric symptoms and functional connectivity in mild cognitive impairment

    Science.gov (United States)

    Munro, Catherine E.; Donovan, Nancy J.; Guercio, Brendan J.; Wigman, Sarah E.; Schultz, Aaron P.; Amariglio, Rebecca E.; Rentz, Dorene M.; Johnson, Keith A.; Sperling, Reisa A.; Marshall, Gad A.

    2015-01-01

    Background Neuropsychiatric symptoms (NPS), such as apathy and depression, commonly accompany cognitive and functional decline in early Alzheimer’s disease (AD). Prior studies have shown associations between affective NPS symptoms and neurodegeneration of medial frontal and inferior temporal regions in mild cognitive impairment (MCI) and AD dementia. Objective To investigate the association between functional connectivity in four brain networks and NPS in elderly with MCI. Methods NPS were assessed using the Neuropsychiatric Inventory in 42 subjects with MCI. Resting-state functional connectivity in four networks (default mode network, fronto-parietal control network (FPCN), dorsal attention network, and ventral attention network) was assessed using seed-based magnetic resonance imaging. Factor analysis was used to identify two factors of NPS: Affective and Hyperactivity. Linear regression models were utilized with the neuropsychiatric factors as the dependent variable and the four networks as the predictors of interest. Covariates included age, sex, premorbid intelligence, processing speed, memory, head movement, and signal-to-noise ratio. These analyses were repeated with the individual items of the Affective factor, using the same predictors. Results There was a significant association between greater Affective factor symptoms and reduced FPCN connectivity (p=0.03). There was no association between the Hyperactivity factor and any of the networks. Secondary analyses revealed an association between greater apathy and reduced FPCN connectivity (p=0.005), but none in other networks. Conclusions Decreased connectivity in the FPCN may be associated with greater affective symptoms, particularly apathy, early in AD. These findings extend prior studies, using different functional imaging modalities in individuals with greater disease severity. PMID:25854929

  4. The PACE Study: A randomised clinical trial of cognitive activity (CA) for older adults with mild cognitive impairment (MCI)

    OpenAIRE

    Flicker Leon; Lautenschlager Nicola T; Vidovich Mandy R; Clare Linda; Almeida Osvaldo P

    2009-01-01

    Abstract Background Research evidence from observational studies suggests that cognitive activity reduces the risk of cognitive impairment in later life as well as the rate of cognitive decline of people with dementia. The Promoting Healthy Ageing with Cognitive Exercise (PACE) study has been designed to determine whether a cognitive activity intervention decreases the rate of cognitive decline amongst older adults with mild cognitive impairment (MCI). Methods/Design The study will recruit 16...

  5. Mild Cognitive Impairment in Parkinson’s Disease: A Review of Current Concepts

    Directory of Open Access Journals (Sweden)

    Natalie C. Palavra

    2013-01-01

    Full Text Available Mild Cognitive Impairment in Parkinson’s Disease (PD-MCI is common and may be associated with accelerated progression to dementia. Considering the importance of this emerging entity, new diagnostic criteria have recently been proposed. Early recognition and accurate classification of PD-MCI could offer opportunities for novel therapeutic interventions. This review discusses current definitions for PD-MCI, the screening tools used, the pattern of cognitive deficits observed, and the predictors of cognitive decline and transition to Parkinson’s Disease Dementia. Emerging biomarkers, which may aid diagnosis, are also explored and the role of novel treatment options is considered.

  6. Cognitive based interventions for elderly people with mild cognitive impairement: Review of effects and efficacy

    Directory of Open Access Journals (Sweden)

    Fátima González Palau

    2012-07-01

    Full Text Available Due to the significant increase in the percentage of older adults, as well as degenerative diseases, there is growing interest in the determination of effective psychosocial approaches aimed to subjects with mild cognitive impairment (MCI. Recent experimental studies indicate positive effects of cognitive interventions in population with DCL in both, traditional methods and computer based interventions. The present review provides a systematic analysis of the literature in order to assess the effect and scope of actual non-pharmacological cognitive interventions, aimed to older adults with mild cognitive impairment.

  7. Cognitive impairments in Hashimoto's encephalopathy: a case-control study.

    Science.gov (United States)

    Wang, Jianhong; Zhang, Jun; Xu, Lan; Shi, Yunbo; Wu, Xunyi; Guo, Qihao

    2013-01-01

    Hashimoto's encephalopathy is considered as a treatable dementia, but it is often misdiagnosed. We investigated cognitive impairment and the MRI pathology of Hashimoto's encephalopathy patients. The study comprised eight patients with Hashimoto's encephalopathy, 16 patients with mild Alzheimer's disease and 24 healthy subjects. A neuropsychological battery included assessments of memory, language, attention, executive function and visuospatial ability. Cranial MRI was obtained from all Hashimoto's encephalopathy patients. Hashimoto's encephalopathy and mild Alzheimer's disease showed cognitive impairments in episodic memory, attention, executive function and visuospatial ability, but naming ability was unaffected in Hashimoto's encephalopathy. The MRI of Hashimoto's encephalopathy showed leukoencephalopathy-like type or limbic encephalitis-like type; the lesions did not affect the temporal cortex which plays a role in naming ability. Except that the naming ability was retained, the impairments in cognitive functions for the Hashimoto's encephalopathy patients were similar to those of Alzheimer's disease patients. These results were consistent with the MRI findings.

  8. Atherosclerotic risk factors, vascular cognitive impairment, and Alzheimer disease.

    Science.gov (United States)

    Kovacic, Jason C; Fuster, Valentin

    2012-01-01

    The involvement of vascular factors in Alzheimer dementia was first appreciated over 100 years ago. Recently, significant advances in our understanding of these brain-vascular relationships have taken place. Vascular cognitive impairment is now recognized as a distinct group of interrelated vascular-based neurological insults that can accumulate and lead to dementia. Importantly, the pathology of vascular cognitive impairment extends far beyond brain destruction wrought by major stroke. Other subtle changes may also arise that contribute to vascular cognitive impairment and dementia, including subclinical stroke, white-matter changes such as hyperintensities and lipohyalinosis, small lacunar infarcts, cerebral hypoperfusion, and compromise of the blood-brain barrier. In this review we critically examine the emerging body of evidence that relates atherosclerotic risk factors, brain functioning, and Alzheimer disease. © 2012 Mount Sinai School of Medicine.

  9. Depressive symptoms predict incident cognitive impairment in cognitive healthy older women

    Science.gov (United States)

    Rosenberg, Paul B.; Mielke, Michelle M.; Xue, Qian-Li; Carlson, Michelle C.

    2009-01-01

    OBJECTIVES There is increasing evidence that depressive symptoms are associated with the development of cognitive impairment and dementia in late life. We sought to examine whether depression increased the risk of incident cognitive impairment in a longitudinal study of older women. DESIGN observational study, up to 6 examinations spanning up to 9 years. SETTING university-based Division of Geriatric Medicine PARTICIPANTS community-based sample of 436 older, non-demented women MEASUREMENTS Participants were followed with regular medical and neuropsychiatric evaluations. Cognitive assessment included episodic immediate and delayed memory, psychomotor speed, and executive functioning. Participants were characterized as having incident impairment on a cognitive test when scores fell below the tenth percentile on age-adjusted norms. Baseline depressive symptoms were measured using the Geriatric Depression Scale (GDS) (30-item). Discrete-time Cox Proportional hazards regression with generalized linear models were used to determine whether baseline risk factors predicted incident impairment on each cognitive test, defined as performance below the tenth percentile on age-adjusted norms. RESULTS Baseline GDS was highly associated with incident impairment on all cognitive tests (p <.03). These associations were unaffected by vascular conditions except diabetes, which was associated with incident impairment in delayed recall and psychomotor speed. CONCLUSIONS These data suggest that depression may be risk factors for cognitive decline, and thus a potential target for diagnostic and therapeutic interventions. PMID:20224517

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Catherine M Sweeney-Reed

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

  12. Frailty and cognitive impairment--a review of the evidence and causal mechanisms.

    Science.gov (United States)

    Robertson, Deirdre A; Savva, George M; Kenny, Rose Anne

    2013-09-01

    Incidence rates of cognitive impairment and dementia are rising with the ageing population. Meanwhile, the limited success of current treatments has led to a search for early markers of dementia which could predict future progression or improve quality of life for those already suffering from the disease. One focus has been on the correlation between physical and cognitive measures with an increasing interest in the association between frailty and cognitive decline. Frailty is an age-related syndrome described as the decreased ability of an organism to respond to stressors. A number of epidemiological studies have reported that frailty increases the risk of future cognitive decline and that cognitive impairment increases the risk of frailty suggesting that cognition and frailty interact within a cycle of decline associated with ageing. This paper reviews the evidence for an association between frailty and cognitive impairment and outlines some of the mechanisms that potentially underpin this relationship from brain neuropathology and hormonal dysregulation to cardiovascular risk and psychological factors. Copyright © 2013 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

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

    2016-03-01

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

  14. Cognitive impairment and depressive symptoms coexisting in an elderly man.

    Science.gov (United States)

    Masiran, Ruziana; Pang, Nicholas Tze Ping

    2017-02-08

    We report a case of a man aged 67 years presenting with recent depressive symptoms and paranoid ideations in addition to 1-year cognitive impairment. He has vascular risk factors and family history of memory loss. An episode of depression 2 decades ago resolved spontaneously but was followed by occupational decline. On mental state examination, he denied having depressed mood, hallucinations or delusions, but there were prominent word-finding difficulties and impaired attention and concentration.

  15. Efficacy of Cellex in patients with mild cognitive impairment

    OpenAIRE

    B. A. Abusueva; M. A. Evzel’man; P R Kamchatnov; Kh. Yu. Umarova

    2016-01-01

    Background. Cognitive disorders may often lead to professional invalidisation and increasing dependence on the external assistance in every day life. Identification of patients with preserved intellectual status and social adaptation but with mild cognitive impairment (MCI) is considered to be an effective measure. MCI detection and timely initiation of treatment in most patients is essential to delay the onset of severe dementia.Objective. Investigating influence of Cellex in patients with c...

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    impaired patients only 18.2% had significantly higher PDQ scores than the normal range. PDQ scores were highly correlated to depressive symptoms (r = 0.67, p correlated with subjective cognitive complaints. When these variables and self...

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

    DEFF Research Database (Denmark)

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

    2005-01-01

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

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

    OpenAIRE

    Federerico Filipin; Mónica Feldman; María Martelli; Viviana Sánchez; Virginia García; Graciela Tufro; Cecilia Serrano; Taragano,Fernando E.; Silvina Heisecke; Carol Dillon

    2015-01-01

    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 ...

  19. Gluten-induced cognitive impairment ("brain fog") in coeliac disease.

    Science.gov (United States)

    Yelland, Gregory W

    2017-03-01

    Much is known about the serious neurological effects of gluten ingestion in coeliac disease patients, such as sporadic ataxia and peripheral neuropathy, although the causal links to gluten are still under debate. However, such disorders are observed in only a small percentage of coeliac patients. Much less is known about the transient cognitive impairments to memory, attention, executive function, and the speed of cognitive processing reported by the majority of patients with coeliac disease. These mild degradations of cognitive functions, referred to as "brain fog," are yet to be formally recognized as a medical or psychological condition. However, subtle tests of cognitive function are measurable in untreated patients with coeliac disease and improve over the first 12 months' therapy with a gluten-free diet. Such deficits also occur in patients with Crohn's disease, particularly in association with systemic inflammatory activity. Thus, cognitive impairments associated with brain fog are psychologically and neurologically real and improve with adherence to a gluten-free diet. There is not yet sufficient evidence to provide a definitive account of the mechanism by which gluten ingestion causes the impairments to cognitive function associated with brain fog, but current evidence suggests that it is more likely that the causal factor is not directly related to exposure to gluten. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  20. Impact of Cognitive Impairment on Functional Outcome in Stroke

    Directory of Open Access Journals (Sweden)

    Nurdan Paker

    2010-01-01

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

  1. Citicoline in vascular cognitive impairment and vascular dementia after stroke.

    Science.gov (United States)

    Alvarez-Sabín, Jose; Román, Gustavo C

    2011-01-01

    Cognitive decline after stroke is more common than stroke recurrence. Stroke doubles the risk of dementia and is a major contributor to vascular cognitive impairment and vascular dementia. Neuropathological studies in most cases of dementia in the elderly reveal a large load of vascular ischemic brain lesions mixed with a lesser contribution of neurodegenerative lesions of Alzheimer disease. Nonetheless, few pharmacological studies have addressed vascular cognitive impairment and vascular dementia after stroke. Citicoline has demonstrated neuroprotective effects in acute stroke and has been shown to improve cognition in patients with chronic cerebrovascular disease and in some patients with Alzheimer disease. A recent trial lasting 6 months in patients with first-ever ischemic stroke showed that citicoline prevented cognitive decline after stroke with significant improvement of temporal orientation, attention, and executive function. Experimentally, citicoline exhibits neuroprotective effects and enhances neural repair. Citicoline appears to be a safe and promising alternative to improve stroke recovery and could be indicated in patients with vascular cognitive impairment, vascular dementia, and Alzheimer disease with significant cerebrovascular disease.

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

    DEFF Research Database (Denmark)

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

    2005-01-01

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

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

    DEFF Research Database (Denmark)

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

    2005-01-01

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

  4. Cognitive impairment and rehabilitation strategies after traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Apurba Barman

    2016-01-01

    Full Text Available Traumatic brain injury (TBI is among the significant causes of morbidity and mortality in the present world. Around 1.6 million persons sustain TBI, whereas 200,000 die annually in India, thus highlighting the rising need for appropriate cognitive rehabilitation strategies. This literature review assesses the current knowledge of various cognitive rehabilitation training strategies. The entire spectrum of TBI severity; mild to severe, is associated with cognitive deficits of varying degree. Cognitive insufficiency is more prevalent and longer lasting in TBI persons than in the general population. A multidisciplinary approach with neuropsychiatric evaluation is warranted. Attention process training and tasks for attention deficits, compensatory strategies and errorless learning training for memory deficits, pragmatic language skills and social behavior guidance for cognitive-communication disorder, meta-cognitive strategy, and problem-solving training for executive disorder are the mainstay of therapy for cognitive deficits in persons with TBI. Cognitive impairments following TBI are common and vary widely. Different cognitive rehabilitation techniques and combinations in addition to pharmacotherapy are helpful in addressing various cognitive deficits.

  5. Alcohol screening in people with cognitive impairment: an exploratory study.

    Science.gov (United States)

    Randall-James, James; Wadd, Sarah; Edwards, Kim; Thake, Anna

    2015-01-01

    Alcohol misuse can coexist with and/or contribute to the development of cognitive impairment in the older adult population but continues to be underestimated and undetected in older people. This study aimed to examine the feasibility and acceptability of routine screening for alcohol misuse in a small sample of older people with cognitive impairment receiving services in memory clinics. This study employed a qualitative and exploratory design, using a convenience sample of individuals attending a memory clinic in England. Ten service users older than 65 with a diagnosis of cognitive impairment (i.e., mild cognitive impairment or dementia) took part in the study. Individuals who met inclusion criteria were invited to take part in an hour-long interview, which included the interviewer administering the alcohol screening tools. Interview transcripts were analyzed using thematic analysis. Participants were able to engage with the screening tools and could, with assistance, complete them in a collaborative and timely manner without distress. All participants reported that these tools were acceptable as part of the clinic assessment. Administering the screening tools was not time-consuming or difficult, making their use feasible within the memory clinic setting. While there were some challenges (e.g., arithmetic, recall, language problems), these challenges could be overcome with the aid of the person administering the screening tool using standardized techniques for assessment administration. Routine screening for alcohol misuse in older people with cognitive impairment receiving services in memory clinics is feasible and acceptable. The process of completing alcohol screening tools with older adults receiving services at memory clinics may increase awareness of the potential impact of alcohol on cognitive functioning and provide practitioners with an opportunity to educate service users about the ways that their drinking is affecting their memory. Several techniques to

  6. Phenotypic cognitive impairment in late-onset delusional disorder.

    Science.gov (United States)

    Harris, Ben S; Kotsopoulos, Eleftheria J; Yamin, Sami

    2014-06-01

    Previous use of heterogeneous diagnostic criteria and insensitive cognitive measures has impeded clarification of the extent and type of cognitive impairment specific to late-onset delusional disorder. We examined whether clinical presentations of late-onset delusional disorder are associated with prodromal or established dementia, and whether it might be a discrete clinical syndrome characterized by its own profile of cognitive impairment. Nineteen patients with late-onset delusional disorder from a hospital psychiatric service and 20 patients with dementia of the Alzheimer's type (AD) from an outpatient memory clinic were recruited in a consecutive case series. All patients underwent comprehensive neuropsychological assessment that included general intellectual function, executive function, new learning and delayed memory, language, processing speed, and visuo-perceptual skills. Late-onset delusional disorder patients showed moderate impairment to conceptual reasoning, visual object recognition, processing speed, and confrontation naming. Severe impairment appeared in visuo-perceptual planning and organization, and divided attention. Compared with the Alzheimer's disease (AD) group, the late-onset delusional disorder group demonstrated significantly poorer visuo-perceptual skills but a significantly better capacity to consolidate information into delayed memory. A high rate of marked cognitive impairment occurs in late-onset delusional disorder. There was evidence of a conceptual reasoning deficit, plus the presence of a visuo-perceptual impairment affecting object recognition. This impairment profile can explain the genesis and maintenance of the observed delusions. Understanding late-onset delusional disorder as other than a purely psychiatric phenomenon or a precursor to AD will lead to better assessment and management approaches.

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

    Directory of Open Access Journals (Sweden)

    Ulf G. Bronas

    2017-01-01

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

  8. The Memory Alteration Test Discriminates between Cognitively Healthy Status, Mild Cognitive Impairment and Alzheimer's Disease

    Science.gov (United States)

    Custodio, Nilton; Lira, David; Herrera-Perez, Eder; Nuñez del Prado, Liza; Parodi, José; Guevara-Silva, Erik; Castro-Suarez, Sheila; Montesinos, Rosa; Cortijo, Patricia

    2014-01-01

    Background/Aims Dementia is a worldwide public health problem and there are several diagnostic tools for its assessment. The aim of this study was to evaluate the performance of the Memory Alteration Test (M@T) to discriminate between patients with early Alzheimer's disease (AD), patients with amnestic mild cognitive impairment (a-MCI), and subjects with a cognitively healthy status (CHS). Methods The discriminative validity was assessed in a sample of 90 patients with AD, 45 patients with a-MCI, and 180 subjects with CHS. Clinical, functional, and cognitive studies were independently performed in a blinded fashion and the gold standard diagnosis was established by consensus on the basis of these results. The test performance was assessed by means of a receiver operating characteristic curve analysis as area under the curve (AUC). Results M@T mean scores were 17.7 (SD = 5.7) in AD, 30.8 (SD = 2.3) in a-MCI, and 44.5 (SD = 3.1) in CHS. A cutoff score of 37 points had a sensitivity of 98.3% and a specificity of 97.8% to differentiate a-MCI from CHS (AUC = 0.999). A cutoff score of 27 points had a sensitivity of 100% and a specificity of 98.9% to differentiate mild AD from a-MCI and from CHS (AUC = 1.000). Conclusions The M@T had a high performance in the discrimination between early AD, a-MCI and CHS. PMID:25298775

  9. Cerebrospinal fluid levels of amyloid beta 1-43 in patients with amnestic mild cognitive impairment or early Alzheimer’s disease: a 2-year follow-up study

    Directory of Open Access Journals (Sweden)

    Camilla eLauridsen

    2016-03-01

    Full Text Available Abstract IntroductionBiomarkers that will reliably predict the onset of Alzheimer’s disease (AD are urgently needed. Although cerebrospinal fluid (CSF amyloid beta 1-42 (Aβ42, total tau and phosphorylated tau can be used to complement the clinical diagnosis of AD, amnestic mild cognitive impairment (aMCI, the prodromal phase of AD, is heterogeneous. Biomarkers should be able to determine which patients with aMCI are at greatest risk of AD. Histological studies and animal models indicate that amyloid beta 1-43 (Aβ43 aggregates early, and may play a role in the pathological process of AD. We have examined levels of CSF Aβ43 in a two-year longitudinal study of aMCI and early AD. Materials and methodsCSF was collected at baseline, and after one and two years from patients with AD (n=19, and patients with aMCI (n=42. Of these, 21 progressed to AD during the two years of study, whereas 21 did not. Controls (n=32 were lumbar punctured at baseline only. CSF analyses of Aβ43, Aβ42 and total tau were carried out with ELISA.ResultsAt baseline, CSF Aβ43, CSF Aβ42 and ratios with total tau could be used to separate controls from all three patient groups. CSF Aβ43, but not Aβ42, could separate patients with aMCI who progressed to AD during the two years of follow-up, from those that did not. The CSF total tau/Aβ43 ratio had a slightly but significantly larger area under the receiver operating characteristic curve when compared to the CSF total tau/Aβ42 ratio. CSF Aβ43 levels, but not Aβ42 levels, decreased from baseline to two years in the AD group.Discussion and conclusionCSF Aβ43 was demonstrated to be significantly reduced in patients already by the time that aMCI or AD was diagnosed, compared to controls, and this change must have occurred during the preclinical period. Since our results suggested that CSF Aβ43 distinguishes between subgroups of patients with aMCI better than CSF Aβ42, it may prove to be a useful additional biomarker for

  10. Distinct Mechanisms of Impairment in Cognitive Ageing and Alzheimer's Disease

    Science.gov (United States)

    Mapstone, Mark; Dickerson, Kathryn; Duffy, Charles J.

    2008-01-01

    Similar manifestations of functional decline in ageing and Alzheimer's disease obscure differences in the underlying cognitive mechanisms of impairment. We sought to examine the contributions of top-down attentional and bottom-up perceptual factors to visual self-movement processing in ageing and Alzheimer's disease. We administered a novel…

  11. Predictors of functional disability in mild cognitive impairment and dementia

    NARCIS (Netherlands)

    van Rossum, M. E.; Koek, H. L.

    2016-01-01

    Objective Knowledge about factors predicting functional disability in mild cognitive impairment (MCI) and dementia would help health care providers to identify those patients who are at high risk of functional disability. Previous research is scarce and focused on only a small number of possible pre

  12. Distinct Mechanisms of Impairment in Cognitive Ageing and Alzheimer's Disease

    Science.gov (United States)

    Mapstone, Mark; Dickerson, Kathryn; Duffy, Charles J.

    2008-01-01

    Similar manifestations of functional decline in ageing and Alzheimer's disease obscure differences in the underlying cognitive mechanisms of impairment. We sought to examine the contributions of top-down attentional and bottom-up perceptual factors to visual self-movement processing in ageing and Alzheimer's disease. We administered a novel…

  13. Nonlinguistic Cognitive Treatment for Bilingual Children with Primary Language Impairment

    Science.gov (United States)

    Ebert, Kerry Danahy; Rentmeester-Disher, Jill; Kohnert, Kathryn

    2012-01-01

    Substantial evidence points to the presence of subtle weaknesses in the nonlinguistic cognitive processing skills of children with primary (or specific) language impairment (PLI). It is possible that these weaknesses contribute to the language learning difficulties that characterize PLI, and that treating them can improve language skills. To test…

  14. Epidemiology of Osteoporosis in Women with Cognitive Impairment

    Science.gov (United States)

    Schrager, Sarina

    2006-01-01

    Osteoporosis is increasing due to the aging of the population. Women with cognitive impairment from childhood are at disproportionally high risk for osteoporosis and fractures. Suggested explanations for this increased risk include high use of anticonvulsant medications, lower peak bone densities, and higher rates of nonambulation. Down syndrome…

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

    NARCIS (Netherlands)

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

    2016-01-01

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

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

    Science.gov (United States)

    Blieszner, Rosemary; Roberto, Karen A.

    2010-01-01

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

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

    NARCIS (Netherlands)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Takehiko Doi

    2013-10-01

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

  19. Cognitive Stimulation Modulates Platelet Total Phospholipases A2 Activity in Subjects with Mild Cognitive Impairment.

    Science.gov (United States)

    Balietti, Marta; Giuli, Cinzia; Fattoretti, Patrizia; Fabbietti, Paolo; Postacchini, Demetrio; Conti, Fiorenzo

    2016-01-01

    We evaluated the effect of cognitive stimulation (CS) on platelet total phospholipases A2 activity (tPLA2A) in patients with mild cognitive impairment (MCI_P). At baseline, tPLA2A negatively correlated with Mini-Mental State Examination score (MMSE_s): patients with MMSE_s cognitive conditions of MCI_P, and that CS acts selectively on subjects with a dysregulated tPLA2A.

  20. Dual Tasking for the Differentiation between Depression and Mild Cognitive Impairment

    Science.gov (United States)

    Metzger, Florian G.; Hobert, Markus A.; Ehlis, Ann-Christine; Hasmann, Sandra E.; Hahn, Tim; Eschweiler, Gerhard W.; Berg, Daniela; Fallgatter, Andreas J.; Maetzler, Walter

    2016-01-01

    Differentiation of mild cognitive impairment from depression in elderly adults is a clinically relevant issue which is not sufficiently solved. Gait and dual task (DT) parameters may have the potential to complement current diagnostic work-up, as both dementia and depression are associated with changes of gait and DT parameters. Methods: Seven hundred and four participants of the TREND study (Tübinger evaluation of Risk factors for Early detection of NeuroDegeneration) aged 50–80 years were assessed using the Consortium to Establish a Registry for Alzheimer's Disease Plus test battery for testing cognition and Beck's Depression Inventory for evaluation of depression. Based on these results, four groups were defined: acute depressed (N = 53), cognitively mildly impaired (N = 97), acute depressed, and cognitively mildly impaired (N = 15), and controls (N = 536). Participants underwent a 20 m walk and checking boxes task under single (ST) and DT conditions. ST and DT performance and dual task costs (DTC) were calculated. Due to the typical age of increasing incidence of depressive and also cognitive symptoms, the 7th decade was calculated separately. Results: ST speeds of gait and checking boxes, DT walking speed, and walking DTC were significantly different between groups. Healthy controls were the fastest in all paradigms and cognitively mildly impaired had higher DTC than depressed individuals. Additionally, we constructed a multivariate predictive model differentiating the groups on a single-subject level. Conclusion: DT parameters are simply and comfortably measureable, and DTC can easily be determined. The combination of these parameters allows a differentiation of depressed and cognitively mildly impaired elderly adults.

  1. Early intervention programme for hearing impaired children.

    Science.gov (United States)

    Narayanswamy, S

    1992-01-01

    The School for Young Deaf Children was founded in 1969 when the All India Institute of Speech and Hearing at Mysore and the Christian Medical College Hospital at Vellore started diagnosing hearing impairment in children and prescribing hearing aids. These schools admitted children when they were 5 years old. Bala Vidyalaya was funded as an experimental school to satisfy the needs of younger children. A multi sensory approach based on the Montessori method of teaching with special emphasis on language acquisition was adopted. The School that began with 5 children and 2 teachers had 120 children and 15 teachers in 1992: 50 children were under 3 years old and the rest were between 3 and 6 years. Early auditory management and training is the foundation of the child's linguistic achievement which help the child use the innate ability to develop sophisticated listening skills such as listening to one signal in the presence of competing sounds. Simple games captivate the infants. At the age of 2 1/2 years ideovisual reading is introduced to the child: written sentences are presented to the child about an activity that the child had just experienced. Even before 2 years of age he or she starts scribbling. School lessons are used as tools for writing. The school takes efforts to win the confidence of the parents. So far 97 children have joined the mainstream of education after an initial training the school. Of these, 6 are settled in jobs, 5 are in college or in postgraduate studies, 11 are studying at the university, 8 are in the higher secondary school (classes XI or XII)m 28 are studying in high school (class VI to class X), while the remaining 39 are in primary schools. It has been demonstrated that early educational intervention and involvement of the family into the educational program are very important for the successful integration of hearing-impaired children into the main stream.

  2. The Effect of Bilingualism on Amnestic Mild Cognitive Impairment

    Science.gov (United States)

    Bialystok, Ellen; Craik, Fergus I. M.; Murphy, Kelly J.; Troyer, Angela K.

    2013-01-01

    Objectives. Previous reports have found that lifelong bilingualism is associated with a delay in the onset of dementia, including Dementia of the Alzheimer’s Type (DAT). Because amnestic mild cognitive impairment (aMCI) is often a transition stage between normal aging and DAT, our aim in this paper was to establish whether this delay in symptom onset for bilinguals would also be seen in the onset of symptoms of aMCI and whether this delay would be consistent in different subtypes of aMCI. Method. We examined the effect of bilingualism on the age of diagnosis in individuals with single- or multiple-domain aMCI who were administered a battery of neuropsychological tests and questionnaires about their language and social background. Results. Our results showed an interaction between aMCI type and language history. Only individuals diagnosed with single-domain aMCI demonstrated a later age of diagnosis for bilinguals (M = 79.4 years) than monolinguals (M = 74.9 years). Discussion. This preliminary evidence suggests that the early protective advantage of bilingualism may be specific to single-domain aMCI, which is the type of aMCI most specifically associated with progression to DAT. PMID:22454387

  3. NOX Activity Is Increased in Mild Cognitive Impairment

    Science.gov (United States)

    Gupta, Sunita; Parrino, Taryn E.; Knight, Alecia G.; Ebenezer, Philip J.; Weidner, Adam M.; LeVine, Harry; Keller, Jeffrey N.; Markesbery, William R.

    2010-01-01

    Abstract This study was undertaken to investigate the profile of NADPH oxidase (NOX) in the clinical progression of Alzheimer's disease (AD). Specifically, NOX activity and expression of the regulatory subunit p47phox and the catalytic subunit gp91phox was evaluated in affected (superior and middle temporal gyri) and unaffected (cerebellum) brain regions from a longitudinally followed group of patients. This group included both control and late-stage AD subjects, and also subjects with preclinical AD and with amnestic mild cognitive impairment (MCI) to evaluate the profile of NOX in the earliest stages of dementia. Data show significant elevations in NOX activity and expression in the temporal gyri of MCI patients as compared with controls, but not in preclinical or late-stage AD samples, and not in the cerebellum. Immunohistochemical evaluations of NOX expression indicate that whereas microglia express high levels of gp91phox, moderate levels of gp91phox also are expressed in neurons. Finally, in vitro experiments showed that NOX inhibition blunted the ability of oligomeric amyloid beta peptides to injure cultured neurons. Collectively, these data show that NOX expression and activity are upregulated specifically in a vulnerable brain region of MCI patients, and suggest that increases in NOX-associated redox pathways in neurons might participate in the early pathogenesis of AD. Antioxid. Redox Signal. 12, 1371–1382. PMID:19929442

  4. Prefrontal contributions to relational encoding in amnestic mild cognitive impairment

    Directory of Open Access Journals (Sweden)

    Chris M. Foster

    2016-01-01

    Full Text Available Relational memory declines are well documented as an early marker for amnestic mild cognitive impairment (aMCI. Episodic memory formation relies on relational processing supported by two mnemonic mechanisms, generation and binding. Neuroimaging studies using functional magnetic resonance imaging (fMRI have primarily focused on binding deficits which are thought to be mediated by medial temporal lobe dysfunction. In this study, prefrontal contributions to relational encoding were also investigated using fMRI by parametrically manipulating generation demands during the encoding of word triads. Participants diagnosed with aMCI and healthy control subjects encoded word triads consisting of a category word with either, zero, one, or two semantically related exemplars. As the need to generate increased (i.e., two- to one- to zero-link triads, both groups recruited a core set of regions associated with the encoding of word triads including the parahippocampal gyrus, superior temporal gyrus, and superior parietal lobule. Participants diagnosed with aMCI also parametrically recruited several frontal regions including the inferior frontal gyrus and middle frontal gyrus as the need to generate increased, whereas the control participants did not show this modulation. While there is some functional overlap in regions recruited by generation demands between the groups, the recruitment of frontal regions in the aMCI participants coincides with worse memory performance, likely representing a form of neural inefficiency associated with Alzheimer's disease.

  5. Prefrontal contributions to relational encoding in amnestic mild cognitive impairment.

    Science.gov (United States)

    Foster, Chris M; Addis, Donna Rose; Ford, Jaclyn H; Kaufer, Daniel I; Burke, James R; Browndyke, Jeffrey N; Welsh-Bohmer, Kathleen A; Giovanello, Kelly S

    2016-01-01

    Relational memory declines are well documented as an early marker for amnestic mild cognitive impairment (aMCI). Episodic memory formation relies on relational processing supported by two mnemonic mechanisms, generation and binding. Neuroimaging studies using functional magnetic resonance imaging (fMRI) have primarily focused on binding deficits which are thought to be mediated by medial temporal lobe dysfunction. In this study, prefrontal contributions to relational encoding were also investigated using fMRI by parametrically manipulating generation demands during the encoding of word triads. Participants diagnosed with aMCI and healthy control subjects encoded word triads consisting of a category word with either, zero, one, or two semantically related exemplars. As the need to generate increased (i.e., two- to one- to zero-link triads), both groups recruited a core set of regions associated with the encoding of word triads including the parahippocampal gyrus, superior temporal gyrus, and superior parietal lobule. Participants diagnosed with aMCI also parametrically recruited several frontal regions including the inferior frontal gyrus and middle frontal gyrus as the need to generate increased, whereas the control participants did not show this modulation. While there is some functional overlap in regions recruited by generation demands between the groups, the recruitment of frontal regions in the aMCI participants coincides with worse memory performance, likely representing a form of neural inefficiency associated with Alzheimer's disease.

  6. Reorganization of functional networks in mild cognitive impairment.

    Directory of Open Access Journals (Sweden)

    Javier M Buldú

    Full Text Available Whether the balance between integration and segregation of information in the brain is damaged in Mild Cognitive Impairment (MCI subjects is still a matter of debate. Here we characterize the functional network architecture of MCI subjects by means of complex networks analysis. Magnetoencephalograms (MEG time series obtained during a memory task were evaluated by synchronization likelihood (SL, to quantify the statistical dependence between MEG signals and to obtain the functional networks. Graphs from MCI subjects show an enhancement of the strength of connections, together with an increase in the outreach parameter, suggesting that memory processing in MCI subjects is associated with higher energy expenditure and a tendency toward random structure, which breaks the balance between integration and segregation. All features are reproduced by an evolutionary network model that simulates the degenerative process of a healthy functional network to that associated with MCI. Due to the high rate of conversion from MCI to Alzheimer Disease (AD, these results show that the analysis of functional networks could be an appropriate tool for the early detection of both MCI and AD.

  7. [Cancer-related Cognitive Impairment: Current Knowledge and Future Challenges].

    Science.gov (United States)

    Tanimukai, Hitoshi

    2015-01-01

    Cancer patients often suffer from various distresses, including cognitive impairment. Cognitive impairment during and after cancer diagnosis and treatment are collectively called "Cancer-related cognitive impairment (CRCI)". The number of publications about cognitive impairment due to cancer therapy, especially chemotherapy, hormonal therapy, and radiotherapy, has been growing. Patients often worry not only about their disease condition and therapies, but also experience concerns regarding their memory, attention, and ability to concentrate. Even subtle CRCI can have a significant impact on social relationships, the ability to work, undergo treatment, accomplish meaningful goals, and the quality of life. Longitudinal studies of cancer patients indicated that up to 75% experience CRCI during treatment. Furthermore, CRCI may persist for many years following treatment. However, it is not well understood by most physicians and medical staff. CRCI can be mediated through increased inflammatory cytokines and hormonal changes. In addition, the biology of the cancer, stress, and attentional fatigue can also contribute to CRCI. Genetic factors and co-occurring symptoms may explain some of the inter-individual variability in CRCI. Researchers and patients are actively trying to identify effective interventional methods and useful coping strategies. Many patients are willing to discuss their disease condition and future treatment with medical staff and/or their families. Some patients also hope to discuss their end-of-life care. However, it is difficult to express their will after developing cognitive impairment. Advance care planning (ACP) can help in such situations. This process involves discussion between a patient, their family, and clinicians to clarify and reflect on values, treatment preferences, and goals to develop a shared understanding of how end-of-life care should proceed. The number of cancer patients with cognitive impairment has been increasing owing to the

  8. Prevalence of cognitive impairment in community-dwelling older adults.

    Science.gov (United States)

    Rashedi, Vahid; Rezaei, Mohammad; Gharib, Masoud

    2014-01-01

    Mild cognitive impairment can be considered as an intermediate clinical state between normal cognitive aging and mild dementia. Elderly people with this impairment represent an at-risk group for the development of dementia. The aim of this study was to investigate the prevalence of cognitive impairment in community-dwelling older adults by Mini-Mental State Examination (MMSE) and its relationship with socio-demographic variables. In this analytical-descriptive study, 212 subjects admitted to Hamadan's day care centers were selected through simple random sampling method. To gather the data, MMSE was used as well as a questionnaire containing demographic variables. Data analysis was completed through SPSS-16. The sample consisted of 17.9% male, 59.4% of whom were married. According to the results, 96 cases (45.3%) suffered from mild (MMSE≥22), 110 cases (51.9%) from moderate (11≤MMSE≤21) and 6 cases (2.8%) from severe cognitive disorder (MMSE≤10). As findings revealed, factors such as age (Pv = 0.005, r = -0.491) and schooling (Pv cognitive decline in community-dwelling older adults was of normal range. Hence, familial relations and social support can decrease mental status disorder.

  9. Hyperbaric oxygen preconditioning attenuates postoperative cognitive impairment in aged rats.

    Science.gov (United States)

    Sun, Li; Xie, Keliang; Zhang, Changsheng; Song, Rui; Zhang, Hong

    2014-06-18

    Cognitive decline after surgery in the elderly population is a major clinical problem with high morbidity. Hyperbaric oxygen (HBO) preconditioning can induce significant neuroprotection against acute neurological injury. We hypothesized that HBO preconditioning would prevent the development of postoperative cognitive impairment. Elderly male rats (20 months old) underwent stabilized tibial fracture operation under general anesthesia after HBO preconditioning (once a day for 5 days). Separate cohorts of animals were tested for cognitive function with fear conditioning and Y-maze tests, or euthanized at different times to assess the blood-brain barrier integrity, systemic and hippocampal proinflammatory cytokines, and caspase-3 activity. Animals exhibited significant cognitive impairment evidenced by a decreased percentage of freezing time and an increased number of learning trials on days 1, 3, and 7 after surgery, which were significantly prevented by HBO preconditioning. Furthermore, HBO preconditioning significantly ameliorated the increase in serum and hippocampal proinflammatory cytokines tumor necrosis factor-α, interleukin-1 β (IL-1β), IL-6, and high-mobility group protein 1 in surgery-challenged animals. Moreover, HBO preconditioning markedly improved blood-brain barrier integrity and caspase-3 activity in the hippocampus of surgery-challenged animals. These findings suggest that HBO preconditioning could significantly mitigate surgery-induced cognitive impairment, which is strongly associated with the reduction of systemic and hippocampal proinflammatory cytokines and caspase-3 activity.

  10. Stroke occurring in patients with cognitive impairment or dementia

    Directory of Open Access Journals (Sweden)

    Solène Moulin

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

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

    Directory of Open Access Journals (Sweden)

    Federerico Filipin

    2015-12-01

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

  12. Association between smoking and cognitive impairment in multiple sclerosis

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    Özcan ME

    2014-09-01

    Full Text Available Muhammed Emin Özcan,1 Bahri İnce,2 Ayhan Bingöl,3 Simge Ertürk,3 Meriç Adil Altınöz,4 Hasan Hüseyin Karadeli,1 Abdulkadir Koçer,5 Talip Asil1 1Deparment of Neurology, Medical Faculty, Bezmialem Vakif University, Istanbul, Turkey; 2Department of Psychiatry, Bakirköy Research and Training Hospital for Psychiatry, Istanbul, Turkey; 3Mayis Psychology Center, Istanbul, Turkey; 4Department of Molecular Biology and Genetics, Haliç University, Istanbul, Turkey; 5Department of Neurology, Medical Faculty, İstanbul Medeniyet University, Göztepe, Istanbul, Turkey Purpose: Although smoking is known to cause various symptoms in multiple sclerosis (MS patients, there have been no reports regarding the relationship between smoking and cognitive impairment in MS. Studying the effects of cigarette smoking in MS patients is imperative as there is a high prevalence of cognitive impairment in MS patients. In this study we examined the potentially deleterious effects of heavy smoking on mentation of patients with MS. Patients and methods: MS patients receiving care at the Neurology Clinic at Bezmialem Vakif University, between the ages of 18–65 years who have at least graduated elementary school were included in the study. The Brief Repeatable Battery of Neuropsychological Tests (BRB-N is a commonly used method to assess cognitive function in MS patients and was utilized in our study. Patients that smoked for at least 10 pack-years were considered heavy smokers.Results: All the patients were stratified into two groups: heavy smokers (n=20 and nonsmokers (n=24. For heavy smokers, their cognitive functioning was more impaired than that of nonsmokers (P=0.04, χ2=4.227. For patients with cognitive impairment, 78.9% of the Paced Auditory Serial Addition Test and 63.2% of the Symbol Digit Modalities Test scores were found to be lower.Conclusion: Previous reports have suggested that smoking increases the frequency of relapse among individuals with

  13. Intraindividual Variability in Domain-Specific Cognition and Risk of Mild Cognitive Impairment and Dementia

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    Leslie Vaughan

    2013-01-01

    Full Text Available Intraindividual variability among cognitive domains may predict dementia independently of interindividual differences in cognition. A multidomain cognitive battery was administered to 2305 older adult women (mean age 74 years enrolled in an ancillary study of the Women’s Health Initiative. Women were evaluated annually for probable dementia and mild cognitive impairment (MCI for an average of 5.3 years using a standardized protocol. Proportional hazards regression showed that lower baseline domain-specific cognitive scores significantly predicted MCI (N=74, probable dementia (N=45, and MCI or probable dementia combined (N=101 and that verbal and figural memory predicted each outcome independently of all other cognitive domains. The baseline intraindividual standard deviation across test scores (IAV Cognitive Domains significantly predicted probable dementia and this effect was attenuated by interindividual differences in verbal episodic memory. Slope increases in IAV Cognitive Domains across measurement occasions (IAV Time explained additional risk for MCI and MCI or probable dementia, beyond that accounted for by interindividual differences in multiple cognitive measures, but risk for probable dementia was attenuated by mean decreases in verbal episodic memory slope. These findings demonstrate that within-person variability across cognitive domains both at baseline and longitudinally independently accounts for risk of cognitive impairment and dementia in support of the predictive utility of within-person variability.

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    BACKGROUND AND PURPOSE: We aimed to study if physical activity could interfere with progression for cognitive impairment and dementia in older people with white matter changes living independently. METHODS: The LADIS (Leukoaraiosis and Disability) prospective multinational European study evaluates...... the impact of white matter changes on the transition of independent elderly subjects into disability. Subjects were evaluated yearly during 3 years with a comprehensive clinical protocol and cognitive assessment with classification of cognitive impairment and dementia according to usual clinical criteria....... Physical activity was recorded during the clinical interview. MRI was performed at entry and at the end of the study. RESULTS: Six hundred thirty-nine subjects were included (74.1±5 years old, 55% women, 9.6±3.8 years of schooling, 64% physically active). At the end of follow-up, 90 patients had dementia...

  15. Orthostatic hypotension and cognitive impairment: a dangerous association?

    Science.gov (United States)

    Sambati, Luisa; Calandra-Buonaura, Giovanna; Poda, Roberto; Guaraldi, Pietro; Cortelli, Pietro

    2014-06-01

    Many studies have addressed the relation between orthostatic hypotension (OH) and cognitive impairment (CI) in the elderly, in mild cognitive impairment, vascular and neurodegenerative dementias and movement disorders, such as Parkinson's disease. However, results concerning both the increased coexistence of the two conditions and their causal relationship remain controversial. According to the literature three hypotheses can be formulated on the relation between OH and CI. In neurodegenerative disease, OH and CI may result from a common pathological process which affects areas involved in both cognition and cardiovascular autonomic control. Alternatively, OH may lead to cerebral hypoperfusion which is supposed to play a role in the development of CI. Finally, recent data suggest that CI should probably be considered more a transient symptom of OH than a chronic effect. This study reviews the literature reports on the relationship between OH and CI, and emphasises the need for longitudinal studies designed to investigate this topic.

  16. Cognitive Impairments Preceding and Outlasting Autoimmune Limbic Encephalitis

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    Robert Gross

    2016-01-01

    Full Text Available Mild cognitive impairment (MCI can be the initial manifestation of autoimmune limbic encephalitis (ALE, a disorder that at times presents a diagnostic challenge. In addition to memory impairment, clinical features that might suggest this disorder include personality changes, agitation, insomnia, alterations of consciousness, and seizures. Once recognized, ALE typically responds to treatment with immune therapies, but long-term cognitive deficits may remain. We report two cases of patients with MCI who were ultimately diagnosed with ALE with antibodies against the voltage gated potassium channel complex. Months after apparent resolution of their encephalitides, both underwent neuropsychological testing, which demonstrated persistent cognitive deficits, primarily in the domains of memory and executive function, for cases 1 and 2, respectively. A brief review of the literature is included.

  17. Early Rehabilitation in the Intensive Care Unit: Preventing Physical and Mental Health Impairments

    OpenAIRE

    Parker, Ann; Sricharoenchai, Thiti; Needham, Dale M.

    2013-01-01

    Survivors of critical illness often experience new or worsening impairments in physical, cognitive and/or mental health, referred to as post-intensive care syndrome (PICS). Such impairments can be long-lasting and negatively impact survivors’ quality of life. Early rehabilitation in the intensive care unit (ICU), while patients remain on life-support therapies, may reduce the complications associated with PICS. This article addresses evidence-based rehabilitation interventions to reduce the p...

  18. Early Rehabilitation in the Intensive Care Unit: Preventing Physical and Mental Health Impairments

    OpenAIRE

    Parker, Ann; Sricharoenchai, Thiti; Needham, Dale M.

    2013-01-01

    Survivors of critical illness often experience new or worsening impairments in physical, cognitive and/or mental health, referred to as post-intensive care syndrome (PICS). Such impairments can be long-lasting and negatively impact survivors’ quality of life. Early rehabilitation in the intensive care unit (ICU), while patients remain on life-support therapies, may reduce the complications associated with PICS. This article addresses evidence-based rehabilitation interventions to reduce the p...

  19. CSF markers in Alzheimer disease patients are not related to the different degree of cognitive impairment.

    Science.gov (United States)

    Stefani, Alessandro; Martorana, Alessandro; Bernardini, Sergio; Panella, Marta; Mercati, Flavio; Orlacchio, Antonio; Pierantozzi, Mariangela

    2006-12-21

    Standard markers in cerebrospinal fluid (CSF), as soluble amyloid beta 1-42 (Abeta1-42) and total tau protein (t-tau), may contribute to dementia subtypes diagnostic accuracy. Yet, their sensitivity to assess the different degree of cognitive deficit is not fully clarified. Our study analyses Abeta1-42 and t-tau CSF levels in different cohorts of Alzheimer's disease (AD) patients, distinguished as early AD (mild cognitively impaired subjects recently converted to AD), mild AD (MMSE or =18), and moderately advanced AD (MMSEstage. In early AD patients, Abeta1-42 levels were already significantly low, if compared to the control group (336 vs 867 ng/L; pdiffer between AD subgroups, and in particular between mild to moderate AD. A significant progressive increase of t-tau concentration was found when comparing early AD (269 ng/L) to more advanced AD stages (468 ng/L and 495 ng/L for mild and moderate AD, respectively). Our findings confirm that the impairment of amyloidogenic cascade is an early, even pre-clinical process, but suggest that soluble Abeta1-42 concentration has a negligible correlation with the clinical progression. Conversely, t-tau concentration correlates with the transition towards marked cognitive impairment.

  20. Diabetes mellitus Type II and cognitive capacity in healthy aging, mild cognitive impairment and Alzheimer's disease.

    Science.gov (United States)

    Degen, Christina; Toro, Pablo; Schönknecht, Peter; Sattler, Christine; Schröder, Johannes

    2016-06-30

    While diabetes mellitus (DM) Type II has repeatedly been linked to Alzheimer´s disease (AD) and mild cognitive impairment (MCI), longitudinal research is scarce and disease duration has not always been taken into account. In a birth cohort born between 1930 and 1932 we investigated the influence of DM Type II and disease duration on neuropsychological functioning (memory/learning, attention, verbal fluency, visuospatial thinking and abstract thinking) across 14 years. Subjects who developed MCI or AD performed significantly poorer on all neuropsychological tests applied. While significant main effects DM Type II did not arise, its presence led to a significant deterioration of performance in the digit symbol test and visuospatial thinking over time. Additionally, in visuospatial thinking this change was more pronounced for individuals suffering from MCI/AD. We found that, as a concomitant disease DM Type II does not affect memory functioning, which is typically compromised in MCI and early AD. Rather, it may lead to deficits in cognitive flexibility and visuospatial thinking. DM Type II can be considered a frequent comorbid condition which can aggravate the course of MCI and AD. In this respect it may serve as a model for other comorbid conditions in AD.

  1. Valpar系统联合计算机辅助技术治疗早期血管性认知障碍的疗效观察%Valpar technology can improve the treatment of early vascular cognitive impairment

    Institute of Scientific and Technical Information of China (English)

    房辉; 谢凌锋; 贾澄杰; 张秀花; 苏彬; 任志恒

    2016-01-01

    目的 观察Valpar系统联合计算机辅助技术治疗早期血管性认知障碍(VCI)的疗效.方法 选取40例符合人选标准的早期VCI患者,按照随机数字表法将其分为治疗组和对照组,每组20例.2组患者均给予常规认知康复训练和计算机辅助治疗,治疗组在此基础上采用Valpar系统进行认知功能训练.治疗前、治疗4周后及8周后,采用洛文斯顿作业疗法认知功能评定量表(LOTCA)和改良Barthel指数(MBI)对2组患者进行认知功能和ADL能力评定.结果 治疗前,2组患者LOTCA评分和MBI评分之间比较,差异无统计学意义(P>0.05).治疗组治疗4周后及8周后,LOTCA各项评分、LOTCA总分及MBI评分均较治疗前改善(P<0.05).对照组治疗4周后,定向能力[(3.50±0.89)分]、视知觉[(13.50±1.43)分]、空间知觉[(2.40土0.50)分]、视运动组织[(24.00±1.17)分]及注意力评分[(2.30土0.87)分]较治疗前明显改善(P<0.05),治疗8周后LOTCA各项评分、LOTCA总分及MBI评分均较治疗前改善(P<0.05).与对照组治疗后同时间点比较,治疗组治疗4周后及8周后LOTCA各项评分、LOTCA总分、MBI评分均较为优异(P<0.05).结论 Valpar系统联合计算机辅助技术能显著改善早期VCI患者的认知功能和ADL能力,值得临床应用、推广.%Objective To observe the therapeutic effect of the Valpar system combined with computer-aided technology in treating early vascular cognitive impairment (VCI).Methods Forty patients in the early stage of VCI were randomly divided into a treatment group and a control group,each of 20.Regular and computer-aided cognition training were applied in both groups,while training using the Valpar system was additionally used in the treatment group.Patients in both groups were assessed using the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) and the modified Barthel Index (MBI) before,and after 4 and 8 weeks of treatment.Results Before the treatment,there were no

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

    Directory of Open Access Journals (Sweden)

    Yen-Hsuan Hsu

    2015-06-01

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

  3. The Genetic Basis of Cognitive Impairment and Dementia in Parkinson's Disease

    Directory of Open Access Journals (Sweden)

    Lucy Mary Collins

    2016-05-01

    Full Text Available AbstractCognitive dysfunction is a common feature of Parkinson's disease (PD with mild cognitive impairment affecting around a quarter of patients in the early stages of their disease, and approximately half developing dementia by 10 years from diagnosis. However the pattern of cognitive impairments and their speed of evolution vary markedly between individuals. Whilst some of this variability may relate to extrinsic factors and comorbidities, inherited genetic heterogeneity is also known to play an important role. A number of common genetic variants have been identified which contribute to cognitive function in PD, including variants in COMT (catechol-o-methyltransferase, MAPT (microtubule-associated protein tau, and APOE (apolipoprotein E. Furthermore, rarer mutations in GBA (glucocerebrosidase and SNCA (α-synuclein and are strongly associated with dementia risk in PD. This review explores the functional impact of these variants on cognition in PD, and discusses how such genotype-phenotype associations provide a window into the mechanistic basis of cognitive heterogeneity in this disorder. This has consequent implications for the development of much more targeted therapeutic strategies for cognitive symptoms in PD.

  4. Nonlinguistic cognitive treatment for bilingual children with primary language impairment.

    Science.gov (United States)

    Ebert, Kerry Danahy; Rentmeester-Disher, Jill; Kohnert, Kathryn

    2012-06-01

    Substantial evidence points to the presence of subtle weaknesses in the nonlinguistic cognitive processing skills of children with primary (or specific) language impairment (PLI). It is possible that these weaknesses contribute to the language learning difficulties that characterize PLI, and that treating them can improve language skills. To test this premise, we treated two nonlinguistic cognitive processing skills, processing speed and sustained selective attention, in two Spanish-English bilingual children with PLI. The study followed a single-subject multiple baseline design, with both repeated measures and standardized pre- and post-testing as outcome measures. Results from the repeated measures tasks showed that both participants made gains in nonlinguistic cognitive processing skills as well as in Spanish and English. These results both replicate and extend prior work showing that nonlinguistic cognitive processing treatment can positively affect language skills in children with PLI.

  5. New strategies for Alzheimer's disease and cognitive impairment.

    Science.gov (United States)

    Maiese, Kenneth; Chong, Zhao Zhong; Hou, Jinling; Shang, Yan Chen

    2009-01-01

    Approximately five million people suffer with Alzheimer's disease (AD) and more than twenty-four million people are diagnosed with AD, pre-senile dementia, and other disorders of cognitive loss worldwide. Furthermore, the annual cost per patient with AD can approach $200,000 with an annual population aggregate cost of $100 billion. Yet, complete therapeutic prevention or reversal of neurovascular injury during AD and cognitive loss is not achievable despite the current understanding of the cellular pathways that modulate nervous system injury during these disorders. As a result, identification of novel therapeutic targets for the treatment of neurovascular injury would be extremely beneficial to reduce or eliminate disability from diseases that lead to cognitive loss or impairment. Here we describe the capacity of intrinsic cellular mechanisms for the novel pathways of erythropoietin and forkhead transcription factors that may offer not only new strategies for disorders such as AD and cognitive loss, but also function as biomarkers for disease onset and progression.

  6. Clinical Relevance of Specific Cognitive Complaints in Determining Mild Cognitive Impairment from Cognitively Normal States in a Study of Healthy Elderly Controls

    Science.gov (United States)

    Ávila-Villanueva, Marina; Rebollo-Vázquez, Ana; Ruiz-Sánchez de León, José M.; Valentí, Meritxell; Medina, Miguel; Fernández-Blázquez, Miguel A.

    2016-01-01

    Introduction: Subjective memory complaints (SMC) in the elderly have been suggested as an early sign of dementia. This study aims at investigating whether specific cognitive complaints are more useful than others to discriminate Mild Cognitive Impairment (MCI) by examining the dimensional structure of the Everyday Memory Questionnaire (EMQ). Materials and Methods: A sample of community-dwelling elderly individuals was recruited (766 controls and 78 MCI). The EMQ was administered to measure self-perception of cognitive complaints. All participants also underwent a comprehensive clinical and neuropsychological battery. Combined exploratory factor analysis (EFA) and Item Response Theory (IRT) were performed to identify the underlying structure of the EMQ. Furthermore, logistic regression analyses were conducted to study whether single cognitive complaints were able to predict MCI. Results: A suitable five-factor solution was found. Each factor focused on a different cognitive domain. Interestingly, just three of them, namely Forgetfulness of Immediate Information (FII), Executive Functions (EF) and Prospective Memory (PM) proved to be effective in distinguishing between cognitively healthy individuals and MCI. Based on these results we propose a shortened EMQ version comprising 10 items (EMQ-10). Discussion: Not all cognitive complaints have the same clinical relevance. Only subjective complaints on specific cognitive domains are able to discriminate MCI. We encourage clinicians to use the EMQ-10 as a useful tool to quantify and monitor the progression of individuals who report cognitive complaints. PMID:27757082

  7. Clinical Relevance of Specific Cognitive Complaints in Determining Mild Cognitive Impairment from Cognitively Normal States in a Study of Healthy Elderly Controls.

    Science.gov (United States)

    Ávila-Villanueva, Marina; Rebollo-Vázquez, Ana; Ruiz-Sánchez de León, José M; Valentí, Meritxell; Medina, Miguel; Fernández-Blázquez, Miguel A

    2016-01-01

    Introduction: Subjective memory complaints (SMC) in the elderly have been suggested as an early sign of dementia. This study aims at investigating whether specific cognitive complaints are more useful than others to discriminate Mild Cognitive Impairment (MCI) by examining the dimensional structure of the Everyday Memory Questionnaire (EMQ). Materials and Methods: A sample of community-dwelling elderly individuals was recruited (766 controls and 78 MCI). The EMQ was administered to measure self-perception of cognitive complaints. All participants also underwent a comprehensive clinical and neuropsychological battery. Combined exploratory factor analysis (EFA) and Item Response Theory (IRT) were performed to identify the underlying structure of the EMQ. Furthermore, logistic regression analyses were conducted to study whether single cognitive complaints were able to predict MCI. Results: A suitable five-factor solution was found. Each factor focused on a different cognitive domain. Interestingly, just three of them, namely Forgetfulness of Immediate Information (FII), Executive Functions (EF) and Prospective Memory (PM) proved to be effective in distinguishing between cognitively healthy individuals and MCI. Based on these results we propose a shortened EMQ version comprising 10 items (EMQ-10). Discussion: Not all cognitive complaints have the same clinical relevance. Only subjective complaints on specific cognitive domains are able to discriminate MCI. We encourage clinicians to use the EMQ-10 as a useful tool to quantify and monitor the progression of individuals who report cognitive complaints.

  8. Structural deficits and cognitive impairment in tuberculous meningitis.

    Science.gov (United States)

    Chen, Hsiu-Ling; Lu, Cheng-Hsien; Chang, Ching-Di; Chen, Pei-Chin; Chen, Meng-Hsiang; Hsu, Nai-Wen; Chou, Kun-Hsien; Lin, Wei-Ming; Lin, Ching-Po; Lin, Wei-Che

    2015-07-22

    Chronic neuropsychological sequelae may occur in patients with tuberculous meningitis (TBM). The impact of structural abnormalities on the clinical performance of patients with TBM is unknown. This study applied the Diffeomorphic Anatomical Registration Through Exponentiated Lie Algebra (DARTEL) voxel-based morphometry (VBM) to determine if gray matter deficits in TBM are associated with acute presentations and chronic cognitive impairment. Seventeen patients with TBM who discontinued their anti-TB therapy for more than six months, and 17 age-, sex-, and education-matched healthy subjects were enrolled. Differences in gray matter volume (GMV) between patients and healthy controls were investigated using DARTEL-VBM to determine structural abnormalities. Disease severity during the acute stage was scored by clinical profiles and conventional imaging findings. Correlations among chronic structural deficits, cognitive impairment, and initial disease severity were assessed. The patients with TBM had worse neuropsychological subtest performances than the healthy controls. Compared to the controls, the patients showed smaller GMVs in the right thalamus, right caudate nucleus, right superior and middle temporal gyrus, right precuneus, and left putamen (p superior temporal gyrus, right precuneus, left putamen, and right caudate nucleus (p < 0.05) were further associated with worse cognitive function. More severe initial disease also correlated with smaller GMVs in the right caudate nucleus (p < 0.05). Multiple domain cognitive impairment may persist in patients with chronic TBM even after appropriate treatment. Worse initial disease severity may contribute to the vulnerability of brain tissue to damage, with subsequent neuropsychological consequences.

  9. Heart failure and cognitive impairment: Challenges and opportunities

    Directory of Open Access Journals (Sweden)

    George A Heckman

    2007-07-01

    Full Text Available George A Heckman, Christopher J Patterson, Catherine Demers, Joye St.Onge, Irene D Turpie, Robert S McKelvieDepartment of Medicine, McMaster University, Hamilton, Ontario, CanadaAbstract: As populations age, heart failure (HF is becoming increasingly common, and in addition to a high burden of morbidity and mortality, HF has an enormous financial impact. Though disproportionately affected by HF, the elderly are less likely to receive recommended therapies, in part because clinical trials of HF therapy have ignored outcomes of importance to this population, including impaired cognitive function (ICF. HF is associated with ICF, manifested primarily as delirium in hospitalized patients, or as mild cognitive impairment or dementia in otherwise stable outpatients. This association is likely the result of shared risk factors, as well as perfusion and rheological abnormalities that occur in patients with HF. Evidence suggests that these abnormalities may be partially reversible with standard HF therapy. The clinical consequences of ICF in HF patients are significant. Clinicians should consider becoming familiar with screening instruments for ICF, including delirium and dementia, in order to identify patients at risk of nonadherence to HF therapy and related adverse consequences. Preliminary evidence suggests that optimal HF therapy in elderly patients may preserve or even improve cognitive function, though the impact on related outcomes remains to be determined.Keywords: heart failure, mild cognitive impairment, delirium, dementia, elderly

  10. Visual personal familiarity in amnestic mild cognitive impairment.

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    Luisa Jurjanz

    Full Text Available BACKGROUND: Patients with amnestic mild cognitive impairment are at high risk for developing Alzheimer's disease. Besides episodic memory dysfunction they show deficits in accessing contextual knowledge that further specifies a general concept or helps to identify an object or a person. METHODOLOGY/PRINCIPAL FINDINGS: Using functional magnetic resonance imaging, we investigated the neural networks associated with the perception of personal familiar faces and places in patients with amnestic mild cognitive impairment and healthy control subjects. Irrespective of stimulus type, patients compared to control subjects showed lower activity in right prefrontal brain regions when perceiving personally familiar versus unfamiliar faces and places. Both groups did not show different neural activity when perceiving faces or places irrespective of familiarity. CONCLUSIONS/SIGNIFICANCE: Our data highlight changes in a frontal cortical network associated with knowledge-based personal familiarity among patients with amnestic mild cognitive impairment. These changes could contribute to deficits in social cognition and may reduce the patients' ability to transition from basic to complex situations and tasks.

  11. Cognitive rehabilitation reduces cognitive impairment and normalizes hippocampal CA1 architecture in a rat model of vascular dementia.

    Science.gov (United States)

    Langdon, Kristopher D; Granter-Button, Shirley; Harley, Carolyn W; Moody-Corbett, Frances; Peeling, James; Corbett, Dale

    2013-06-01

    Dementia is a major cause of morbidity in the western society. Pharmacological therapies to delay the progression of cognitive impairments are modestly successful. Consequently, new therapies are urgently required to improve cognitive deficits associated with dementia. We evaluated the effects of physical and cognitive activity on learning and memory in a rat model of vascular dementia (VasD). Male Sprague-Dawley rats (6 months old) were exposed to either regular chow or a diet rich in saturated fats and sucrose and chronic bilateral common carotid artery occlusion or sham surgery. First, this model of VasD was validated using a 2 × 2 experimental design (surgery × diet) and standard cognitive outcomes. Next, using identical surgical procedures, we exposed animals to a paradigm of cognitive rehabilitation or a sedentary condition. At 16 weeks post surgery, VasD animals demonstrated significant learning and memory deficits in the Morris water maze, independent of diet. Rehabilitation significantly attenuated these cognitive deficits at this time point as well as at 24 weeks. Further, rehabilitation normalized hippocampal CA1 soma size (area and volume) to that of control animals, independent of cell number. Importantly, these findings demonstrate beneficial neuroplasticity in early middle-aged rats that promoted cognitive recovery, an area rarely explored in preclinical studies.

  12. Characteristics of early spelling of children with Specific Language Impairment

    NARCIS (Netherlands)

    Cordewener, K.A.H.; Bosman, A.M.T.; Verhoeven, L.T.W.

    2012-01-01

    The present study investigated active grapheme knowledge and early spelling of 59 first grade children with Specific Language Impairment (SLI). Speed, nature, and knowledge transfer of spelling acquisition were taken into account. Four orthographic characteristics that influence early spelling, name

  13. Screening Utility of the King-Devick Test in Mild Cognitive Impairment and Alzheimer Disease Dementia.

    Science.gov (United States)

    Galetta, Kristin M; Chapman, Kimberly R; Essis, Maritza D; Alosco, Michael L; Gillard, Danielle; Steinberg, Eric; Dixon, Diane; Martin, Brett; Chaisson, Christine E; Kowall, Neil W; Tripodis, Yorghos; Balcer, Laura J; Stern, Robert A

    2017-01-01

    The King-Devick (K-D) test is a 1 to 2 minute, rapid number naming test, often used to assist with detection of concussion, but also has clinical utility in other neurological conditions (eg, Parkinson disease). The K-D involves saccadic eye and other eye movements, and abnormalities thereof may be an early indicator of Alzheimer disease (AD)-associated cognitive impairment. No study has tested the utility of the K-D in AD and we sought to do so. The sample included 206 [135 controls, 39 mild cognitive impairment (MCI), and 32 AD dementia] consecutive subjects from the Boston University Alzheimer's Disease Center registry undergoing their initial annual evaluation between March 2013 and July 2015. The K-D was administered during this period. Areas under the receiver operating characteristic curves generated from logistic regression models revealed the K-D test distinguished controls from subjects with cognitive impairment (MCI and AD dementia) [area under the curve (AUC)=0.72], MCI (AUC=0.71) and AD dementia (AUC=0.74). K-D time scores between 48 and 52 seconds were associated with high sensitivity (>90.0%) and negative predictive values (>85.0%) for each diagnostic group. The K-D correlated strongly with validated attention, processing speed, and visual scanning tests. The K-D test may be a rapid and simple effective screening tool to detect cognitive impairment associated with AD.

  14. Neuropsychological Testing and Machine Learning Distinguish Alzheimer’s Disease from Other Causes for Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Helmut Hildebrandt

    2017-04-01

    Full Text Available With promising results in recent treatment trials for Alzheimer’s disease (AD, it becomes increasingly important to distinguish AD at early stages from other causes for cognitive impairment. However, existing diagnostic methods are either invasive (lumbar punctures, PET or inaccurate Magnetic Resonance Imaging (MRI. This study investigates the potential of neuropsychological testing (NPT to specifically identify those patients with possible AD among a sample of 158 patients with Mild Cognitive Impairment (MCI or dementia for various causes. Patients were divided into an early stage and a late stage group according to their Mini Mental State Examination (MMSE score and labeled as AD or non-AD patients based on a post-mortem validated threshold of the ratio between total tau and beta amyloid in the cerebrospinal fluid (CSF; Total tau/Aβ(1–42 ratio, TB ratio. All patients completed the established Consortium to Establish a Registry for Alzheimer’s Disease—Neuropsychological Assessment Battery (CERAD-NAB test battery and two additional newly-developed neuropsychological tests (recollection and verbal comprehension that aimed at carving out specific Alzheimer-typical deficits. Based on these test results, an underlying AD (pathologically increased TB ratio was predicted with a machine learning algorithm. To this end, the algorithm was trained in each case on all patients except the one to predict (leave-one-out validation. In the total group, 82% of the patients could be correctly identified as AD or non-AD. In the early group with small general cognitive impairment, classification accuracy was increased to 89%. NPT thus seems to be capable of discriminating between AD patients and patients with cognitive impairment due to other neurodegenerative or vascular causes with a high accuracy, and may be used for screening in clinical routine and drug studies, especially in the early course of this disease.

  15. Neuropsychological Testing and Machine Learning Distinguish Alzheimer's Disease from Other Causes for Cognitive Impairment.

    Science.gov (United States)

    Gurevich, Pavel; Stuke, Hannes; Kastrup, Andreas; Stuke, Heiner; Hildebrandt, Helmut

    2017-01-01

    With promising results in recent treatment trials for Alzheimer's disease (AD), it becomes increasingly important to distinguish AD at early stages from other causes for cognitive impairment. However, existing diagnostic methods are either invasive (lumbar punctures, PET) or inaccurate Magnetic Resonance Imaging (MRI). This study investigates the potential of neuropsychological testing (NPT) to specifically identify those patients with possible AD among a sample of 158 patients with Mild Cognitive Impairment (MCI) or dementia for various causes. Patients were divided into an early stage and a late stage group according to their Mini Mental State Examination (MMSE) score and labeled as AD or non-AD patients based on a post-mortem validated threshold of the ratio between total tau and beta amyloid in the cerebrospinal fluid (CSF; Total tau/Aβ(1-42) ratio, TB ratio). All patients completed the established Consortium to Establish a Registry for Alzheimer's Disease-Neuropsychological Assessment Battery (CERAD-NAB) test battery and two additional newly-developed neuropsychological tests (recollection and verbal comprehension) that aimed at carving out specific Alzheimer-typical deficits. Based on these test results, an underlying AD (pathologically increased TB ratio) was predicted with a machine learning algorithm. To this end, the algorithm was trained in each case on all patients except the one to predict (leave-one-out validation). In the total group, 82% of the patients could be correctly identified as AD or non-AD. In the early group with small general cognitive impairment, classification accuracy was increased to 89%. NPT thus seems to be capable of discriminating between AD patients and patients with cognitive impairment due to other neurodegenerative or vascular causes with a high accuracy, and may be used for screening in clinical routine and drug studies, especially in the early course of this disease.

  16. Treating cognitive impairment with transcranial low level laser therapy.

    Science.gov (United States)

    de la Torre, Jack C

    2017-03-01

    This report examines the potential of low level laser therapy (LLLT) to alter brain cell function and neurometabolic pathways using red or near infrared (NIR) wavelengths transcranially for the prevention and treatment of cognitive impairment. Although laser therapy on human tissue has been used for a number of medical conditions since the late 1960s, it is only recently that several clinical studies have shown its value in raising neurometabolic energy levels that can improve cerebral hemodynamics and cognitive abilities in humans. The rationale for this approach, as indicated in this report, is supported by growing evidence that neurodegenerative damage and cognitive impairment during advanced aging is accelerated or triggered by a neuronal energy crisis generated by brain hypoperfusion. We have previously proposed that chronic brain hypoperfusion in the elderly can worsen in the presence of one or more vascular risk factors, including hypertension, cardiac disease, atherosclerosis and diabetes type 2. Although many unanswered questions remain, boosting neurometabolic activity through non-invasive transcranial laser biostimulation of neuronal mitochondria may be a valuable tool in preventing or delaying age-related cognitive decline that can lead to dementia, including its two major subtypes, Alzheimer's and vascular dementia. The technology to achieve significant improvement of cognitive dysfunction using LLLT or variations of this technique is moving fast and may signal a new chapter in the treatment and prevention of neurocognitive disorders. Copyright © 2017 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

    Rise, Ida Vikan; Haro, Josep Maria; Gjervan, Bjørn

    2016-01-01

    Introduction Data specific to late-life bipolar disorder (BD) are limited. Current research is sparse and present guidelines are not adapted to this group of patients. Objectives We present a literature review on clinical characteristics, comorbidities, and cognitive impairment in patients with late-life BD. This review discusses common comorbidities that affect BD elders and how aging might affect cognition and treatment. Methods Eligible studies were identified in MedLine by the Medical Subject Headings terms “bipolar disorder” and “aged”. We only included original research reports published in English between 2012 and 2015. Results From 414 articles extracted, 16 studies were included in the review. Cardiovascular and respiratory conditions, type II diabetes, and endocrinological abnormalities were observed as highly prevalent. BD is associated with a high suicide risk. Bipolar elderly had an increased risk of dementia and performed worse on cognitive screening tests compared to age-matched controls across different levels of cognition. Despite high rates of medical comorbidity among bipolar elderly, a systematic under-recognition and undertreatment of cardiovascular disease have been suggested. Conclusion There was a high burden of physical comorbidities and cognitive impairment in late-life BD. Bipolar elderly might be under-recorded and undertreated in primary medical care, indicating that this group needs an adapted clinical assessment and specific clinical guidelines need to be established. PMID:27274256

  18. Impaired cognitive function and mental performance in mild dehydration.

    Science.gov (United States)

    Wilson, M-M G; Morley, J E

    2003-12-01

    Dehydration is a reliable predictor of impaired cognitive status. Objective data, using tests of cortical function, support the deterioration of mental performance in mildly dehydrated younger adults. Dehydration frequently results in delirium as a manifestation of cognitive dysfunction. Although, the occurrence of delirium suggests transient acute global cerebral dysfunction, cognitive impairment may not be completely reversible. Animal studies have identified neuronal mitochondrial damage and glutamate hypertransmission in dehydrated rats. Additional studies have identified an increase in cerebral nicotinamide adenine dinucleotide phosphate-diaphorase activity (nitric oxide synthase, NOS) with dehydration. Available evidence also implicates NOS as a neurotransmitter in long-term potentiation, rendering this a critical enzyme in facilitating learning and memory. With ageing, a reduction of NOS activity has been identified in the cortex and striatum of rats. The reduction of NOs synthase activity that occurs with ageing may blunt the rise that occurs with dehydration, and possibly interfere with memory processing and cognitive function. Dehydration has been shown to be a reliable predictor of increasing frailty, deteriorating mental performance and poor quality of life. Intervention models directed toward improving outcomes in dehydration must incorporate strategies to enhance prompt recognition of cognitive dysfunction.

  19. Anti-MuSK-Positive Myasthenia Gravis in a Patient with Parkinsonism and Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    S. Lanfranconi

    2011-01-01

    Full Text Available Muscle-specific tyrosine kinase- (MuSK- antibodies-positive Myasthenia Gravis accounts for about one third of Seronegative Myasthenia Gravis and is clinically characterized by early onset of prominent bulbar, neck, shoulder girdle, and respiratory weakness. The response to medical therapy is generally poor. Here we report a case of late-onset MuSK-antibodies-positive Myasthenia Gravis presenting with signs of cognitive impairment and parkinsonism in addition to bulbar involvement and external ophthalmoplegia. The pattern of involvement of both peripheral and central nervous system dysfunction might suggest a common pathogenic mechanism, involving impaired cholinergic transmission.

  20. Effectiveness of exercise on cognitive impairment and Alzheimer's disease.

    Science.gov (United States)

    Balsamo, Sandor; Willardson, Jeffrey M; Frederico, Santos de Santana; Prestes, Jonato; Balsamo, Denise Coscrato; Dahan, da Cunha Nascimento; Dos Santos-Neto, Leopoldo; Nobrega, Otávio T

    2013-01-01

    Physical activity has a protective effect on brain function in older people. Here, we briefly reviewed the studies and results related to the effects of exercise on cognitive impairment and Alzheimer's disease. The main findings from the current body of literature indicate positive evidence for structured physical activity (cardiorespiratory and resistance exercise) as a promising non-pharmacological intervention for preventing cognitive decline. More studies are needed to determine the mechanisms involved in this preventative effect, including on strength, cardiorespiratory, and other types of exercise. Thus, the prevention of Alzheimer's disease may depend on healthy lifestyle habits, such as a structured physical fitness program.

  1. Immunological processes related to cognitive impairment in MS.

    Science.gov (United States)

    Berger, T

    2016-09-01

    In this review, the immune-to-brain communication pathways are briefly summarized, with emphasis on the impact of immune cells and their mediators on learning, memory and other cognitive domains. Further, the acute response of the central nervous system to peripherally generated inflammatory stimuli - termed as sickness behaviour - is described, and the central role of microglia in this immune-to-brain crosstalk in physiological and pathological conditions is highlighted. Finally, the role and consequences of immunological processes related to cognitive impairment in multiple sclerosis are discussed. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Cross-sectional analysis of cognitive impairment and relative factors after acute ischemic stroke

    Directory of Open Access Journals (Sweden)

    ZHOU Yu-ying

    2013-04-01

    Full Text Available Background Acute ischemic stroke may decline cognitive function and induce vascular dementia (VaD. In early identification of vascular cognitive impairment (VCI, active searching for relevant factors, effective and timely treatment can reduce or even prevent further decline of cognitive function. The purpose of this study is to investigate the cognitive impairment after acute ischemic stroke and its associated factors. Methods A total of 314 cases of acute ischemic stroke patients were recruited in this study. The Montreal Cognitive Assessment (MoCA was used to evaluate the degree of cognitive impairment. The American National Institutes of Health Stroke Scale (NIHSS was used to evaluate the extent of neurological deficit. The Barthel Index (BI was used to evaluate activities of daily living. Hamilton Depression Rating Scale (HAMD was used to evaluate the patients' mental or emotional state. Results Based on the examination results, post-stroke cognitive impairment (PSCI group were less educated ( P = 0.000 with lower BI score ( P = 0.008, higher HAMD score and higher NIHSS score ( P = 0.000, for all, and elevated serum high-sensitivity C-reactive protein (hs-CRP, P = 0.002 and glycosylated hemoglobin A1c (HbA1c levels (P = 0.005 than those in post-stroke no cognitive impairment (PSNCI group. In PSCI group, the concentration of serum hs-CRP and HbA1c, NIHSS and HAMD scores were negatively correlated with the MoCA rating (P < 0.05, for all; whereas, BI score was positively correlated with the MoCA rating (P < 0.05. The subjects in PSCI group had more cortical ischemic vascular disease (CIVD and left hemisphere ischemic vascular disease (LHIVD than subjects in PSNCI group ( P < 0.05. Logistic regression analysis indicated that lower education, history of diabetes, higher HAMD score, higher serum hs-CRP and HbA1c levels were independent risk factors for PSCI. Conclusion Cognitive impairment after acute ischemic stroke may be closely related to

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

    DEFF Research Database (Denmark)

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

      Background Between 75% and 85% of patients with schizophrenia have cognitive impairments. The impairments have a negative influence on the patient's ability to maintain work, maintain contact with friends, independent living and living in a social relationship. Compared to treatment as usual......, studies using Cognitive Adaptation Training (CAT), including training of compensatory strategies to sequence patient's adaptive behaviours, have shown improvement in social functioning, decreased relapse, better compliance to medical treatment and increased quality of life. However, no studies, up to now......, have investigated the effect of CAT in younger patients with schizophrenia   Purpose The purpose of this study is to evaluate the effect of CAT in comparison with treatment as usual, focusing on social functions, symptoms, relapse, re-hospitalisation, and quality of life in younger outpatients...

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

    DEFF Research Database (Denmark)

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

    Background Bewteen 75% and 85% of patients with schizophrenia have cognitive impairments. The impairments have a negative influence on the patient's ability to maintain work, maintain contact with friends, independent living and living in a social relationship. Compared to treatment as usual......, studies using Cognitive Adaptation Training (CAT), including training of compensatory strategies to sequence patient's adaptive behaviours, have shown improvement in social functioning, decreased relapse, better compliance to medical treatment and increased quality of life. However, no studies, up to now......, have investigated the effect of CAT in younger patients with schizophrenia     Purpose The purpose of this study is to evaluate the effect of CAT in comparison with treatment as usual, focusing on social functions, symptoms, relapse, re-hospitalisation, and quality of life in younger outpatients...

  5. [Pain measurement in cognitively impaired patients with the Doloshort scale].

    Science.gov (United States)

    Likar, R; Pipam, W; Neuwersch, S; Köstenberger, M; Pinter, G; Gatternig, C; Marksteiner, J

    2015-08-01

    Until recently the measurement of pain in cognitively impaired patients represented a neglected field in the diagnostics and treatment of pain. Investigations indicate a prevalence of pain in nursing home residents of between 45 % and 80 %. This study investigated the reliability of the German translation of the Doloshort scale and compared it with the visual analog scale (VS). The aim of this study was to determine the practical applicability of this scale in the clinical routine and to calculate the intrarater reliability (retest) and interrater reliability. The interrater and intrarater reliability of the Doloshort scale was between 0.949 and 0.970. There was a highly significant correlation between the values of the Doloshort scale and the VAS. The Doloshort scale is a well suited measurement instrument for the evaluation of pain in cognitively impaired patients. Because of the short form only simple instructions are necessary and it has a high acceptance with users.

  6. Update on TBI and Cognitive Impairment in Military Veterans.

    Science.gov (United States)

    Elder, Gregory A

    2015-10-01

    Traumatic brain injury (TBI) is a common cause of morbidity and mortality in military life. Interest in military TBI has increased recently due to the conflicts in Iraq and Afghanistan. Certain types of TBI are relatively unique to the military, the most prominent being blast-related TBI. Blast-related mild TBI has been of particular concern in veterans from the most recent conflicts although controversy remains concerning its separation from post-traumatic stress disorder. TBI is also a risk factor for the later development of neurodegenerative diseases in which cognitive impairment is prominent putting veterans at risk for disorders including Alzheimer's disease and chronic traumatic encephalopathy. Recent evidence associating TBI with chronic cognitive impairment is reviewed in the context of its relevance to military veterans.

  7. Parkinson’s disease progression: implicit acquisition, cognitive and motor impairments, and medication effects

    Directory of Open Access Journals (Sweden)

    Rodrigo ePavão

    2012-08-01

    Full Text Available Parkinson’s disease (PD symptoms have been collectively ascribed to malfunctioning of dopamine-related nigro-striatal and cortico-striatal loops. However, some doubts about this proposition are raised by controversies about the temporal progression of the impairments, and whether they are concomitant or not. The present study consists of a systematic revision of literature data on both functional PD impairments and dopaminergic medication effects in order to draw a coherent picture about the disease progression. It was done in terms of an explanatory model for the disruption of implicit knowledge acquisition, motor and cognitive impairments, and the effects of dopaminergic medication on these functions. Cognitive impairments arise at early stages of PD and stabilizes while disruption of acquisition of implicit knowledge and motor impairments are still in progression; additionally, dopaminergic medication reduces motor impairments and increases disruption of acquisition of implicit knowledge. Since this model revealed consistency and plausibility when confronted with data of others studies not included in model's formulation, it may turn out to be a useful tool for understanding the multifaceted characteristics of PD.

  8. Cognitive Impairment in MS Linked to Structural and Functional Connectivity

    Science.gov (United States)

    2016-10-01

    performance over time. This is a sensitive indicator of cognitive impairment in individuals with neurological disorders including MS. Multiple types of...in individuals with neurological disorders including MS. Multiple types of brain imaging will be used to acquire data from participants, including... person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control

  9. Dementia and Cognitive Impairment: Epidemiology, Diagnosis, and Treatment

    Science.gov (United States)

    Hugo, Julie; Ganguli, Mary

    2014-01-01

    Synopsis Clinicians can diagnose the syndromes of dementia (major neurocognitive disorder) and mild cognitive impairment (mild neurocognitive disorder) based on history, examination, and appropriate objective assessments, using standard criteria such as DSM-5. They can then diagnose the etiological subtypes of these syndromes using standard criteria for each of them. Brain imaging and biomarkers are gaining ground for the differential diagnoses among the different disorders. Treatments for the most part are still symptomatic. PMID:25037289

  10. Deficits in episodic memory retrieval reveal impaired default mode network connectivity in amnestic mild cognitive impairment

    Directory of Open Access Journals (Sweden)

    Cameron J. Dunn

    2014-01-01

    Full Text Available Amnestic mild cognitive impairment (aMCI is believed to represent a transitional stage between normal healthy ageing and the development of dementia. In particular, aMCI patients have been shown to have higher annual transition rates to Alzheimer's Disease (AD than individuals without cognitive impairment. Despite intensifying interest investigating the neuroanatomical basis of this transition, there remain a number of questions regarding the pathophysiological process underlying aMCI itself. A number of recent studies in aMCI have shown specific impairments in connectivity within the default mode network (DMN, which is a group of regions strongly related to episodic memory capacities. However to date, no study has investigated the integrity of the DMN between patients with aMCI and those with a non-amnestic pattern of MCI (naMCI, who have cognitive impairment, but intact memory storage systems. In this study, we contrasted the DMN connectivity in 24 aMCI and 33 naMCI patients using seed-based resting state fMRI. The two groups showed no statistical difference in their DMN intra-connectivity. However when connectivity was analysed according to performance on measures of episodic memory retrieval, the two groups were separable, with aMCI patients demonstrating impaired functional connectivity between the hippocampal formation and the posterior cingulate cortex. We provide evidence that this lack of connectivity is driven by impaired communication from the posterior cingulate hub and does not simply represent hippocampal atrophy, suggesting that posterior cingulate degeneration is the driving force behind impaired DMN connectivity in aMCI.

  11. Deficits in episodic memory retrieval reveal impaired default mode network connectivity in amnestic mild cognitive impairment

    Science.gov (United States)

    Dunn, Cameron J.; Duffy, Shantel L; Hickie, Ian B; Lagopoulos, Jim; Lewis, Simon J.G.; Naismith, Sharon L.; Shine, James M.

    2014-01-01

    Amnestic mild cognitive impairment (aMCI) is believed to represent a transitional stage between normal healthy ageing and the development of dementia. In particular, aMCI patients have been shown to have higher annual transition rates to Alzheimer's Disease (AD) than individuals without cognitive impairment. Despite intensifying interest investigating the neuroanatomical basis of this transition, there remain a number of questions regarding the pathophysiological process underlying aMCI itself. A number of recent studies in aMCI have shown specific impairments in connectivity within the default mode network (DMN), which is a group of regions strongly related to episodic memory capacities. However to date, no study has investigated the integrity of the DMN between patients with aMCI and those with a non-amnestic pattern of MCI (naMCI), who have cognitive impairment, but intact memory storage systems. In this study, we contrasted the DMN connectivity in 24 aMCI and 33 naMCI patients using seed-based resting state fMRI. The two groups showed no statistical difference in their DMN intra-connectivity. However when connectivity was analysed according to performance on measures of episodic memory retrieval, the two groups were separable, with aMCI patients demonstrating impaired functional connectivity between the hippocampal formation and the posterior cingulate cortex. We provide evidence that this lack of connectivity is driven by impaired communication from the posterior cingulate hub and does not simply represent hippocampal atrophy, suggesting that posterior cingulate degeneration is the driving force behind impaired DMN connectivity in aMCI. PMID:24634833

  12. Cognitive impairments in Hashimoto's encephalopathy: a case-control study.

    Directory of Open Access Journals (Sweden)

    Jianhong Wang

    Full Text Available BACKGROUND/AIMS: Hashimoto's encephalopathy is considered as a treatable dementia, but it is often misdiagnosed. We investigated cognitive impairment and the MRI pathology of Hashimoto's encephalopathy patients. METHODS: The study comprised eight patients with Hashimoto's encephalopathy, 16 patients with mild Alzheimer's disease and 24 healthy subjects. A neuropsychological battery included assessments of memory, language, attention, executive function and visuospatial ability. Cranial MRI was obtained from all Hashimoto's encephalopathy patients. RESULTS: Hashimoto's encephalopathy and mild Alzheimer's disease showed cognitive impairments in episodic memory, attention, executive function and visuospatial ability, but naming ability was unaffected in Hashimoto's encephalopathy. The MRI of Hashimoto's encephalopathy showed leukoencephalopathy-like type or limbic encephalitis-like type; the lesions did not affect the temporal cortex which plays a role in naming ability. CONCLUSION: Except that the naming ability was retained, the impairments in cognitive functions for the Hashimoto's encephalopathy patients were similar to those of Alzheimer's disease patients. These results were consistent with the MRI findings.

  13. Paradoxical upregulation of glutamatergic presynaptic boutons during mild cognitive impairment.

    Science.gov (United States)

    Bell, Karen F S; Bennett, David A; Cuello, A Claudio

    2007-10-03

    Synaptic integrity is now recognized as a central component of Alzheimer's disease. Surprisingly, however, the structural status of glutamatergic synapses in Alzheimer's disease is unclear, despite the fact that glutamate is the major excitatory transmitter of the CNS and has key roles in excitotoxicity and long-term potentiation. The identification of specific markers of glutamatergic neurons now allows an assessment of the structural involvement of the glutamatergic system across progressive stages of the Alzheimer's pathology, an opportunity not afforded by previously used neurochemical approaches. Glutamatergic presynaptic bouton density and dystrophic neurite abundance were quantified in midfrontal gyrus brain tissue from subjects with no cognitive impairment, mild cognitive impairment, or mild- or severe-stage Alzheimer's disease. Our study demonstrates a striking pathology-dependent pattern of glutamatergic synaptic remodeling with disease progression. Subjects with mild cognitive impairment display a paradoxical elevation in glutamatergic presynaptic bouton density, a situation akin to that observed in the cholinergic system, which then depletes and drops with disease progression. This pattern of synaptic remodeling mirrors our previous findings in transgenic animal models and is of major relevance to current transmitter-based therapeutics.

  14. Stress-related cognitive and non-cognitive impairments in elderly patients

    Directory of Open Access Journals (Sweden)

    G. R. Tabeeva

    2015-01-01

    Full Text Available Aging is a physiological process that may develop long without manifestations of comorbidities. In the meantime a high proportion of elderly people very often experience limitations in daily life due to impairments in memory and other cognitive functions. Non-cognitive neuropsychiatric disorders, most commonly stress-related anxiety disorders, are a major contribution to maladaptation in these patients. The present studies of the neurobiology of aging enable one to decipher not only the mechanisms that underlie the physiology of brain aging, but also the factors that influence cognitive aging and aggravate the manifestations of cognitive dysfunction and neurodegenerative disease. The process of brain aging is known to presume the long-term preservation of functional neuroplasticity that is greatly influenced by different lifestyle factors, such as daily social and physical activities, the pattern and amount of food taken, cognitive activity, and stressful life events. These lifestyle factors are supposedly a potent tool to maintain physiological brain aging and a delayed cognitive diminution in elderly people. At the same time, studies of the possibility of pharmacologically correcting age-related (both cognitive and non-cognitive impairments are promising to improve everyday function in elderly people. 

  15. Impaired cognitive performance and hippocampal atrophy in Parkinson disease.

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    Yildiz, Demet; Erer, Sevda; Zarifoğlu, Mehmet; Hakyemez, Bahattin; Bakar, Mustafa; Karli, Necdet; Varlibaş, Zeynep Nigar; Tufan, Fatih

    2015-01-01

    Dementia is common in Parkinson disease (PD). Since magnetic resonance imaging has been used, hippocampal atrophy has been shown in PD patients with or without dementia. In this study we sought the correlation of cognitive decline with bilateral hippocampal volume in PD patients. Thirty-three patients with diagnosis of idiopathic PD and 16 healthy subjects were included in this study. PD patients were divided into two groups as normal cognitive function and mild cognitive impairment (MCI). The Mini-Mental State Examination and detailed cognitive assessment tests were performed for all patients for cognitive analyses. Depression was excluded by the Geriatric Depression Scale. The mean onset age of disease was 55 years for PD patients without dementia and 59 for PD patients with MCI. According to the Hoehn-Yahr scales, 24% of patients had grade 1, 58% had grade 2, and 18% had grade 3 disease. Right and left hippocampal volumes decreased along with cognitive test scores in PD patients. Increased right hippocampal volume was correlated with forward number test in the MCI-PD group. These findings suggest that memory deficit is associated with hippocampal atrophy in PD patients.

  16. Understanding the mechanisms of cognitive impairments in developmental coordination disorder.

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    Deng, Shining; Li, Wei-Guang; Ding, Jing; Wu, Jinlin; Zhang, Yuanyuan; Li, Fei; Shen, Xiaoming

    2014-01-01

    Developmental coordination disorder (DCD), a neurodevelopmental disability in which a child's motor coordination difficulties significantly interfere with activities of daily life or academic achievement, together with additional symptoms of diseases with childhood sensorimotor impairments, increases the risk of many cognitive problems. This exhibits the dynamic interplay between sensorimotor and cognition systems. However, the brain structures and pathways involved have remained unknown over the past decades. Here, we review developments in recent years that elucidate the neural mechanisms involved in the sensorimotor-cognitive difficulties. First, we briefly address the clinical and epidemiological discoveries in DCD as well as its comorbidities. Subsequently, we group the growing evidence including our findings that support the notion that sensorimotor manipulation indeed affects the cognition development at systematic, circuitry, cellular, and molecular levels. This corresponds to changes in diverse brain regions, synaptic plasticity, and neurotransmitter and receptor activity during development under these effects. Finally, we address the treatment potentials of task-oriented sensorimotor enhancement, as a new therapeutic strategy for cognitive rehabilitation, based on our current understanding of the neurobiology of cognitive-sensorimotor interaction.

  17. Brain-derived neurotrophic factor plasma levels and premature cognitive impairment/dementia in type 2 diabetes

    Institute of Scientific and Technical Information of China (English)

    Blanca; Murillo; Ortíz[1; Joel; Ramírez; Emiliano[2; Edna; Ramos-Rodríguez[1; Sandra; Martínez-Garza[1; Hilda; Macías-Cervantes[1; Sergio; Solorio-Meza[1; Texar; Alfonso; Pereyra-Nobara[1

    2016-01-01

    AIM To assess the relationship of brain-derived neurotrophic factor (BDNF) with cognitive impairment in patients with type 2 diabetes.METHODS The study included 40 patients with diabetes mellitus type 2 (DM2), 37 patients with chronic kidney disease in hem dialysis hemodialysis therapy (HD) and 40 healthy subjects. BDNF in serum was quantified by ELISA. The Folstein Mini-Mental State Examination was used to evaluate cognitive impairment. RESULTS The patients with DM2 and the patients in HD were categorized into two groups, with cognitive impairment and without cognitive impairment. The levels of BDNF showed significant differences between patients with DM2 (43.78 ± 9.05 vs 31.55 ± 10.24, P = 0.005). There were no differences between patients in HD (11.39 ± 8.87 vs 11.11 ± 10.64 P = 0.77); interestingly, ferritin levels were higher in patients with cognitive impairment (1564 ± 1335 vs 664 ± 484 P = 0.001). The comparison of BDNF values, using a Kruskal Wallis test, between patients with DM2, in HD and healthy controls showed statistical differences (P < 0.001).CONCLUSION Low levels of BDNF are associated with cognitive impairment in patients with DM2. The decrease of BDNF occurs early and progressively in patients in HD.

  18. [Social Cognitive Impairment in Myotonic Dystrophy Type 1].

    Science.gov (United States)

    Kobayakawa, Mutsutaka

    2016-02-01

    Myotonic dystrophy type 1 (DM 1) is a heritable, multisystem disease that affects not only the muscles but also the brain. DM 1 is often accompanied by developmental behavioral disorders, such as autism spectrum disorders. The autistic traits in DM 1 may be related to social cognitive dysfunction. The social cognitive function of patients with DM 1 was examined with respect to facial emotion recognition and theory of mind, which is the specific cognitive ability to understand the mental states of other people. With respect to facial emotion recognition, the sensitivities to disgust and anger were lower among patients with DM 1 than among healthy subjects, and this difference could not be attributed to visual impairment. To examine the theory of mind ability, the "Reading the Mind in the Eyes" test and the faux pas recognition test were used. Patients with DM 1 were found to be impaired in both tests, but the results were not attributed to visual ability and lexical comprehension. The possible causes of social cognitive dysfunction in DM 1 are the l cerebral atrophy and white matter abnormalities in the temporal, frontal, and insular cortex. Dysfunctions in these areas may affect the emotional and theory of mind abilities in DM 1, which result in the behavioral and communication disorders.

  19. Social cognition impairments in Asperger syndrome and schizophrenia.

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    Lugnegård, Tove; Unenge Hallerbäck, Maria; Hjärthag, Fredrik; Gillberg, Christopher

    2013-02-01

    Social cognition impairments are well described in both autism spectrum disorders, including Asperger syndrome (AS), and in schizophrenia spectrum disorders. However, little is known about whether there are differences between the two groups of disorders regarding this ability. The aim of this study was to compare social cognition abilities in AS and schizophrenia. Fifty-three individuals (26 men, 27 women) with a clinical diagnosis of AS, 36 (22 men, 14 women) with a clinical diagnosis of schizophrenic psychosis, and 50 non-clinical controls (19 men, 31 women) participated in the study. Clinical diagnoses were confirmed either by Structured Clinical Interview on DSM-IV diagnosis or the Diagnostic Interview for Social and Communication Disorders. Verbal ability was assessed using the Vocabulary subtest of the WAIS-III. Two social cognition instruments were used: Reading the Mind in the Eyes Test (Eyes Test) and the Animations Task. On the Eyes Test, patients with schizophrenia showed poorer results compared to non-clinical controls; however, no other group differences were seen. Both clinical groups scored significantly lower than the comparison group on the Animations Task. The AS group performed somewhat better than the schizophrenia group. Some differences were accounted for by gender effects. Implicit social cognition impairments appear to be at least as severe in schizophrenia as they are in AS. Possible gender differences have to be taken into account in future research on this topic.

  20. Cognitive impairments in poly-drug ketamine users.

    Science.gov (United States)

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

    2013-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Alessandra Giordano

    2011-10-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  3. Cognitive Correlates of Timed Up and Go Subtasks in Older People With Preserved Cognition, Mild Cognitive Impairment, and Alzheimer's Disease.

    Science.gov (United States)

    Ansai, Juliana Hotta; Andrade, Larissa Pires de; Nakagawa, Theresa Helissa; Vale, Francisco Assis Carvalho; Caetano, Maria Joana Duarte; Lord, Stephen Ronald; Rebelatto, José Rubens

    2017-10-01

    To determine whether impaired Timed Up and Go Test (TUG) subtask performances are associated with specific cognitive domains among older people with preserved cognition (PC), mild cognitive impairment (MCI), and mild Alzheimer's disease (AD). TUG subtasks performances were assessed by the Qualisys motion system. Cognition was assessed by Addenbrooke's Cognitive Examination and the Frontal Assessment Battery (FAB). The highest correlations with transition subtasks were with aspects of executive function, i.e. the fluency domain in the PC group (n = 40), FAB scores in the MCI group (n = 40), and the visuospatial domain in the AD group (n = 38). No significant associations were found between the walking subtasks and cognition in any group. Multivariate linear regression models identified the fluency domain as an independent predictor of turn-to-walk and turn-to-sit measures in the PC group, and the visuospatial domain as an independent predictor of turn-to-walk and turn-to-sit measures in the AD group, adjusted for age and sex. Poorer executive functioning was associated with impaired transition mobility in all groups. The significant associations between visuospatial impairment and poor transition mobility in the AD participants may provide insight into why this group has an elevated fall risk.

  4. Cognitive impairment in patients with stress-related exhaustion.

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    Jonsdottir, I H; Nordlund, A; Ellbin, S; Ljung, T; Glise, K; Währborg, P; Wallin, A

    2013-03-01

    Patients who seek medical care for stress-related mental health problems frequently report cognitive impairments as the most pronounced symptom. The purpose of the present study was to compare cognitive function in patients with stress-related exhaustion with that in healthy controls, using a comprehensive battery of cognitive tests. We also explored whether neuropsychological findings were related to severity of illness measured using the Shirom-Melamed burnout questionnaire and hospital anxiety and depression scale. Thirty-three patients (15 males) and 37 healthy controls (11 males), mean age 46 years [standard deviation (SD) 3.9] and 47 years (SD 4.3), respectively, were included in the final analysis. Five cognitive domains were assessed: (1) speed, attention and working memory, (2) learning and episodic memory, (3) executive functions, (4) visuospatial functions and (5) language. The most pronounced difference between patients and controls was seen on executive function, when tested with a multidimensional test, including aspects of speed, control and working memory. The patients also performed poorer on Digit span, measuring attention span and working memory as well as on learning and episodic memory, when measured as delayed recall and the difference between immediate and delayed recall. Delayed recall was the only test that was significantly related to severity of burnout symptoms among the patients. This could reflect poor cognitive sustainability in the patients with the highest burnout scores, as this particular test was the last one performed during the test session. This study clearly shows that cognitive impairment should be considered when evaluating and treating patients who seek medical care for stress-related exhaustion.

  5. 吡拉西坦治疗脑梗死患者早期认知功能障碍的疗效观察%Therapeutic Effect of Laci Staw on Early Cognitive Impairment in Patients with Cerebral Infarction

    Institute of Scientific and Technical Information of China (English)

    王彦月

    2016-01-01

    Objective To investigate the therapeutic effect of piracetam and sodium chlorid injection in treatment of post-stroke cognitive impairment patients.Methods From January 2012 to October 2015, 120 cases of post-stroke cognitive impairment patients were recruited and divided into study group and control group, each had 60 cases. The control group patients received basic treatment, the study group patients applied piracetam and sodium chlorid injection treatment on the basic treatment, cognitive impairment and therapeutic effect were be observed.Result There were no significant differences between the two groups in MMSE scores before treatment. MMSE scores of the two groups were higher after treatment separately, the significant differences were observed between the two groups in MMSE scores after treatment (P<0.05).There were significant differences between the two groups when compared the total effective rate(P<0.05).Conclusion The application of piracetam and sodium chlorid injection in treatment of post-stroke cognitive impairment patients can improve cognitive function, and get better therapeutic effect.%目的:探讨吡拉西坦注射液在有早期认知功能障碍的脑梗死患者中的治疗效果。方法选取重庆医科大学附属第一医院及附属大学城医院120例有认知功能障碍的脑梗死患者为临床研究对象(2012年1月至2015年10月间),将全部患者随机分为对照组和研究组(n=60)。对照组给予基础治疗,研究组在基础治疗上应用吡拉西坦注射液治疗,观察两组认知功能损害和疗效。结果治疗前研究组和对照组的MMSE评分差异无统计学意义。治疗后研究组的MMSE评分明显高于对照组,且两组间的数据比较有统计学差异(P<0.05)。研究组总有效率明显高于对照组(P<0.05)。结论临床中有认知功能障碍的脑梗死患者在基础治疗上应用吡拉西坦注射液治疗能够改善认知功能,并且提高临床疗效。

  6. Cognitive Impairment among Older Adults in the Emergency Department

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    Hirschman, Karen

    2011-02-01

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

  7. Cognitive training changes hippocampal function in mild cognitive impairment: a pilot study.

    Science.gov (United States)

    Rosen, Allyson C; Sugiura, Lisa; Kramer, Joel H; Whitfield-Gabrieli, Susan; Gabrieli, John D

    2011-01-01

    A randomized pilot experiment examined the neural substrates of response to cognitive training in participants with mild cognitive impairment (MCI). Participants performed exercises previously demonstrated to improve verbal memory and an active control group performed other computer activities. An auditory-verbal fMRI task was conducted before and after the two-month training program. Verbal memory scores improved significantly and left hippocampal activation increased significantly in the experimental group (gains in 5 of 6 participants) relative to the control group (reductions in all 6 participants). Results suggest that the hippocampus in MCI may retain sufficient neuroplasticity to benefit from cognitive training.

  8. The patterns of cognitive and functional impairment in amnestic and non-amnestic mild cognitive impairment in geriatric depression.

    Science.gov (United States)

    Reinlieb, Michelle; Ercoli, Linda M; Siddarth, Prabha; St Cyr, Natalie; Lavretsky, Helen

    2014-12-01

    Depressed older adults are at risk for the development of mild cognitive impairment (MCI), but few studies have characterized MCI subtypes in geriatric depression. The objective of this study was to identify the clinical patterns of MCI in late-life depression. Baseline demographic, clinical, and neuropsychological test data collected as part of a randomized antidepressant trial for geriatric depression. UCLA-based outpatient clinic. One hundred thirty-eight older adults with major depression. A neuropsychological test battery and comprehensive evaluations of depression, apathy, quality of life, medical burden, and vascular risk factors. Seventy-one participants (51%) had MCI and 67 (49%) were cognitively normal. Of subjects with MCI, 14 (20%) had amnestic MCI and 57 (80%) had non-amnestic MCI. Overall, patients with MCI had greater depression severity, poorer quality of life, and worse performance on the Mini-Mental State Exam than patients without MCI. Patients with non-amnestic MCI had significantly greater depression severity than patients without MCI. Across all subjects, depression severity correlated with impaired performance in language and visuospatial functioning. Our findings suggest that MCI is associated with greater severity of depression, poorer quality of life, and worse global cognitive function. Overall, subtypes of MCI in geriatric depression differ in the patterns of functional impairment, which may require different therapeutic approaches. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Chun-Jen Lin

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

  10. Evaluation of Cognitive Impairment After Posterior Cerebral Artery Infarction

    Directory of Open Access Journals (Sweden)

    Nilgün Çınar

    2013-02-01

    Full Text Available OBJECTIVE: The assessment of cognitive impairment after posterior cerebral artery (PCA ischemic infarction has not been well documanted. MATERIAL and METHODS: Twenty-six oriented, cooperated and non-aphasic consecutive patients with right or left (10/16 PCA infarction who were hospitalized between the years 2010-2012 were enrolled to the study. The branches of PSA were dealt as cortical and subcortical infarct under two groups. Short mental state examination test and cognitive test battery (CTB created from Wechsler memory scale (WMS, word-catogory association test and similarity test parameters were applied to the patients at the first week and third month follow-up visits and the groups were compared with each other. RESULTS: There was a significant improvement in catogory association test and total score of cognitive test battery (CTB in right PCA group, also there was a significant improvement in catogory association test in left PCA group at the first and 3th month evaluations. At the first month evaluations, total score of CTB of the subcortical segment PCA infarcts are lower than the cortical segment PCA infarcts. At the 3th month evaluations the scores increased in the both groups; but the scores in the subcortical PCA infarcts were lower than the cortical PCA infarcts. CONCLUSION: Our findings suggest that there was a cognitive impairment in patients with PCA infarction. The impairment in verbal fluency which was showed by catogory association test was found more prominent in the second evaluation. Further studies including functional imaging methods and cortical function tests are needed.

  11. Regional cingulum disruption, not gray matter atrophy, detects cognitive changes in amnestic mild cognitive impairment subtypes.

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    Chang, Yu-Ling; Chen, Ta-Fu; Shih, Yao-Chia; Chiu, Ming-Jang; Yan, Sui-Hing; Tseng, Wen-Yih Isaac

    2015-01-01

    Amnestic mild cognitive impairment (aMCI), which has a high risk of progression to Alzheimer's disease (AD), can be classified into single domain (S-aMCI) and multiple domain (M-aMCI) subtypes. We investigated the integrity of regional gray matter and segments of the cingulum bundle with diffusion spectrum imaging tract-specific analysis, and their relationships to neuropsychological functioning, in 46 individuals with aMCI (S-aMCI n = 24; M-aMCI n = 22) and 36 healthy controls (HC). Results demonstrated that although both aMCI groups were impaired on all memory measures relative to HCs, the M-aMCI group demonstrated worse performance on paired association memory and on selective executive function relative to the S-aMCI group. The two aMCI groups did not show significant atrophy in regional gray matter indices as compared to the HC group, but the M-aMCI group showed significant disruption in white matter of the left anterior and inferior cingulum bundles relative to the S-aMCI and HC groups. Furthermore, disruption in the inferior cingulum bundles was significantly associated with executive function and attention/processing speed in all aMCI participants above and beyond the contribution of bilateral hippocampal volumes. Overall, these results indicate that the degeneration of cingulum fibers did not appear to arise from degeneration of the corresponding cerebral cortex. It also suggests relatively greater sensitivity of a white matter biomarker and comprehensive neuropsychological evaluation over gray matter biomarkers in early detection of AD.

  12. Cognitive impairment and antiretroviral treatment in a Peruvian population of patients with human immunodeficiency virus.

    Science.gov (United States)

    Guevara-Silva, E A

    2014-05-01

    HIV-associated cognitive impairment occurs even in the early stages of infection. Short-term memory, psychomotor speed, attention, and executive functioning are the main capacities affected. Controversy exists regarding whether highly active antiretroviral therapy (HAART) is helpful in combating this process. The objective of the present study is to determine the association between cognitive impairment and HAART in HIV-infected patients from Hospital Regional de Huacho. Prospective study of HIV patients meeting criteria to start HAART. Twenty-one HIV-positive patients were recruited between April and July 2011. Researchers administered a standardised neuropsychological test battery before and 4 weeks after onset of HAART. Psychomotor speed, executive function, short term memory (visual and verbal), attention, and visuospatial performance were evaluated. Nineteen patients completed the study (14 males and 5 females). In the pre-HAART evaluation, most patients scored below average on the executive function and psychomotor speed subtests. Psychomotor speed and immediate visual memory improved significantly after four months of treatment with HAART. Some degree of cognitive decline may present even in the early and asymptomatic stages of HIV infection. The benefits of antiretroviral treatment for cognitive performance can be detected after only a few weeks of follow-up. Copyright © 2013 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  13. Domain-specific cognitive impairment in patients with COPD and control subjects

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    Cleutjens, Fiona AHM; Franssen, Frits ME; Spruit, Martijn A; Vanfleteren, Lowie EGW; Gijsen, Candy; Dijkstra, Jeanette B; Ponds, Rudolf WHM; Wouters, Emiel FM; Janssen, Daisy JA

    2017-01-01

    Impaired cognitive function is increasingly recognized in COPD. Yet, the prevalence of cognitive impairment in specific cognitive domains in COPD has been poorly studied. The aim of this cross-sectional observational study was to compare the prevalence of domain-specific cognitive impairment between patients with COPD and non-COPD controls. A neuropsychological assessment was administered in 90 stable COPD patients and 90 non-COPD controls with comparable smoking status, age, and level of education. Six core tests from the Maastricht Aging Study were used to assess general cognitive impairment. By using Z-scores, compound scores were constructed for the following domains: psychomotor speed, planning, working memory, verbal memory, and cognitive flexibility. General cognitive impairment and domain-specific cognitive impairment were compared between COPD patients and controls after correction for comorbidities using multivariate linear and logistic regression models. General cognitive impairment was found in 56.7% of patients with COPD and in 13.3% of controls. Deficits in the following domains were more often present in patients with COPD after correction for comorbidities: psychomotor speed (17.8% vs 3.3%; P<0.001), planning (17.8% vs 1.1%; P<0.001), and cognitive flexibility (43.3% vs 12.2%; P<0.001). General cognitive impairment and impairments in the domains psychomotor speed, planning, and cognitive flexibility affect the COPD patients more than their matched controls. PMID:28031706

  14. Autonomous indoor wayfinding for individuals with cognitive impairments

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    Chang Yao-Jen

    2010-09-01

    Full Text Available Abstract Background A challenge to individuals with cognitive impairments in wayfinding is how to remain oriented, recall routines, and travel in unfamiliar areas in a way relying on limited cognitive capacity. While people without disabilities often use maps or written directions as navigation tools or for remaining oriented, this cognitively-impaired population is very sensitive to issues of abstraction (e.g. icons on maps or signage and presents the designer with a challenge to tailor navigation information specific to each user and context. Methods This paper describes an approach to providing distributed cognition support of travel guidance for persons with cognitive disabilities. A solution is proposed based on passive near-field RFID tags and scanning PDAs. A prototype is built and tested in field experiments with real subjects. The unique strength of the system is the ability to provide unique-to-the-user prompts that are triggered by context. The key to the approach is to spread the context awareness across the system, with the context being flagged by the RFID tags and the appropriate response being evoked by displaying the appropriate path guidance images indexed by the intersection of specific end-user and context ID embedded in RFID tags. Results We found that passive RFIDs generally served as good context for triggering navigation prompts, although individual differences in effectiveness varied. The results of controlled experiments provided more evidence with regard to applicabilities of the proposed autonomous indoor wayfinding method. Conclusions Our findings suggest that the ability to adapt indoor wayfinding devices for appropriate timing of directions and standing orientation will be particularly important.

  15. Item and associative memory in amnestic mild cognitive impairment: performance on standardized memory tests.

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    Troyer, Angela K; Murphy, Kelly J; Anderson, Nicole D; Hayman-Abello, Brent A; Craik, Fergus I M; Moscovitch, Morris

    2008-01-01

    The earliest neuroanatomical changes in amnestic mild cognitive impairment (aMCI) involve the hippocampus and entorhinal cortex, structures implicated in the integration and learning of associative information. The authors hypothesized that individuals with aMCI would have impairments in associative memory above and beyond the known impairments in item memory. A group of 29 individuals with aMCI and 30 matched control participants were administered standardized tests of object-location recall and symbol-symbol recall, from which both item and associative recall scores were derived. As expected, item recall was impaired in the aMCI group relative to controls. Associative recall in the aMCI group was even more impaired than was item recall. The best group discriminators were measures of associative recall, with which the sensitivity and specificity for detecting aMCI were 76% and 90% for symbol-symbol recall and were 86% and 97% for object-location recall. Associative recall may be particularly sensitive to early cognitive change in aMCI, because this ability relies heavily on the medial temporal lobe structures that are affected earliest in aMCI. Incorporating measures of associative recall into clinical evaluations of individuals with memory change may be useful for detecting aMCI.

  16. Mild cognitive impairment: Profile of a cohort from a private sector memory clinic

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    Srinivasan, Srikanth

    2014-01-01

    Background: Private hospital memory clinics might see a different clientele than university or academic institutes due to referral biases. Objective: To characterize the profile of patients with mild cognitive impairment (MCI) from a private sector memory clinic. Materials and Methods: MCI was diagnosed according to revised clinical criteria of Petersen et al. For a subset of patients with MCI medial temporal atrophy and cerebral small vessel disease (white matter lesions and lacunes) were rated on magnetic resonance imaging (MRI) scans and analyzed for their contribution towards cognitive impairment. Results: Subjects with MCI formed one-third (113/371) of this memory clinic sample from a private hospital. MCI could be effectively diagnosed and subtyped using a brief cognitive scale (Concise Cognitive Test (CONCOG)). The amnestic MCI (single and multiple domains) subtype comprised the majority of cases with MCI. In a subsample of 33 patients, lacunar infarcts were more common than white matter lesions and hippocampal atrophy and were inversely associated with verbal fluency. Conclusions: MCI may be more commonly encountered in private hospital settings probably due to early referrals. It is possible to diagnose and subtype MCI using a brief cognitive instrument such as the CONCOG. In this sample, lacunar infarcts were more commonly encountered than medial temporal atrophy in such patients. PMID:25221408

  17. Mild cognitive impairment: Profile of a cohort from a private sector memory clinic

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    Srikanth Srinivasan

    2014-01-01

    Full Text Available Background: Private hospital memory clinics might see a different clientele than university or academic institutes due to referral biases. Objective: To characterize the profile of patients with mild cognitive impairment (MCI from a private sector memory clinic. Materials and Methods: MCI was diagnosed according to revised clinical criteria of Petersen et al. For a subset of patients with MCI medial temporal atrophy and cerebral small vessel disease (white matter lesions and lacunes were rated on magnetic resonance imaging (MRI scans and analyzed for their contribution towards cognitive impairment. Results: Subjects with MCI formed one-third (113/371 of this memory clinic sample from a private hospital. MCI could be effectively diagnosed and subtyped using a brief cognitive scale (Concise Cognitive Test (CONCOG. The amnestic MCI (single and multiple domains subtype comprised the majority of cases with MCI. In a subsample of 33 patients, lacunar infarcts were more common than white matter lesions and hippocampal atrophy and were inversely associated with verbal fluency. Conclusions: MCI may be more commonly encountered in private hospital settings probably due to early referrals. It is possible to diagnose and subtype MCI using a brief cognitive instrument such as the CONCOG. In this sample, lacunar infarcts were more commonly encountered than medial temporal atrophy in such patients.

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  19. Regional functional connectivity predicts distinct cognitive impairments in Alzheimer’s disease spectrum

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    Kamalini G. Ranasinghe

    2014-01-01

    Full Text Available Understanding neural network dysfunction in neurodegenerative disease is imperative to effectively develop network-modulating therapies. In Alzheimer’s disease (AD, cognitive decline associates with deficits in resting-state functional connectivity of diffuse brain networks. The goal of the current study was to test whether specific cognitive impairments in AD spectrum correlate with reduced functional connectivity of distinct brain regions. We recorded resting-state functional connectivity of alpha-band activity in 27 patients with AD spectrum − 22 patients with probable AD (5 logopenic variant primary progressive aphasia, 7 posterior cortical atrophy, and 10 early-onset amnestic/dysexecutive AD and 5 patients with mild cognitive impairment due to AD. We used magnetoencephalographic imaging (MEGI to perform an unbiased search for regions where patterns of functional connectivity correlated with disease severity and cognitive performance. Functional connectivity measured the strength of coherence between a given region and the rest of the brain. Decreased neural connectivity of multiple brain regions including the right posterior perisylvian region and left middle frontal cortex correlated with a higher degree of disease severity. Deficits in executive control and episodic memory correlated with reduced functional connectivity of the left frontal cortex, whereas visuospatial impairments correlated with reduced functional connectivity of the left inferior parietal cortex. Our findings indicate that reductions in region-specific alpha-band resting-state functional connectivity are strongly correlated with, and might contribute to, specific cognitive deficits in AD spectrum. In the future, MEGI functional connectivity could be an important biomarker to map and follow defective networks in the early stages of AD.

  20. Cognitive impairment after cerebrovascular stroke: Relationship to vascular risk factors

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    Eman M Khedr

    2009-02-01

    Full Text Available Eman M Khedr1, Sherifa A Hamed1, Hala K El-Shereef2, Ola A Shawky1, Khalid A Mohamed1, Effat M Awad3, Mohamed A Ahmed2, Ghaydaa A Shehata1, Mahmoud A Eltahtawy41Department of Neurology and Psychiatry, 2Department of Internal Medicine, 3Department of Physiology, 4Department of Clinical Pathology, Assiut University, Faculty of Medicine, Assiut, EgyptBackground: Cognitive decline after cerebrovascular stroke has adverse outcome consequences. Since some vascular causes can be prevented and treated, the identification of stroke-related cognitive impairment is a challenge. Patients with cognitive impairment and vascular diseases exhibit higher homocysteine (Hcy concentrations. Whether Hcy is an independent risk factor for cognitive impairment after stoke is still in question. The objectives of this study were to determine: 1 the relative frequency of first-ever post-stroke dementia (PSD (three months after onset in a consecutive sample of our population, 2 the risk factors associated with PSD, and 3 the relationship between Hcy levels and PSD.Methods: Eighty-one inpatients with first-ever stroke were prospectively evaluated with a neuropsychological battery and event-related evoked potentials (P300 at onset and then after three months. A wide range of demographic, clinical, radiological and laboratory variables were examined. PSD was diagnosed if the clinical presentation fulfilled DSM-IV criteria of vascular dementia, the patient scored ≤21 on Mini Mental State Examination (MMSE and ≤67 points on Cognitive Abilities Screening Instruments (CASI.Results: PSD was diagnosed in 21%. PSD was significantly associated with increasing age, low levels of education, large sized and lacunar infarctions, severity of stroke, prolonged P300 latency, smoking, hypertension, and elevated Hcy levels. High Hcy levels increased the odds ratio of PSD after adjustment of significantly relevant variables including age, smoking, size of infarction, and carotid stenosis

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

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    Rise IV

    2016-05-01

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

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

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    Rok Berlot

    2016-12-01

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

  3. Increased prolactin levels are associated with impaired processing speed in subjects with early psychosis.

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    Itziar Montalvo

    Full Text Available Hyperprolactinaemia, a common side effect of some antipsychotic drugs, is also present in drug-naïve psychotic patients and subjects at risk for psychosis. Recent studies in non-psychiatric populations suggest that increased prolactin may have negative effects on cognition. The aim of our study was to explore whether high plasma prolactin levels are associated with poorer cognitive functioning in subjects with early psychoses. We studied 107 participants: 29 healthy subjects and 78 subjects with an early psychosis (55 psychotic disorders with <3 years of illness, 23 high-risk subjects. Cognitive assessment was performed with the MATRICS Cognitive Consensus Cognitive Battery, and prolactin levels were determined as well as total cortisol levels in plasma. Psychopathological status was assessed and the use of psychopharmacological treatments (antipsychotics, antidepressants, benzodiazepines recorded. Prolactin levels were negatively associated with cognitive performance in processing speed, in patients with a psychotic disorder and high-risk subjects. In the latter group, increased prolactin levels were also associated with impaired reasoning and problem solving and poorer general cognition. In a multiple linear regression analysis conducted in both high-risk and psychotic patients, controlling for potential confounders, prolactin and benzodiazepines were independently related to poorer cognitive performance in the speed of processing domain. A mediation analysis showed that both prolactin and benzodiazepine treatment act as mediators of the relationship between risperidone/paliperidone treatment and speed of processing. These results suggest that increased prolactin levels are associated with impaired processing speed in early psychosis. If these results are confirmed in future studies, strategies targeting reduction of prolactin levels may improve cognition in this population.

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

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

    2017-01-01

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

  5. Can cognitive enhancers reduce the risk of falls in older people with Mild Cognitive Impairment? A protocol for a randomised controlled double blind trial

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    Wells Jennie L

    2009-08-01

    Full Text Available Abstract Background Older adults with cognitive problems have a higher risk of falls, at least twice that of cognitively normal older adults. The consequences of falls in this population are very serious: fallers with cognitive problems suffer more injuries due to falls and are approximately five times more likely to be admitted to institutional care. Although the mechanisms of increased fall risk in cognitively impaired people are not completely understood, it is known that impaired cognitive abilities can reduce attentional resource allocation while walking. Since cognitive enhancers, such as cholinesterase inhibitors, improve attention and executive function, we hypothesise that cognitive enhancers may reduce fall risk in elderly people in the early stages of cognitive decline by improving their gait and balance performance due to an enhancement in attention and executive function. Method/Design Double blinded randomized controlled trial with 6 months follow-up in 140 older individuals with Mild Cognitive Impairment (MCI. Participants will be randomized to the intervention group, receiving donepezil, and to the control group, receiving placebo. A block randomization by four and stratification based on fall history will be performed. Primary outcomes are improvements in gait velocity and reduction in gait variability. Secondary outcomes are changes in the balance confidence, balance sway, attention, executive function, and number of falls. Discussion By characterizing and understanding the effects of cognitive enhancers on fall risk in older adults with cognitive impairments, we will be able to pave the way for a new approach to fall prevention in this population. This RCT study will provide, for the first time, information regarding the effect of a medication designed to augment cognitive functioning have on the risk of falls in older adults with Mild Cognitive Impairment. We expect a significant reduction in the risk of falls in this

  6. Validity of a novel computerized cognitive battery for mild cognitive impairment

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    Schweiger Avraham

    2003-11-01

    Full Text Available Abstract Background The NeuroTrax Mindstreams computerized cognitive assessment system was designed for widespread clinical and research use in detecting mild cognitive impairment (MCI. However, the capability of Mindstreams tests to discriminate elderly with MCI from those who are cognitively healthy has yet to be evaluated. Moreover, the comparability between these tests and traditional neuropsychological tests in detecting MCI has not been examined. Methods A 2-center study was designed to assess discriminant validity of tests in the Mindstreams Mild Impairment Battery. Participants were 30 individuals diagnosed with MCI, 29 with mild Alzheimer's disease (AD, and 39 healthy elderly. Testing was with the Mindstreams battery and traditional neuropsychological tests. Receiver operating characteristic (ROC analysis was used to examine the ability of Mindstreams and traditional measures to discriminate those with MCI from cognitively healthy elderly. Between-group comparisons were made (Mann-Whitney U test between MCI and healthy elderly and between MCI and mild AD groups. Results Mindstreams outcome parameters across multiple cognitive domains significantly discriminated among MCI and healthy elderly with considerable effect sizes (p Conclusions Mindstreams tests are effective in detecting MCI, providing a comprehensive profile of cognitive function. Further, the enhanced precision and ease of use of these computerized tests make the NeuroTrax system a valuable clinical tool in the identification of elderly at high risk for dementia.

  7. Awareness of cognitive deficits in older adults with epilepsy and mild cognitive impairment.

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    Galioto, Rachel; Thamilavel, Selvan; Blum, Andrew S; Tremont, Geoffrey

    2015-01-01

    A significant portion of individuals with mild cognitive impairment (MCI) experience limited awareness of cognitive deficits. Although older adults with epilepsy have comparable cognitive deficits to individuals with MCI, little is known about awareness of cognitive deficit in epilepsy. This study compared deficit awareness in epilepsy and MCI and examined its relationship with neuropsychological performance. Sixty-two older adults (31 epilepsy, 31 MCI) completed neuropsychological testing and the Cognitive Difficulties Scale (CDS), a self-report measure of everyday cognitive skills. Informants completed the CDS only. Cognitive domain scores were created. CDS composite scores were created by summing attention-concentration and language and delayed memory factors. Awareness was defined as the difference between patient and informant CDS scores, with limited awareness defined as greater informant complaints. Neuropsychological performance was similar between groups for all domains except that MCI participants had worse delayed memory, t(60) = 2.49, p .05). Epilepsy informant CDS scores were related to poorer immediate memory (r = -.41, p = .02). MCI informant CDS scores were related to worse delayed memory (r = -.41, p = .02). Limited awareness was found in 29.0% of epilepsy and 61.3% of MCI participants. Awareness was not related to cognition in epilepsy but was related to worse delayed memory (r = -.41, p = .02) for MCI participants. Older adults with epilepsy and MCI had similar cognitive deficits with the exception of greater impairment in delayed memory for MCI patients. There was less awareness of deficit in the MCI group, suggesting that delayed memory may be a critical factor for deficit awareness. Results argue against executive dysfunction as a major contributor to deficit awareness.

  8. Influence of cognitive impairment, functional impairment and care setting on dementia care mapping results.

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    Edelman, P; Kuhn, D; Fulton, B R

    2004-11-01

    Quality of life (QOL) for people with dementia has become a major focus over the past decade. Dementia care mapping (DCM) is an observational measure of quality of care given by staff in formal care settings, as well as a measure of QOL that has been used in many studies of people with dementia in residential care settings. However, the method itself has not been rigorously studied in a scientific manner. For this report, mapping data were collected for 166 persons with dementia in three types of care settings: special care facilities that are licensed nursing homes, assisted living facilities, and adult day centers. The relationships between DCM and several independent variables including cognitive status, functional status, care setting, depression, length of stay, and co-morbid illnesses were assessed. Both cognitive status and functional status were found to be associated with DCM scores. Moreover, DCM was sensitive in differentiating among persons with four levels of cognitive impairment. Implications for practice are discussed.

  9. Making sense of mild cognitive impairment: a qualitative exploration of the patient's experience.

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    Lingler, Jennifer Hagerty; Nightingale, Marcie C; Erlen, Judith A; Kane, April L; Reynolds, Charles F; Schulz, Richard; DeKosky, Steven T

    2006-12-01

    The proposed dementia precursor state of mild cognitive impairment is emerging as a primary target of aging research. Yet, little is known about the subjective experience of living with a diagnosis of mild cognitive impairment. This study examines, from the patient's perspective, the experience of living with and making sense of the diagnosis. We recruited 12 older adults with amnestic or nonamnestic mild cognitive impairment from a university-based memory disorders clinic. We conducted in-home, semistructured interviews in order to elicit rich descriptions of the personal experience of having mild cognitive impairment. We used the qualitative method of grounded theory to analyze narrative data. Understanding and coming to terms with the syndrome, or assigning meaning, constituted a fundamental aspect of living with a diagnosis of mild cognitive impairment. This process comprised interrelated emotional and cognitive dimensions. Participants employed a range of positive, neutral, and negative phrasing in order to depict their emotional reactions to receiving a diagnosis. Cognitive representations of mild cognitive impairment included both prognosis-focused and face-value appraisals. Expectations of normal aging, personal experience with dementia, and concurrent health problems were key contextual factors that provided the backdrop against which participants assigned meaning to a diagnosis of mild cognitive impairment. Clinicians who disclose diagnoses of mild cognitive impairment need to be mindful of the potential for varying interpretations of the information that is conveyed. Future research needs to include systematic, longitudinal investigations of illness representation and its impact on health behaviors among individuals with mild cognitive impairment.

  10. Effects of Aerobic Exercise on Mild Cognitive Impairment

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    Baker, Laura D.; Frank, Laura L.; Foster-Schubert, Karen; Green, Pattie S.; Wilkinson, Charles W.; McTiernan, Anne; Plymate, Stephen R.; Fishel, Mark A.; Stennis Watson, G.; Cholerton, Brenna A.; Duncan, Glen E.; Mehta, Pankaj D.; Craft, Suzanne

    2011-01-01

    Objectives To examine the effects of aerobic exercise on cognition and other biomarkers associated with Alzheimer disease pathology for older adults with mild cognitive impairment, and assess the role of sex as a predictor of response. Design Six-month, randomized, controlled, clinical trial. Setting Veterans Affairs Puget Sound Health Care System clinical research unit. Participants Thirty-three adults (17 women) with amnestic mild cognitive impairment ranging in age from 55 to 85 years (mean age,70 years). Intervention Participants were randomized either to a high-intensity aerobic exercise or stretching control group. The aerobic group exercised under the supervision of a fitness trainer at 75% to 85% of heart rate reserve for 45 to 60 min/d, 4 d/wk for 6 months. The control group carried out supervised stretching activities according to the same schedule but maintained their heart rate at or below 50% of their heart rate reserve. Before and after the study, glucometabolic and treadmill tests were performed and fat distribution was assessed using dual-energy x-ray absorptiometry. At baseline, month 3, and month 6, blood was collected for assay and cognitive tests were administered. Main Outcome Measures Performance measures on Symbol-Digit Modalities, Verbal Fluency, Stroop, Trails B, Task Switching, Story Recall, and List Learning. Fasting plasma levels of insulin, cortisol, brain-derived neurotrophic factor, insulinlike growth factor-I, and β-amyloids 40 and 42. Results Six months of high-intensity aerobic exercise had sex-specific effects on cognition, glucose metabolism, and hypothalamic-pituitary-adrenal axis and trophic activity despite comparable gains in cardiorespiratory fitness and body fat reduction. For women, aerobic exercise improved performance on multiple tests of executive function, increased glucose disposal during the metabolic clamp, and reduced fasting plasma levels of insulin, cortisol, and brain-derived neurotrophic factor. For men

  11. Early Language Impairment and Young Adult Delinquent and Aggressive Behavior

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    Brownlie, E.B.; Beitchman, Joseph H.; Escobar, Michael; Young, Arlene; Atkinson, Leslie; Johnson, Carla; Wilson, Beth; Douglas, Lori

    2004-01-01

    Clinic and forensic studies have reported high rates of language impairments in conduct- disordered and incarcerated youth. In community samples followed to early adolescence, speech and language impairments have been linked to attention deficits and internalizing problems, rather than conduct problems, delinquency, or aggression. This study…

  12. Chronic renal dysfunction and anaemia are associated with cognitive impairment in older patients with heart failure.

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    Pulignano, Giovanni; Del Sindaco, Donatella; Di Lenarda, Andrea; Tinti, Maria Denitza; Tarantini, Luigi; Cioffi, Giovanni; Tolone, Stefano; Pero, Gaetano; Minardi, Giovanni

    2014-06-01

    Cognitive impairment, anaemia and chronic kidney disease (CKD) are associated with mortality and disability in chronic heart failure patients. We hypothesized that anaemia and CKD are independent predictors of cognitive impairment in older patients with heart failure. One hundred and ninety community-living elderly patients aged at least 70 years, treated with optimized therapy for heart failure in stable clinical conditions, were prospectively studied. They underwent clinical and multidimensional assessment. Cognitive status was assessed by the Mini Mental State Examination. Cognitive impairment was defined as the Mini Mental State Examination score adjusted by age and educational level below 24. CKD was defined as the Cockcroft-Gault glomerular filtration rate below 60  ml/min and anaemia as haemoglobin below 12  g/dl. Cognitive impairment was diagnosed in 38.9% of patients, CKD in 85.7% and anaemia in 42.6%. Age, female sex, BMI, education less than 5 years, depressive symptoms, anaemia, CKD, disability and worse quality of life were significantly associated with cognitive impairment. Cognitive impairment involved primarily global cognitive deficit, memory, mental speed, attention, calculation and language. A significant relationship between haemoglobin levels and cognitive impairment was found, with the range of 15-16.5  g/dl having the lower prevalence of cognitive impairment (19.4%). At multivariate analysis, advanced age, low education level, anaemia and CKD were independently associated with cognitive impairment. Cox analysis showed that cognitive impairment was an independent predictor of hospitalization for worsening heart failure alone and combined with all-cause death. Cognitive impairment is common in elderly heart failure patients and is independently associated with anaemia and renal dysfunction. Further studies are needed to assess whether optimal treatment of anaemia and CKD may prevent the development of cognitive impairment in heart failure

  13. Negative affective states and cognitive impairments in nicotine dependence.

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    Hall, F Scott; Der-Avakian, Andre; Gould, Thomas J; Markou, Athina; Shoaib, Mohammed; Young, Jared W

    2015-11-01

    Smokers have substantial individual differences in quit success in response to current treatments for nicotine dependence. This observation may suggest that different underlying motivations for continued tobacco use across individuals and nicotine cessation may require different treatments in different individuals. Although most animal models of nicotine dependence emphasize the positive reinforcing effects of nicotine as the major motivational force behind nicotine use, smokers generally report that other consequences of nicotine use, including the ability of nicotine to alleviate negative affective states or cognitive impairments, as reasons for continued smoking. These states could result from nicotine withdrawal, but also may be associated with premorbid differences in affective and/or cognitive function. Effects of nicotine on cognition and affect may alleviate these impairments regardless of their premorbid or postmorbid origin (e.g., before or after the development of nicotine dependence). The ability of nicotine to alleviate these symptoms would thus negatively reinforce behavior, and thus maintain subsequent nicotine use, contributing to the initiation of smoking, the progression to dependence and relapse during quit attempts. The human and animal studies reviewed here support the idea that self-medication for pre-morbid and withdrawal-induced impairments may be more important factors in nicotine addiction and relapse than has been previously appreciated in preclinical research into nicotine dependence. Given the diverse beneficial effects of nicotine under these conditions, individuals might smoke for quite different reasons. This review suggests that inter-individual differences in the diverse effects of nicotine associated with self-medication and negative reinforcement are an important consideration in studies attempting to understand the causes of nicotine addiction, as well as in the development of effective, individualized nicotine cessation

  14. Telmisartan attenuates cognitive impairment caused by chronic stress in rats.

    Science.gov (United States)

    Wincewicz, Dominik; Braszko, Jan J

    2014-06-01

    The potential effect of chronic treatment with telmisartan, an angiotensin type 1 receptor blocker (ARB) and partial agonist of peroxisome proliferator--activated receptor γ (PPARγ), on stress-related disorders is a matter of considerable interest. The existing data suggest that angiotensin II (Ang II) plays a major role in exaggerated sympathetic and hormonal response to stress. Enhanced formation of Ang II and increased AT1 receptor activity is associated with devastating impact of stress on central nervous system, which may trigger many psychiatric disorders such as depression, schizophrenia or post-traumatic stress disorder. Some of the anti-stress effects of ARBs have already been proven but these on the stress-induced cognitive impairment were examined only for candesartan. In this study, we tested a hypothesis that blockade of stress response by another ARB telmisartan alleviates the negative effect of prolonged restraint stress on cognitive functions of male Wistar rats. The preventive action of long-lasting treatment with telmisartan (1mg/kg body weight) against impairment caused by chronic stress (2h daily for 21 days) on recall was evaluated in a passive avoidance (PA) situation and object recognition test (ORT). Locomotor activity and anxiety behavior were tested respectively, in an open field and an elevated plus-maze. The results of this study indicate that telmisartan diminishes deleterious effects of chronic restraint stress on memory in a statistically significant manner (ptelmisartan may constitute a new therapeutic option in a stress-related cognitive impairment. Copyright © 2014 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  15. Paramedic assessment of pain in the cognitively impaired adult patient

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    Lord Bill

    2009-10-01

    Full Text Available Abstract Background Paramedics are often a first point of contact for people experiencing pain in the community. Wherever possible the patient's self report of pain should be sought to guide the assessment and management of this complaint. Communication difficulty or disability such as cognitive impairment associated with dementia may limit the patient's ability to report their pain experience, and this has the potential to affect the quality of care. The primary objective of this study was to systematically locate evidence relating to the use of pain assessment tools that have been validated for use with cognitively impaired adults and to identify those that have been recommended for use by paramedics. Methods A systematic search of health databases for evidence relating to the use of pain assessment tools that have been validated for use with cognitively impaired adults was undertaken using specific search criteria. An extended search included position statements and clinical practice guidelines developed by health agencies to identify evidence-based recommendations regarding pain assessment in older adults. Results Two systematic reviews met study inclusion criteria. Weaknesses in tools evaluated by these studies limited their application in assessing pain in the population of interest. Only one tool was designed to assess pain in acute care settings. No tools were located that are designed for paramedic use. Conclusion The reviews of pain assessment tools found that the majority were developed to assess chronic pain in aged care, hospital or hospice settings. An analysis of the characteristics of these pain assessment tools identified attributes that may limit their use in paramedic practice. One tool - the Abbey Pain Scale - may have application in paramedic assessment of pain, but clinical evaluation is required to validate this tool in the paramedic practice setting. Further research is recommended to evaluate the Abbey Pain Scale and to

  16. Neural and socio-cognitive sequelae of congenital visual impairment during midchildhood

    OpenAIRE

    Bathelt, J. M. C.

    2015-01-01

    Previous studies identified cognitive difficulties in individuals with congenital visual impairment that significantly impacted on wellbeing and educational attainment. However, factors leading to adverse outcome remained unclear. The current study aimed to identify associations and mechanisms of specific cognitive deficits associated with visual impairment from a neurodevelopmental perspective. Based on recent theoretical advances (Johnson, 2011), it was assumed that visual impairment leads ...

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

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    Philip Benjamin

    2014-01-01

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

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

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    Abdul Rashid

    2016-08-01

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

  19. Effect of Pain and Mild Cognitive Impairment on Mobility

    DEFF Research Database (Denmark)

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

    2016-01-01

    OBJECTIVES: To examine the effect of pain and mild cognitive impairment (MCI)-together and separately-on performance-based and self-reported mobility outcomes in older adults in primary care with mild to moderate self-reported mobility limitations. DESIGN: Cross-sectional analysis. SETTING...... mobility, and the presence of both comorbidities was associated with the poorest status. Primary care practitioners who encounter older adults in need of mobility rehabilitation should consider screening them for pain and MCI to better inform subsequent therapeutic interventions.......: Academic community outpatient clinic. PARTICIPANTS: Individuals aged 65 and older in primary care enrolled in the Boston Rehabilitative Impairment Study in the Elderly who were at risk of mobility decline (N = 430). MEASUREMENTS: Participants with an average score greater than three on the Brief Pain...

  20. Profiles of Mild Cognitive Impairment (MCI) in the Elderly.

    Science.gov (United States)

    Peraita, Herminia; Chacón, José; Díaz-Mardomingo, Carmen; Martínez-Arias, Rosario

    2015-11-20

    We applied latent class analysis (LCA) to a set of neuropsychological data with the aim of corroborating the three cognitive profiles of mild cognitive impairment (MCI) described in the literature, namely: healthy, amnestic, non-amnestic, and multidomain. The ultimate purpose of the LCA was to try to find the underlying classification of MCI and related pathologies by means of the participants' response patterns, rather than on more classical psychometric criteria, such as the standard deviation of the mean. We computed 547 neuropsychological assessments derived from 223 participants who were assessed annually for three consecutive years. The battery included tests of memory, language, executive function, and praxis. The results obtained by means of LCA, with a four-group solution and using the 40th percentile as the criterion, confirm prior classifications obtained with more questionable psychometric criteria, while providing longitudinal data on the course of MCI and the stability of group assignment over time.

  1. Strictly Lobar Cerebral Microbleeds Are Associated With Cognitive Impairment.

    Science.gov (United States)

    Chung, Chih-Ping; Chou, Kun-Hsien; Chen, Wei-Ta; Liu, Li-Kuo; Lee, Wei-Ju; Chen, Liang-Kung; Lin, Ching-Po; Wang, Pei-Ning

    2016-10-01

    Different distributions of cerebral microbleeds (CMBs) are associated with distinct pathological mechanisms. Lobar CMBs are thought to be related to cerebral amyloid angiopathy, whereas deep or infratentorial CMBs are related to hypertensive vasculopathy. The present study aimed to evaluate the effects of CMBs and their locations on a variety of cognitive domains. Study subjects were selected from the community-based I-Lan Longitudinal Aging Study. We assessed cognitive domains, including verbal memory, language, visuospatial executive function, and verbal executive function. CMBs were evaluated using 3T susceptibility-weighted magnetic resonance imaging. We studied 959 subjects (mean±SD, 62.5±8.6 years; 425 [44.3%] men). CMBs were found in 14.2% of the population. We classified subjects with CMBs into 2 different groups based on the locations of their CMBs: (1) deep or infratentorial (85 subjects, 8.8% of population) and (2) strictly lobar (49, 5.1%). Multivariate linear analysis showed that strictly lobar CMBs were significantly associated with deficits in global cognitive function (Mini-Mental State Examination) and visuospatial executive function, as determined by the copy test of the Taylor complex figure test and the clock drawing test. We adjusted our results for age, sex, years of education, cardiovascular risk factors, and other markers of cerebral small vessel disease, lacunes, and white matter hyperintensity. Deep or infratentorial CMBs were not associated with changes in cognitive function in our population. Strictly lobar, but not deep or infratentorial, CMBs are associated with changes in cognitive function, especially in visuospatial executive functions. Cerebral amyloid angiopathy may be the underlying pathology associated with CMB-related cognitive impairment. © 2016 American Heart Association, Inc.

  2. Contextual social cognition impairments in schizophrenia and bipolar disorder.

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    Sandra Baez

    Full Text Available BACKGROUND: The ability to integrate contextual information with social cues to generate social meaning is a key aspect of social cognition. It is widely accepted that patients with schizophrenia and bipolar disorders have deficits in social cognition; however, previous studies on these disorders did not use tasks that replicate everyday situations. METHODOLOGY/PRINCIPAL FINDINGS: This study evaluates the performance of patients with schizophrenia and bipolar disorders on social cognition tasks (emotional processing, empathy, and social norms knowledge that incorporate different levels of contextual dependence and involvement of real-life scenarios. Furthermore, we explored the association between social cognition measures, clinical symptoms and executive functions. Using a logistic regression analysis, we explored whether the involvement of more basic skills in emotional processing predicted performance on empathy tasks. The results showed that both patient groups exhibited deficits in social cognition tasks with greater context sensitivity and involvement of real-life scenarios. These deficits were more severe in schizophrenic than in bipolar patients. Patients did not differ from controls in tasks involving explicit knowledge. Moreover, schizophrenic patients' depression levels were negatively correlated with performance on empathy tasks. CONCLUSIONS/SIGNIFICANCE: Overall performance on emotion recognition predicted performance on intentionality attribution during the more ambiguous situations of the empathy task. These results suggest that social cognition deficits could be related to a general impairment in the capacity to implicitly integrate contextual cues. Important implications for the assessment and treatment of individuals with schizophrenia and bipolar disorders, as well as for neurocognitive models of these pathologies are discussed.

  3. Naturalistic measures of prospective memory in amnestic mild cognitive impairment.

    Science.gov (United States)

    Delprado, Jacinta; Kinsella, Glynda; Ong, Ben; Pike, Kerryn

    2013-06-01

    Several studies have now reported that individuals with amnestic mild cognitive impairment (aMCI) are impaired on laboratory-based measures of prospective memory (PM). However, the age-PM paradox has revealed that impairment observed in the laboratory does not necessarily reflect functioning in day-to-day life. The current study examined naturalistic measures of PM by comparing participants with aMCI to healthy older adults on experimenter-introduced PM tasks (Experiment 1) and on participants' own, self-generated PM tasks (Experiment 2). Individuals with aMCI were found to be globally impaired on each of the naturalistic measures of PM Strategy use was found to be a distinguishing feature between the two groups with healthy older adults using more written strategies, whereas individuals with aMCI relied more on another person providing a reminder. Also of note was that both groups only used strategies around half the time for their own PM tasks. Findings are discussed in terms of implications for interventions and the day-to-day functioning of individuals with aMCI, a population that is struggling to maintain independence in the community. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  4. Driving in mild cognitive impairment: The role of depressive symptoms.

    Science.gov (United States)

    Beratis, Ion N; Andronas, Nikos; Kontaxopoulou, Dionysia; Fragkiadaki, Stella; Pavlou, Dimosthenis; Papatriantafyllou, John; Economou, Alexandra; Yannis, George; Papageorgiou, Sokratis G

    2017-07-04

    Previous studies indicate a negative association between depression and driving fitness in the general population. Our goal was to cover a gap in the literature and to explore the link between depressive symptoms and driving behavior in individuals with mild cognitive impairment (MCI) through the use of a driving simulator experiment. Twenty-four individuals with MCI (mean age = 67.42, SD = 7.13) and 23 cognitively healthy individuals (mean age = 65.13, SD = 7.21) were introduced in the study. A valid driving license and regular car use served as main inclusion criteria. Data collection included a neurological/neuropsychological assessment and a driving simulator evaluation. Depressive symptomatology was assessed with the Patient Health Questionnaire (PHQ-9). Significant interaction effects indicating a greater negative impact of depressive symptoms in drivers with MCI than in cognitively healthy drivers were observed in the case of various driving indexes, namely, average speed, accident risk, side bar hits, headway distance, headway distance variation, and lateral position variation. The associations between depressive symptoms and driving behavior remained significant after controlling for daytime sleepiness and cognition. Depressive symptoms could be a factor explaining why certain patients with MCI present altered driving skills. Therefore, interventions for treating the depressive symptoms of individuals with MCI could prove to be beneficial regarding their driving performance.

  5. New Strategies for Alzheimer Disease and Cognitive Impairment

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    Kenneth Maiese

    2009-01-01

    Full Text Available Approximately five million people suffer with Alzheimer disease (AD and more than twenty-four million people are diagnosed with AD, pre-senile dementia, and other disorders of cognitive loss worldwide. Furthermore, the annual cost per patient with AD can approach $200,000 with an annual population aggregate cost of $100 billion. Yet, complete therapeutic prevention or reversal of neurovascular injury during AD and cognitive loss is not achievable despite the current understanding of the cellular pathways that modulate nervous system injury during these disorders. As a result, identification of novel therapeutic targets for the treatment of neurovascular injury would be extremely beneficial to reduce or eliminate disability from diseases that lead to cognitive loss or impairment. Here we describe the capacity of intrinsic cellular mechanisms for the novel pathways of erythropoietin and forkhead transcription factors that may offer not only new strategies for disorders such as AD and cognitive loss, but also function as biomarkers for disease onset and progression.

  6. Movements Execution in Amnestic Mild Cognitive Impairment and Alzheimer’s Disease

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    Rosolino Camarda

    2007-01-01

    Full Text Available We evaluated the relationship between motor and neuropsychological deficits in subjects affected by amnestic Mild Cognitive Impairment (aMCI and early Alzheimer’s Disease (AD. Kinematics of goal-directed movement of aMCI and AD subjects were compared to those of age-matched control subjects. AD showed a slowing down of motor performance compared to aMCI and controls. No relationships were found between motor and cognitive performances in both AD and aMCI. Our results suggest that the different motor behaviour between AD and aMCI cannot be related to memory deficits, probably reflecting the initial degeneration of parietal-frontal circuits for movement planning. The onset of motor dysfunction in early AD could represent the transition from aMCI to AD.

  7. Reduced 5-HT2A receptor binding in patients with mild cognitive impairment

    DEFF Research Database (Denmark)

    Hasselbalch, S G; Madsen, K; Svarer, C;

    2008-01-01

    Previous studies of patients with Alzheimer's disease (AD) have described reduced brain serotonin 2A (5-HT(2A)) receptor density. It is unclear whether this abnormality sets in early in the course of the disease and whether it is related to early cognitive and neuropsychiatric symptoms. We assessed...... cerebral 5-HT(2A) receptor binding in patients with mild cognitive impairment (MCI) and related 5-HT(2A) receptor binding to clinical symptoms. Sixteen patients with MCI of the amnestic type (mean age 73, mean MMSE 26.1) and 17 age and sex matched control subjects were studied with MRI and [(18)F......]altanserin PET in a bolus-infusion approach. A significant global reduction of 20-30% in 5-HT(2A) binding (atrophy corrected) was found in most neocortical areas. Reduced 5-HT(2A) binding in the striatum correlated significantly with Neuropsychiatric Inventory depression and anxiety scores. We conclude...

  8. Detecting Cognitive Impairment and Dementia in Deaf People: The British Sign Language Cognitive Screening Test.

    Science.gov (United States)

    Atkinson, Joanna; Denmark, Tanya; Marshall, Jane; Mummery, Cath; Woll, Bencie

    2015-11-01

    To provide accurate diagnostic screening of deaf people who use signed communication, cognitive tests must be devised in signed languages with normative deaf samples. This article describes the development of the first screening test for the detection of cognitive impairment and dementia in deaf signers. The British Sign Language Cognitive Screening Test uses standardized video administration to screen cognition using signed, rather than spoken or written, instructions and a large norm-referenced sample of 226 deaf older people. Percentiles are provided for clinical comparison. The tests showed good reliability, content validity, and correlation with age, intellectual ability, and education. Clinical discrimination was shown between the normative sample and 14 deaf patients with dementia. This innovative testing approach transforms the ability to detect dementia in deaf people, avoids the difficulties of using an interpreter, and enables culturally and linguistically sensitive assessment of deaf signers, with international potential for adaptation into other signed languages.

  9. Cognitive stimulation of executive functions in mild cognitive impairment: specific efficacy and impact in memory.

    Science.gov (United States)

    Moro, V; Condoleo, M T; Valbusa, V; Broggio, E; Moretto, G; Gambina, G

    2015-03-01

    Executive functions play an important role in the maintenance of autonomy in day-to-day activities. Nevertheless, there is little research into specific cognitive training for Mild Cognitive Impairment (MCI). We present the results of a program which aims to teach specific strategies and metacognitive abilities in order for patients to be able to carry out attentional and executive tasks. Two groups (A and B) were compared in a cross-over design. After the first evaluation, Group A (but not B) participated in a six month cognitive stimulation program. After a second assessment, only Group B received treatment and then a final evaluation was carried out on both groups. The results show that: i) both groups improved their performance as an effect of training; ii) improvements generalized to memory and general cognitive tasks; iii) in the interval without training, Group B's performance worsened and iv) Group A partially maintained their results over time.

  10. Cognitive Effects of Intentional Weight Loss in Elderly Obese Individuals With Mild Cognitive Impairment.

    Science.gov (United States)

    Horie, Nidia Celeste; Serrao, Valeria T; Simon, Sharon Sanz; Gascon, Maria Rita Polo; Dos Santos, Alessandra Xavier; Zambone, Maria Aquimara; Del Bigio de Freitas, Marta Merenciana; Cunha-Neto, Edecio; Marques, Emerson Leonildo; Halpern, Alfredo; de Melo, Maria Edna; Mancini, Marcio C; Cercato, Cintia

    2016-03-01

    Obesity in midlife is a risk factor for dementia, but it is unknown if caloric restriction-induced weight loss could prevent cognitive decline and therefore dementia in elderly patients with cognitive impairment. To evaluate the cognitive effect of intentional weight loss in obese elderly patients with mild cognitive impairment (MCI), considering the influence of age, apolipoprotein E (APOE) genotype, physical activity, biochemical markers, and diet. Single-center, prospective controlled trial. Academic medical center. Eighty obese patients with MCI, aged 60 or older (68.1 ± 4.9 y, body mass index [BMI] 35.5 ± 4.4 kg/m(2), 83.7% women, 26.3% APOE allele ϵ4 carriers). Random allocation to conventional medical care alone (n = 40) or together with nutritional counselling (n = 40) in group meetings aiming to promote weight loss through caloric restriction for 12 months. clinical data, body composition, neuropsychological tests (main outcome), serum biomarkers, APOE genotype, physical performance, dietary recalls. Seventy-five patients completed the follow-up. BMI, on average, decreased 1.7 ± 1.8 kg/m(2) (P = .021), and most of the cognitive tests improved, without difference between the groups. In analysis with linear generalized models, the BMI decrease was associated with improvements in verbal memory, verbal fluency, executive function, and global cognition, after adjustment for education, gender, physical activity, and baseline tests. This association was strongest in younger seniors (for memory and fluency) and in APOE allele ϵ4 carriers (for executive function). Changes in homeostasis model assessment-estimated insulin resistance, C-reactive protein, leptin and intake of energy, carbohydrates, and fats were associated with improvement in cognitive tests. Intentional weight loss through diet was associated with cognitive improvement in patients with MCI.

  11. Cognition Enhancing Activity of Sulforaphane Against Scopolamine Induced Cognitive Impairment in Zebra Fish (Danio rerio).

    Science.gov (United States)

    Rajesh, Venugopalan; Ilanthalir, Sakthivel

    2016-10-01

    Several epidemiological studies have shown that consumption of large quantities of vegetables especially cruciferous vegetables (Broccoli and Brussels sprouts) can protect against chronic diseases. Sulforaphane, an isothiocynate found in cruciferous vegetables has been demonstrated to have neuroprotective effects in several experimental paradigms. This study was undertaken to examine the effect of sulforaphane on cognitive impairment in zebra fish model using a novel method of fear conditioning. Initially, the normal behaviour of zebra fishes was studied in light-dark tank for 10 min daily for 10 days. Fishes were then divided into seven groups of twelve in each. Group I served as normal, group II served as fear conditioned control, group III and group IV were sulforaphane (25 µM/L) and piracetam (200 mg/L) treated respectively. Group V served as scopolamine (400 µM/L) induced memory impairment fishes. Group VI and VII were sulforaphane (25 µM/L) and piracetam (200 mg/L) treated scopolamine induced memory impairment groups respectively. In normal behavioural analysis, fishes preferred to stay in dark compartment. The average number of entries into the dark and time spent in dark were significantly more. Fishes in group II to VII were individually subjected to fear conditioning passive avoidance task and evaluated for learned task memory. It was observed that the average number of entries into dark and time spent in dark were significantly decreased. After exposure to respective treatment fishes in group III to VII were subjected to cognitive evaluation. There was no significant difference in cognition of group III and IV fishes exposed to sulforaphane and piracetam alone respectively. Fishes exposed to scopolamine showed a significant cognitive impairment. Sulforaphane exposure prior to scopolamine significantly retained the memory of learned task. These findings suggest that sulforaphane might be a promising therapeutic agent for cognitive enhancement in

  12. Thickness in Entorhinal and Subicular Cortex Predicts Episodic Memory Decline in Mild Cognitive Impairment

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    A. C. Burggren

    2011-01-01

    Full Text Available Identifying subjects with mild cognitive impairment (MCI most likely to decline in cognition over time is a major focus in Alzheimer's disease (AD research. Neuroimaging biomarkers that predict decline would have great potential for increasing the efficacy of early intervention. In this study, we used high-resolution MRI, combined with a cortical unfolding technique to increase visibility of the convoluted medial temporal lobe (MTL, to assess whether gray matter thickness in subjects with MCI correlated to decline in cognition over two years. We found that thickness in the entorhinal (ERC and subicular (Sub cortices of MCI subjects at initial assessment correlated to change in memory encoding over two years (ERC: r=0.34; P=.003 and Sub (r=0.26; P=.011 but not delayed recall performance. Our findings suggest that aspects of memory performance may be differentially affected in the early stages of AD. Given the MTL's involvement in early stages of neurodegeneration in AD, clarifying the relationship of these brain regions and the link to resultant cognitive decline is critical in understanding disease progression.

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

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    Leigh A Johnson

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

  14. Recollection and familiarity in aging individuals with mild cognitive impairment and Alzheimer's disease: a literature review.

    Science.gov (United States)

    Schoemaker, Dorothee; Gauthier, Serge; Pruessner, Jens C

    2014-09-01

    Memory impairment is a central cognitive symptom in mild cognitive impairment (MCI) and Alzheimer Disease (AD). Recognition tasks are often used to characterize and define the nature of memory deficits. Dual-process theories posit that familiarity and recollection are independently involved in the recognition of previously encountered material and both contribute to successful recognition. Recent evidence indicates that there is a double dissociation in the neuronal substrates of those two processes. More precisely, it has been suggested that perirhinal and entorhinal areas are selectively involved in familiarity-based recognition, while the hippocampus is associated with recollection. Interestingly, these regions are among the first to be targeted by neurofibrillary tangles, one of AD's neuropathological hallmarks. Impairment in recognition performance can occur in the very early stages of AD, such as MCI. To define the nature of recognition impairment in these clinical populations, we reviewed the current literature on familiarity and recollection performance in individuals with MCI and AD. Together with clinical features, methodological factors are taken into consideration in the interpretation of findings.

  15. DEFINING PLASMA MICRORNAS ASSOCIATED WITH COGNITIVE IMPAIRMENT IN HIV-INFECTED PATIENTS†

    Science.gov (United States)

    Kadri, Ferdous; LaPlante, Andrea; De Luca, Mariacristina; Doyle, Lisa; Velasco-Gonzalez, Cruz; Patterson, Jonathan R.; Molina, Patricia E.; Nelson, Steve; Zea, Arnold; Parsons, Christopher H.; Peruzzi, Francesca

    2015-01-01

    Human Immunodeficiency Virus (HIV)-infected individuals are at increased risk for developing neurocognitive disorders and depression. These conditions collectively affect more than 50% of people living with HIV/AIDS and adversely impact adherence to HIV therapy. Thus, identification of early markers of neurocognitive impairment could lead to interventions that improve psychosocial functioning and slow or reverse disease progression through improved treatment adherence. Evidence has accumulated for the role and function of microRNAs in normal and pathological conditions. We have optimized a protocol to profile microRNAs in body fluids. Using this methodology, we have profiled plasma microRNA expression for 30 age-matched, HIV-infected (HIV+) patients and identified highly sensitive and specific microRNA signatures distinguishing HIV+ patients with cognitive impairment from those without cognitive impairment. These results justify follow-on studies to determine whether plasma microRNA signatures can be used as a screening or prognostic tool for HIV+ patients with neurocognitive impairment. PMID:26284581

  16. Cognitive impairment in childhood onset epilepsy: up-to-date information about its causes.

    Science.gov (United States)

    Kim, Eun-Hee; Ko, Tae-Sung

    2016-04-01

    Cognitive impairment associated with childhood-onset epilepsy is an important consequence in the developing brain owing to its negative effects on neurodevelopmental and social outcomes. While the cause of cognitive impairment in epilepsy appears to be multifactorial, epilepsy-related factors such as type of epilepsy and underlying etiology, age at onset, frequency of seizures, duration of epilepsy, and its treatment are considered important. In recent studies, antecedent cognitive impairment before the first recognized seizure and microstructural and functional alteration of the brain at onset of epilepsy suggest the presence of a common neurobiological mechanism between epilepsy and cognitive comorbidity. However, the overall impact of cognitive comorbidity in children with epilepsy and the independent contribution of each of these factors to cognitive impairment have not been clearly delineated. This review article focuses on the significant contributors to cognitive impairment in children with epilepsy.

  17. Interference Impacts Working Memory in Mild Cognitive Impairment

    Science.gov (United States)

    Aurtenetxe, Sara; García-Pacios, Javier; del Río, David; López, María E.; Pineda-Pardo, José A.; Marcos, Alberto; Delgado Losada, Maria L.; López-Frutos, José M.; Maestú, Fernando

    2016-01-01

    Mild cognitive impairment (MCI) is considered a transitional stage between healthy aging and dementia, specifically Alzheimer's disease (AD). The most common cognitive impairment of MCI includes episodic memory loss and difficulties in working memory (WM). Interference can deplete WM, and an optimal WM performance requires an effective control of attentional resources between the memoranda and the incoming stimuli. Difficulties in handling interference lead to forgetting. However, the interplay between interference and WM in MCI is not well-understood and needs further investigation. The current study investigated the effect of interference during a WM task in 20 MCIs and 20 healthy elder volunteers. Participants performed a delayed match-to-sample paradigm which consisted in two interference conditions, distraction and interruption, and one control condition without any interference. Results evidenced a disproportionate impact of interference on the WM performance of MCIs, mainly in the presence of interruption. These findings demonstrate that interference, and more precisely interruption, is an important proxy for memory-related deficits in MCI. Thus, the current findings reveal novel evidence regarding the causes of WM forgetting in MCI patients, associated with difficulties in the mechanisms of attentional control. PMID:27790082

  18. Interference impacts working memory in mild cognitive impairment

    Directory of Open Access Journals (Sweden)

    Sara Aurtenetxe

    2016-10-01

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

  19. Spared and impaired aspects of motivated cognitive control in schizophrenia.

    Science.gov (United States)

    Mann, Claire L; Footer, Owen; Chung, Yu Sun; Driscoll, Lori L; Barch, Deanna M

    2013-08-01

    The ability to upregulate cognitive control in motivationally salient situations was examined in individuals with schizophrenia (patients) and healthy controls. Fifty-four patients and 39 healthy controls were recruited. A computerized monetary response conflict task required participants to identity a picture, over which was printed a matching (congruent), neutral, or incongruent word. This baseline condition was followed by an incentive condition, in which participants were given the opportunity to win money on reward-cued trials. These reward-cued trials were interleaved with nonreward cued trials. Reaction times (RT) were examined for both incentive context effects (difference in RT between baseline and nonreward cue trials in the incentive condition) and incentive cue effects (difference in RT between nonreward and reward cue trials in the incentive condition). Compared with baseline, controls showed a speeding of responses during both the nonreward (incentive context effect) and reward cued (incentive cue effect) trials during the incentive condition, but with a larger incentive context than incentive cue effect, suggesting a reliance on proactive control strategies. Although patients also showed a speeding of responses to both nonreward and reward cued trials, they showed a significantly smaller incentive context effect than controls, suggesting a reduction in the use of proactive control and a greater reliance on the use of "just-in-time," reactive control strategies. These results are discussed in light of the relationship between motivation and cognitive impairments in schizophrenia, and the potential role of impairments in prefrontally mediated active maintenance mechanisms.

  20. Visual hallucinations and cognitive impairment in Parkinson's disease.

    Science.gov (United States)

    Park, Hee Kyung; Kim, Jae Seung; Im, Ki Chun; Kim, Mi Jung; Lee, Jae-Hong; Lee, Myoung C; Kim, Juhan; Chung, Sun Ju

    2013-09-01

    Visual hallucination (VH) is a common psychotic symptom in patients with Parkinson's disease (PD) and may be a significant predictor of cognitive impairment (CI) in such patients. This study aimed to investigate the pattern of glucose metabolism of VH and the relationship between VH and CI in PD. We studied 28 PD patients, including 15 with VH (PD-VH) and 13 without VH (PD-NVH). Of the 15 PD-VH patients, 8 patients had cognitive impairment (PD-VHCI) whereas 7 did not (PD-VHNCI). All patients underwent [18F] fluorodeoxyglucose positron emission tomography ([18F] FDG PET) followed by statistical parametric mapping (SPM) analyses. Compared to the patients with PDNVH, PD-VHNCI patients showed glucose hypometabolism in the inferior and middle temporal cortices, fusiform gyri, and frontal areas, suggesting the involvement of the ventral visual pathway. Compared to the patients with PDNVH, PD-VHCI patients showed glucose hypometabolism in the temporoparietal association cortices with scattered frontal areas. Dysfunction of ventral visual pathway involving the temporal lobe may play a key role in VH development in PD patients. The evolving distribution from the ventral visual pathway to more extensive posterior cortices in PD-VHCI patients suggests that VH may be a prodromal symptom occurring prior to CI in PD patients.

  1. Fear of falling, but not gait impairment, predicts subjective memory complaints in cognitively intact older adults.

    Science.gov (United States)

    Sakurai, Ryota; Suzuki, Hiroyuki; Ogawa, Susumu; Kawai, Hisashi; Yoshida, Hideyo; Hirano, Hirohiko; Ihara, Kazushige; Obuchi, Shuichi; Fujiwara, Yoshinori

    2017-07-01

    Understanding the risk factors for developing subjective memory complaints (SMC) could help with early screening and treatment for cognitive impairment. The aim of the present study was to explore the risk factors for developing SMC, by focusing on gait-related variables. A total of 406 community-dwelling older adults aged 65-85 years without impending cognitive impairment participated in baseline and 1-year follow-up evaluations. A comprehensive evaluation was carried out, and included gait speed and fear of falling (FoF) assessments, and the Montreal Cognitive Assessment test. Logistic regression analyses were carried out to independently evaluate the risk factors at baseline and follow-up evaluations. At baseline, 45.1% of older adults had SMC. The presence of SMC at baseline was associated with being female, subjective hearing loss and FoF. Of 223 participants who did not report SMC at baseline, 48 had newly developed SMC at follow up (21.5%). The significant predictors for developing SMC were being female and FoF, but not gait speed, and were independent of depression symptoms. The Montreal Cognitive Assessment total score at baseline was a marginally significant predictor for developing SMC at follow up (P = 0.06), but a lower score in the language domain was a significant predictor in further analysis. FoF was a significant risk for future development of SMC, suggesting that FoF might reflect the risk of cognitive impairment at an earlier stage, or that FoF and SMC could share the same basis of anxiety for daily activities. The mechanisms and consequence of this longitudinal relationship require further study. Geriatr Gerontol Int 2017; 17: 1125-1131. © 2016 Japan Geriatrics Society.

  2. Anatomical substrates and neurocognitive predictors of daily numerical abilities in mild cognitive impairment.

    Science.gov (United States)

    Benavides-Varela, Silvia; Burgio, Francesca; Meneghello, Francesca; De Marco, Matteo; Arcara, Giorgio; Rigon, Jessica; Pilosio, Cristina; Butterworth, Brian; Venneri, Annalena; Semenza, Carlo

    2015-10-01

    Patients with mild cognitive impairment experience difficulties in mathematics that affect their functioning in the activities of everyday life. What are the associated anatomical brain changes and the cognitive correlates underlying such deficits? In the present study, 33 patients with Mild Cognitive Impairments (MCI) and 29 cognitively normal controls underwent volumetric MRI, and completed the standardized battery of Numerical Activities of Daily Living (NADL) along with a comprehensive clinical neuropsychological assessment. Group differences were examined on the numerical tasks and volumetric brain measures. The gray (GM) and white matter (WM) volume correlates were also evaluated. The results showed that relative to controls, the MCI group had impairments in number comprehension, transcoding, written operations, and in daily activities involving time estimation and money usage. In the volumetric measures, group differences emerged for the transcoding subtask in the left insula and left superior temporal gyrus. Among MCI patients, number comprehension and formal numerical performance were correlated with volumetric variability in the right middle occipital areas and right frontal gyrus. Money-usage scores showed significant correlations with left mesial frontal cortex, right superior frontal and right superior temporal cortex. Regression models revealed that neuropsychological measures of long-term memory, language, visuo-spatial abilities, and abstract reasoning were predictive of the patients' decline in daily activities. The present findings suggest that early neuropathology in distributed cortical regions of the brain including frontal, temporal and occipital areas leads to a breakdown of cognitive abilities in MCI that impacts on numerical daily functioning. The findings have implications for diagnosis, clinical and domestic care of patients with MCI. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Application of the PredictAD Software Tool to Predict Progression in Patients with Mild Cognitive Impairment

    DEFF Research Database (Denmark)

    Simonsen, Anja H; Mattila, Jussi; Hejl, Anne-Mette

    2012-01-01

    Background: The PredictAD tool integrates heterogeneous data such as imaging, cerebrospinal fluid biomarkers and results from neuropsychological tests for compact visualization in an interactive user interface. This study investigated whether the software tool could assist physicians in the early...... diagnosis of Alzheimer's disease. Methods: Baseline data from 140 patients with mild cognitive impairment were selected from the Alzheimer's Disease Neuroimaging Study. Three clinical raters classified patients into 6 categories of confidence in the prediction of early Alzheimer's disease, in 4 phases...

  4. Comparison of efficacy of telmisartan with losartan in patients of essential hypertension with cognitive impairment

    Directory of Open Access Journals (Sweden)

    Nitin Natthuji Puram

    2016-06-01

    Conclusions: Telmisartan is as effective as losartan in controlling blood pressure and improving cognitive function in hypertensive patients with cognitive impairment. [Int J Basic Clin Pharmacol 2016; 5(3.000: 702-706

  5. The Group Embedded Figures Test: a measure of cognitive style or cognitive impairment.

    Science.gov (United States)

    O'Leary, M R; Calsyn, D A; Fauria, T

    1980-10-01

    The Group Embedded Figures Test (GEFT) purports to be a measure of field articulation. The extent to which the GEFT measures apsects of personality and cognitive impairment was explored. Eighty-one male alcoholics, mean age of 42.9, receiving treatment for alcoholism at the Seattle VA Medical Center were administered the GEFT, Shipley Hartford Institute of Living Scale, the Trail Making Test (TMT), and the Clinical Analysis Questionnaire (CAQ). Multiple regression analysis indicates that Part B of the TMT and the residual abstraction score from the Shipley share 32% of the common variance with GEFT. The CAQ second-order factors of depression and independence also contributed significantly to the regression equation accounting for an additional 10% of the common variance. The results suggest the GEFT may be more a measure of cognitive impairment than personality. Alternative explanations are explored.

  6. Characteristics of Early Spelling of Children with Specific Language Impairment

    Science.gov (United States)

    Cordewener, Kim A. H.; Bosman, Anna M. T.; Verhoeven, Ludo

    2012-01-01

    The present study investigated active grapheme knowledge and early spelling of 59 first grade children with Specific Language Impairment (SLI). "Speed", "nature", and "knowledge transfer" of spelling acquisition were taken into account. Four orthographic characteristics that influence early spelling, namely, "Type of Grapheme", "Grapheme…

  7. Impaired cognitive control over emotional material in euthymic bipolar disorder.

    Science.gov (United States)

    Wolkenstein, Larissa; Kanske, Philipp; Bailer, Josef; Wessa, Michèle; Hautzinger, Martin; Joormann, Jutta

    2017-05-01

    Previous research suggests that bipolar disorder (BD) is characterized by deficits in cognitive control (CC). Impaired CC has been found in high-risk samples and is associated with the maintenance of BD symptoms. It remains unclear, however, whether BD is characterized by a general deficit in CC or by a deficit that is specifically related to the processing of emotional material. The sample consisted of 42 remitted bipolar patients and 39 healthy controls (HC). We examined whether BD individuals display impaired CC when confronted with negative as well as positive material using an arithmetic inhibition task that required inhibition of pictorial stimulus material. Whereas both groups showed difficulties in exerting CC over negative material, only BD individuals exhibited deficient CC over positive material. Even though we intended the negative and positive pictures in the arithmetic inhibition task to be similarly arousing, participants in the current study rated the negative compared to the positive pictures as more arousing. BD is associated with impaired CC when processing emotional - especially positive - stimuli even when patients are in remission. Possible implications of this deficit especially for emotion regulation are discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

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

    DEFF Research Database (Denmark)

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

    2006-01-01

    The estrogen receptor alpha (ESR1) gene has been implicated in the process of cognitive impairment in elderly women. In a paired case-control study, we tested whether two ESR1 gene polymorphisms (the XbaI and PvuII sites) are risk factors for cognitive impairment as measured by the six-item Orien......The estrogen receptor alpha (ESR1) gene has been implicated in the process of cognitive impairment in elderly women. In a paired case-control study, we tested whether two ESR1 gene polymorphisms (the XbaI and PvuII sites) are risk factors for cognitive impairment as measured by the six...

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

    Science.gov (United States)

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

    2015-01-01

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

  10. Post-stroke cognitive impairments: diagnosis and therapeutic approaches

    Directory of Open Access Journals (Sweden)

    Natalia Vyacheslavovna Pizova

    2013-01-01

    Full Text Available Stroke is a leading cause of disability not only due to its impact on motor or sensory functions, but also to post-stroke cognitive impairments (CI. Within the first year after stroke, the rate of CI may be as high as 80-90% and 7-23% of patients develop dementia. The most important risk factors for CI are strokes, their extent, site, and number. Old age, low education level, severe previous pathological changes in the brain parenchyma, diabetes mellitus, atrial fibrillations, and recurrent strokes in particular, are associated with an increased risk of CI. Examining cognitive functions, monitoring the evolution of cognitive deficit, and post-stroke rehabilitation are indicated in patients who have had stroke. The main treatments in patients with CI are secondary stroke prevention, including lifestyle modification and symptomatic therapy. Sermion is one of the promising agents for the prevention and treatment of CI in these patients.

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

    Directory of Open Access Journals (Sweden)

    Baozhen Dai

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

  12. Cognitive impairments in common and rare somatic diseases

    Directory of Open Access Journals (Sweden)

    Natalia Vyacheslavovna Pizova

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  14. Mild cognitive impairment. Diagnostic value of different MR techniques; ''Mild cognitive impairment''. Diagnostische Wertigkeit verschiedener MR-Techniken

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    Hauser, T.; Stieltjes, B.; Essig, M. [Deutsches Krebsforschungszentrum (DKFZ) Heidelberg, Abteilung E010 Radiologie, Heidelberg (Germany); Thomann, P.A. [Zentrum fuer Psychosoziale Medizin, Universitaetsklinikum Heidelberg, AG Strukturelle Bildgebung, Klinik fuer Allgemeine Psychiatrie, Heidelberg (Germany)

    2011-04-15

    In view of an increasingly aging population the prevalence of dementia is also expected to increase rapidly. As well as clinical, neuropsychological and laboratory procedures magnetic resonance imaging (MRI) plays an important role in the early diagnosis of dementia which is important in the precursor stage of mild cognitive impairment (MCI). On the one hand this stage is associated with an increased risk of dementia and on the other hand an early treatment in this stage could attenuate development of the disease. In addition to morphological changes different functional MRI techniques can help in the early diagnosis of dementia and the precursor stages. Moreover, it is important to detect those MCI patients who are at particularly risk for developing dementia. In the differentiation of converters to non-converters initial studies suggest that particularly voxel-based morphometry, MR spectroscopy and diffusion tensor imaging can provide important additional information. (orig.) [German] Angesichts einer immer aelter werdenden Bevoelkerung sind wir mit dem Problem einer zunehmenden Zahl an Patienten mit Demenzerkrankungen konfrontiert. In der Fruehdiagnostik einer Demenz spielen neben klinischen, neuropsychologischen und laborchemischen Untersuchungen nichtinvasive Bildgebungsverfahren wie die MRT eine bedeutende Rolle. Wichtig ist dabei die Fruehdiagnostik einer Demenz bereits im Vorstadium der leichten kognitiven Beeintraechtigung (''mild cognitive impairment'', MCI), da dieses Krankheitsbild mit einem deutlich erhoehten Demenzrisiko einhergeht und durch eine fruehzeitige Therapie der Krankheitsverlauf abgemildert oder deutlich verzoegert werden kann. Neben morphologischen Veraenderungen helfen verschiedene funktionelle MR-Verfahren bei der Fruehdiagnostik einer Demenz. Darueber hinaus ist es von grosser Bedeutung, diejenigen MCI-Patienten zu detektieren, die in besonderem Masse von einer Demenz bedroht sind. Bei der Differenzierung von

  15. Response to Algarabel et al., 2012 "Recognition memory deficits in mild cognitive impairment". Reconsidering claims of familiarity disruptions in mild cognitive impairment.

    Science.gov (United States)

    Migo, E M; Westerberg, C E

    2014-01-01

    There is some debate over the relative impairment of recollection and familiarity in mild cognitive impairment (MCI). A recent publication by Algarabel et al. (2012, Recognition memory deficits in mild cognitive impairment, Aging, Neuropsychology, and Cognition, 19, 608-619) claims to undermine previous studies reporting preserved familiarity in patients with MCI. Here, we respond to their main criticisms, concluding that they are not sufficiently supported by the data presented. The role of recollection and familiarity in MCI remains unresolved and further work will be required to disentangle the mixed literature.

  16. Clinical and Cognitive Phenotype of Mild Cognitive Impairment Evolving to Dementia with Lewy Bodies

    Science.gov (United States)

    Cagnin, Annachiara; Bussè, Cinzia; Gardini, Simona; Jelcic, Nela; Guzzo, Caterina; Gnoato, Francesca; Mitolo, Micaela; Ermani, Mario; Caffarra, Paolo

    2015-01-01

    Objective The aim of this study was to determine which characteristics could better distinguish dementia with Lewy bodies (DLB) from Alzheimer's disease (AD) at the mild cognitive impairment (MCI) stage, with particular emphasis on visual space and object perception abilities. Methods Fifty-three patients with mild cognitive deficits that were eventually diagnosed with probable DLB (MCI-DLB: n = 25) and AD (MCI-AD: n = 28) at a 3-year follow-up were retrospectively studied. At the first visit, the patients underwent cognitive assessment including the Qualitative Scoring Mini Mental State Examination Pentagon Test and the Visual Object and Space Perception Battery. The Neuropsychiatric Inventory Questionnaire, Unified Parkinson's Disease Rating Scale (UPDRS) and questionnaires for cognitive fluctuations and sleep disorders were also administered. Results The best clinical predictor of DLB was the presence of soft extrapyramidal signs (mean UPDRS score: 4.04 ± 5.9) detected in 72% of patients, followed by REM sleep behavior disorder (60%) and fluctuations (60%). Wrong performances in the pentagon's number of angles were obtained in 44% of DLB and 3.7% of AD patients and correlated with speed of visual attention. Executive functions, visual attention and visuospatial abilities were worse in DLB, while verbal episodic memory impairment was greater in AD. Deficits in the visual-perceptual domain were present in both MCI-DLB and AD. Conclusions Poor performance in the pentagon's number of angles is specific of DLB and correlates with speed of visual attention. The dorsal visual stream seems specifically more impaired in MCI-DLB with respect to the ventral visual stream, the latter being involved in both DLB and AD. These cognitive features, associated with subtle extrapyramidal signs, should alert clinicians to a diagnostic hypothesis of DLB. PMID:26674638

  17. Cognitive screening for dementia and mild cognitive impairment in assisted living: comparison of 3 tests.

    Science.gov (United States)

    Kaufer, Daniel I; Williams, Christianna S; Braaten, Alyssa J; Gill, Karminder; Zimmerman, Sheryl; Sloane, Philip D

    2008-10-01

    Compare diagnostic characteristics of brief cognitive screening tests in residential care/assisted living (RC/AL) residents. Cross-sectional study involving a comprehensive clinical examination to ascertain a consensus diagnosis of probable dementia, no significant cognitive impairment, or mild cognitive impairment (MCI), including both amnestic and non-amnestic subtypes. Fourteen RC/AL facilities in North Carolina. Participants were 146 RC/AL residents, aged 65 years or older, who did not have diagnosed cognitive impairment. Diagnostic characteristics of the Mini-Cog, the Mini-Mental State Exam (MMSE), and a new 50-point test based on expanding selected MMSE items (MMX). Overall, 55/146 (38%) participants were diagnosed with probable dementia, and 76 (52%) met criteria for MCI (most non-amnestic). Both the Mini-Cog and the MMSE showed high sensitivity and negative predictive value for dementia, but had relatively low sensitivity and negative predictive value for MCI. The Mini-Cog had low specificity and was less accurate as a dementia screen than either the MMSE or MMX. Reliability and validity data for the MMX were satisfactory, and it performed better as a screening test for MCI than either the MMSE or Mini-Cog. Although the MMSE and Mini-Cog are both sensitive to dementia, modest specificity and positive predictive value may limit their utility as screening tools. Preliminary MMX data suggest it improves screening for MCI compared to the Mini-Cog or MMSE, while providing a similar level of screening for dementia. Further work is needed to identify suitable instruments for cognitive screening across the range of MCI and dementia.

  18. Clinical and Cognitive Phenotype of Mild Cognitive Impairment Evolving to Dementia with Lewy Bodies

    Directory of Open Access Journals (Sweden)

    Annachiara Cagnin

    2015-11-01

    Full Text Available Objective: The aim of this study was to determine which characteristics could better distinguish dementia with Lewy bodies (DLB from Alzheimer's disease (AD at the mild cognitive impairment (MCI stage, with particular emphasis on visual space and object perception abilities. Methods: Fifty-three patients with mild cognitive deficits that were eventually diagnosed with probable DLB (MCI-DLB: n = 25 and AD (MCI-AD: n = 28 at a 3-year follow-up were retrospectively studied. At the first visit, the patients underwent cognitive assessment including the Qualitative Scoring Mini Mental State Examination Pentagon Test and the Visual Object and Space Perception Battery. The Neuropsychiatric Inventory Questionnaire, Unified Parkinson's Disease Rating Scale (UPDRS and questionnaires for cognitive fluctuations and sleep disorders were also administered. Results: The best clinical predictor of DLB was the presence of soft extrapyramidal signs (mean UPDRS score: 4.04 ± 5.9 detected in 72% of patients, followed by REM sleep behavior disorder (60% and fluctuations (60%. Wrong performances in the pentagon's number of angles were obtained in 44% of DLB and 3.7% of AD patients and correlated with speed of visual attention. Executive functions, visual attention and visuospatial abilities were worse in DLB, while verbal episodic memory impairment was greater in AD. Deficits in the visual-perceptual domain were present in both MCI-DLB and AD. Conclusions: Poor performance in the pentagon's number of angles is specific of DLB and correlates with speed of visual attention. The dorsal visual stream seems specifically more impaired in MCI-DLB with respect to the ventral visual stream, the latter being involved in both DLB and AD. These cognitive features, associated with subtle extrapyramidal signs, should alert clinicians to a diagnostic hypothesis of DLB.

  19. Cognitive impairment as a mediator in the developmental pathway from infant malnutrition to adolescent depressive symptoms in Barbadian youth.

    Science.gov (United States)

    Waber, Deborah P; Eaglesfield, David; Fitzmaurice, Garrett M; Bryce, Cyralene; Harrison, Robert H; Galler, Janina R

    2011-04-01

    Depressive symptoms are elevated in adolescents who experienced significant malnutrition early in life. Early malnutrition can also have a significant impact on cognitive functioning, presumably because of the adverse impact of the malnutrition on the very young brain. In the context of a developmental cascade model, we tested the hypothesis that the association between early malnutrition and adolescent depressive symptoms is mediated by the cognitive impairment that ensues from the malnutrition. We evaluated Barbadian youth (N = 57) hospitalized for moderate to severe protein-energy malnutrition in the first year of life and healthy controls (N = 60) longitudinally. The primary hypothesis was tested by multiple regression models. After adjusting for covariates, early malnutrition predicted both cognitive functioning in childhood (IQ, p malnutrition and depressive symptoms in adolescence (p malnutrition and depressive symptoms in adolescence is small.

  20. Mild cognitive impairment: a concept and diagnostic entity in need of input from neuropsychology.

    Science.gov (United States)

    Bondi, Mark W; Smith, Glenn E

    2014-02-01

    This virtual issue consists of studies previously published in the Journal of the International Neuropsychological Society and selected on the basis of their content related to one of the most highly researched concepts in behavioral neurology and neuropsychology over the past decade: mild cognitive impairment (MCI). The reliance on cognitive screening measures, staging-based rating scales, and limited neuropsychological testing in diagnosing MCI across most research studies may miss individuals with subtle cognitive declines or mis-diagnose MCI in those who are otherwise cognitively normal on a broader neuropsychological battery of tests. The assembled articles highlight the perils of relying on these conventional criteria for MCI diagnosis and reveal how the reliability of diagnosis is improved when sound neuropsychological approaches are adopted. When these requirements are met, we illustrate with a second series of articles that neuropsychological measures associate strongly with biomarkers and often reflect pathology beyond or instead of typical AD distributions. The final set of articles reveal that people with MCI demonstrate mild but identifiable functional difficulties, and a challenge for neuropsychology is how to incorporate this information to better define MCI and distinguish it from early dementia. Neuropsychology is uniquely positioned to improve upon the state of the science in MCI research and practice by providing critically important empirical information on the specific cognitive domains affected by the predominant neurodegenerative disorders of late life as well as on the diagnostic decision-making strategies used in studies. When such efforts to more comprehensively assess neuropsychological functions are undertaken, better characterizations of spared and impaired cognitive and functional abilities result and lead to more convincing associations with other biomarkers as well as to prediction of clinical outcomes.

  1. Inappropriate sexual behaviors in cognitively impaired older individuals.

    Science.gov (United States)

    Guay, David R P

    2008-12-01

    Agitated and aggressive behaviors are common in older patients with dementia (33% of the community-dwelling and 80% of the institutionalized populations). Although inappropriate verbal and physical sexual behaviors are among the least common of these actions, they can be profoundly disruptive to caregivers (spouse, institutional staff, or both) and other individuals in the immediate surroundings. Substantial mental and physical harm can occur secondary to these behaviors. The common perception is that such behavior cannot be treated. This review summarizes the epidemiology, etiology, and biology of abnormal sexual behaviors in cognitively impaired older individuals and highlights potentially useful drug therapies. Primary research and review articles in the English language were identified through a search of MEDLINE/PubMed (1966-September 2008). Search terms included aged, hypersexuality, sexual disorders, paraphilia, sexual behaviors, tricyclic antidepressants, selective serotonin reuptake inhibitors, medroxyprogesterone acetate, cyproterone acetate, estrogens, LHRH agonists, leuprolide, and triptorelin. The bibliographies of all articles obtained were also reviewed for relevant citations. All articles involving abnormal sexual behaviors in older humans were reviewed. Use of pharmacotherapy in managing inappropriate sexual behaviors in cognitively impaired older individuals has been detailed in only 23 case reports and case series (N = 55 subjects). Additional supportive data from case reports and case series are available in nonsexual agitation/aggression in elderly patients with dementia (N = 16 subjects) and abnormal sexual behaviors in cognitively intact elderly (N = 2 subjects). One comparative trial in nonsexual agitation/aggression in elderly patients with dementia also exists (N = 27 subjects). There are no practice guidelines available for the treatment of abnormal sexual behaviors in the cognitively impaired elderly population. Recommendations must be

  2. Neuroanatomy of impaired self-awareness in Alzheimer's disease and mild cognitive impairment.

    Science.gov (United States)

    Zamboni, Giovanna; Drazich, Erin; McCulloch, Ellen; Filippini, Nicola; Mackay, Clare E; Jenkinson, Mark; Tracey, Irene; Wilcock, Gordon K

    2013-03-01

    Patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI) may be unaware of their cognitive impairment. The neuroanatomical mechanisms underlying this symptom, termed anosognosia or impaired self-awareness, are still poorly understood. In the present study we aimed to explore the functional correlates of self-awareness in patients with MCI and AD. Fifty-one participants (17 healthy elderly, 17 patients with MCI, and 17 patients with AD), each accompanied by a study partner, took part in a functional magnetic resonance imaging (fMRI) study, in which they were presented with questions regarding themselves (Self condition) or their study partner (Other condition). The study partner was asked to complete a paper questionnaire answering the same questions so the responses of participant and study partner could be compared and "discrepancy" scores calculated for each of the 2 conditions (Self and Other). Behavioural results showed that AD patients had significantly higher "Self discrepancy scores" than controls and MCI patients, whereas there were no significant differences between groups for "Other discrepancy scores". Imaging results showed a significant group-by-condition interaction in brain activation in medial prefrontal and anterior temporal regions, with AD patients showing significantly decreased activation in these regions only for the Self condition. There were no significant differences between Self and Other conditions in either control or MCI groups, suggesting that, in these groups, Self- and Other-appraisal share similar neuroanatomical substrates. Decreased functional activation of medial prefrontal and anterior temporal cortices is associated with impaired self-awareness in AD patients. This dysfunction, which is specific for Self- but not for Other-appraisal, may be a contributing factor to anosognosia in AD. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. SCREENING FOR POSTSTROKE COGNITIVE IMPAIRMENT VIA MINI MENTAL STATE EXAMINATION AND MONTREAL COGNITIVE ASSESSMENT SCALE

    Directory of Open Access Journals (Sweden)

    Mirena Valkova

    2012-10-01

    Full Text Available Objective: The aim of our study is to examine cognitive performance after mild stroke via Mini Mental State Examination (MMSE and Montreal cognitive assessment scale (MoCA and to compare the results.Material and methods: We examined 54 patients with mild stroke (aged 52 to 72 (mean 63.17, SD 5.96; 34 males and 20 females and 54 controls, adjusted by age, sex and education level. All subjects were tested via MMSE (Bulgarian version and MoCa (Bulgarian version. Data was collected in the single step model at the 90th day after stroke incident for patients and at the day of obtaining informed consent for controls. Results: Patients have poorer performance on both MMSE and MoCa than controls. MoCa has comparatively good discriminative validity and sensitivity.Conclusions: Although MMSE is one of the classical screening tools for cognitive impairment widely used in Bulgaria, other screening tools should not be ignored. On the basis of our results, MoCa is also a good screening instrument, especially for poststroke cognitive impairment.

  4. The neuroimaging approach to the assessment of mild cognitive impairment

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    Lucignani, Giovanni [University of Milan and Unit of Molecular Imaging, Division of Radiation Therapy, European Institute of Oncology, Institute of Radiological Sciences, Milan (Italy)

    2006-06-15

    Imaging techniques, including emission tomography and magnetic resonance imaging, are progressively being exploited for the classification and prognostic evaluation (indispensable for possible treatments) of mild cognitive impairment (MCI). The main traits of MCI and unsolved issues in its assessment are discussed in two review articles by Feldman and Jacova from the Division of Neurology, Dept. of Medicine, Clinic for Alzheimer Disease and Related Disorders, University of British Columbia, in Vancouver, Canada [1] and Chong and Sahadevan from the Department of Geriatric Medicine, Tan Tock Seng Hospital, Jalan Tan Tock Seng, Singapore [2]. Because MCI has different presentations in terms of the type and degree of cognitive deficits observed, several clinical subtypes of MCI besides the amnestic form have now been recognised and characterised on the basis of deficits in different cognitive domains, either in isolation or in combination with amnesia. The different subtypes of MCI suggest that MCI has a heterogeneous nature, with several possible causes that lead to the same symptoms. This is a field in evolution, and a uniform diagnostic classification of MCI has not yet been accomplished. Lopez et al. from the Departments of Neurology and Psychiatry, University of Pittsburgh, School of Medicine,Pittsburgh, Pennsylvania, USA [3] point out that the classification of MCI subtypes is useful to improve prediction of the subsequent risk of dementia and the type of dementia, and that the manner in which MCI subjects are classified into subgroups has implications for the cognitive profile of the group and thus for our inferences about the aetiology and possible clinical course of the disorder.

  5. The PACE Study: A randomised clinical trial of cognitive activity (CA for older adults with mild cognitive impairment (MCI

    Directory of Open Access Journals (Sweden)

    Flicker Leon

    2009-12-01

    Full Text Available Abstract Background Research evidence from observational studies suggests that cognitive activity reduces the risk of cognitive impairment in later life as well as the rate of cognitive decline of people with dementia. The Promoting Healthy Ageing with Cognitive Exercise (PACE study has been designed to determine whether a cognitive activity intervention decreases the rate of cognitive decline amongst older adults with mild cognitive impairment (MCI. Methods/Design The study will recruit 160 community-dwelling men and women aged 65 years of age or over with mild cognitive impairment (MCI. Participants will be randomly allocated to two treatment groups: non-specific education and cognitive activity. The intervention will consist of ten 90-minute sessions delivered twice per week over a period of five weeks. The primary outcome measure of the study is the change from baseline in the total score on the Cambridge Cognitive Score (CAMCOG. Secondary outcomes of interest include changes in memory, attention, executive functions, mood and quality of life. Primary endpoints will be collected 12, 52 and 104 weeks after the baseline assessment. Discussion The proposed project will produce the best available evidence on the merits of increased cognitive activity as a strategy to prevent cognitive decline among older adults with MCI. We anticipate that the results of this study will have implications for the development of evidence-based preventive strategies to reduce the rate of cognitive decline amongst older people at risk of dementia. Trial registration ACTRN12608000556347

  6. The PACE study: a randomised clinical trial of cognitive activity (CA) for older adults with mild cognitive impairment (MCI).

    Science.gov (United States)

    Vidovich, Mandy R; Lautenschlager, Nicola T; Flicker, Leon; Clare, Linda; Almeida, Osvaldo P

    2009-12-14

    Research evidence from observational studies suggests that cognitive activity reduces the risk of cognitive impairment in later life as well as the rate of cognitive decline of people with dementia. The Promoting Healthy Ageing with Cognitive Exercise (PACE) study has been designed to determine whether a cognitive activity intervention decreases the rate of cognitive decline amongst older adults with mild cognitive impairment (MCI). The study will recruit 160 community-dwelling men and women aged 65 years of age or over with mild cognitive impairment (MCI). Participants will be randomly allocated to two treatment groups: non-specific education and cognitive activity. The intervention will consist of ten 90-minute sessions delivered twice per week over a period of five weeks. The primary outcome measure of the study is the change from baseline in the total score on the Cambridge Cognitive Score (CAMCOG). Secondary outcomes of interest include changes in memory, attention, executive functions, mood and quality of life. Primary endpoints will be collected 12, 52 and 104 weeks after the baseline assessment. The proposed project will produce the best available evidence on the merits of increased cognitive activity as a strategy to prevent cognitive decline among older adults with MCI. We anticipate that the results of this study will have implications for the development of evidence-based preventive strategies to reduce the rate of cognitive decline amongst older people at risk of dementia. ACTRN12608000556347.

  7. Cognitive impairment among the elderly in a rural community in Malaysia.

    Science.gov (United States)

    Sherina, M S; Rampal, L; Mustaqim, A

    2004-06-01

    Cognitive impairment is common in late life and may be due to the normal process of ageing or associated with physical or mental disorders. The aim of this study was to determine the prevalence of cognitive impairment among the elderly in a rural community setting. A cross sectional study design using stratified proportionate cluster sampling method was used in this study. A questionnaire similar to the Elderly Cognitive Assessment Questionnaire (ECAQ) was used as a screening instrument for cognitive impairment. The prevalence of cognitive impairment was 22.4% (50/223) among the elderly respondents. Cognitive impairment among the elderly was significantly associated with age, gender, ethnicity, marital status and level of education.

  8. Different Characteristics of Cognitive Impairment in Elderly Schizophrenia and Alzheimer’s Disease in the Mild Cognitive Impairment Stage

    Directory of Open Access Journals (Sweden)

    Hiroaki Kazui

    2011-01-01

    Full Text Available We compared indices of the revised version of the Wechsler Memory Scale (WMS-R and scaled scores of the five subtests of the revised version of the Wechsler Adult Intelligence Scale (WAIS-R in 30 elderly schizophrenia (ES patients and 25 Alzheimer’s disease (AD patients in the amnestic mild cognitive impairment (aMCI stage (AD-aMCI. In the WMS-R, attention/concentration was rated lower and delayed recall was rated higher in ES than in AD-aMCI, although general memory was comparable in the two groups. In WAIS-R, digit symbol substitution, similarity, picture completion, and block design scores were significantly lower in ES than in AD-aMCI, but the information scores were comparable between the two groups. Delayed recall and forgetfulness were less impaired, and attention, working memory and executive function were more impaired in ES than in AD-aMCI. These results should help clinicians to distinguish ES combined with AD-aMCI from ES alone.

  9. Effect of the cognitive rehabilitation in patients with mild cognitive impairment and identified brain atrophy

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    Petr Nilius

    2015-12-01

    Full Text Available Aim: The main objective of this study was to analyse the development of cognitive functions and effect of cognitive rehabilitation on patients diagnosed with mild cognitive impairment (MCI, as a result of brain atrophy. Design: A quantitative non-randomized intervention study on a control sample of patients. Methods: The effect was observed in a group of patients ranging 59-91 years of age (N = 36. Only patients fulfilling the diagnostic criteria of mild cognitive disorder diagnosed by tomography (CT that had undergone 22 sessions, were involved in the clinical sample (n = 21. The control sample (n = 15 consisted of patients without any neurological diagnosis and who did not undergo cognitive sessions. Results: The effect of cognitive rehabilitation was measured by Addenbrooke's cognitive test, revised in 2010 (ACE-R; affective changes were measured by Beck´s scale of depression BDI-2 and by a scale used to detect anxiety and depression: the Hospital Anxiety and Depression Scale (HADS. Subjective change and improvement were observed using the Clinical Global Impression (CGI psychiatric scale. Changes in the functional state of patients were measured by means of the activities of daily living scale (ADL, including the instrumental version (IADL. The effect was examined in the form of entry and output tests, which were verified by statistical analysis, a significant level being p > 0.05. Conclusions: Significant differences in verbal tests and ACE-R were observed in the clinical sample of patients. Some significant changes were observed in the field of affective symptoms, according to the HADS and BDI-2. The clinical sample showed a significant improvement in subjective clinical state (CGI. The ADL and IADL questionnaires seem to have been inadequate for purpose due to their low sensitivity. The effect of cognitive rehabilitation in patients diagnosed with mild cognitive disorder can be seen and verified in comparison with the control sample

  10. The influence of impaired processing speed on cognition in first-episode antipsychotic-naïve schizophrenic patients

    DEFF Research Database (Denmark)

    Andersen, Rune; Fagerlund, B; Rasmussen, Hans

    2013-01-01

    BACKGROUND: Impaired cognition is a prominent feature of schizophrenia. To what extent the heterogeneous cognitive impairments can be accounted for by considering only a single underlying impairment or a small number of core impairments remains elusive. This study examined whether cognitive impai...

  11. Correlations between Cognitive Impairments and Employment Status in Patients with Diffuse Axonal Injury

    Science.gov (United States)

    HIROTA, Shin; INAJI, Motoki; NARIAI, Tadashi; HARA, Mutsuya; TAMAKI, Masashi; MAEHARA, Taketoshi; TOMITA, Hiroki; TONE, Osamu

    2017-01-01

    Patients with diffuse axonal injury (DAI) may initially present with prominent physical impairments, but their cognitive dysfunctions are more persistent and are attributable to later unemployment. In this study, we analyzed how the findings of early and delayed neuropsychological assessments correlated with employment outcome of patients with DAI. A total of 56 patients with DAI without motor or visual dysfunction were included in this study. The neuropsychological battery consisted of the Wechsler Adult Intelligent Scale - Revised (WAIS-R), Wechsler Memory Scale - Revised (WMS-R), Trail Making Test (TMT), Wisconsin Card Sorting Test (WCST), and Word Fluency Test (WFT). This battery of tests was administered twice in early stage after injury and in later stage. The results of all of the neuropsychological tests improved significantly (P <0.001) between the early and later assessments. All scores other than TMT part A and B improved to the normal range (Z-score ≥ 2). The patient characteristics (age, gender, initial Glasgow Coma Scale, and duration of posttraumatic amnesia) had no relationship to the outcome. The results of TMT part B, however, were significantly correlated with employment outcome in both the early and later assessments (P = 0.01, 0.04). Given that TMT evaluates visual attention, we surmise that a lack of attention may be the core symptom of the cognitive deficit and cause the re-employment failure in patients with DAI. TMT part B in both early and later assessments has the potential to accurately predict chronic functional outcome. PMID:28003570

  12. Modeling of cognitive impairment by disease duration in multiple sclerosis: a cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Anat Achiron

    Full Text Available BACKGROUND/AIMS: Large-scale population studies measuring rates and dynamics of cognitive decline in multiple sclerosis (MS are lacking. In the current cross-sectional study we evaluated the patterns of cognitive impairment in MS patients with disease duration of up to 30 years. METHODS: 1,500 patients with MS were assessed by a computerized cognitive battery measuring verbal and non-verbal memory, executive function, visual spatial perception, verbal function, attention, information processing speed and motor skills. Cognitive impairment was defined as below one standard deviation (SD and severe cognitive impairment as below 2SD for age and education matched healthy population norms. RESULTS: Cognitive performance in our cohort was poorer than healthy population norms. The most frequently impaired domains were information processing speed and executive function. MS patients with secondary-progressive disease course performed poorly compared with clinically isolated syndrome, relapsing-remitting and primary progressive MS patients. By the fifth year from disease onset, 20.9% of patients performed below the 1SD cutoff for impairment, p=0.005, and 6.0% performed below the 2SD cutoff for severe cognitive impairment, p=0.002. By 10 years from onset 29.3% and 9.0% of patients performed below the 1SD and 2SD cutoffs, respectively, p=0.0001. Regression modeling suggested that cognitive impairment may precede MS onset by 1.2 years. CONCLUSIONS: The rates of cognitive impairment in this large sample of MS patients were lower than previously reported and severe cognitive impairment was evident only in a relatively small group of patients. Cognitive impairment differed significantly from expected normal distribution only at five years from onset, suggesting the existence of a therapeutic window during which patients may benefit from interventions to maintain cognitive health.

  13. Delirium is associated with early postoperative cognitive dysfunction

    DEFF Research Database (Denmark)

    Rudolph, J.L.; Marcantonio, E.R.; Culley, D.J.

    2008-01-01

    The purpose of this analysis was to determine if postoperative delirium was associated with early postoperative cognitive dysfunction (at 7 days) and long-term postoperative cognitive dysfunction (at 3 months). The International Study of Postoperative Cognitive Dysfunction recruited 1218 subjects......). Postoperative cognitive dysfunction was defined as a composite Z-score > 2 across tests or at least two individual test Z-scores > 2. Subjects with delirium were significantly less likely to participate in postoperative testing. Delirium was associated with an increased incidence of early postoperative...... cognitive dysfunction (adjusted risk ratio 1.6, 95% CI 1.1-2.1), but not long-term postoperative cognitive dysfunction (adjusted risk ratio 1.3, 95% CI 0.6-2.4). Delirium was associated with early postoperative cognitive dysfunction, but the relationship of delirium to long-term postoperative cognitive...

  14. ATTITUDE PARENTS TO EARLY INTERVENTION OF VISUALLY IMPAIRED CHILDREN

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    Mira CVETKOVA

    1997-06-01

    Full Text Available For centuries Visually Impaired children have been educated within the high walls of special schools (Loots ET al., 1992. It is only during the last decades that more and more Visually Impaired children were brought up in their own environment:· the integrated education is not a trend anymore, but an educational policy;· The Early Intervention has transferred into approach to young Visually Impaired children.Early Intervention is crucial because the Visually Impairment affects the early development of a child in several ways:· motor functioning;· concept development;· social skills;· range of experience;· ability to move independently;· play etc.All these obstacles in early development create the necessity of Early Intervention programs which should start immediately after child’s is diagnosed.As it was said above the best approach to involve parents in early Intervention programs is to develop strategies, which fit individual family needs. This means to take into account many factors important for each family. Some of them are:· future believes and expectations;· educational background and culture;· religion;· financial situation.

  15. Mild cognitive impairment: making headway by stepping backwards.

    Science.gov (United States)

    Förstl, Hans; Lautenschlager, Nicola; Bickel, Horst

    2003-01-01

    Mild cognitive impairment (MCI) is a prevalent medical problem and the concept and term have become a catch-phrase for research and clinical practice. However, little is known about the most effective tools for a clinical diagnosis of MCI, its potential significance for individual patients and the best possible intervention--at least as long as MCI is considered as a diagnostic entity. We propose a simplified diagnostic and interventional algorithm for the detection and management of patients with MCI. We argue that MCI is so important, because it represents the closest call for an identification of treatable diseases or risk factors before the final manifestation of irreversible brain changes. Stepping backward by focussing on underlying disease processes and attempting causal interventions must be preferred to a mere symptomatic treatment of MCI as a preclinical form of Alzheimer's disease.

  16. Review of emotion recognition in mild cognitive impairment.

    Science.gov (United States)

    McCade, Donna; Savage, Greg; Naismith, Sharon L

    2011-01-01

    While dysfunction in emotion recognition is sometimes apparent with aging, and is frequently evident in Alzheimer's disease, it is unclear whether individuals who have a high risk of developing dementia exhibit demonstrable changes. A review of the literature pertaining to mild cognitive impairment was undertaken to discern the extent to which emotion recognition deficits are evident in this prodromal period. A search of Medline, Psycinfo and Psyextra databases using specific key words identified only six relevant studies. These studies suggest that the ability to accurately identify facial expressions of affect is compromised. Research in this area is in its infancy. Suggestions are made for furthering our knowledge about this important ability which affects interpersonal relationships, daily functioning, mental well-being and quality of life. Copyright © 2012 S. Karger AG, Basel.

  17. DNA-repair in mild cognitive impairment and Alzheimer's disease.

    Science.gov (United States)

    Bucholtz, Nina; Demuth, Ilja

    2013-10-01

    While the pathogenesis of the sporadic form of Alzheimer disease (late onset Alzheimer disease, LOAD) is not fully understood, it seems to be clear that a combination of genetic and environmental factors are involved and influence the course of the disease. Among these factors, elevated levels of oxidative stress have been recognized and individual differences in the capacity to deal with DNA damage caused by its effects have been the subject of numerous studies. This review summarizes the research on DNA repair proteins and genes in the context of LOAD pathogenesis and its possible prodromal stage, mild cognitive impairment (MCI). The current status of the research in this field is discussed with respect to methodological issues which might have compromised the outcome of some studies and future directions of investigation on this subject are depicted.

  18. Functional Literacy for Students with Visual Impairments and Significant Cognitive Disabilities: The Perspective of Teachers of Students with Visual Impairments

    Science.gov (United States)

    Zebehazy, Kim T.

    2014-01-01

    This study reports opinions and practices of teachers of students with visual impairments (TSVIs) in 34 states regarding functional literacy for students with visual impairments (VIs) and significant cognitive disabilities (SCDs). The survey asked TSVIs to select a definition of functional literacy, indicate agreement with a series of literacy…

  19. Similar Verbal Fluency Patterns in Amnestic Mild Cognitive Impairment and Alzheimer's Disease

    Science.gov (United States)

    Teng, Edmond; Leone-Friedman, Judith; Lee, Grace J.; Woo, Stephanie; Apostolova, Liana G.; Harrell, Shelly; Ringman, John M.; Lu, Po H.

    2013-01-01

    Disproportionately greater deficits in semantic relative to phonemic verbal fluency are seen in Alzheimer's disease (AD) and have been attributed to neurodegenerative changes in the temporal lobe. Amnestic (AMN) mild cognitive impairment (MCI), which often represents incipient AD, is also characterized by early temporal lobe neuropathology, but previous comparisons of verbal fluency between AD and AMN MCI have yielded mixed results. We examined semantic and phonemic verbal fluency performance in 399 individuals (78 AD, 138 AMN MCI, 72 non-amnestic MCI, and 111 cognitively normal controls). Similar verbal fluency patterns were seen in AMN MCI and AD; both groups exhibited disproportionately poorer performance on semantic verbal fluency relative to normal controls. However, relative verbal fluency indices performed more poorly than individual semantic or phonemic verbal fluency indices for discriminating AMN MCI or AD participants from normal controls, suggesting that they are unlikely to provide additional utility for predicting progression from MCI to AD. PMID:23752677

  20. A clinical classification acknowledging neuropsychiatric and cognitive impairment in Huntingtons disease

    DEFF Research Database (Denmark)

    Vinther-Jensen, Tua; Larsen, Ida U; Hjermind, Lena E;

    2014-01-01

    BackgroundInvoluntary movements, neuropsychiatric symptoms, and cognitive impairment are all part of the symptom triad in Huntington¿s disease (HD). Despite the fact that neuropsychiatric symptoms and cognitive decline may be early manifestations of HD, the clinical diagnosis is conventionally...... based on the presence of involuntary movements and a positive genetic test for the HD CAG repeat expansion. After investigating the frequencies of the triad manifestations in a large outpatient clinical cohort of HD gene-expansion carriers, we propose a new clinical classification.MethodsIn this cross......-sectional study, 107 gene-expansion carriers from a Danish outpatient clinic were recruited. All participants underwent neurological examination, psychiatric evaluation and neuropsychological testing. Participants were categorised according to motor symptoms, neuropsychiatric symptoms, the use of psychotropic...

  1. Cognitive and Emotional Impairments in Obstructive Sleep Apnea Syndrome

    Institute of Scientific and Technical Information of China (English)

    Shun-wei Li; Bin Peng; Hong Kong

    2000-01-01

    Objective: To evaluate the P3 latency in OSAS patients ,snorers and nonsnore subjects and observe the emotional disturbance in OSAS patients. Backround: Neurobehavioral abnormalities are the most common nonrespiratory manifestations in OSAS. Impairment of cognitive functions, as well as emotional disturbances and abnormal P3 latency in OSAS have been documnerted. However, seldom studies were done on comparing the changes the P3 and memory function between OSAS patients and snorers, and the psychological scales of OSAS patients before and after CPAP treatrment Methods: For P3 and memory study, three groups: OSAS group, snorer group, and nosnorer group,21 sub jects each, were administered PSG, ERP and Clinical Memory Test All data were analyzed by General Linear Model; For psychological scales, 16 OSAS patients were tested by SAS,SDS,HRSD and HRSA. Two-tailed students t-test was used for data analysis. A value of p<0.05 was considered statistically significant. Results: The P3 latency in OSAS patients were significant longer than that in snorers and nosnorers. There′s no signficant difference between snorers and norsnorers. No differerces in amplitude were seen among three groups. Scores of MQ and sulbtest FRP was higher than that ofOSAS group and nonsnorers group. Differences in MSO2 and SE among three groups were noticed. Twelve patients′ scores of SDS, SAS, HAMD and HAMA were beyond the normal range. The scores decreased significantly after three months treatment of CPAP. Discussion: Our study revealed the prolonged P3 latency with auditory evoked potential which indicated the impairment of cognitive function in OSAS patients. Deficits of memory were also documented in OSAS patients. As to our knowledge, snoreres were not exclude from controls subjects in many studies when compared with OSAS patient. In our study, data showed significant difference between srorers and nonsnore subjects in merb SO2 value although no difference was seen in the P3 latency. The

  2. Cognitive and Emotional Impairments in Obstructive Sleep Apnea Syndrome

    Institute of Scientific and Technical Information of China (English)

    Shun-wei Li; Bin Peng; Hong Kong

    2000-01-01

    Objective: To evaluate the P3 latency in OSAS patients ,snorers and nonsnore subjects and observe the emotional disturbance in OSAS patients. Backround: Neurobehavioral abnormalities are the most common nonrespiratory manifestations in OSAS. Impairment of cognitive functions, as well as emotional disturbances and abnormal P3 latency in OSAS have been documnerted. However, seldom studies were done on comparing the changes the P3 and memory function between OSAS patients and snorers, and the psychological scales of OSAS patients before and after CPAP treatrment Methods: For P3 and memory study, three groups: OSAS group, snorer group, and nosnorer group,21 sub jects each, were administered PSG, ERP and Clinical Memory Test All data were analyzed by General Linear Model; For psychological scales, 16 OSAS patients were tested by SAS,SDS,HRSD and HRSA. Two-tailed students t-test was used for data analysis. A value of p<0.05 was considered statistically significant. Results: The P3 latency in OSAS patients were significant longer than that in snorers and nosnorers. There′s no signficant difference between snorers and norsnorers. No differerces in amplitude were seen among three groups. Scores of MQ and sulbtest FRP was higher than that ofOSAS group and nonsnorers group. Differences in MSO2 and SE among three groups were noticed. Twelve patients′ scores of SDS, SAS, HAMD and HAMA were beyond the normal range. The scores decreased significantly after three months treatment of CPAP. Discussion: Our study revealed the prolonged P3 latency with auditory evoked potential which indicated the impairment of cognitive function in OSAS patients. Deficits of memory were also documented in OSAS patients. As to our knowledge, snoreres were not exclude from controls subjects in many studies when compared with OSAS patient. In our study, data showed significant difference between srorers and nonsnore subjects in merb SO2 value although no difference was seen in the P3 latency. The

  3. Is statin-associated cognitive impairment clinically relevant? A narrative review and clinical recommendations.

    Science.gov (United States)

    Rojas-Fernandez, Carlos H; Cameron, Jean-Christy F

    2012-04-01

    To explore the impact of statin use on cognition. A literature search was performed using MEDLINE (1950-November 2011), EMBASE (1980-November 2011), and the Cochrane Library (1960-November 2011) using the search terms "cognition/drug effects," "delirium, dementia, amnestic, cognitive disorders/chemically induced," "memory disorders/chemically induced," "hydroxymethylglutaryl-CoA reductase inhibitors/adverse effects," and "hydroxymethylglutaryl-CoA reductase inhibitors." A bibliographic search on included references was also conducted. Studies were included for analysis if they were conducted in humans and examined the impact of statin use on cognition as either a primary or secondary endpoint; case reports and case series were also included for analysis. Reports of statin-associated cognitive impairment were found primarily in observational studies (eg, case reports/series). One randomized controlled trial demonstrated that simvastatin impaired some measures of cognition compared to placebo. Conversely, in the majority of randomiz