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Sample records for numerical cognition impairments

  1. Mild Cognitive Impairment (MCI)

    Science.gov (United States)

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

  2. Mild Cognitive Impairment (MCI)

    Science.gov (United States)

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

  3. Hypertension and cognitive impairment

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    Su-hang SHANG

    2015-08-01

    Full Text Available As a leading risk factor for stroke, hypertension is also an important risk factor for cognitive impairment. Midlife hypertension doubles the risk of dementia later in life and accelerates the progression of dementia, but the correlation between late-life blood pressure and cognitive impairment is still unclear. Beside blood pressure, the effect of pulse pressure, blood pressure variability and circadian rhythm of blood pressure on cognition is currently attracting more and more attention. Hypertension induces alterations in cerebrovascular structure and functions, which lead to brain lesions including cerebral atrophy, stroke, lacunar infarcts, diffuse white matter damage, microinfarct and microhemorrhage, resuling in cognitive impairment. Hypertension also impairs the metabolism and transfer of amyloid-β protein (Aβ, thus accelerates cognitive impairment. Individualized therapy, focusing on characteristics of hypertensive patients, may be a good choice for prevention and treatment of cognitive impairment. DOI: 10.3969/j.issn.1672-6731.2015.08.004

  4. Overlapping Numerical Cognition Impairments in Children with Chromosome 22q11.2 Deletion or Turner Syndromes

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    Simon, T. J.; Takarae, Y.; DeBoer, T.; McDonald-McGinn, D. M.; Zackai, E. H.; Ross, J. L.

    2008-01-01

    Children with one of two genetic disorders (chromosome 22q11.2 deletion syndrome and Turner syndrome) as well typically developing controls, participated in three cognitive processing experiments. Two experiments were designed to test cognitive processes involved in basic aspects numerical cognition. The third was a test of simple manual motor…

  5. Vascular cognitive impairment

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    N.V. Vakhnina

    2014-01-01

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

  6. Mild cognitive impairment

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    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.

  7. Endocrine Risk Factors for Cognitive Impairment

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    Jae Hoon Moon

    2016-06-01

    Full Text Available Cognitive impairment, including Alzheimer's disease and other kinds of dementia, is a major health problem in older adults worldwide. Although numerous investigators have attempted to develop effective treatment modalities or drugs, there is no reasonably efficacious strategy for preventing or recovering from cognitive impairment. Therefore, modifiable risk factors for cognitive impairment have received attention, and the growing literature of metabolic risk factors for cognitive impairment has expanded from epidemiology to molecular pathogenesis and therapeutic management. This review focuses on the epidemiological evidence for the association between cognitive impairment and several endocrine risk factors, including insulin resistance, dyslipidemia, thyroid dysfunction, vitamin D deficiency, and subclinical atherosclerosis. Researches suggesting possible mechanisms for this association are reviewed. The research investigating modifiable endocrine risk factors for cognitive impairment provides clues for understanding the pathogenesis of cognitive impairment and developing novel treatment modalities. However, so far, interventional studies investigating the beneficial effect of the "modification" of these "modifiable risk factors" on cognitive impairment have reported variable results. Therefore, well-designed, randomized prospective interventional studies are needed.

  8. Cognitive impairment and pragmatics.

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    Gutiérrez-Rexach, Javier; Schatz, Sara

    2016-01-01

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

  9. Nutrition and cognitive impairment

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    Hernando-Requejo, Virgilio

    2016-07-12

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

  10. Arterial stiffness and cognitive impairment.

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

    2017-09-15

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

  11. Cognitive and Learning Impairments

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    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.

  12. Cognitive impairment in Chinese neuromyelitis optica

    NARCIS (Netherlands)

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

    2015-01-01

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

  13. Epigenetic treatments for cognitive impairments.

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    Day, Jeremy J; Sweatt, J David

    2012-01-01

    Epigenetic mechanisms integrate signals from diverse intracellular transduction cascades and in turn regulate genetic readout. Accumulating evidence has revealed that these mechanisms are critical components of ongoing physiology and function in the adult nervous system, and are essential for many cognitive processes, including learning and memory. Moreover, a number of psychiatric disorders and syndromes that involve cognitive impairments are associated with altered epigenetic function. In this review, we will examine how epigenetic mechanisms contribute to cognition, consider how changes in these mechanisms may lead to cognitive impairments in a range of disorders and discuss the potential utility of therapeutic treatments that target epigenetic machinery. Finally, we will comment on a number of caveats associated with interpreting epigenetic changes and using epigenetic treatments, and suggest future directions for research in this area that will expand our understanding of the epigenetic changes underlying cognitive disorders.

  14. Parkinson's Disease and Cognitive Impairment.

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    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.

  15. Cognitive impairment in Parkinson's disease

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    Jing YUAN

    2017-07-01

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

  16. Impaired Cardiac Function and Cognitive Brain Aging.

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    van der Velpen, Isabelle F; Yancy, Clyde W; Sorond, Farzaneh A; Sabayan, Behnam

    2017-12-01

    It is well established that patients with heart failure are at a greater risk for dementia. Recent evidence suggests that the heart-brain link goes beyond advanced heart failure, and even suboptimal cardiac function is associated with brain structural and functional changes leading to cognitive impairment. In this review, we address several pathophysiological mechanisms underlying this association, including hemodynamic stress and cerebral hypoperfusion, neuroinflammation, cardiac arrhythmias, and hypercoagulation. The close link between cardiac function and brain health has numerous clinical and public health implications. Cardiac dysfunction and cognitive impairment are both common in older adults. However, in our current clinical practice, these medical conditions are generally evaluated and treated in isolation. Emerging evidence on the significance of the heart-brain link calls for comprehensive cardiovascular risk assessment in patients with cognitive impairment and a neurocognitive workup in patients with impaired cardiac function. A multidisciplinary approach by cardiologists, neurologists, and geriatricians would benefit the diagnostic process and disease management and ultimately improve the quality of life for patients with cardiac and cognitive dysfunction. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  17. Vascular cognitive impairment in dementia.

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    Etherton-Beer, Christopher D

    2014-10-01

    Vascular risk factors and cerebrovascular disease are common causes of dementia. Shared risk factors for vascular dementia and Alzheimer's disease, as well as frequent coexistence of these pathologies in cognitively impaired older people, suggests convergence of the aetiology, prevention and management of the commonest dementias affecting older people. In light of this understanding, the cognitive impairment associated with cerebrovascular disease is an increasingly important and recognised area of the medicine of older people. Although the incidence of cerebrovascular events is declining in many populations, the overall burden associated with brain vascular disease will continue to increase associated with population ageing. A spectrum of cognitive disorders related to cerebrovascular disease is now recognised. Cerebrovascular disease in older people is associated with specific clinical and imaging findings. Although prevention remains the cornerstone of management, the diagnosis of brain vascular disease is important because of the potential to improve clinical outcomes through clear diagnosis, enhanced control of risk factors, lifestyle interventions and secondary prevention. Specific pharmacological intervention may also be indicated for some patients with cognitive impairment and cerebrovascular disease. However the evidence base to guide intervention remains relatively sparse. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Cognitive Impairment in Infratentorial Strokes

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    Melek Kandemir

    2009-12-01

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

  19. Cognitive Impairment in Heart Failure

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    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.

  20. 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.

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

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    Bora, Emre; Yener, Görsev G

    2017-07-01

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

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

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

    2016-01-01

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

  3. 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 dementia or Alzheimer's disease. Hearing 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 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.

  4. 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.

  5. 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.

  6. Arthritis and cognitive impairment in older adults.

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    Baker, Nancy A; Barbour, Kamil E; Helmick, Charles G; Zack, Matthew; Al Snih, Soham

    2017-06-01

    Adults aged 65 or older with arthritis may be at increased risk for cognitive impairment [cognitive impairment but not dementia (CIND) or dementia]. Studies have found associations between arthritis and cognition impairments; however, none have examined whether persons with arthritis develop cognitive impairments at higher rates than those without arthritis. Using data from the Health and Retirement Study, we estimated the prevalence of cognitive impairments in older adults with and without arthritis, and examined associations between arthritis status and cognitive impairments. We calculated incidence density ratios (IDRs) using generalized estimating equations to estimate associations between arthritis and cognitive impairments adjusting for age, sex, race/ethnicity, marital status, education, income, depression, obesity, smoking, the number of chronic conditions, physical activity, and birth cohort. The prevalence of CIND and dementia did not significantly differ between those with and without arthritis (CIND: 20.8%, 95% CI 19.7-21.9 vs. 18.3%, 95% CI 16.8-19.8; dementia: 5.2% 95% CI 4.6-5.8 vs. 5.1% 95% CI 4.3-5.9). After covariate control, older adults with arthritis did not differ significantly from those without arthritis for either cognitive outcome (CIND IDR: 1.6, 95% CI = 0.9-2.9; dementia IDR: 1.1, 95% CI = 0.4-3.3) and developed cognitive impairments at a similar rate to those without arthritis. Older adults with arthritis were not significantly more at risk to develop cognitive impairments and developed cognitive impairments at a similar rate as older adults without arthritis over 6 years.

  7. Cognitive impairment and mortality among nonagenarians

    DEFF Research Database (Denmark)

    Andersen, Kjeld; Nybo, Hanne; Gaist, David

    2002-01-01

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

  8. Social Cognition in Children with Visual Impairments.

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    Pring, Linda; Dewart, Hazel; Brockbank, Margaret

    1998-01-01

    Comparison of 16 children (ages 9 to 12) with visual impairment to 16 sighted children found visually impaired children had a poorer understanding than did sighted children of characters in stories, as shown by fewer correct justifications based on mental states. Some subgroup patterns concerning congenital impairments and cognitive style were…

  9. Intracranial stenosis in cognitive impairment and dementia.

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

    2017-06-01

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

  10. Preventing cognitive impairment in children with epilepsy

    NARCIS (Netherlands)

    Braun, Kees P J

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

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

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    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.

  12. 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

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

    LENUS (Irish Health Repository)

    O'Caoimh, Rónán

    2012-09-01

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

  14. Preexisting cognitive impairment in intracerebral hemorrhage.

    Science.gov (United States)

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

    2017-06-01

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

  15. Pain in cognitively impaired older persons.

    Science.gov (United States)

    Parmelee, P A

    1996-08-01

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

  16. 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.

  17. 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

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

    Science.gov (United States)

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

    2017-11-22

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

  19. RBD: a red flag for cognitive impairment in Parkinson's disease?

    Science.gov (United States)

    Lin, Yi-Qi; Chen, Sheng-Di

    2018-04-01

    Increasing evidence indicates a strong association between rapid eye movement sleep behavior disorder (RBD) and Parkinson's disease - cognitive impairment (PD-CI). Numerous longitudinal and cross-sectional studies have shown that RBD may be an important risk factor and predictor of Parkinson's disease - mild cognitive impairment (PD-MCI) and Parkinson's disease dementia (PDD); which may be explained by the association of mechanisms between RBD and PD-CI, including neurotransmitter alterations, genetic mutation, neuroinflammation, alpha-synuclein inclusion, abnormal cerebral metabolism and cortical activity slowing. Understanding the role of RBD in cognition of PD, we may predict and prevent the presence of PD-CI. The purpose of our comprehensive narrative review was to investigate the role of RBD in cognition of PD patients and its possible mechanism with lights from clinical epidemiological evidence, neuroimaging and electrophysiology studies. Copyright © 2018. Published by Elsevier B.V.

  20. Correlates of cognitive impairment in older Vietnamese.

    Science.gov (United States)

    Leggett, Amanda; Zarit, Steven H; Hoang, Chuong N; Nguyen, Ha T

    2013-01-01

    This study examined correlates of cognitive functioning and possible cognitive impairment among older adults living in Da Nang, Vietnam and surrounding rural areas. The analytic sample consisted of 489 adults, 55 and older stratified by gender, age, and residence in a rural or urban area. The sample was 46% rural, 44% women, with a mean age of 69.04. Interviews were conducted in individuals' homes by trained interviewers. The dependent variable was a Vietnamese version of the mini mental status examination (MMSE). A multiple linear regression was run with the MMSE continuous scores reflecting cognitive functioning, while a binary logistic regression was conducted with an education-adjusted cut-off score reflecting possible cognitive impairment. Age, gender, education, material hardship, depressive symptoms Center for Epidemiologic Studies - Depression Scale, war injury, head trauma, diabetes, cardiovascular and cerebrovascular disease conditions served as correlates, controlling for marital status and rural/urban residence. About 33% of the sample scored below the standard cutoff of 23 on the MMSE. However, only 12.9% of the sample would be considered impaired using the education-adjusted cut-off score. Cognitive functioning and possible cognitive impairment as indicated by MMSE scores were significantly associated with being older, completing fewer years of education, and material hardship. Gender, depressive symptoms, and cerebrovascular disease were associated with cognitive functioning, but not cognitive impairment. These results show that social characteristics, physical illness, and mental health are associated with cognitive functioning. The study also raises questions about the need for standardization of screening measures on Vietnamese populations.

  1. 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.

  2. Polypharmacy Cutoff for Gait and Cognitive Impairments

    Directory of Open Access Journals (Sweden)

    Antoine Langeard

    2016-08-01

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

  3. Stroke injury, cognitive impairment and vascular dementia☆

    Science.gov (United States)

    Kalaria, Raj N.; Akinyemi, Rufus; Ihara, Masafumi

    2016-01-01

    The global burden of ischaemic strokes is almost 4-fold greater than haemorrhagic strokes. Current evidence suggests that 25–30% of ischaemic stroke survivors develop immediate or delayed vascular cognitive impairment (VCI) or vascular dementia (VaD). Dementia after stroke injury may encompass all types of cognitive disorders. States of cognitive dysfunction before the index stroke are described under the umbrella of pre-stroke dementia, which may entail vascular changes as well as insidious neurodegenerative processes. Risk factors for cognitive impairment and dementia after stroke are multifactorial including older age, family history, genetic variants, low educational status, vascular comorbidities, prior transient ischaemic attack or recurrent stroke and depressive illness. Neuroimaging determinants of dementia after stroke comprise silent brain infarcts, white matter changes, lacunar infarcts and medial temporal lobe atrophy. Until recently, the neuropathology of dementia after stroke was poorly defined. Most of post-stroke dementia is consistent with VaD involving multiple substrates. Microinfarction, microvascular changes related to blood–brain barrier damage, focal neuronal atrophy and low burden of co-existing neurodegenerative pathology appear key substrates of dementia after stroke injury. The elucidation of mechanisms of dementia after stroke injury will enable establishment of effective strategy for symptomatic relief and prevention. Controlling vascular disease risk factors is essential to reduce the burden of cognitive dysfunction after stroke. 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. PMID:26806700

  4. screening for cognitive impairment in Nigerians*

    African Journals Online (AJOL)

    Email: rglew@salud.unm.edu. Summary. Background: Since it is projected that by 2020 seventy percent of the elderly will reside in developing countries, a reliable screening method for dementia and cognitive impairment in general in populations with diverse lan- guages, culture, education and literacy will be needed.

  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. The assessment of cognition in visually impaired older adults.

    Science.gov (United States)

    Killen, Alison; Firbank, Michael J; Collerton, Daniel; Clarke, Michael; Jefferis, Joanna Mary; Taylor, John-Paul; McKeith, Ian G; Mosimann, Urs Peter

    2013-01-01

    visual and cognitive impairments are common in later life. Yet there are very few cognitive screening tests for the visually impaired. to screen for cognitive impairment in the visually impaired. case-control study including 150 elderly participants with visual impairment (n = 74) and a control group without visual impairment (n = 76) using vision-independent cognitive tests and cognitive screening tests (MMSE and clock drawing tests (CDT)) which are in part vision dependent. the scoring of the two groups did not differ in the vision-independent cognitive tests. Visually impaired patients performed poorer than controls in the vision-dependent items of the MMSE (T = 7.3; df: 148; P visual impairment (P visually impaired patients benefit from cognitive tests, which do not rely on vision. The more visually impaired the greater the benefit.

  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. Patterns of Semantic Memory Impairment in Mild Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Sven Joubert

    2008-01-01

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

  9. Preeclampsia and cognitive impairment later in life.

    Science.gov (United States)

    Fields, Julie A; Garovic, Vesna D; Mielke, Michelle M; Kantarci, Kejal; Jayachandran, Muthuvel; White, Wendy M; Butts, Alissa M; Graff-Radford, Jonathan; Lahr, Brian D; Bailey, Kent R; Miller, Virginia M

    2017-07-01

    Hypertension is a risk factor for cerebrovascular disease and cognitive impairment. Women with hypertensive episodes during pregnancy report variable neurocognitive changes within the first decade following the affected pregnancy. However, long-term follow-up of these women into their postmenopausal years has not been conducted. The aim of this study was to examine whether women with a history of preeclampsia were at increased risk of cognitive decline 35-40 years after the affected pregnancy. Women were identified and recruited through the medical linkage, population-based Rochester Epidemiologic Project. Forty women with a history of preeclampsia were age- and parity-matched to 40 women with a history of normotensive pregnancy. All women underwent comprehensive neuropsychological assessment and completed self-report inventories measuring mood, ie, depression, anxiety, and other symptoms related to emotional state. Scores were compared between groups. In addition, individual cognitive scores were examined by neuropsychologists and a neurologist blinded to pregnancy status, and a clinical consensus diagnosis of normal, mild cognitive impairment, or dementia for each participant was conferred. Age at time of consent did not differ between preeclampsia (59.2 [range 50.9-71.5] years) and normotensive (59.6 [range 52.1-72.2] years) groups, nor did time from index pregnancy (34.9 [range 32.0-47.2] vs 34.5 [range 32.0-46.4] years, respectively). There were no statistically significant differences in raw scores on tests of cognition and mood between women with histories of preeclampsia compared to women with histories of normotensive pregnancy. However, a consensus diagnosis of mild cognitive impairment or dementia trended toward greater frequency in women with histories of preeclampsia compared to those with normotensive pregnancies (20% vs 8%, P = .10) and affected more domains among the preeclampsia group (P = .03), most strongly related to executive dysfunction (d

  10. Assessing functional impairment in individuals with mild cognitive impairment

    Directory of Open Access Journals (Sweden)

    Patrícia Belchior

    2016-04-01

    Full Text Available To date, there is no consensus on how to assess functional impairment in individuals with mild cognitive impairment (MCI, and this lack of consensus is reflected in the clinical practice. Since the criterion used in the literature is very vague, clinicians are still left without much guidance in this area. Thus, the main goal of this study was to examine how functional impairment in individuals with MCI has been assessed in the literature. An electronic database search strategy was developed in consultation with an experienced librarian. Four databases (CINAHL, PsycINFO, PubMed, and MEDLINE were searched from 2000 to May 2014 to provide a comprehensive coverage of the literature. The literature search yielded 14 tools that assessed functional impairment in MCI. Among those, nine tools were performance-based measures in which participants were observed while executing a task in a simulated environment using real life material. In terms of questionnaires (either informant- or self-reports, five tools were found. Different functional domains have been assessed in each tool. According to this review, the characteristics of the instruments used in the literature to assess functional impairment in individuals with MCI vary greatly. Nonetheless, results of this study allow clinicians to make better-informed decisions when choosing a functional assessment for this population.

  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......: An analysis was conducted on baseline data from the Boston Rehabilitative Impairment Study in the Elderly study, a cohort study of 430 primary care patients aged 65 or older. Neuropsychological tests identified participants with MCI and further subclassified those with impairment in memory domains (a......'s Basic Lower Extremity and Advanced Lower Extremity function scales. RESULTS: Participants had a mean age of 76.6 years, and 42% were characterized with MCI. Participants with MCI performed significantly worse than participants without MCI (No-MCI) on all performance and self-report measures (p

  12. Cognitive impairment in Parkinson's disease without dementia.

    Science.gov (United States)

    Rodríguez-Ferreiro, Javier; Cuetos, Fernando; Herrera, Elena; Menéndez, Manuel; Ribacoba, Renée

    2010-10-15

    Some degree of cognitive impairment appears frequently in Parkinson's disease (PD) patients, even at the onset of the disease. However, due to the heterogeneity of the patients and the lack of standardized assessment batteries, it remains unclear which capacities are primarily affected by this disease. Fifty PD patients were assessed with 15 tests including executive functions, attention, temporal and spatial orientation, memory, and language tasks. Their results were compared with those of 42 age- and education-matched healthy seniors. Semantic fluency, along with visual search appeared to be the most discriminant tasks, followed by temporal orientation and face naming, as well as action naming and immediate recall. PD patients studied showed an impairment of frontal- to posterior-dependent capacities. Executive functions, attention, and recall tasks appeared to be significantly impaired in the patients. Nevertheless, significantly poor scores in tasks like action and face naming, as well as semantic fluency, also reveal a mainly semantic deficit.

  13. Vascular Contributions to Cognitive Impairment and Dementia

    Science.gov (United States)

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

    2013-01-01

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

  14. Retinal vascular fractals and cognitive impairment.

    Science.gov (United States)

    Ong, Yi-Ting; Hilal, Saima; Cheung, Carol Yim-Lui; Xu, Xin; Chen, Christopher; Venketasubramanian, Narayanaswamy; Wong, Tien Yin; Ikram, Mohammad Kamran

    2014-05-01

    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. 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. 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. 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.

  15. Retinal Vascular Fractals and Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

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

    2017-08-01

    Hearing, visual, and olfactory impairments have been associated with cognitive impairment in older adults but less is known about associations with cognitive function in middle-aged adults. Sensory and cognitive functions were measured on participants in the baseline examination (2005-2008) of the Beaver Dam Offspring Study. Cognitive function was measured with the Trail Making tests A (TMTA) and B (TMTB) and the Grooved Peg Board test. Pure-tone audiometry, Pelli-Robson letter charts, and the San Diego Odor Identification test were used to measure hearing, contrast sensitivity, and olfaction, respectively. There were 2,836 participants aged 21-84 years with measures of hearing, visual, olfactory, and cognitive function at the baseline examination. Nineteen percent of the cohort had one sensory impairment and 3% had multiple sensory impairments. In multivariable adjusted linear regression models that included all three sensory impairments, hearing impairment, visual impairment, and olfactory impairment were each independently associated with poorer performance on the TMTA, TMTB, and Grooved Peg Board (p impairments in all models). Participants with a sensory impairment took on average from 2 to 10 seconds longer than participants without the corresponding sensory impairment to complete these tests. Results were similar in models that included adjustment for hearing aid use. Hearing, visual and olfactory impairment were associated with poorer performance on cognitive function tests independent of the other sensory impairments and factors associated with cognition. Sensory impairments in midlife are associated with subtle deficits in cognitive function which may be indicative of early brain aging.

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

    Science.gov (United States)

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

    2016-11-01

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

  18. 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.

  19. 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.

  20. Prevalence and types of cognitive impairment among patients with ...

    African Journals Online (AJOL)

    Background Cognitive impairment is associated with short and long term adverse outcomes in stroke patients that may impair functional recovery during their rehabilitative process. Aims This study determined the prevalence, grades and demographic factors associated with cognitive impairment among patients with stroke ...

  1. Serial position effects in mild cognitive impairment.

    Science.gov (United States)

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

    2011-03-01

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

  2. 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.

  3. Mild cognitive impairment: a concept in evolution.

    Science.gov (United States)

    Petersen, R C; Caracciolo, B; Brayne, C; Gauthier, S; Jelic, V; Fratiglioni, L

    2014-03-01

    The construct of mild cognitive impairment (MCI) has evolved over the past 10 years since the publication of the new MCI definition at the Key Symposium in 2003, but the core criteria have remained unchanged. The construct has been extensively used worldwide, both in clinical and in research settings, to define the grey area between intact cognitive functioning and clinical dementia. A rich set of data regarding occurrence, risk factors and progression of MCI has been generated. Discrepancies between studies can be mostly explained by differences in the operationalization of the criteria, differences in the setting where the criteria have been applied, selection of subjects and length of follow-up in longitudinal studies. Major controversial issues that remain to be further explored are algorithmic versus clinical classification, reliability of clinical judgment, temporal changes in cognitive performances and predictivity of putative biomarkers. Some suggestions to further develop the MCI construct include the tailoring of the clinical criteria to specific populations and to specific contexts. The addition of biomarkers to the clinical phenotypes is promising but requires deeper investigation. Translation of findings from the specialty clinic to the population setting, although challenging, will enhance uniformity of outcomes. More longitudinal population-based studies on cognitive ageing and MCI need to be performed to clarify all these issues. © 2014 The Association for the Publication of the Journal of Internal Medicine.

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

    OpenAIRE

    Xiao-fei ZHANG; Sheng-yuan YU

    2016-01-01

    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 cogni...

  5. 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

  6. 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

  7. [Cognitive impairment and parkinsonism due to use of sodium valproate

    NARCIS (Netherlands)

    Schreur, L.; Middeljans-Tijssen, C.W.; Hengstman, G.J.D.; Olde Rikkert, M.G.M.

    2009-01-01

    Two patients presented with progressive cognitive impairment and parkinsonism related symptoms while being treated with sodium valproate. Both patients suffered from progressive cognitive decline and mobility disorders with an insidious onset over a period of months to years. After discontinuation

  8. 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,

  9. Mitochondrial disorders, cognitive impairment and dementia.

    Science.gov (United States)

    Finsterer, Josef

    2009-08-15

    The organ most frequently affected in mitochondrial disorders, particularly respiratory chain diseases (RCDs), in addition to the skeletal muscle, is the central nervous system (CNS). CNS manifestations of RCDs comprise stroke-like episodes, epilepsy, migraine, ataxia, spasticity, movement disorders, psychiatric disorders, cognitive decline, or even dementia (mitochondrial dementia). So far mitochondrial dementia has been reported in MELAS, MERRF, LHON, CPEO, KSS, MNGIE, NARP, Leigh syndrome, and Alpers-Huttenlocher disease. Mitochondrial dementia not only results from mutations in the mitochondrial genome but also from mutations in nuclear genes, such as POLG, thymidine kinase 2, or DDP1. Often mitochondrial dementia starts with specific cognitive deficits, particularly in visual construction, attention, abstraction, or flexibility but without a general intellectual deterioration. Cognitive impairment in RCDs is diagnosed upon neuropsychological testing, imaging studies, such as MRI, PET, or MR-spectroscopy, CSF-investigations, or electroencephalography. Therapy of mitochondrial dementia relies on symptomatic measures. Only single patients profit from cholinesterase inhibitors or memantine, antioxidants, vitamins, coenzyme-Q, or other substitutes. Overall, mitochondrial dementia is an important differential of dementias and should be considered in patients with multi-system disease.

  10. 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

  11. Interventions to reduce cognitive impairments following critical illness

    DEFF Research Database (Denmark)

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

    2017-01-01

    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...... affected by study limitations, imprecision and indirectness in evidence. Clinical research on cognition is feasible, but large, well designed trials with a specific aim at reducing cognitive impairments are needed....

  12. 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

  13. [Pharmacological therapeutic intervention in mild cognitive impairment].

    Science.gov (United States)

    Arriola Manchola, Enrique; Alaba Loinaz, Javier

    2017-06-01

    Mild cognitive impairment (MCI) is a syndrome encompassing affective and behavioural symptoms and various subtypes. MCI is a heterogeneous clinical entity with varied causes (degenerative, vascular, psychiatric, non-neurological disorders), and there is wide variation in symptoms and clinical course. There are multiple causes and consequently various treatments can be applied and should be combined with non-pharmacological measures. This article describes both preventive and therapeutic pharmacological interventions: control of vascular risk factors, avoidance of iatrogeny, use of nutraceuticals, CDP-choline, and Ginkgo biloba EGb 761 ® , and improvement in sense organs. Copyright © 2017 Sociedad Española de Geriatría y Gerontología. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Olfactory screening test in mild cognitive impairment.

    Science.gov (United States)

    Eibenstein, A; Fioretti, A B; Simaskou, M N; Sucapane, P; Mearelli, S; Mina, C; Amabile, G; Fusetti, M

    2005-07-01

    Mild cognitive impairment (MCI) is a transient status between physiologic ageing and dementia. Each year more than 12% of subjects with MCI develop Alzheimer's disease. This study evaluated the presence of an olfactory deficit in amnesic MCI (aMCI) patients. Twenty-nine patients diagnosed with aMCI and a homogeneous control group of 29 subjects were enrolled in the study. Olfactory function was assessed by the Sniffin' Sticks Screening Test (SSST) and the Mini Mental State Examination, the Clinical Dementia Rating, the Geriatric Depression Scale and the Mental Deterioration Battery were used to evaluate the neurocognitive status. aMCI patients showed a significant impairment of their olfactory identification compared to controls (SSST score: 8.3+/-2.1 vs. 10.8+/-0.9; p<0.001). These results suggest that olfactory tests should be part of the diagnostic armamentarium of pre-clinical dementia. A long-term follow up might confirm the olfactory identification function as an early and reliable marker in the diagnosis of pre-clinical dementia.

  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. Mnemonic Strategy Instruction for Beginning Readers with Cognitive Impairments

    Science.gov (United States)

    Burton, Rivka

    2013-01-01

    Many students with cognitive impairments are not afforded the opportunity to develop their potential as readers. A review of the literature reveals that few researchers have evaluated the effects of phonics instruction on the reading skills of students with cognitive impairments. The purpose of this study was to test the effectiveness of a…

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

    African Journals Online (AJOL)

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

  19. Brain dynamics of mild cognitive impairment during face encoding

    OpenAIRE

    Aurtenetxe, Sara; Perales Castellanos, Nazareth; López García, María Eugenia; Cuesta, Pablo; Garces, Pilar; Bajo Breton, Ricardo; García Prieto, Juan; Montejo Carrasco, Pedro; Gil, Pedro; Delgado Losada, María Luisa; Rodriguez, Octavio José; Marcos, Alberto; Pozo, Francisco del; Maestú, Fernando

    2012-01-01

    Brain oscillations are closely correlated with human information processing and fundamental aspects of cognition. Previous literature shows that due to the relation between brain oscillations and memory processes, spectral dynamics during such tasks are good candidates to study and characterize memory related pathologies. Mild cognitive impairment (MCI), defined as a clinical condition characterized by memory impairment and/ or deterioration of additional cognitive domains, is considered a pr...

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

    Science.gov (United States)

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

    2016-11-01

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

  1. 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.

  2. 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).

  3. Neuropathology of mild cognitive impairment (MCI)

    International Nuclear Information System (INIS)

    Murayama, Shigeo; Saito, Yuko

    2007-01-01

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

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

    Science.gov (United States)

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

    2018-01-18

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

  5. Cognitive impairment, behavioral impairment, depression, and wish to die in an ALS cohort.

    Science.gov (United States)

    Rabkin, Judith; Goetz, Raymond; Murphy, Jennifer Mary; Factor-Litvak, Pam; Mitsumoto, Hiroshi

    2016-09-27

    To evaluate relationships among cognitive, behavioral, and psychiatric/psychosocial measures assessed in a multicenter cohort of patients with amyotrophic lateral sclerosis (ALS). Recently diagnosed patients with definite or probable ALS diagnosis were administered 7 standardized psychiatric/psychosocial measures, including the Patient Health Questionnaire for diagnosis of depression and elicitation of wish to die. The Cognitive Behavioral Screen was used to classify both cognitive and behavioral impairment (emotional-interpersonal function). An ALS version of the Frontal Behavioral Inventory and Mini-Mental State Examination were also administered. Of 247 patients included, 79 patients (32%) had neither cognitive nor behavioral impairment, 100 (40%) had cognitive impairment, 23 (9%) had behavioral impairment, and 45 (18%) had comorbid cognitive and behavioral decline. Cognitive impairment, when present, was in the mild range for 90% and severe for 10%. Thirty-one patients (12%) had a major or minor depressive disorder (DSM-IV criteria). Cognitive impairment was unrelated to all psychiatric/psychosocial measures. In contrast, patients with behavioral impairment reported more depressive symptoms, greater hopelessness, negative mood, and more negative feedback from spouse or caregiver. A wish to die was unrelated to either cognitive or behavioral impairment. While we found no association between cognitive impairment and depression or any measure of distress, behavioral impairment was strongly associated with depressive symptoms and diagnoses although seldom addressed by clinicians. Thoughts about ending life were unrelated to either cognitive or behavioral changes, a finding useful to consider in the context of policy debate about physician-assisted death. © 2016 American Academy of Neurology.

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

    Science.gov (United States)

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

    2007-06-01

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

  7. Effect of Cognitive and Central Auditory Impairments on Satisfaction of Amplification in Hearing Impaired Older Adults

    Directory of Open Access Journals (Sweden)

    Younes Lotfi

    2012-07-01

    Full Text Available Objectives: Older adults show many difficulties of speech perception in noisy situations due to peripheral and central auditory impairments, and cognitive dysfunctions. One of the most common rehabilitative procedures for older adults with hearing loss is amplification. However, there is some evidence of dissatisfaction of amplification in older adults. Methods & Materials: We assessed cognitive station, central auditory function, and satisfaction of 19 participants with hearing aids using mini-mental state examination (MMSE, dichotic digits test (DDT, and the satisfaction with amplification in daily life scale respectively. Our cases had moderate sensory hearing loss in both ears. Results: Kruskal-Wallis statistics showed significant correlation between cognitive impairments (MMSE scores and satisfaction of amplification (P0.05. Conclusion: We showed central auditory processing impairments in hearing impaired older adults with cognitive dysfunctions. It is indicated that older adults with hearing loss might have cognitive impairments inducing dissatisfaction of amplification.

  8. 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.

  9. Cognitive impairment in multiple system atrophy: Changing concepts

    Directory of Open Access Journals (Sweden)

    Agessandro Abrahão

    Full Text Available Abstract Multiple system atrophy (MSA is characterized by a variable combination of cerebellar ataxia, parkinsonism and pyramidal signs associated with autonomic failure. Classically, cognitive impairment was not considered a clinical feature of MSA and dementia was pointed out as an exclusion diagnostic criteria. Based on comprehensive neuropsychological assessment, cognitive impairment was found to be a frequent feature in MSA, and clinically-defined dementia is now reported in 14-16% of cases. This article reviews the current data on cognitive impairment in MSA along with its neuropsychological profile and pathophysiology.

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

    Science.gov (United States)

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

    2017-10-01

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

  11. Homelessness and Cognitive Impairment: An Exploratory Study in Tokyo, Japan.

    Science.gov (United States)

    Pluck, G; Nakakarumai, M; Sato, Y

    2015-09-01

    Homelessness has frequently been associated with neuropsychological impairment. This has been observed using general screening tests for dementia as well as tests of more focal abilities, particularly executive function. Most studies have been of homeless individuals from North America with none reported from Japan. In this exploratory study we interviewed a sample of 16 homeless adults from Tokyo, Japan, and performed tests of cognitive function, assessed head injury, addictive behaviours (drug use, gambling, alcohol abuse), and recorded details of homelessness history. The cognitive examination involved the Japanese Adult Reading Test to estimate premorbid intelligence quotient, the Wisconsin Card Sorting Test to measure frontal lobe-related cognitive function, and the Mini-Mental State Examination to measure global cognitive impairment associated with dementia. Among the 16 homeless individuals, 7 (44%) displayed global cognitive impairment. In addition, executive function tended to be poor. In contrast, estimated premorbid intelligence quotient was within the normal range. Substance abuse in general was not at a level to cause clinical concern, although a high level of pathological gambling was observed. There were no associations between cognitive function and clinical and addictive behaviour variables, although associations were noted between cognitive scores and time spent homeless. The results suggest high levels of neuropsychological impairment in this sample of homeless adults in Japan. Furthermore, cognitive impairment is acquired rather than developmental in origin, and is proportional to the length of time spent homeless.

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

    Directory of Open Access Journals (Sweden)

    Maya Danovska

    2012-09-01

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

  13. Mild cognitive impairment and dementia in a heterogeneous elderly ...

    African Journals Online (AJOL)

    , Major Depression ..... Further large scale community studies are needed to confirm the prevalence of dementia in South Africa. ..... Impairment-Results From the German Study on Ageing, Cognition, and Dementia in Primary Care Patients.

  14. [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.

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

    Science.gov (United States)

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

    2017-09-01

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

  16. 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

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

    Science.gov (United States)

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

    2018-01-24

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

  18. Cognitive Impairment in Rural Elderly Population in Ecuador

    OpenAIRE

    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 func...

  19. Cognitive Processes of Numerical Estimation in Children

    Science.gov (United States)

    Ashcraft, Mark H.; Moore, Alex M.

    2012-01-01

    We tested children in Grades 1 to 5, as well as college students, on a number line estimation task and examined latencies and errors to explore the cognitive processes involved in estimation. The developmental trends in estimation were more consistent with the hypothesized shift from logarithmic to linear representation than with an account based…

  20. 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.

  1. Factors predicting reversion from mild cognitive impairment to normal cognitive functioning: a population-based study.

    Directory of Open Access Journals (Sweden)

    Perminder S Sachdev

    Full Text Available Mild cognitive impairment (MCI is associated with an increased risk of developing dementia. However, many individuals diagnosed with MCI are found to have reverted to normal cognition on follow-up. This study investigated factors predicting or associated with reversion from MCI to normal cognition.Our analyses considered 223 participants (48.9% male aged 71-89 years, drawn from the prospective, population-based Sydney Memory and Ageing Study. All were diagnosed with MCI at baseline and subsequently classified with either normal cognition or repeat diagnosis of MCI after two years (a further 11 participants who progressed from MCI to dementia were excluded. Associations with reversion were investigated for (1 baseline factors that included diagnostic features, personality, neuroimaging, sociodemographics, lifestyle, and physical and mental health; (2 longitudinal change in potentially modifiable factors.There were 66 reverters to normal cognition and 157 non-reverters (stable MCI. Regression analyses identified diagnostic features as most predictive of prognosis, with reversion less likely in participants with multiple-domain MCI (p = 0.011, a moderately or severely impaired cognitive domain (p = 0.002 and p = 0.006, or an informant-based memory complaint (p = 0.031. Reversion was also less likely for participants with arthritis (p = 0.037, but more likely for participants with higher complex mental activity (p = 0.003, greater openness to experience (p = 0.041, better vision (p = 0.014, better smelling ability (p = 0.040, or larger combined volume of the left hippocampus and left amygdala (p<0.040. Reversion was also associated with a larger drop in diastolic blood pressure between baseline and follow-up (p = 0.026.Numerous factors are associated with reversion from MCI to normal cognition. Assessing these factors could facilitate more accurate prognosis of individuals with MCI. Participation in

  2. [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...

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

    NARCIS (Netherlands)

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

    2008-01-01

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

  4. [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.

  5. Cognitive Impairment in Fall-Related Studies in Parkinson's Disease

    NARCIS (Netherlands)

    Domingos, J.M.M.; Godinho, C.; Dean, J.; Coelho, M.; Pinto, A.; Bloem, B.R.; Ferreira, J.J.

    2015-01-01

    BACKGROUND: There is increasing evidence to suggest a tight relationship between cognitive impairment and falls in Parkinson's disease (PD). Here, we draw attention to a potentially significant flaw in the existent falls-related research, namely the apparent exclusion of patients with cognitive

  6. 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.

  7. Use of Genetic Variation as Biomarkers for Mild Cognitive Impairment and Progression of Mild Cognitive Impairment to Dementia

    OpenAIRE

    Reitz, Christiane; Mayeux, Richard

    2010-01-01

    Cognitive impairment is highly frequent in the elderly. The high estimates of conversion to dementia have spurred the interest in identification of genetic risk factors associated with development of cognitive impairment and or its progression. However, despite notable achievements in human genetics over the years, in particular technological advances in gene mapping and in statistical methods that relate genetic variants to disease, to date only a small proportion of the genetic contribution...

  8. 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

  9. The Economics of Cognitive Impairment: Volunteering and Cognitive Function in the HILDA Survey.

    Science.gov (United States)

    Hosking, Diane E; Anstey, Kaarin J

    2016-01-01

    The economic impact of older-age cognitive impairment has been estimated primarily by the direct and indirect costs associated with dementia care. Other potential costs associated with milder cognitive impairment in the community have received little attention. To quantify the cost of nonclinical cognitive impairment in a large population-based sample in order to more fully inform cost-effectiveness evaluations of interventions to maintain cognitive health. Volunteering by seniors has economic value but those with lower cognitive function may contribute fewer hours. Relations between hours volunteering and cognitive impairment were assessed using the Household, Income and Labour Dynamics in Australia (HILDA) survey data. These findings were extrapolated to the Australian population to estimate one potential cost attributable to nonclinical cognitive impairment. In those aged ≥60 years in HILDA (n = 3,127), conservatively defined cognitive impairment was present in 3.8% of the sample. Impairment was defined by performance ≥1 standard deviation below the age- and education-adjusted mean on both the Symbol Digit Modalities Test and Backwards Digit Span test. In fully adjusted binomial regression models, impairment was associated with the probability of undertaking 1 h 9 min less volunteering a week compared to being nonimpaired (β = -1.15, 95% confidence interval -1.82 to -0.47, p = 0.001). In the population, 3.8% impairment equated to probable loss of AUD 302,307,969 per annum estimated by hours of volunteering valued by replacement cost. Nonclinical cognitive impairment in older age impacts upon on the nonmonetary economy via probable loss of volunteering contribution. Valuing loss of contribution provides additional information for cost-effectiveness evaluations of research and action directed toward maintaining older-age cognitive functioning. © 2016 S. Karger AG, Basel.

  10. 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...... research program 36 consecutive patients with mild AD (MMSE above 19), 30 with amnesic MCI and 33 matched controls were examined. Using three methods for awareness assessment we found no significant differences in the level of awareness between MCI and AD. Both groups had impaired awareness and significant...

  11. Cognitive impairment and Charles Bonnet syndrome: a prospective study.

    Science.gov (United States)

    Russell, Gregor; Harper, Robert; Allen, Harry; Baldwin, Robert; Burns, Alistair

    2018-01-01

    Charles Bonnet syndrome (CBS) is a common cause of visual hallucinations in older people. The relationship between CBS and cognitive impairment is unclear, but anecdotal reports exist of dementia emerging in patients diagnosed with CBS. This work set out to determine if there is an increased incidence of dementia, and increased severity of cognitive impairment, in people with CBS compared to controls from the same clinical setting. People over 65 attending low-vision and glaucoma clinics, and a cohort of age-matched controls, underwent a psychiatric assessment. The cohorts were followed up after one year. Mild cognitive impairment was present in 2/12 CBS participants and 2/10 controls. Partial insight was seen in nine CBS participants. Two participants with CBS, and no controls, developed dementia at follow-up. No significant differences in performance on the ACE-R were found between the groups. Both participants who developed dementia had partial insight and hallucinations of familiar figures at diagnosis of CBS, and one had mild cognitive impairment. Reassurance that CBS is universally benign may be misplaced. Some people given this diagnosis go on to develop dementia. Cognitive testing at the point of diagnosis was unable to identify those at risk of this outcome. Partial insight, the presence of Mild Cognitive Impairment, and hallucinations of familiar figures at diagnosis of CBS may confer an increased risk of subsequent dementia diagnosis. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  12. 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.

  13. 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

  14. Risk factors and predictors of dementia and cognitive impairment

    DEFF Research Database (Denmark)

    Neergaard, Jesper

    of older people in the total population. Dementia and cognitive impairment are by far the leading causes of disability and in particularly the need for care among older people. Surprisingly there has been much less investment in dementia research, given its burden. Consequently, Alzheimer’s disease, being...... were related to cognitive dysfunction at the follow-up visit (chapter 5). These studies found that Body Mass Index (BMI) in the overweight range and physical activity were associated with lower risk of dementia (Chapter 4), while increasing age, history of depression, insulin resistance (using......) was an important predictor of dementia and in subjects with subtle objective cognitive impairment physical inactivity, elevated total cholesterol and a history of depression were associated with progression to dementia or severe cognitive impairment. In chapter 7, we evaluated the possible utility of two novel...

  15. Cognitive Reserve Moderates the Association between Heart Failure and Cognitive Impairment

    Science.gov (United States)

    Alosco, Michael L.; Spitznagel, Mary Beth; Raz, Naftali; Cohen, Ronald; Sweet, Lawrence H.; van Dulmen, Manfred; Colbert, Lisa H.; Josephson, Richard; Waechter, Donna; Hughes, Joel; Rosneck, Jim; Gunstad, John

    2016-01-01

    Background Cognitive impairment in persons with heart failure is common. Theories of cognitive reserve suggest that premorbid factors, such as intellectual ability, may provide a buffer against cognitive impairment due to neuropathological insult. No study has examined the influence of cognitive reserve on cognitive functioning in older adults with heart failure. Aim This study examined whether cognitive reserve moderates the relationship between heart failure severity and cognitive function. Methods A total of 157 persons with heart failure (69.26 ± 9.26 years; 39% female) completed neuropsychological testing and a brief fitness assessment. Cognitive reserve was operationalized using estimated premorbid intellect on American National Adult Reading Test (AMNART). Results A moderation analysis was performed using a hierarchical regression models for each cognitive domain. An interaction term between the AMNART and 2-minute step test was created and entered into the final block of the model, with demographic, psychosocial, and heart failure severity entered in the previous blocks. The interaction term was significant for attention (t(155) = −2.54, p = .012), executive function (t(155) = −3.30, p = .001), and language (t(155) = −2.83, p = .005) domains. Conclusion The current findings suggest that cognitive reserve moderates the association between heart failure severity and cognitive function in multiple cognitive domains. Further work is needed to clarify the mechanisms by which cognitive reserve attenuates cognitive impairment in this population. PMID:22034987

  16. Regional hippocampal involvement and cognitive impairment in pediatric multiple sclerosis.

    Science.gov (United States)

    Rocca, Maria A; Morelli, Maria E; Amato, Maria P; Moiola, Lucia; Ghezzi, Angelo; Veggiotti, Pierangelo; Capra, Ruggero; Pagani, Elisabetta; Portaccio, Emilio; Fiorino, Agnese; Pippolo, Lorena; Pera, Maria C; Comi, Giancarlo; Falini, Andrea; Filippi, Massimo

    2016-04-01

    We assessed global and regional hippocampal volume abnormalities in pediatric multiple sclerosis (MS) patients and their correlations with clinical, neuropsychological and magnetic resonance imaging metrics. From 53 pediatric MS patients and 18 healthy controls, global hippocampal volume was computed using a manual tracing procedure. Regional hippocampal volume modifications were assessed using a radial mapping analysis. MS patients with abnormal performance in three or more tests of a neuropsychological battery for children were classified as cognitively impaired. Global hippocampal volume was reduced in MS patients compared with controls, but did not correlate with clinical, neuropsychological and magnetic resonance imaging measures. Compared to controls, MS patients experienced bilateral radial atrophy of the cornu ammonis, subiculum and dentate gyrus subfields as well as radial hypertrophy of the dentate gyrus subfield. Regional hippocampal volume modifications correlated with brain T2 lesion volume as well as attention and language abilities. Global hippocampal volume did not differ between cognitively impaired (n=12) and cognitively preserved MS patients. Compared to cognitively preserved, cognitively impaired MS patients had atrophy of the subiculum and dentate gyrus subfields of the right hippocampus. Hippocampal subregions have different vulnerability to damage in pediatric MS. Regional rather than global hippocampal involvement contributes to global cognitive impairment as well as to deficits of selected cognitive tests. © The Author(s), 2015.

  17. Vision impairment and combined vision and hearing impairment predict cognitive and functional decline in older women.

    Science.gov (United States)

    Lin, Michael Y; Gutierrez, Peter R; Stone, Katie L; Yaffe, Kristine; Ensrud, Kristine E; Fink, Howard A; Sarkisian, Catherine A; Coleman, Anne L; Mangione, Carol M

    2004-12-01

    To determine the association between vision and hearing impairment and subsequent cognitive and functional decline in community-residing older women. Prospective cohort study. Four metropolitan areas of the United States. A total of 6,112 women aged 69 and older participating in the Study of Osteoporotic Fractures (SOF) between 1992 and 1994. Five thousand three hundred forty-five participants had hearing measured, 1,668 had visual acuity measured, and 1,636 had both measured. Visual impairment was defined as corrected vision worse than 20/40. Hearing impairment was defined as the inability to hear a tone of 40 dB or greater at 2,000 hertz. Participants completed the modified Mini-Mental State Examination and/or a functional status assessment at baseline and follow-up. Cognitive and functional decline were defined as the amount of decline from baseline to follow-up that exceeded the observed average change in scores by at least 1 standard deviation. About one-sixth (15.7%) of the sample had cognitive decline; 10.1% had functional decline. In multivariate models adjusted for sociodemographic characteristics and chronic conditions, vision impairment at baseline was associated with cognitive (odds ratio (OR)=1.78, 95% confidence interval (CI)=1.21-2.61) and functional (OR=1.79, 95% CI=1.15-2.79) decline. Hearing impairment was not associated with cognitive or functional decline. Combined impairment was associated with the greatest odds for cognitive (OR=2.19, 95% CI=1.26-3.81) and functional (OR=1.87, 95% CI=1.01-3.47) decline. Sensory impairment is associated with cognitive and functional decline in older women. Studies are needed to determine whether treatment of vision and hearing impairment can decrease the risk for cognitive and functional decline.

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

    Science.gov (United States)

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

    2017-08-01

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

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

    NARCIS (Netherlands)

    Tiemensma, Jitske; Kokshoorn, Nieke E.; Biermasz, Nienke R.; Keijser, Bart-Jan S. A.; Wassenaar, Moniek J. E.; Middelkoop, Huub A. M.; Pereira, Alberto M.; Romijn, Johannes A.

    2010-01-01

    Active Cushing's disease is associated with cognitive impairments. We hypothesized that previous hypercortisolism in patients with Cushing's disease results in irreversible impairments in cognitive functioning. Therefore, our aim was to assess cognitive functioning after long-term cure of Cushing's

  20. Cognitive executive impairment and dopaminergic deficits in de novo Parkinson's disease

    NARCIS (Netherlands)

    Siepel, Françoise J.; Brønnick, Kolbjørn S.; Booij, Jan; Ravina, Bernard M.; Lebedev, Alexander V.; Pereira, Joana B.; Grüner, Renate; Aarsland, Dag

    2014-01-01

    Cognitive impairment in Parkinson's disease (PD) is common and does directly impact patients' everyday functioning. However, the underlying mechanisms of early cognitive decline are not known. This study explored the association between striatal dopaminergic deficits and cognitive impairment within

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

    Science.gov (United States)

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

    2007-02-01

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

  2. Mild cognitive impairment affects motor control and skill learning.

    Science.gov (United States)

    Wu, Qiaofeng; Chan, John S Y; Yan, Jin H

    2016-02-01

    Mild cognitive impairment (MCI) is a transitional phase between normal cognitive aging and dementia. As the world population is aging rapidly, more MCI patients will be identified, posing significant problems to society. Normal aging is associated with cognitive and motor decline, and MCI brings additional impairments. Compared to healthy older adults, MCI patients show poorer motor control in a variety of tasks. Efficient motor control and skill learning are essential for occupational and leisure purposes; degradation of motor behaviors in MCI patients often adversely affects their health and quality of life. In this article, we first define MCI and describe its pathology and neural correlates. After this, we review cognitive changes and motor control and skill learning in normal aging. This section is followed by a discussion of MCI-related degradation of motor behaviors. Finally, we propose that multicomponent interventions targeting both cognitive and motor domains can improve MCI patients' motor functions. Future research directions are also raised.

  3. Aberrant Functional Connectivity and Structural Atrophy in Subcortical Vascular Cognitive Impairment: Relationship with Cognitive Impairments

    Directory of Open Access Journals (Sweden)

    Xia eZhou

    2016-02-01

    Full Text Available Abnormal structures in the cortical and subcortical regions have been identified in subcortical vascular cognition impairment (SVCI. However, little is known about the functional alterations in SVCI, and no study refers to the functional connectivity in the prefrontal and subcortical regions in this context. The medial prefrontal cortex (MPFC is an important region of the executive network and default mode network (DMN, and the subcortical thalamus plays vital roles in mediating or modulating these two networks. To investigate both thalamus- and MPFC-related functional connectivity as well as its relationship with cognition in SVCI, 32 SVCI patients and 23 control individuals were administered neuropsychological assessments. They also underwent structural and functional magnetic resonance imaging (MRI scans. Voxel-based morphometry (VBM and functional connectivity analysis were performed to detect gray matter (GM atrophy and to characterize the functional alterations in the thalamus and the MPFC. For structural data, we observed that GM atrophy was distributed in both cortical regions and subcortical areas. For functional data, we observed that the thalamus functional connectivity in SVCI was significantly decreased in several cortical regions (i.e., the orbitofrontal lobe (OFL, which are mainly involved in executive function and memory function. However, connectivity was increased in several frontal regions (i.e., the inferior frontal gyrus (IFG, which may be induced by the compensatory recruitment of the decreased functional connectivity. The MPFC functional connectivity was also decreased in executive- and memory-related regions (i.e., the anterior cingulate cortex (ACC along with a motor region (i.e., the supplementary motor region (SMA. In addition, the cognitive performance was closely correlated with functional connectivity between the left thalamus and the left OFL in SVCI. The present study thus provides evidence for an association

  4. Characterization of social cognition impairment in multiple sclerosis.

    Science.gov (United States)

    Neuhaus, M; Bagutti, S; Yaldizli, Ö; Zwahlen, D; Schaub, S; Frey, B; Fischer-Barnicol, B; Burgunder, J-M; Martory, M-D; Pöttgen, J; Annoni, J-M; Penner, I-K

    2018-01-01

    Multiple sclerosis (MS) has been associated with deficits in social cognition. However, little is known about which domains of social cognition are predominantly affected and what other factors are associated with it. The aim was (i) to characterize social cognition deficit in a group of MS outpatients and (ii) to relate impairment in social cognition to overall cognitive status, depression and fatigue. Thirty-five MS patients (mean disease duration 12.9 years, median Expanded Disability Status Scale (EDSS) 3 and 34 healthy controls (HCs) were examined using the German version of the Geneva Social Cognition Scale to measure different domains of social cognition. Standard neuropsychological testing was applied to all patients and to 20 HCs. Patient-reported outcomes included questionnaires for fatigue, depression, anxiety and executive-behavioural disturbances. The mean social cognition raw score was lower in the MS patients compared to the HCs (86.5 ± 8.7 vs. 91.2 ± 5.9, P = 0.005; d = 0.6) and did not correlate with EDSS or disease duration. The difference was driven by facial affect recognition and the understanding of complex social situations (14% and 23% of patients respectively under the cut-off). The impairment in these two tasks did not correlate with general cognitive performance or depression but with fatigue. The impairment in our group was restricted to high order and affective social cognition tasks and independent of general cognitive performance, EDSS, disease duration and depression. Fatigue correlated with social cognition performance, which might be due to common underlying neuronal networks. © 2017 EAN.

  5. Attention and CERAD test performances in cognitively impaired elderly subjects.

    Science.gov (United States)

    Verhülsdonk, S; Hellen, F; Höft, B; Supprian, T; Lange-Asschenfeldt, C

    2015-06-01

    Attention plays a fundamental role in cognitive performance and is closely interrelated with all major cognitive domains. In this retrospective study, we correlated different measures of attention with standard cognitive parameters in 85 cognitively impaired elderly individuals presenting with cognitive complaints to a memory clinic. Z-scores of all relevant cognitive parameters of a extended Consortium to Establish a Registry for Alzheimer's disease (CERAD-Plus) neuropsychological battery were correlated with tonic and phasic alertness, inhibition, and divided attention, assessed by a computerized test battery of attention. The pooled sample consisted of 36 patients with the diagnosis of mild AD, 30 patients with mild cognitive impairment, and 19 patients with major depressive disorder. Subjects of all diagnostic groups exhibited normal results in all subtests of attention. Reaction times of neither the tonic nor the phasic alertness task were correlated with any parameter of memory and global cognition. However, significant correlations were obtained between reaction times in the alertness tasks and the trail-making tests. Omissions in the divided attention task yielded the strongest correlations with deficits in cognitive performance, particularly in the verbal learning tasks, the Boston naming test, and the trail-making tests. Our data demonstrate the relative independency of the CERAD-Plus on the variability of attention and particularly alertness suggesting its robustness in psychiatric memory clinic settings. Moreover, CERAD-Plus subtests correlated considerably with failure rates in divided attention, suggesting that impairment in divided attention tasks may be early markers of cognitive impairment. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. 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.

  7. Cognitive Impairment in Rural Elderly Population in Ecuador.

    Science.gov (United States)

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

    2017-08-01

    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. 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. 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. 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.

  8. Cognitive impairment in Parkinson's disease and dementia with Lewy bodies.

    Science.gov (United States)

    Aarsland, Dag

    2016-01-01

    Parkinson's disease (PD) and dementia with Lewy bodies (DLB) share clinical and pathological similarities. The defining features are motor parkinsonism and cognitive impairment, often accompanied by visual hallucinations, fluctuating consciousness, autonomic and sleep disturbances, and a number of other non-motor symptoms. Mild cognitive impairment (MCI) can be identified in 15% of PD patients at time of diagnosis, and may even precede motor symptoms. MCI usually progresses further, and dementia is a common endpoint. Cognitive impairment is usually the initial symptom of DLB, and the disease course is severe. A variety of biomarkers can assist in the diagnosis and prognosis of PD and DLB, including structural and functional imaging, cerebrospinal fluid, and EEG. Compared to the many treatments available for motor symptoms, relatively few systematic studies exist to guide the treatment of cognitive impairment in PD, and even less in DLB. However, there is good evidence for cholinesterase inhibitors in both DLB and PD with dementia, and some indications that memantine is helpful. Emerging evidence suggest that physical exercise and cognitive training are also effective, as are some reports of various brain stimulation techniques. Disease-modifying agents that delay the rate of cognitive decline in PD and DLB are urgently needed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Finances in the Older Patient with Cognitive Impairment

    Science.gov (United States)

    Widera, Eric; Steenpass, Veronika; Marson, Daniel; Sudore, Rebecca

    2013-01-01

    Financial capacity is the ability to manage money and financial assets in ways that meet a person’s needs and which are consistent with his/her values and self-interest. Financial capacity is essential for an individual to function independently in our society; however, dementia eventually leads to a complete loss of financial capacity. Many patients with cognitive impairment and their families turn to their primary care clinician for help with financial impairment, yet most clinicians do not understand their role or how to help. We review the prevalence and impact of financial incapacity in older adults with cognitive impairment. We also articulate the role of the primary clinician which includes: (1) educating older adult patients and families about the need for advance financial planning; (2) recognizing signs of possible impaired financial capacity; (3) assessing financial impairments in cognitively impaired adults; (4) recommending interventions to help patients maintain financial independence; and (5) knowing when and to whom to make medical and legal referrals. Clearly delineating the clinician’s role in financial impairment can lead to the establishment of effective financial protections and can limit the economic, psychological, and legal hardships of financial incapacity on patients with dementia and their families. PMID:21325186

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

    Science.gov (United States)

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

    2015-06-01

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

  11. THE NUMERICAL COGNITION BIAS AND ITS CONSEQUENCES ON ACCOUNTING DECISIONS

    OpenAIRE

    Marcelino, Carolina Venturini; Bruni, Adriano Leal

    2013-01-01

    This theoretical essay is dedicated to the further study of numerical cognition and discussion of the presence of bias arising from it within the accounting environment. Accounting provides information to ensure decision-making which is likely to be influenced by shortcuts or cognitive biases. Decisions are made faster and not necessarily more correct. Research in management accounting has traditionally been influenced by neoclassical economics theory, whose main assumption is economic ration...

  12. Perceptual and Cognitive Impairments and Driving

    Science.gov (United States)

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

    1990-01-01

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

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  14. Mild cognitive impairment and progression to dementia of Alzheimer's disease

    Directory of Open Access Journals (Sweden)

    Ana Beatriz Quintes Steiner

    Full Text Available Summary The increase in life expectancy in the Brazilian population raises questions about the preparation of the public health system in identifying elderly patients with signs of cognitive impairment. Currently, as a consequence of the long duration of preclinical phase of Alzheimer's disease, efforts of early detection have been emphasized. Clinical dementia presents an important impact on the individual's caregivers, family, society and economy. Identifying individuals who already have some cognitive impairment, despite remaining functional, as well as analyzing associated comorbidities, constitutes an opportunity to analyze possibilities for future interventions. Dementias are clinical conditions that impose a burden on the health system with its high costs, whereas the identification of individuals with cognitive impairment without dementia can aid patients and their families to plan the future and mitigate costs. This narrative revision can provide general practitioners with more information on the subject.

  15. 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.

  16. Potential Therapeutics for Vascular Cognitive Impairment and Dementia.

    Science.gov (United States)

    Sun, Miao-Kun

    2017-10-16

    As the human lifespan increases, the number of people affected by age-related dementia is growing at an epidemic pace. Vascular pathology dramatically affects cognitive profiles, resulting in dementia and cognitive impairment. While vascular dementia itself constitutes a medical challenge, hypoperfusion/vascular risk factors enhance amyloid toxicity and other memory-damaging factors and hasten Alzheimer's disease (AD) and other memory disorders' progression, as well as negatively affect treatment outcome. Few therapeutic options are, however, currently available to improve the prognosis of patients with vascular dementia and cognitive impairment, mixed AD dementia with vascular pathology, or other memory disorders. Emerging evidence, however, indicates that, like AD and other memory disorders, synaptic impairment underlies much of the memory impairment in the cognitive decline of vascular cognitive impairment and vascular dementia. Effective rescues of the memory functions might be achieved through synaptic and memory therapeutics, targeting distinct molecular signaling pathways that support the formation of new synapses and maintaining their connections. Potential therapeutic agents include: 1) memory therapeutic agents that rescue synaptic and memory functions after the brain insults; 2) anti-pathologic therapeutics and an effective management of vascular risk factors; and 3) preventative therapeutic agents that achieve memory therapy through functional enhancement. Their development and potential as clinically effective memory therapeutics for vascular cognitive impairment and dementia are discussed in this review. These therapeutic agents are also likely to benefit patients with AD and/or other types of memory disorders. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  17. Polypharmacy Cut-Off for Gait and Cognitive Impairments.

    Science.gov (United States)

    Langeard, Antoine; Pothier, Kristell; Morello, Remy; Lelong-Boulouard, Véronique; Lescure, Pascale; Bocca, Marie-Laure; Marcelli, Christian; Descatoire, Pablo; Chavoix, Chantal

    2016-01-01

    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. Studying relationships between polypharmacy and both mobility and cognitive impairments, and statistically determining a cut-off point in the number of medicinal molecule beyond which polypharmacy has deleterious consequences with respect to mobility and cognitive impairment. 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 medicinal molecules taken. We assessed basic mobility and global cognition with the Time-Up-and-Go and the Montreal Cognitive Assessment (MoCA) test, respectively (clinicaltrials.gov NCT02292316). Timed-Up and Go test and MoCA scores were both significantly correlated with the number of molecule, used. Receiver Operating Characteristic curves indicate, with high prediction (p risk for both impaired mobility and global cognition. These relationships were independent of the number of comorbidities and of the pharmacological class. Community-dwelling adults aged 55 years and older who take five or more daily medicinal molecules 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.

  18. Posterior brain damage and cognitive impairment in pediatric multiple sclerosis.

    Science.gov (United States)

    Rocca, Maria A; Absinta, Martina; Amato, Maria Pia; Moiola, Lucia; Ghezzi, Angelo; Veggiotti, Pierangelo; Capra, Ruggero; Portaccio, Emilio; Fiorino, Agnese; Pippolo, Lorena; Pera, Maria Carmela; Horsfield, Mark A; Falini, Andrea; Comi, Giancarlo; Filippi, Massimo

    2014-04-15

    We combined structural and functional MRI to better understand the mechanisms responsible for cognitive impairment in pediatric patients with multiple sclerosis (MS). Brain dual-echo, diffusion tensor, 3D T1-weighted, and resting-state (RS) fMRI scans were acquired from 35 consecutive pediatric patients with MS and 16 sex- and age-matched healthy controls. Patients with abnormalities in ≥2 neuropsychological tests were classified as cognitively impaired. The regional distribution of white matter (WM) and gray matter (GM) damage was assessed using voxel-wise analyses. Default mode network (DMN) RS functional connectivity (FC) was also measured. Sixteen patients (45%) were classified as cognitively impaired. Compared to cognitively preserved (CP) patients, cognitively impaired patients with MS had higher occurrence of T2 lesions as well as more severe damage to the WM and GM, as measured by atrophy and diffusivity abnormalities, in the posterior regions of the parietal lobes close to the midline (precuneus, posterior cingulum, and corpus callosum). Compared to the other study groups, they also showed reduced RS FC of the precuneus, whereas CP patients experienced an increased RS FC of the anterior cingulate cortex. A multivariable model identified diffusivity abnormalities of the cingulum and corpus callosum and RS FC of the precuneus as the covariates more strongly associated with cognitive impairment (C-index = 0.99). In pediatric patients with MS, cognitive dysfunction is associated with structural and functional abnormalities of the posterior core regions of the DMN. WM structural abnormalities co-occurring at this level are likely to be the substrate of such modifications.

  19. Cognitive Impairment and Dementia in Patients with Parkinson Disease

    Science.gov (United States)

    Leverenz, James B.; Quinn, Joseph F.; Zabetian, Cyrus; Zhang, Jing; Montine, Kathleen S.; Montine, Thomas J.

    2009-01-01

    Parkinson disease (PD) is an already prevalent neurodegenerative disease that is poised to at least double over the next 25 years. Although best known for its characteristic movement disorder, PD is now appreciated commonly to cause cognitive impairment, including dementia, and behavioral changes. Dementia in patients with PD is consequential and has been associated with reduced quality of life, shortened survival, and increased caregiver distress. Here we review clinical presentation and progression, pathological bases, identification of genetic risk factors, development of small molecule biomarkers, and emerging treatments for cognitive impairment in patients with PD. PMID:19754405

  20. Improvement in cognitive impairment after cataract surgery in elderly patients.

    Science.gov (United States)

    Tamura, Hiroki; Tsukamoto, Hidetoshi; Mukai, Satoshi; Kato, Tomoko; Minamoto, Atsushi; Ohno, Yuko; Yamashita, Hidetoshi; Mishima, Hiromu K

    2004-03-01

    To evaluate whether cognitive impairment improves in elderly patients who have cataract surgery with intraocular lens (IOL) implantation. Kouki Hospital, Yamaguchi, Japan. A prospective observational study evaluated patients' scores on the Revised Hasegawa Dementia Scale (HDS-R) and the HDS-R minus 1 item regarding immediate regeneration (ie, function of vision and memory). Twenty patients (6 men, 14 women) with cognitive impairment had cataract surgery in 1 eye between March 1996 and July 2001 at Kouki Hospital, Japan. The mean age of the patients was 81.8 years (range 61 to 90 years). Twenty patients (4 men, 16 women) with cognitive impairment who did not have cataract surgery were selected as a control. The mean age in the control group was 84.3 years (range 70 to 93 years). The HDS-R was administered twice between March 1996 and July 2001. The mean HDS-R scores in the cataract surgery group improved from 12.5 points +/- 5.3 (SD) preoperatively to 16.6 +/- 6.2 points postoperatively; the improvement was significant (t = -5.02; Pcognitive impairment improved in 12 patients (60%), was unchanged in 7 (35%), and was worse in 1 (5%). Cataract surgery improved cognitive impairment in elderly Japanese patients.

  1. Episodic future thinking in amnesic mild cognitive impairment

    OpenAIRE

    Gamboz, Nadia; De Vito, Stefania; Brandimonte, Maria A.; Pappalardo, Stella; Galeone, Filomena; Iavarone, Alessandro; Della Sala, Sergio

    2010-01-01

    Results from behavioral studies of amnesic patients and neuroimaging studies of individuals with intact memory suggest that a brain system involving direct contributions from the medial temporal lobes supports both remembering the past and imagining the future (Episodic Future Thinking). In the present study, we investigated whether amnesic Mild Cognitive Impairment (aMCI) affects EFT. Amnesic MCI is a high-risk factor for Alzheimer's disease and is characterized by a selective impairment of ...

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

    Science.gov (United States)

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

    2012-09-01

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

  3. [Life styles associated cognitive impairment. Study from the community pharmacy].

    Science.gov (United States)

    Moreno-Royo, Lucrecia; Climent, María Teresa; Vilaplana, Ana María; Arnedo, Alberto; Vilar, José

    2013-01-01

    Frequency of cognitive impairment among people over 65 years old in community pharmacy. Study of asssociated factors, referral of cases to the specialist and inclusion in a program of health education. Cross-sectional study of prevalence, frequency, conducted in four pharmacies (two urban and two rural pharmacies) in the Autonomous Community of Valencia. people over 65 years old who come to the pharmacy and who agree to participate in the study after signing an informed consent. It is used as the initial screening test, the Short Portable Mental State Questionnaire of Pfeiffer. Pfeiffer positive cases undergo a second test (Mini-Mental State Examination, NORMACODEM version). A questionnaire designed specifically for the study has been used to collect information. It includes questions to gain demographic data, questions on lifestyle and chronic diseases. We used analysis logistic regression multilevel. 245 patients have participated (76% of respondents). 12.65% were detected to have cognitive impairment. In the Logistic regression analysis multivariate there is a relation between cognitive impairment and some variables: age, lack of reading habit, unusual reading habit, sleeping less than 6 or more than 8 hours a day. Only 12.9% wanted to be referred for clinical evaluation and 42% were included in a cognitive training program. There are asssociation between lifestyle habits that are modifiable and cognitive impairment.

  4. [Dissociating between Enhancing and Impairing Effects of Emotion on Cognition].

    Science.gov (United States)

    Dolcos, Florin; Denkova, Ekaterina

    Objectives Emerging evidence suggests that emotion can have both enhancing and impairing effects on various cognitive processes. These opposing effects can be identified at different levels, both within the same cognitive process and across different processes, as well as at more general levels, such as in the case of the response to stress. The aim of the present review is to discuss recent advances in the mechanisms underlying the enhancing and impairing effects of emotion on different aspects within the same process (e.g., episodic memory) and across specific cognitive processes (perception vs. episodic memory, working memory vs. episodic memory), as well as in the context of the response to stress.Emerging Evidence The available evidence points to a number of aspects that dissociate the opposing effects of emotion on cognition. (i) Opposing effects within episodic memory can be attributed to different accounts, involving dissociation at different levels: central vs. peripheral trade-off, high vs. low prioritization of information processing, and items encoding vs. the formation of complex associations. (ii) The opposing effects across cognitive processes, such as perception and episodic memory, can be linked to dissociation between immediate/impairing vs. long-term/enhancing effects, which are mediated by common and dissociable neural mechanisms, involving bottom-up and top-down processes. (iii) Finally, in the larger context of the response to stress, emotional stress can lead to opposing effects depending on the degree, context, and controllability of the stressors.Conclusions Overall, the present review highlights the need to consider the various factors that can influence enhancing or impairing effects of emotion on cognition, in studies investigating emotion-cognition interactions. These issues are important for understanding mechanisms of emotion-cognition interactions not only in healthy functioning but also in emotional disturbances, where these

  5. 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.

  6. 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.

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

    NARCIS (Netherlands)

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

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Georg Adler

    2018-02-01

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

  9. 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)....

  10. Predicting cognitive impairment and accident risk.

    Science.gov (United States)

    Raslear, Thomas G; Hursh, Steven R; Van Dongen, Hans P A

    2011-01-01

    Sleep and cognition are temporally regulated by a homeostatic process generating pressure for sleep as a function of sleep/wake history, and a circadian process generating pressure for wakefulness as a function of time of day. Under normal nocturnal sleep conditions, these two processes are aligned in such a manner as to provide optimal daytime performance and consolidated nighttime sleep. Under conditions of sleep deprivation, shift work or transmeridian travel, the two processes are misaligned, resulting in fatigue and cognitive deficits. Mathematical models of fatigue and performance have been developed to predict these cognitive deficits. Recent studies showing long-term effects on performance of chronic sleep restriction suggest that the homeostatic process undergoes gradual changes that are slow to recover. New developments in mathematical modeling of performance are focused on capturing these gradual changes and their effects on fatigue. Accident risk increases as a function of fatigue severity as well as the duration of exposure to fatigue. Work schedule and accident rate information from an operational setting can thus be used to calibrate a mathematical model of fatigue and performance to predict accident risk. This provides a fatigue risk management tool that helps to direct mitigation resources to where they would have the greatest mitigating effect. Copyright © 2011 Elsevier B.V. All rights reserved.

  11. Semantic clustering and sleep in patients with amnestic mild cognitive impairment or with vascular cognitive impairment-no dementia.

    Science.gov (United States)

    Sun, Qingna; Luo, Lanlan; Ren, Honglei; Wei, Changjuan; Xing, Mengya; Cheng, Yan; Zhang, Nan

    2016-09-01

    Cognition and sleep deficits occur in amnestic mild cognitive impairment (aMCI) and vascular cognitive impairment-no dementia (VCIND). However, how memory and sleep deficits differ between aMCI and VCIND remains unclear. Fifty aMCI and 50 VCIND patients and 38 sex- and age-matched healthy controls (HCs) were administered the Hopkins Verbal Learning Test-Revised (HVLT-R), Trail Making Test-A/B (TMT-A/B), Wisconsin Card Sorting Test (WCST), Paced Auditory Serial Addition Test (PASAT), Symbol Digit Modalities Test (SDMT), Benton Judgment of Line Orientation (JLO) test, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Insomnia Severity Index (ISI) to quantify cognitive deficits and subjective sleep disturbance. Compared with VCIND patients, aMCI patients had lower HVLT-R scores for total recall (p sleep disturbance (PSQI, p sleep quality and efficiency were related to total and delayed recall (all r values from -0.31 to -0.60, p memory strategy and sleep impairment; these characteristics are helpful to identify and distinguish patients with very early cognitive impairment. Our results also suggest that memory deficits are associated with sleep disturbance in aMCI and VCIND.

  12. Vision and hearing impairments, cognitive impairment and mortality among long-term care recipients: a population-based cohort study

    OpenAIRE

    Mitoku, Kazuko; Masaki, Naoko; Ogata, Yukiko; Okamoto, Kazushi

    2016-01-01

    Background Vision and hearing impairments among elders are common, and cognitive impairment is a concern. This study assessed the association of vision and hearing impairments with cognitive impairment and mortality among long-term care recipients. Methods Data of 1754 adults aged 65 or older were included in analysis from the Gujo City Long-Term Care Insurance Database in Japan for a mean follow-up period of 4.7?years. Trained and certified investigators assessed sensory impairments and cogn...

  13. 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.

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

    Science.gov (United States)

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

    2016-10-01

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

  15. Cognitive impairment and structural brain damage in benign multiple sclerosis.

    Science.gov (United States)

    Rovaris, M; Riccitelli, G; Judica, E; Possa, F; Caputo, D; Ghezzi, A; Bertolotto, A; Capra, R; Falautano, M; Mattioli, F; Martinelli, V; Comi, G; Filippi, M

    2008-11-04

    Although in benign multiple sclerosis (BMS) locomotor disability is absent or only minimal, subclinical cognitive impairment seems to occur in many cases. Diffusion tensor (DT) MRI enables us to quantify the extent of "actual" tissue damage, which goes undetected when using conventional MRI. Against this background, we investigated the extent of structural brain damage underlying cognitive dysfunction in BMS, with the ultimate aim to move a first step toward a more reliable definition of this disease phenotype. Conventional and DT MRI scans of the brain were acquired from 62 BMS patients. Thirty-six secondary progressive multiple sclerosis (SPMS) patients and 19 healthy subjects served as controls. In BMS patients, neuropsychological tests exploring memory, attention, and frontal lobe functions were administered. Normalized brain volume (NBV), mean diffusivity (MD), and fractional anisotropy (FA) of the normal-appearing white matter (NAWM) and MD of the gray matter (GM) were computed. Twelve BMS patients (19%) fulfilled predefined criteria for cognitive impairment. BMS patients had abnormal MD and FA values from both NAWM and GM. Whereas BMS patients without cognitive impairment had lower T2 LV (p = 0.03), higher NBV (p = 0.006), and lower average GM MD (p = 0.03) than SPMS patients, BMS patients with cognitive impairment did not significantly differ from SPMS patients for any MRI-derived metric. In benign multiple sclerosis (BMS), cognitive dysfunction is associated with severe structural brain damage, which resembles that of patients with a much more disabling disease course. A reliable definition of BMS should, therefore, include the preservation of cognitive functioning as an additional requisite.

  16. 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

  17. Knight's move thinking? Mild cognitive impairment in a chess player.

    Science.gov (United States)

    Archer, H A; Schott, J M; Barnes, J; Fox, N C; Holton, J L; Revesz, T; Cipolotti, L; Rossor, M N

    2005-02-01

    We report the case of a chess player with superior premorbid cognitive function who presented to the Cognitive Disorders clinic at the National Hospital for Neurology and Neurosurgery with a 2-year history of symptoms of possible memory loss. Initially the MRI scan appearance was within normal limits and his cognitive scores inside the normal range; subsequently his cognitive function deteriorated and he fulfilled criteria for Mild Cognitive Impairment (MCI) two years later. Unexpectedly he died of an unrelated illness seven months later and post mortem examination of the brain was carried out, revealing advanced Alzheimer's disease (CERAD definite and NIA-Regan Institute high likelihood). This case highlights the difficulties encountered in assessing patients with superior premorbid function in the early stages of Alzheimer's disease, and reveals the value of serial MRI and neuropsychological assessment in detecting and monitoring early neurodegenerative disease.

  18. Assessing and addressing cognitive impairment in bipolar disorder

    DEFF Research Database (Denmark)

    Miskowiak, K W; Burdick, K E; Martinez-Aran, A

    2018-01-01

    OBJECTIVES: Cognition is a new treatment target to aid functional recovery and enhance quality of life for patients with bipolar disorder. The International Society for Bipolar Disorders (ISBD) Targeting Cognition Task Force aimed to develop consensus-based clinical recommendations on whether, when...... through these exchanges with no need for formal consensus methods. RESULTS: The identified questions were: (I) Should cognitive screening assessments be routinely conducted in clinical settings? (II) What are the most feasible screening tools? (III) What are the implications if cognitive impairment...... in Bipolar Disorder Rating Assessment, and (III) evaluate the impact of medication and comorbidity, refer patients for comprehensive neuropsychological evaluation when clinically indicated, and encourage patients to build cognitive reserve. Regarding question (IV), there is limited evidence for current...

  19. Retinal pathology as biomarker for cognitive impairment and Alzheimer's disease

    NARCIS (Netherlands)

    M.K. Ikram (Kamran); C.Y.-L. Cheung (Carol Yim-Lui); T.Y. Wong (Tien Yin); C. Chen (Christopher)

    2012-01-01

    textabstractAlzheimer's disease (AD) is the most common cause of dementia. Furthermore, over the last few decades, there has been a shift towards identifying earlier stages of AD, which include mild cognitive impairment (MCI). Improved methods of screening and early detection are essential to

  20. Amyrin attenuates scopolamine-induced cognitive impairment in mice.

    Science.gov (United States)

    Park, Se Jin; Ahn, Young Je; Oh, Sa Rang; Lee, Younghwan; Kwon, Guyoung; Woo, Hyun; Lee, Hyung Eun; Jang, Dae Sik; Jung, Ji Wook; Ryu, Jong Hoon

    2014-01-01

    Alzheimer's disease, a neurodegenerative disorder, is characterized by progressive cognitive impairment associated with the disruption of cholinergic neurotransmission. The aim of the present study was to evaluate the effect of α- or β-amyrin, a type of pentacyclic triterpene, on the cognitive impairment induced by scopolamine, a muscarinic acetylcholine receptor antagonist. To measure the abilities of various types of learning and memory, we conducted step-through passive avoidance task. Scopolamine induced deficits in learning and memory processes in mice, which were antagonized by a single administration of α-amyrin (2 or 4 mg/kg) or β-amyrin (4 mg/kg), respectively. Additionally, in vitro analysis revealed that acetylcholinesterase activity was inhibited by β-amyrin, but not by α-amyrin. Furthermore, Western blot analysis revealed that the expression levels of phosphorylated extracellular signal-regulated kinase 1/2 (pERK) and phosphorylated glycogen synthase kinase-3β (pGSK-3β) were significantly enhanced by a single administration of α- and β-amyrin in the hippocampus. Finally, the memory ameliorating effects of α- or β-amyrin on the scopolamine-induced cognitive impairments were significantly blocked by ERK inhibitor U0126. The present study suggests that α- and β-amyrin may ameliorate the cognitive impairment induced by hypocholinergic neurotransmission via the activation of ERK as well as GSK-3β signaling.

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

    African Journals Online (AJOL)

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

  2. Emotion and Cognition: Attitudes toward Persons Who Are Visually Impaired.

    Science.gov (United States)

    Verplanken, B.; And Others

    1994-01-01

    A survey of the attitudes toward people with visual impairments in rehabilitation agencies or health care centers in the Netherlands received 263 responses from the general public and rehabilitation workers. Analysis supported the usefulness of distinguishing between the emotional and cognitive components of attitudes. Implications for public and…

  3. 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…

  4. Mild cognitive impairment and dementia in a heterogeneous elderly ...

    African Journals Online (AJOL)

    Objective: To describe the demographic, clinical and risk profile of Mild Cognitive Impairment and dementia in a sample of elderly South Africans within a residential setting. Method: One hundred and forty participants residing in a group of residential homes for the elderly were assessed by psychiatrists and assigned ...

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

    Czech Academy of Sciences Publication Activity Database

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

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

  6. 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...

  7. Behavioral Syndromes in Mild Cognitive Impairment and Alzheimer's Disease

    NARCIS (Netherlands)

    Van der Mussele, Stefan; Marien, Peter; Saerens, Jos; Somers, Nore; Goeman, Johan; De Deyn, Peter P.; Engelborghs, Sebastiaan

    2014-01-01

    Background: Behavioral disturbances belong to the core symptoms of dementia and are also common in mild cognitive impairment (MCI). The identification of sets of symptoms is clinically interesting, as interventions targeting syndromes may be more effective than the management of individual symptoms.

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

    NARCIS (Netherlands)

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

    2016-01-01

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

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

    NARCIS (Netherlands)

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

    2013-01-01

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

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

    African Journals Online (AJOL)

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

  11. Frequency of cognitive impairment and depression in Parkinson's ...

    African Journals Online (AJOL)

    Background: This study aimed to determine the frequency of cognitive impairment and depression in our Parkinson's Disease (PD) and their relationship with disease severity and disability. Patients and Methods: A total of 40 PD patients and 40 age-, sex-, and educationally matched controls were studied. The Unified ...

  12. 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…

  13. Stroke occurring in patients with cognitive impairment or dementia

    Directory of Open Access Journals (Sweden)

    Solène Moulin

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

  14. Association between smoking and cognitive impairment in multiple sclerosis

    Directory of Open Access Journals (Sweden)

    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

  15. 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.

  16. Twelve tips for teaching about patients with cognitive impairment.

    Science.gov (United States)

    Fisher, James Michael; Tullo, Ellen; Chan, Kwong; Teodorczuk, Andrew

    2017-05-01

    The global population is ageing and consequently cognitive problems are increasingly prevalent. To ensure that the healthcare needs of this complex group are met, healthcare professionals must receive adequate training in this field. There are, however, a variety of reasons why this is not currently being achieved, including, but not limited to: ethical and logistical issues relating to the delivery of educational experiences involving cognitively impaired patients; a failure of curricula to keep pace with the changing demographic; societal and institutional ageism; and the inherent complexity of the conditions. This article highlights challenges associated with the delivery of such training to medical undergraduates and presents strategies to tackle these. Drawing on current evidence where available, the 12 tips below offer educators practical advice on how to maximize the value of medical undergraduates' educational experiences with cognitively impaired patients.

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

    DEFF Research Database (Denmark)

    Cosentino, Stephanie; Schupf, Nicole; Christensen, Kaare

    2013-01-01

    IMPORTANCE Family studies of centenarians and long-lived persons have found substantial familial aggregation of survival to extreme ages; however, the extent to which such familial longevity is characterized by cognitively intact survival is not established. OBJECTIVE To determine whether families...... of probands had significantly lower rates than spouse controls. Results suggest a delayed onset of cognitive impairment in families with exceptional longevity, but assessment of age-specific incidence rates is required to confirm this hypothesis....... with exceptional longevity are protected against cognitive impairment consistent with Alzheimer disease. DESIGN Cross-sectional analysis. SETTING Multisite study in New York, Massachusetts, Pennsylvania, and Denmark. PARTICIPANTS A total of 1870 individuals (1510 family members and 360 spouse controls) recruited...

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

    Directory of Open Access Journals (Sweden)

    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.

  19. Early numerical abilities and cognitive skills in kindergarten children.

    Science.gov (United States)

    Passolunghi, Maria Chiara; Lanfranchi, Silvia; Altoè, Gianmarco; Sollazzo, Nadia

    2015-07-01

    In this study, a unitary path analysis model was developed to investigate the relationship between cognitive variables (derived from published studies) and early numerical abilities in children attending the last year of kindergarten. We tested 100 children starting their last year of kindergarten on the following cognitive abilities: intelligence, phonological abilities, counting, verbal and visuospatial short-term memory and working memory, processing speed, and early numerical abilities. The same children were tested again on early numerical abilities at the end of the same year. The children's early numerical abilities at the beginning of the final year of kindergarten were found to be directly related to their verbal intelligence, phonological abilities, processing speed, and working memory and to be indirectly related to their nonverbal intelligence. Early numerical abilities at the end of the same year are directly related not only to early numerical abilities assessed at the beginning of the year but also to working memory and phonological abilities as well as have an indirect relationship with verbal and nonverbal intelligence. Overall, our results showed that both general and specific abilities are related to early mathematic learning in kindergarten-age children. Copyright © 2015 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2010-01-01

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

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

    NARCIS (Netherlands)

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

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

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  3. 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.

  4. Cognitive and behavioral consequences of impaired immunoregulation in aging.

    Science.gov (United States)

    Corona, Angela W; Fenn, Ashley M; Godbout, Jonathan P

    2012-03-01

    A hallmark of the aged immune system is impaired immunoregulation of the innate and adaptive immune system in the periphery and also in the central nervous system (CNS). Impaired immunoregulation may predispose older individuals to an increased frequency of peripheral infections with concomitant cognitive and behavioral complications. Thus, normal aging is hypothesized to alter the highly coordinated interactions between the immune system and the brain. In support of this notion, mounting evidence in rodent models indicate that the increased inflammatory status of the brain is associated with increased reactivity of microglia, the innate immune cells of the CNS. Understanding how immunity is affected with age is important because CNS immune cells play an integral role in propagating inflammatory signals that are initiated in the periphery. Increased reactivity of microglia sets the stage for an exaggerated inflammatory cytokine response following activation of the peripheral innate immune system that is paralleled by prolonged sickness, depressive-like complications and cognitive impairment. Moreover, amplified neuroinflammation negatively affects several aspects of neural plasticity (e.g., neurogenesis, long-term potentiation, and dendritic morphology) that can contribute to the severity of neurological complications. The purpose of this review is to discuss several key peripheral and central immune changes that impair the coordinated response between the immune system and the brain and result in behavioral and cognitive deficits.

  5. Cognitive impairment in patients with clinically isolated syndrome

    Directory of Open Access Journals (Sweden)

    Carolina Fiorin Anhoque

    Full Text Available ABSTRACT Cognitive abnormalities have been extensively studied in Multiple Sclerosis (MS. However, little is known about the cognitive involvement in patients with Clinically Isolated Syndrome (CIS. Objective: This study aimed to investigate cognitive impairment in patients with CIS compared with healthy subjects. Methods: 18 CIS patients and 18 controls were subjected to the Wechsler memory scale, Rey Auditory Verbal Learning, Rey Complex Figure, Paced Auditory Serial Addition, Digit Span, verbal fluency, Stroop color card test, D2, and Digit Symbol tests. Results: CIS patients had significantly worse performance on the Paced Auditory Serial Addition Test (PASAT 2 seconds (P=0.009 and on verbal fluency tests (P=0.0038 than controls. Conclusion: CIS patients had worse cognitive performance than controls on neuropsychological tests evaluating executive functioning.

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

    Science.gov (United States)

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

    2017-07-01

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

  7. Count on dopamine: influences of COMT polymorphisms on numerical cognition

    Directory of Open Access Journals (Sweden)

    Annelise eJúlio-Costa

    2013-08-01

    Full Text Available Catechol-O-methyltransferase (COMT is an enzyme that is particularly important for the metabolism of dopamine. Functional polymorphisms of COMT have been implicated in working memory and numerical cognition. This is an exploratory study that aims at investigating associations between COMT polymorphisms, working memory and numerical cognition. Elementary school children from 2th to 6th grades were divided into two groups according to their COMT val158met polymorphism (homozygous for valine allele [n= 61] versus heterozygous plus methionine homozygous children or met+ group [n=94]. Both groups were matched for age and intelligence. Working memory was assessed through digit span and Corsi blocks. Symbolic numerical processing was assessed through transcoding and single-digit word problem tasks. Non-symbolic magnitude comparison and estimation tasks were used to assess number sense. Between-group differences were found in symbolic and non-symbolic numerical tasks, but not in working memory tasks. Children in the met+ group showed better performance in all numerical tasks while val homozygous children presented slower development of non-symbolic magnitude representations. These results suggest COMT-related dopaminergic modulation may be related not only to working memory, as found in previous studies, but also to the development of magnitude processing and magnitude representations.

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

    Science.gov (United States)

    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. Copyright © 2012 Elsevier Inc. All rights reserved.

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

    Czech Academy of Sciences Publication Activity Database

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

    2016-01-01

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

  10. Non-Pharmacological Treatment in People With Cognitive Impairment.

    Science.gov (United States)

    Straubmeier, Melanie; Behrndt, Elisa-Marie; Seidl, Hildegard; Özbe, Dominik; Luttenberger, Katharina; Graessel, Elmar

    2017-12-01

    A number of non-pharmacological methods are available to help elderly people with cognitive impairment. Unstructured and non-evidencebased interventions are commonly used. The multicomponent therapy MAKS (a German acronym for Motor, Activities of daily living, Cognitive, Social) has already been evaluated in nursing homes; in this study, we investigated its use in day care centers (DCCs). A cluster-randomized, controlled, single-blinded trial involving a 6-month intervention phase was performed. 362 cognitively impaired persons in 32 DCCs took part in the trial. Multiple regression analyses were used to determine whether MAKS therapy led to any statistically significant and clinically relevant improvement over time (compared to membership in the control group) in these persons' cognitive abilities and activities of daily living (ADL) abilities, as assessed, respectively, with the Mini-Mental State Examination (MMSE) and the Erlangen Test of Activities of Daily Living in Persons with Mild Dementia or Mild Cognitive Impairment (ETAM). A primary per-protocol analysis was supplemented by an intention-to-treat analysis. Two secondary outcomes (social behavior and neuropsychiatric symptoms) were analyzed exploratively as well. Study registration: ISRCTN16412551. In the primary per-protocol analysis at 6 months, the intervention group had significantly better MMSE and ETAM scores than the control group (Cohen's d, 0.26 and 0.21, respectively; p = 0.012 for both). The same was found in the ITT analysis at 6 months (Cohen's d = 0.21, p = 0.033; and Cohen's d = 0.20, p = 0.019, respectively). Neuropsychiatric symptoms, one of the secondary outcomes, also evolved more favorably in the intervention group (Cohen's d = 0.23, p = 0.055). MAKS therapy is effective for persons with cognitive impairment ranging from mild cognitive impairment (MCI) to moderate dementia who live at home and regularly visit a day care center. The fact that 32 day care facilities from all over Germany

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    This study examined the prevalence of cognitive impairment and its association with depressive symptoms and self-reported cognitive complaints in Danish outpatients with systemic lupus erythematosus (SLE). Fifty-seven consecutive female SLE-outpatients were examined with a comprehensive neuropsyc......This study examined the prevalence of cognitive impairment and its association with depressive symptoms and self-reported cognitive complaints in Danish outpatients with systemic lupus erythematosus (SLE). Fifty-seven consecutive female SLE-outpatients were examined with a comprehensive...... 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 subjective cognitive complaints. When these variables and self......-rated depression score were entered into a regression model both depression score and Symbol Digit Modalities Test performances were significantly associated with the PDQ score. In conclusion, cognitive impairments were common in this group of (mild) SLE outpatients, but the level of significant subjective...

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

    Science.gov (United States)

    Johnson, Leigh A; Hall, James R; O'Bryant, Sid E

    2013-01-01

    Alzheimer's disease (AD) is a devastating public health problem that affects over 5.4 million Americans. Depression increases the risk of Mild Cognitive Impairment (MCI) and AD. By understanding the influence of depression on cognition, the potential exists to identify subgroups of depressed elders at greater risk for cognitive decline and AD. The current study sought to: 1) clinically identify a sub group of geriatric patients who suffer from depression related cognitive impairment; 2) cross validate this depressive endophenotype of MCI/AD in an independent cohort. Data was analyzed from 519 participants of Project FRONTIER. Depression was assessed with the GDS30 and cognition was assessed using the EXIT 25 and RBANS. Five GDS items were used to create the Depressive endophenotype of MCI and AD (DepE). DepE was significantly negatively related to RBANS index scores of Immediate Memory (B=-2.22, SE=.37, pcognitive change over 12- and 24-months. The current findings suggest that a depressive endophenotype of MCI and AD exists and can be clinically identified using the GDS-30. Higher scores increased risk for MCI and was cross-validated by predicting AD in the TARCC. A key purpose for the search for distinct subgroups of individuals at risk for AD and MCI is to identify novel treatment and preventative opportunities.

  13. Incidental MRI Findings in Patients with Impaired Cognitive Function

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Yoon Joon [Dept. of Radiology, College of Medicine, Inje University, Ilsan Paik Hospital, Goyang (Korea, Republic of)

    2013-01-15

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

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

    Science.gov (United States)

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

    2017-06-01

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

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

    Science.gov (United States)

    Sebastián Hernández, Ana J; Arranz Santamaría, Luís Carlos

    2017-06-01

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

  16. Daily circadian misalignment impairs human cognitive performance task-dependently.

    Science.gov (United States)

    Chellappa, Sarah L; Morris, Christopher J; Scheer, Frank A J L

    2018-02-14

    Shift work increases the risk for human errors, such that drowsiness due to shift work has contributed to major industrial disasters, including Space Shuttle Challenger, Chernobyl and Alaska Oil Spill disasters, with extraordinary socio-economical costs. Overnight operations pose a challenge because our circadian biology inhibits cognitive performance at night. Yet how the circadian system modulates cognition over multiple days under realistic shift work conditions remains to be established. Importantly, because task-specific cognitive brain regions show different 24-h circadian dynamics, we hypothesize that circadian misalignment impacts cognition task-dependently. Using a biologically-driven paradigm mimicking night shift work, with a randomized, cross-over design, we show that misalignment between the circadian pacemaker and behavioral/environmental cycles increases cognitive vulnerability on sustained attention, cognitive throughput, information processing and visual-motor performance over multiple days, compared to circadian alignment (day shifts). Circadian misalignment effects are task-dependent: while they acutely impair sustained attention with recovery after 3-days, they progressively hinder daily learning. Individuals felt sleepier during circadian misalignment, but they did not rate their performance as worse. Furthermore, circadian misalignment effects on sustained attention depended on prior sleep history. Collectively, daily circadian misalignment may provide an important biological framework for developing countermeasures against adverse cognitive effects in shift workers.

  17. 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.

  18. Brain Rhythms Connect Impaired Inhibition to Altered Cognition in Schizophrenia

    Science.gov (United States)

    Pittman-Polletta, Benjamin R.; Kocsis, Bernat; Vijayan, Sujith; Whittington, Miles A.; Kopell, Nancy J.

    2015-01-01

    In recent years, schizophrenia research has focused on inhibitory interneuron dysfunction at the level of neurobiology, and on cognitive impairments at the psychological level. Reviewing both experimental and computational findings, we show how the temporal structure of the activity of neuronal populations, exemplified by brain rhythms, can begin to bridge these levels of complexity. Oscillations in neuronal activity tie the pathophysiology of schizophrenia to alterations in local processing and large-scale coordination, and these alterations in turn can lead to the cognitive and perceptual disturbances observed in schizophrenia. PMID:25850619

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

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  20. Development of cognitive screening test for the severely hearing impaired: Hearing-impaired MoCA.

    Science.gov (United States)

    Lin, Vincent Y W; Chung, Janet; Callahan, Brandy L; Smith, Leah; Gritters, Nils; Chen, Joseph M; Black, Sandra E; Masellis, Mario

    2017-05-01

    To develop a version of the Montreal Cognitive Assessment (MoCA) to be administered to the severely hearing impaired (HI-MoCA), and to assess its performance in two groups of cognitively intact adults over the age of 60. Test development followed by prospective subject recruitment. The MoCA was converted into a timed PowerPoint (Microsoft Corp., Redmond, WA) presentation, and verbal instructions were converted into visual instructions. Two groups of subjects over the age of 60 were recruited. All subjects passed screening questionnaires to eliminate those with undiagnosed mild cognitive impairment. The first group had normal hearing (group 1). The second group was severely hearing impaired (group 2). Group 1 received either the MoCA or HI-MoCA test (T1). Six months later (T2), subjects were administered the test (MoCA or HI-MoCA) they had not received previously to determine equivalency. Group 2 received the HI-MoCA at T1 and again at T2 to determine test-retest reliability. One hundred and three subjects were recruited into group 1, with a score of 26.66 (HI-MoCA) versus 27.14 (MoCA). This was significant (P 0.05), with a test-retest coefficient of 0.66. The HI-MoCA is easy to administer and reliable for screening cognitive impairment in the severely hearing impaired. No conversion factor is required in our prospectively tested cohort of cognitively intact subjects. 1b. Laryngoscope, 127:S4-S11, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  1. Gray matter network measures are associated with cognitive decline in mild cognitive impairment.

    Science.gov (United States)

    Dicks, Ellen; Tijms, Betty M; Ten Kate, Mara; Gouw, Alida A; Benedictus, Marije R; Teunissen, Charlotte E; Barkhof, Frederik; Scheltens, Philip; van der Flier, Wiesje M

    2018-01-01

    Gray matter networks are disrupted in Alzheimer's disease and related to cognitive impairment. However, it is still unclear whether these disruptions are associated with cognitive decline over time. Here, we studied this question in a large sample of patients with mild cognitive impairment with extensive longitudinal neuropsychological assessments. Gray matter networks were extracted from baseline structural magnetic resonance imaging, and we tested associations of network measures and cognitive decline in Mini-Mental State Examination and 5 cognitive domains (i.e., memory, attention, executive function, visuospatial, and language). Disrupted network properties were cross-sectionally related to worse cognitive impairment. Longitudinally, lower small-world coefficient values were associated with a steeper decline in almost all domains. Lower betweenness centrality values correlated with a faster decline in Mini-Mental State Examination and memory, and at a regional level, these associations were specific for the precuneus, medial frontal, and temporal cortex. Furthermore, network measures showed additive value over established biomarkers in predicting cognitive decline. Our results suggest that gray matter network measures might have use in identifying patients who will show fast disease progression. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Simultaneously measuring gait and cognitive performance in cognitively healthy and cognitively impaired older adults: the basel motor-cognition dual-task paradigm

    OpenAIRE

    Theill, Nathan; Martin, Mike; Schumacher, Vera; Bridenbaugh, S A; Kressig, R W

    2011-01-01

    OBJECTIVES: To investigate dual-task performance of gait and cognition in cognitively healthy and cognitively impaired older adults using a motor–cognition dual-task paradigm. DESIGN: Cross-sectional retrospective study. SETTING: The Basel Memory Clinic and the Basel Study on the Elderly (Project BASEL). PARTICIPANTS: Seven hundred eleven older adults (mean age 77.2 ± 6.2, 350 (49.2%) female and 361 (50.8%) male). MEASUREMENTS: Gait velocity and cognitive task performance usin...

  3. Cognitive training for impaired neural systems in neuropsychiatric illness.

    Science.gov (United States)

    Vinogradov, Sophia; Fisher, Melissa; de Villers-Sidani, Etienne

    2012-01-01

    Neuropsychiatric illnesses are associated with dysfunction in distributed prefrontal neural systems that underlie perception, cognition, social interactions, emotion regulation, and motivation. The high degree of learning-dependent plasticity in these networks-combined with the availability of advanced computerized technology-suggests that we should be able to engineer very specific training programs that drive meaningful and enduring improvements in impaired neural systems relevant to neuropsychiatric illness. However, cognitive training approaches for mental and addictive disorders must take into account possible inherent limitations in the underlying brain 'learning machinery' due to pathophysiology, must grapple with the presence of complex overlearned maladaptive patterns of neural functioning, and must find a way to ally with developmental and psychosocial factors that influence response to illness and to treatment. In this review, we briefly examine the current state of knowledge from studies of cognitive remediation in psychiatry and we highlight open questions. We then present a systems neuroscience rationale for successful cognitive training for neuropsychiatric illnesses, one that emphasizes the distributed nature of neural assemblies that support cognitive and affective processing, as well as their plasticity. It is based on the notion that, during successful learning, the brain represents the relevant perceptual and cognitive/affective inputs and action outputs with disproportionately larger and more coordinated populations of neurons that are distributed (and that are interacting) across multiple levels of processing and throughout multiple brain regions. This approach allows us to address limitations found in earlier research and to introduce important principles for the design and evaluation of the next generation of cognitive training for impaired neural systems. We summarize work to date using such neuroscience-informed methods and indicate some

  4. 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...

  5. Learning mnemonics: roles of aging and subtle cognitive impairment.

    Science.gov (United States)

    Yesavage, J A; Sheikh, J I; Friedman, L; Tanke, E

    1990-03-01

    Previously validated methods of memory training were used in conjunction with the Folstein Mini-Mental State Examination (MMSE) to explore the relationship between complexity of learned mnemonic, aging, and subtle cognitive impairment. Subjects were 218 community-dwelling elderly. Treatment included imagery mnemonics for remembering names and faces and lists. There was a significant interaction among age, type of learning task (face-name vs. list), and improvement when controlling for MMSE score. There was also a significant interaction among MMSE score, type of learning task, and improvement when controlling for age. Scores on the more complex list-learning mnemonic were more affected by age and MMSE scores than were scores on the face-name mnemonic. Implications of the findings for cognitive training of the old old and the impaired are discussed.

  6. Spatial Navigation and APOE in Amnestic Mild Cognitive Impairment

    Czech Academy of Sciences Publication Activity Database

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

    2011-01-01

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

  7. Spatial navigation deficit in amnestic mild cognitive impairment

    Czech Academy of Sciences Publication Activity Database

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

    2007-01-01

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

  8. Il1-β involvement in cognitive impairment after sepsis.

    Science.gov (United States)

    Mina, Francielle; Comim, Clarissa M; Dominguini, Diogo; Cassol, Omar J; Dall Igna, Dhébora M; Ferreira, Gabriela K; Silva, Milena C; Galant, Leticia S; Streck, Emílio L; Quevedo, João; Dal-Pizzol, Felipe

    2014-04-01

    Sepsis is defined as the host's reaction to infection and characterised by a systemic inflammatory response with important clinical implications. Central nervous system dysfunction secondary to sepsis is associated with local generation of pro- and anti-inflammatory cytokines, impaired cerebral microcirculation, an imbalance of neurotransmitters, apoptosis and cognitive impairment. It's known that the IL-1β is one of the first cytokines to be altered. Thus, the objective of this study was to evaluate the role of IL-1β in cognitive parameters in brain tissue through the use of an IL-1β (IL-1ra) receptor antagonist up to 10 days and to assess blood-brain barrier permeability, cytokine levels, oxidative parameters and energetic metabolism up to 24 h, after sepsis induction. To this aim, we used sham-operated Wistar rats or submitted to the cecal ligation and perforation (CLP) procedure. Immediately after, the animals received one dose of 10 μg of IL-1ra. After 24 h, the rats were killed and were evaluated for biochemical parameters in the pre-frontal cortex, hippocampus and striatum. After 10 days, the animals were submitted to the habituation to the open field and step-down inhibitory avoidance task. We observed that the use of IL-1ra reverted the increase of blood-brain barrier permeability in the pre-frontal cortex, hippocampus and striatum; the increase of IL-1β, IL1-6 and TNF-α levels in the pre-frontal cortex and striatum; the decrease of complex I activity in the pre-frontal, hippocampus and striatum; the increase of oxidative parameters in pre-frontal cortex, hippocampus and striatum; and cognitive impairment. In conclusion, the results observed in this study reinforce the role of acute brain inflammatory response, in particular, the IL1β response, in the cognitive impairment associated with sepsis.

  9. Threat Perception in Mild Cognitive Impairment and Early Dementia

    OpenAIRE

    Julie D. Henry; Claire Thompson; Ted Ruffman; Felicity Leslie; Adrienne Withall; Perminder Sachdev; Henry Brodaty

    2009-01-01

    Mild cognitive impairment (MCI) and dementia affect many aspects of emotion processing. Even though the ability to detect threat is a particularly important aspect of emotion processing, no study to date has assessed threat perception in either of these groups. The purpose of the present study was to test whether individuals with MCI (n = 38) and mild dementia (n = 34) have difficulty differentiating between faces and situations normatively judged to be either high or low in threat relative t...

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

    Science.gov (United States)

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

    2010-01-01

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

  11. Physical Frailty, Cognitive Impairment, and the Risk of Neurocognitive Disorder in the Singapore Longitudinal Ageing Studies.

    Science.gov (United States)

    Feng, Liang; Nyunt, Ma Shwe Zin; Gao, Qi; Feng, Lei; Lee, Tih Shih; Tsoi, Tung; Chong, Mei Sian; Lim, Wee Shiong; Collinson, Simon; Yap, Philip; Yap, Keng Bee; Ng, Tze Pin

    2017-03-01

    The independent and combined effects of physical and cognitive domains of frailty in predicting the development of mild cognitive impairment (MCI) or dementia are not firmly established. This study included cross-sectional and longitudinal analyses of physical frailty (Cardiovascular Health Study criteria), cognitive impairment (Mini-Mental State Examination [MMSE]), and neurocognitive disorder (DSM-5 criteria) among 1,575 community-living Chinese older adults from the Singapore Longitudinal Ageing Studies. At baseline, 2% were frail, 32% were prefrail, and 9% had cognitive impairment (MMSE score impairment. Physical frailty categories were not significantly associated with incident NCD, but continuous physical frailty score and MMSE score showed significant individual and joint associations with incident mild NCD and dementia. Compared with those who were robust and cognitively normal, prefrail or frail old adults without cognitive impairment had no increased risk of incident NCD, but elevated odds of association with incident NCD were observed for robust with cognitive impairment (odds ratio [OR] = 4.04, p impairment (OR = 2.22, p = .044), and especially for frail with cognitive impairment (OR = 6.37, p = .005). The prevalence of co-existing frailty and cognitive impairment (cognitive frailty) was 1% (95% confidence interval [CI]: 0.5-1.4), but was higher among participants aged 75 and older at 5.0% (95% CI: 1.8-8.1). Physical frailty is associated with increased prevalence and incidence of cognitive impairment, and co-existing physical frailty and cognitive impairment confers additionally greater risk of incident NCD.

  12. Neuroimaging criteria and cognitive performance in vascular mild cognitive impairment: A systematic review

    Science.gov (United States)

    Sudo, Felipe Kenji; Alves, Gilberto Sousa; Tiel, Chan; Ericeira-Valente, Letice; Moreira, Denise Madeira; Laks, Jerson; Engelhardt, Eliasz

    2015-01-01

    The recognition of Cerebrovascular Disease (CVD) at earlier clinical stages may favor the control of vascular risk factors and prevention of dementia. However, operational criteria for symptomatic phases at non-dementia stages are often difficult, as the current criteria normally require the evidence of extensive subcortical disease. Objective To identify the neuroimaging profile of Vascular Mild Cognitive Impairment (VaMCI), the impact of those aspects over cognition and the neuropsychological tests that distinguished VaMCI from other groups. Methods Searches were performed in Scopus, ISI and PsycINFO, using the following key terms: "vascular mild cognitive impairment" OR "vascular cognitive impairment no dementia" OR "vascular cognitive impairment not demented" OR "subcortical mild cognitive impairment". Results Of 249 papers, 20 studies were selected. Ten of those included only patients with severe White Matter Hyperintensities (WMH), whereas 10 others admitted subjects with moderate-to-severe WMH. Both groups showed poor performances in Executive Function (EF) tasks in comparison to normal controls and other diagnostic groups. Among EF tests, those assessing "complex" EF abilities consistently distinguished VaMCI from other groups, regardless of the severity of WMH. VaMCI subjects with severe or moderate-to-severe WMH showed cognitive deficits in comparison with other groups. "Complex" EF tests were the most useful in differentiating those patients from the other groups. Conclusion The occurrence of VaMCI may be associated with the presence of CVD at moderate levels; the detection of vascular damage at earlier stages may allow the adoption of therapeutic actions with significant effect-sizes. PMID:29213989

  13. Perceived loneliness among older adults with mild cognitive impairment.

    Science.gov (United States)

    Yu, Junhong; Lam, Charlene L M; Lee, Tatia M C

    2016-10-01

    The high prevalence of mild cognitive impairment (MCI) in Hong Kong, as previously reported, requires verification. Furthermore, the relationship between loneliness, depression, and cognitive impairment with regards to MCI are unclear. The present study aims to establish the prevalence of MCI in a community sample in Hong Kong and determine if participants with MCI feel significantly lonelier, even after depression has been taken into consideration. Participants from a community sample (N = 376) were assessed with subjective and objective measures of cognitive impairments to determine whether the criteria had been met for MCI. The MCI cases are then compared with age, sex, and education-matched controls on subjective measures of loneliness and depression. A total of 66 (17.6%) participants were diagnosed with MCI. These participants reported significantly higher levels of perceived loneliness and depression compared to the matched controls. Differences between groups in loneliness remained significant, even after depression levels have been controlled. Loneliness is implicated in MCI. The relationship between loneliness and MCI is, at least, partially independent of depression. The implications of these finding are discussed.

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

    Science.gov (United States)

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

    2016-05-01

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

  15. Two systems of non-symbolic numerical cognition

    Directory of Open Access Journals (Sweden)

    Daniel C. Hyde

    2011-11-01

    Full Text Available Studies of human adults, infants, and non-human animals demonstrate that non-symbolic numerical cognition is supported by at least two distinct cognitive systems: a ‘parallel individuation system’ that encodes the numerical identity of individual items and an ‘approximate number system’ that encodes the approximate numerical magnitude, or numerosity, of a set. The exact nature of these systems, however, have been debated for over a hundred years. Some argue that the non-symbolic representation of small numbers (< 4 is carried out solely by the parallel individuation system and the non-symbolic representation of large numbers (> 4 is carried out solely by the approximate number system. Others argue that all numbers are represented by the approximate number system. This debate has been fueled largely by some studies showing dissociations in processing and other studies showing similar processing of small and large numbers. Recent work has addressed this debate by showing that the two systems are present and distinct from early infancy, persist despite the acquisition of a symbolic number system, activate distinct cortical networks, and engage differentially based attentional constraints. Based on the recent discoveries, I provide a hypothesis that may explain the puzzling findings and makes testable predictions as to when each system will be engaged. In particular, when items are presented under conditions that allow selection of individuals, they will be represented as distinct mental items through parallel individuation and not as a numerical magnitude. In contrast, when items are presented outside attentional limits (e.g. too many, too close together, under high attentional load, they will be represented as a single mental numerical magnitude and not as distinct mental items. These predictions provide a basis on which researchers can further investigate the role of each system in the development of uniquely human numerical thought.

  16. Screening for Cognitive Impairment in Multiple Sclerosis with MOCA Test

    Directory of Open Access Journals (Sweden)

    Selma Aksoy

    2013-06-01

    Full Text Available OBJECTIVE: Cognitive dysfunction is currently recognized as a significant cause of disability in multiple sclerosis (MS. The Montreal Cognitive Assessment (MOCA is screening device used to evaluate executive functions, visuo-spatial abilities, language, attention, and concentration, abstract thinking, memory, and orientation domain. The aim of this study is to compare cognitive functions of MS patients with age-matched controls using MOCA test. METHODS: Thirty nine subjects with a diagnosis of relapsing-remitting MS according to the 2010 revised McDonald criteria and 20 healthy volunteer controls participated in this study. Patients and controls underwent Turkish version of MOCA test. Total and subgroup scores were compared. RESULTS: Total MOCA score in MS patients and controls were 21,74±4,48 and 26,9±2,53 respectively. Total MOCA score of MS patients was significantly lower than controls. Significant deterioration was also found in language, attention, memory and executive functions domain. Disease duration and expanded disability status scale (EDSS did not differ in patients with and without cognitive deficits. CONCLUSION: Patients with MS showed deterioration in language, attention, working and long term-memory and executive functions compared to controls. MOCA is a simple, stand-alone cognitive screening test with superior sensitivity. Our findings suggest that the MOCA test may be useful for screening cognitive impairment in MS patients early in the disease course

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

    Directory of Open Access Journals (Sweden)

    Maria Lindau

    2014-12-01

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

  18. Contextual social cognition impairments in schizophrenia and bipolar disorder.

    Science.gov (United States)

    Baez, Sandra; Herrera, Eduar; Villarin, Lilian; Theil, Donna; Gonzalez-Gadea, María Luz; Gomez, Pedro; Mosquera, Marcela; Huepe, David; Strejilevich, Sergio; Vigliecca, Nora Silvana; Matthäus, Franziska; Decety, Jean; Manes, Facundo; Ibañez, Agustín M

    2013-01-01

    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. 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. 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.

  19. 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.

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

    OpenAIRE

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

    2009-01-01

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

  1. Social cognition impairments in Asperger syndrome and schizophrenia.

    Science.gov (United States)

    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. Copyright © 2012 Elsevier B.V. All rights reserved.

  2. 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.

  3. Cognitive Impairment among Older Adults in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Hirschman, Karen

    2011-02-01

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

  4. Pulmonary Function Impairment May be An Early Risk Factor for Late-Life Cognitive Impairment

    Science.gov (United States)

    Vidal, Jean-Sébastien; Aspelund, Thor; Jonsdottir, Maria K.; Jonsson, Palmi V.; Harris, Tamara B.; Lopez, Oscar L.; Gudnason, Vilmundur; Launer, Lenore J.

    2012-01-01

    Background Low pulmonary function (PF) is associated with poor cognitive function and dementia. There are few studies of change in PF in mid-life and late-life cognitive status. Design and Participants We studied this is 3,665 subjects from AGES-Reykjavik Study who had at least one measure of forced expiratory volume/ 1 sec (FEV1) and were cognitively tested on average 23 years later. A subset of 1,281 subjects had two or three measures of FEV1 acquired over a 7.8 year period. PF was estimated as FEV1/Height2. Rate of PF decline was estimated as the slope of decline over time. Cognitive status was measured with continuous scores of memory, speed of processing, and executive function, and as the dichotomous outcomes of mild cognitive impairment (MCI) and dementia. Results Lower PF measured in mid-life predicted lower memory, speed of processing, executive function, and higher likelihood of MCI and dementia 23 years later. Decrease of PF over a 7.8-year period in mid-life was not associated with lower cognitive function or dementia. Conclusion Reduced PF measured in mid-life may be an early marker of later cognitive problems. Additional studies characterizing early and late PF changes are needed. PMID:23311554

  5. Cognitive decline and amyloid accumulation in patients with mild cognitive impairment

    DEFF Research Database (Denmark)

    Koivunen, Jaana; Karrasch, Mira; Scheinin, Noora M

    2012-01-01

    Background/Aims: The relationship between baseline (11)C-Pittsburgh compound B ((11)C-PIB) uptake and cognitive decline during a 2-year follow-up was studied in 9 patients with mild cognitive impairment (MCI) who converted to Alzheimer's disease (AD) and 7 who remained with MCI. Methods: (11)C......-PIB PET scan was conducted at baseline and cognitive assessment both at baseline and at follow-up. To obtain quantitative regional values of (11)C-PIB uptake, automated region of interest analysis was done using spatially normalized parametric ratio (region-to-cerebellar cortex) images. Results...

  6. 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

  7. 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.

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

    OpenAIRE

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

    2017-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Kell Grandjean da Costa

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

  10. Vision impairment and combined vision and hearing impairment predict cognitive and functional decline in older women

    OpenAIRE

    Lin, MY; Gutierrez, PR; Stone, KL; Yaffe, K; Ensrud, KE; Fink, HA; Sarkisian, CA; Coleman, AL; Mangione, CM

    2004-01-01

    OBJECTIVES: To determine the association between vision and hearing impairment and subsequent cognitive and functional decline in community-residing older women. DESIGN: Prospective cohort study. SETTING: Four metropolitan areas of the United States. PARTICIPANTS: A total of 6,112 women aged 69 and older participating in the Study of Osteoporotic Fractures (SOF) between 1992 and 1994. MEASUREMENTS: Five thousand three hundred forty-five participants had hearing measured, 1,668 had visual acui...

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

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    Juliana Yumi Tizon Kasai

    2010-03-01

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

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

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    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.

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

    LENUS (Irish Health Repository)

    Rohde, Daniela

    2017-12-08

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

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  15. 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

  16. [Awareness disorders in Alzheimer's disease and in mild cognitive impairment].

    Science.gov (United States)

    Jacus, J-P; Dupont, M-P; Herades, Y; Pelix, C; Large, H; Baud, M

    2014-04-01

    Awareness disorders in Alzheimer's disease still remains unclear despite much research regarding this phenomenon. Papers report various and contrasted results with varying frequency from one study to another. Hence, the interest in awareness in Alzheimer's disease remains limited. Nevertheless, this symptom is closely associated with caregivers' burden and increases the patient's dependency, since the patient is unable to avoid dangers, requiring some care services or institutionalization The purpose of this current review is to recall the main neuro-anatomical and theoretical basis of awareness disorders, and to highlight the recent findings in Alzheimer's disease and in its pre-clinical stages. With this in mind, we have conducted a non-exhaustive search using the pubmed online database to collect the most important reviews and the most recent findings regarding awareness disorders in Mild Cognitive Impairment (MCI) and/or in Alzheimer's disease. In Alzheimer's disease, the links between awareness disorders and other variables, such as severity of dementia or depression, change from one study to the other and do not permit one to understand whether unawareness is an intrinsic or extrinsic reaction to the pathological process itself. Recent results suggest executive, cognitive and behavioral correlates more than psychopathological correlates, although the latter cannot be excluded. In Mild Cognitive Impairment, studies show varied results. Some studies report that patients suffering from Mild Cognitive Impairment can be compared to healthy control subjects and both groups have better awareness than patients with Alzheimer's disease. However, other studies show contrary results and awareness disorders might be a predictor of conversion from Mild Cognitive Impairment to dementia, as with apathy, in which the ability to cope with difficulties represents one of the main features. These controversial results are due to the heterogeneity of Alzheimer patients and in

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

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    Ma Shwe Zin Nyunt

    2017-12-01

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

  18. Assessment for apraxia in Mild Cognitive Impairment and Alzheimer's disease

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    Mirela Ward

    Full Text Available OBJECTIVE: To evaluate apraxia in healthy elderly and in patients diagnosed with Alzheimer's disease (AD and Mild cognitive impairment (MCI. METHODS: We evaluated 136 subjects with an average age of 75.74 years (minimum 60 years old, maximum 92 years old and average schooling of 9 years (minimum of 7 and a maximum of 12 years, using the Mini-Mental State examination (MMSE, Cambridge Cognitive Examination (CAMCOG and the Clock Drawing Test. For the analysis of the presence of apraxia, eight subitems from the CAMCOG were selected: the drawings of the pentagon, spiral, house, clock; and the tasks of putting a piece of paper in an envelope; the correct one hand waiving "Goodbye" movements; paper cutting using scissors; and brushing teeth. RESULTS: Elder controls had an average score of 11.51, compared to MCI (11.13, and AD patients, whose average apraxia test scores were the lowest (10.23. Apraxia scores proved able to differentiate the three groups studied (p=0.001. In addition, a negative correlation was observed between apraxia and MMSE scores. CONCLUSION: We conclude that testing for the presence of apraxia is important in the evaluation of patients with cognitive impairments and may help to differentiate elderly controls, MCI and AD.

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Matheus U. Chupel

    2017-06-01

    Full Text Available 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.

  1. 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

  2. Functional impairment in elderly patients with mild cognitive impairment and mild Alzheimer disease.

    Science.gov (United States)

    Brown, Patrick J; Devanand, D P; Liu, Xinhua; Caccappolo, Elise

    2011-06-01

    The original mild cognitive impairment (MCI) criteria exclude substantial functional deficits, but recent reports suggest otherwise. Identifying the extent, severity, type, and correlates of functional deficits that occur in MCI and mild Alzheimer disease (AD) can aid in early detection of incipient dementia and can identify potential mechanistic pathways to disrupted instrumental activities of daily living (IADLs). To examine the number, type, and severity of functional impairments and to identify the clinical characteristics associated with functional impairment across patients with amnestic MCI (aMCI) and those with mild AD. Study using baseline data from the Alzheimer's Disease Neuroimaging Initiative. Multiple research sites in the United States and Canada. Patients Samples included 229 control individuals, 394 patients with aMCI, and 193 patients with AD. The 10-item Pfeffer Functional Activities Questionnaire (FAQ) assessed function. Informant-reported FAQ deficits were common in patients with aMCI (72.3%) and AD (97.4%) but were rarely self-reported by controls (7.9%). The average severity per FAQ deficit did not differ between patients with aMCI and controls; both were less impaired than patients with AD (P holidays, and medications and assembling tax records, business affairs, or other papers) were specific (specificity estimate, 0.95) in differentiating the control group from the combined aMCI and AD groups (only 34.0% of patients with aMCI and 3.6% of patients with AD had no difficulty with these 2 items). The severity of FAQ deficits in the combined aMCI and AD group was associated with worse Trail Making Test, part A scores and smaller hippocampal volumes (P holidays, and medications and assembling tax records, business affairs, or other papers--appear to be characteristic of clinically significant cognitive impairment. In patients with aMCI, impairment in memory and processing speed and greater medial temporal atrophy were associated with greater

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

    Science.gov (United States)

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

    2014-04-01

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

  4. Validity of a novel computerized cognitive battery for mild cognitive impairment

    Directory of Open Access Journals (Sweden)

    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.

  5. Experimental Neonatal Sepsis Causes Long-Term Cognitive Impairment.

    Science.gov (United States)

    Comim, Clarissa M; Bussmann, Regina M; Simão, Silvia R; Ventura, Letícia; Freiberger, Viviane; Patrício, Janini J; Palmas, Daphne; Mendonça, Bruna P; Cassol, Omar J; Quevedo, João

    2016-11-01

    Neonatal sepsis is a major cause of morbidity and mortality in neonatal intensive care units. Treatment with antibiotics reduces mortality and morbidity, but neonatal sepsis remains a serious life-threatening condition. The objective of this study was to evaluate cognitive impairment in adult mice submitted to sepsis in the neonatal period. To this aim, 2-day-old male C57BL/6 mice were submitted to sepsis by injection of 25 μg of LPS. Sixty days after, the learning and memory were evaluated. It was observed that the mice submitted to neonatal sepsis presented impairment of habituation, aversive, and object recognition memories, and had an increase of immobility time in forced swimming test in adulthood. In conclusion, this study shows that the neonatal sepsis causes long-term brain alterations. These alterations can persist to adulthood in an animal model due to a vulnerability of the developing brain.

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

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  7. Experimental pain processing in individuals with cognitive impairment

    DEFF Research Database (Denmark)

    Defrin, Ruth; Amanzio, Martina; de Tommaso, Marina

    2015-01-01

    communicating the features of their pain to others, which in turn presents a significant challenge for effective diagnosis and treatment of their pain. Herein, we review the literature on responsivity of individuals with CI to experimental pain stimuli. We discuss pain responding across a large number......Cognitive impairment (CI) can develop during the course of ageing and is a feature of many neurological and neurodegenerative diseases. Many individuals with CI have substantial, sustained and complex healthcare needs which frequently include pain. However, individuals with CI can have difficulty...... of neurological and neurodegenerative disorders in which CI is typically present. Overall, the existing data suggest that pain processing is altered in most individuals with CI compared to cognitively intact matched controls. The precise nature of these alterations varies with the type of CI (or associated...

  8. Coping with cognitive impairment and dementia: Rural caregivers' perspectives.

    Science.gov (United States)

    Branger, Camille; Burton, Rachel; O'Connell, Megan E; Stewart, Norma; Morgan, Debra

    2016-07-01

    Caregiving in a rural context is unique, but the experience of rural caregivers is understudied. This paper describes how rural caregivers cope with caring for a loved one diagnosed with mild cognitive impairment or dementia using qualitative description to generate a low-inference summary of a response to an open-ended question. This approach allowed these rural caregivers to describe their positive experiences in addition to the more commonly explored caregiver experiences related to stress. Analyses of coping revealed use of social support, engaging in relaxing and physical activity, and cognitive reframing. In addition, caregivers reported strong faith and religiosity, and to a lesser frequency behavioral changes, checking in with the person with dementia via telephone, and joint activity. Predominantly, these methods reflect approach-based strategies. The current data suggest that these caregivers manage well and adopt adaptive coping strategies to meet the demands of the caregiving role. © The Author(s) 2014.

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

    Directory of Open Access Journals (Sweden)

    Philip Benjamin

    2014-01-01

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

  10. Bibliometric analysis of papers on mild cognitive impairment nursing in China

    Directory of Open Access Journals (Sweden)

    Yating Ai

    2017-01-01

    Conclusion: Beijing and Shanghai established core author groups for mild cognitive impairment nursing research. These studies should focus on the community and psychological nursing of such impairment. Targeted nursing interventions on different types of mild cognitive impairment should be adopted, new avenues for research should be opened, and various research methods should be introduced.

  11. Depression and Cognitive Function in Mild Cognitive Impairment: A 1-Year Follow-Up Study.

    Science.gov (United States)

    Yoon, Seoyoung; Shin, Cheolmin; Han, Changsu

    2017-09-01

    The coexistence of depression with mild cognitive impairment (MCI) seems to increase the risk of dementia. However, the explanations of that relationship have been inconsistent. We investigated cognitive profiles in patients with MCI with and without depression and whether changes in depression symptoms affect cognition longitudinally. For the study, 161 patients with MCI were divided into a depressed group (D+) and a nondepressed group (D-). After 1 year, we redivided the original D- group into D- and newly developed depression (Dd) groups and the D+ group into improved depression (Di) and nonimproved depression (Dn) groups. Neuropsychological tests assessing depression and cognitive domains were performed at baseline and follow-up. When age-adjusted, the D+ group showed significantly poorer performance in general cognition and some subtests regarding memory, executive function, and attention. At the 1-year follow-up, changes in the calculation test ( P = .005) and Controlled Oral Word Test (COWAT; P = .048) were significantly different between groups. Only the Di group showed significant improvement in calculation. The Dn group showed significant decrement in COWAT that was significantly different from that of the Di group, which showed no significant change. Patients with depression having MCI showed poorer cognitive function than nondepressed patients with MCI in some cognitive domains. Improvement in depression was related to improvement or prevention of decline in cognitive measures.

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

    Directory of Open Access Journals (Sweden)

    Eliane Correa Miotto

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

  13. Contextual Social Cognition Impairments in Schizophrenia and Bipolar Disorder

    Science.gov (United States)

    Villarin, Lilian; Theil, Donna; Gonzalez-Gadea, María Luz; Gomez, Pedro; Mosquera, Marcela; Huepe, David; Strejilevich, Sergio; Vigliecca, Nora Silvana; Matthäus, Franziska; Decety, Jean; Manes, Facundo; Ibañez, Agustín M.

    2013-01-01

    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. PMID:23520477

  14. Contextual social cognition impairments in schizophrenia and bipolar disorder.

    Directory of Open Access Journals (Sweden)

    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.

  15. 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.

  16. Psychological changes and cognitive impairments in adolescent heavy drinkers.

    Science.gov (United States)

    Peeters, Margot; Vollebergh, Wilma A M; Wiers, Reinout W; Field, Matt

    2014-01-01

    Adolescence is a developmental period characterized by increased risk-taking behavior, including the initiation of alcohol and other substance use. In this brief review paper we describe psychological and cognitive constructs that are associated with heavy drinking during adolescence. These associations raise the question of causality: is alcohol somehow neurotoxic, or can we identify specific psychological and cognitive variables that serve as risk factors for the escalation of heavy drinking? This narrative review summarizes results of recent prospective studies that focus on causal relationships between adolescents' alcohol use, and psychological changes and cognitive impairments. Psychological constructs such as elevated impulsivity and poor executive function are risk factors for alcohol involvement in youth. Furthermore heavy drinking during adolescence, particularly in a binge pattern, may exert neurotoxic effects and produce corresponding changes in executive function, perhaps setting the stage for the development of alcohol use disorders later on in life. Although the findings of the discussed studies shed light on the nature of the relationships between alcohol involvement and cognitive deficits, the question of cause and effect remains unanswered. The limitations of existing research and the need for well-powered prospective studies are highlighted.

  17. Anticholinergic drugs and cognitive impairment in the elderly.

    Science.gov (United States)

    López-Matons, Núria; Conill Badell, Dolors; Obrero Cusidó, Gloria; Gil Saladié, Domènec; Padrós Selma, Jaume; Martin-López, Adela

    2018-03-07

    Describe the prevalence of the anticholinergic drugs (AD) used in patients who consult in regard to loss of memory. Assess the cognitive and functional repercussion of these drugs. Retrospective review of the clinic history of the patients who consulted the clinic in 2015 and 2016. We used the Anticholinergic Cognitive Burden Scale. We explored cognition with the Mini Mental State Examination (MMSE) and function with the Barthel Index and the Lawton and Brody Scale. We compared the difference of scale scores between the patients exposed and not exposed to AD. Sample size of 610 patients (mean age=81.1years), 71% female. 37.2% of patients took AD. The mean (SD) difference between exposed and not exposed patients and the year-on-year worsening rate of the Barthel Index and the Lawton and Brody Scale and MMSE were -4 (4.5), -0.3 (0.4) and -1 (0.9), respectively. One third of patients who consulted for cognitive loss are taking AD. Patients exposed to AD show a greater tendency to impairment. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

  18. Enhanced neural activation with blueberry supplementation in mild cognitive impairment.

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    Boespflug, Erin L; Eliassen, James C; Dudley, Jonathan A; Shidler, Marcelle D; Kalt, Wilhelmina; Summer, Suzanne S; Stein, Amanda L; Stover, Amanda N; Krikorian, Robert

    2018-05-01

    Preclinical studies have shown that blueberry supplementation can improve cognitive performance and neural function in aged animals and have identified associations between anthocyanins and such benefits. Preliminary human trials also suggest cognitive improvement in older adults, although direct evidence of enhancement of brain function has not been demonstrated. In this study, we investigated the effect of blueberry supplementation on regional brain activation in older adults at risk for dementia. In a randomized, double-blind, placebo-controlled trial we performed pre- and post-intervention functional magnetic resonance imaging during a working memory (WM) task to assess the effect of blueberry supplementation on blood oxygen level-dependent (BOLD) signal in older adults with mild cognitive impairment, a risk condition for dementia. Following daily supplementation for 16 weeks, blueberry-treated participants exhibited increased BOLD activation in the left pre-central gyrus, left middle frontal gyrus, and left inferior parietal lobe during WM load conditions (corrected P blueberry supplementation. Diet records indicated no between-group difference in anthocyanin consumption external to the intervention. These data demonstrate, for the first time, enhanced neural response during WM challenge in blueberry-treated older adults with cognitive decline and are consistent with prior trials showing neurocognitive benefit with blueberry supplementation in this at-risk population.

  19. 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.

  20. Characteristics of the GPCOG, a screening tool for cognitive impairment.

    Science.gov (United States)

    Brodaty, Henry; Kemp, Nicola M; Low, Lee-Fay

    2004-09-01

    Early dementia diagnosis is aided by the use of brief screening tests; scores can be biased by patient and informant characteristics such as age, gender and education. To assess whether the General Practitioner's Assessment of Cognition (GPCOG), a brief screening tool for detecting cognitive impairment comprising a patient cognitive test and questions to an informant, is biased by patient and informant characteristics. Sixty-seven general practitioners recruited consecutive patients (with informants). Patients were subsequently assessed by a research psychologist, and DSM-IV diagnoses assigned following a case-conference. Primary Care. Two hundred and eighty three home-dwelling individuals, 11.3% of whom were aged 50-74 years with suspected memory problems and the rest aged 75 or more. The GPCOG, Cambridge Mental Disorder of the Elderly Examination cognitive scale (CAMCOG), Geriatric Depression Scale (GDS), and the SF-12 Health Survey (SF-12) were administered and demographic data were collected and consensus DSM-IV diagnoses of dementia made. Relationships between patient and informant characteristics and the GPCOG measure were examined using Pearson correlations and linear regression analyses. There were correlations in GPCOG-patient scores with age, education and depression scores but on regression analysis only age was associated with the GPCOG-patient section. The GPCOG-informant section was free of bias. The GPCOG has advantages for use in primary care and is free of many biases common in other scales.

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

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    Leigh A Johnson

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

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

    Science.gov (United States)

    Girard, Timothy D; Self, Wesley H; Edwards, Kathryn M; Grijalva, Carlos G; Zhu, Yuwei; Williams, Derek J; Jain, Seema; Jackson, James C

    2018-01-26

    Recent studies suggest older patients hospitalized for community-acquired pneumonia are at risk for new-onset cognitive impairment. The characteristics of long-term cognitive impairment after pneumonia, however, have not been elucidated. To characterize long-term cognitive impairment among adults of all ages hospitalized for community-acquired pneumonia. Prospective cohort study. Adults without severe preexisting cognitive impairment who were hospitalized with community-acquired pneumonia. At enrollment, we estimated baseline cognitive function with the Short Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). At 2- and 12-month follow-up, we assessed cognition using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and tests of executive function, diagnosing cognitive impairment when results were ≥ 1.5 standard deviations below published age-adjusted means for the general population. We also identified subtypes of mild cognitive impairment using standard definitions. We assessed 58 (73%) of 80 patients who survived to 2-month follow-up and 57 (77%) of 74 who survived to 12-month follow-up. The median [range] age of survivors tested was 57 [19-97] years. Only 8 (12%) had evidence of mild cognitive impairment at baseline according to the Short IQCODE, but 21 (38%) at 2 months and 17 (30%) at 12 months had mild cognitive impairment per the RBANS. Moderate-to-severe cognitive impairment was common among adults ≥ 65 years [4/13 (31%) and 5/13 (38%) at 2 and 12 months, respectively] but also affected many of those impairment in multiple cognitive domains affected one-third of patients ≥ 65 years old and 20% of younger patients, and another third of survivors had mild cognitive impairment.

  4. Aboriginal prisoners and cognitive impairment: the impact of dual disadvantage on Social and Emotional Wellbeing.

    Science.gov (United States)

    Shepherd, S M; Ogloff, J R P; Shea, D; Pfeifer, J E; Paradies, Y

    2017-04-01

    Negligible information is available regarding the Social and Emotional Wellbeing (SEWB) needs of Aboriginal Australian individuals in custody with cognitive impairment. This is problematic given that Aboriginal people with cognitive impairment often experience dual disadvantage in the context of the justice system. This study sought to ascertain the relationship between cognitive impairment and mental health/cultural needs (SEWB) Aboriginal and Torres Strait Islander people in custody. A sample of 122 Aboriginal and Torres Strait Islander people were administered a culturally themed semi-structured questionnaire in custodial settings in Victoria, Australia. The questionnaire included measures of cognitive impairment, SEWB and forensic needs. Analyses were performed to determine differences in the presence of SEWB and unmet custodial needs by level of cognitive impairment. Findings revealed a diminished level of wellbeing for cognitively impaired participants across several factors. Cognitive impairment was associated with poorer coping mechanisms, additional experiences of racism, difficulties handling emotions, discomfort around non-Aboriginal people and reduced access to meaningful activities in custody. All participants regardless of their level of impairment recognised the importance of cultural engagement; however, cognitively impaired participants had greater difficulty accessing/practicing cultural activities. Culturally responsive disability assistance should be available at all phases of the justice system for Indigenous people with cognitive impairment to ensure that equitable care is accessible and needs are addressed. © 2017 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  5. Audiospatial cognitive ability of visually impaired athletes in static and dynamic spatial cognitive tasks.

    Science.gov (United States)

    Shiota, Kotomi; Tokui, Akane

    2017-11-01

    [Purpose] This study compares the orientation sense of sighted and visually impaired participants to provide basic research on the audiospatial cognitive ability of visually impaired athletes. [Subjects and Methods] Subjects included nine blind athletes and seven sighted subjects wearing eyeshades during static and dynamic tasks. In the static spatial cognitive task, a coin was dropped towards the right, center, or left of the subject, and the task consisted of identifying the location of the coin. In the dynamic spatial cognitive task, performed with the participant walking, an auditory stimulus was provided. In both spatial cognitive tasks, the independent variables consisted of the "blind athlete" and "sight" groups, as well as three directions; a one-way analysis of variance was performed with the mean error angle as a dependent variable using IBM SPSS Statistics. [Results] The error angles found in the rightward and leftward directions during the static task showed no significant differences, but in the dynamic task, the sight group showed a markedly greater error in the left side, indicating a right-and-left asymmetry in spatial cognition. [Conclusion] Our results suggest a highly developed skill of instantly determining the spatial orientation of auditory information in dynamic situations in blind athletes.

  6. Impact of cognitive and social cognitive impairment on functional outcomes in patients with schizophrenia.

    Science.gov (United States)

    Green, Michael F

    2016-02-01

    Schizophrenia is a severely disabling disease that affects millions of people worldwide. The notion of recovery from schizophrenia has recently become a topic of both research and clinical focus. With the advent of antipsychotic medications in the 1950s, many more patients achieved symptom remission than ever before. However, less than half of all patients have been able to achieve recovery. With so many drugs available to improve the symptoms of schizophrenia, why is the disorder still associated with such severe disability? In the last couple of decades, researchers and clinicians have begun to realize that a hindrance to widespread recovery is that available antipsychotic medications have been effective in treating the positive symptoms (hallucinations and delusions) of schizophrenia but not other features of illness such as cognitive impairment. Dysfunction in cognition and social cognition has a significant impact on patients' functional status, meaning that impaired cognition and social cognition should be treatment targets to improve the likelihood of recovery. © Copyright 2016 Physicians Postgraduate Press, Inc.

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

    Science.gov (United States)

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

    2016-07-01

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

  8. 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.

  9. [Beyond Cognitive Impairment: Neuropsychiatric Symptoms in Neurodegenerative Dementias].

    Science.gov (United States)

    Ahunca Velásquez, Luisa Fernanda

    2017-10-01

    As life expectancy increases, the number of people diagnosed with neurodegenerative dementia also increases. Although cognitive impairment is central in dementia, neuropsychiatric symptoms (NPS) are very important because they increase both direct and indirect costs by generating greater morbidity, caregiver distress, use of medication and institutionalisation. Furthermore, it is important to understand the nature of NPS, since they can vary across the different types of dementia and may provide useful clinical information regarding the aetiology of cognitive impairment. The first-line management of NPS in dementia is non-pharmacological; internal and external causes should first be identified and strategies developed to modify the behavioural patterns of the patient and their caregiver. In addition, changes in the patient's surroundings that may improve patient performance and behaviour should be encouraged. If these practices are not satisfactory, a pharmacological treatment approach is adopted that includes anti-dementia drugs, antipsychotics, antidepressants, mood stabilisers and benzodiazepines. However, psychoactive drugs do not offer sufficient efficacy and most of them have significant adverse effects, so each patient should be individually assessed, together with the implementation of non-pharmacological strategies, before deciding on pharmacological treatment for the management of NPS in dementia. Copyright © 2017 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  10. Hippocampal dysfunction and cognitive impairment in Fragile-X Syndrome.

    Science.gov (United States)

    Bostrom, Crystal; Yau, Suk-Yu; Majaess, Namat; Vetrici, Mariana; Gil-Mohapel, Joana; Christie, Brian R

    2016-09-01

    Fragile-X Syndrome (FXS) is the most common form of inherited intellectual disability and the leading genetic cause of autism spectrum disorder. FXS is caused by transcriptional silencing of the Fragile X Mental Retardation 1 (Fmr1) gene due to a CGG repeat expansion, resulting in the loss of Fragile X Mental Retardation Protein (FMRP). FMRP is involved in transcriptional regulation and trafficking of mRNA from the nucleus to the cytoplasm and distal sites both in pre- and post-synaptic terminals. Consequently, FXS is a multifaceted disorder associated with impaired synaptic plasticity. One region of the brain that is significantly impacted by the loss of FMRP is the hippocampus, a structure that plays a critical role in the regulation of mood and cognition. This review provides an overview of the neuropathology of Fragile-X Syndrome, highlighting how structural and synaptic deficits in hippocampal subregions, including the CA1 exhibiting exaggerated metabotropic glutamate receptor dependent long-term depression and the dentate gyrus displaying hypofunction of N-methyl-d-aspartate receptors, contribute to cognitive impairments associated with this neurodevelopmental disorder. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Phase Measurement of Cognitive Impairment Specific to Radiotherapy

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    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.

  12. Phase Measurement of Cognitive Impairment Specific to Radiotherapy

    International Nuclear Information System (INIS)

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

    2012-01-01

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

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

    Science.gov (United States)

    Kulesh, A A; Shestakov, V V

    2014-01-01

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

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

    Science.gov (United States)

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

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

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

    Science.gov (United States)

    ... All Cognitive Disorders/Dementia http: / / n. neurology. org/ / cgi/ collection/ all_ cognitive_ disorders_ dementia Assessment of cognitive disorders/dementia http: / / n. neurology. org/ / cgi/ collection/ assessment_ of_ cognitive_ disorde rs_ dementia Cognitive ...

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  17. Hypoxia induced cognitive impairment modulating activity of Cyperus rotundus.

    Science.gov (United States)

    Kandikattu, Hemanth Kumar; Deep, Satya Narayan; Razack, Sakina; Amruta, Narayanappa; Prasad, Dipti; Khanum, Farhath

    2017-06-01

    Hypobaric hypoxia leads to decrease in cellular oxygen content which subsequently damages the hippocampus with an increase in brain oxidative stress and impairs the memory of the individual. In the present study, we have evaluated the cognitive impairment modulating activity of total oligomeric flavonoids fraction of Cyperus rotundus (TOF) in Sprague Dawley rats. The rats were trained for memory activity for a period of 7days followed by 7days exposure to 25,000ft. altitude and the spatial reference memory was evaluated. Behavioral analysis of the rats by Morris water maze experiment showed that TOF supplementation enhanced the spatial reference memory activity of the rats exposed to hypobaric hypoxia. The decrease in antioxidant status of the animals exposed to hypoxia was restored with TOF supplementation. The increase in ROS, lipid peroxidation products and protein carbonyls of the hippocampus was significantly decreased in animals with TOF administration. The histological assessment of the pyramidal cells of the hippocampus of hypoxia-exposed animals showed nuclear damage and TOF supplementation prevented nuclear damage. TOF administration suppressed hypoxia-induced increase in serotonin, dopamine, and norepinephrine. GABA and Ach levels were decreased by hypoxia which was prevented by TOF supplementation. The increase in GFAP, HIF-1α and VEGF expression in CA3 region of the hippocampus in hypoxia-exposed rats was decreased in TOF administered rats. Taken together, TOF extract ameliorates hypobaric hypoxia induced memory impairment and neurodegeneration in hippocampus through its anti-stress effects. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Patterns of executive dysfunction in amnestic mild cognitive impairment.

    Science.gov (United States)

    Chen, Nai-Ching; Chang, Chiung-Chih; Lin, Ker-Neng; Huang, Chi-Wei; Chang, Wen-Neng; Chang, Ya-Ting; Chen, Ching; Yeh, Yen-Chi; Wang, Pei-Ning

    2013-07-01

    Executive dysfunction is not uncommon in patients with amnestic mild cognitive impairment (aMCI). This study aimed to investigate the applicability of executive function tests (EFTs) in aMCI as an aid in establishing the diagnosis of multi-domain MCI. One hundred and twenty (120) aMCI patients, 126 Alzheimer's disease (AD) patients, and 100 normal controls were enrolled. The EFTs evaluated included the trail making test, digit backward span, Stroop color-word test, and design fluency and category fluency tests. Of the aMCI participants, 66% exhibited impairment in at least one EFT. Among the five selected EFTs, the category fluency test was the most discriminative in detecting executive dysfunction between patients with aMCI (standardized β = 0.264) or AD (standardized β = 0.361) with the controls, followed by the Stroop test. The performance of aMCI patients with two or more impaired EFTs was significantly different from those of controls but not from those of AD patients. In the clinical setting, aMCI patients who fail in two or more EFTs may represent a unique population with multi-domain MCI that require close follow-up.

  19. Visual Event-Related Potentials in Patients with Mild Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Eren Gozke

    2016-12-01

    Conclusion: Visual ERP can be used to support MCI diagnosis. Although it is not a diagnostic test for cognitive impairment per se, it is an important, feasible, and noninvasive technique for evaluating the cognitive state.

  20. 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.

  1. Recent progress in understanding skills and impairments in social cognition.

    Science.gov (United States)

    Happé, Francesca; Conway, Jane R

    2016-12-01

    Social interaction is affected in many different developmental disorders; indeed, the new Diagnostic and Statistical Manual of Mental Disorders has introduced social cognition as one of six core components of neurocognitive functioning. Social cognition is not one thing, but a wide range of putative processes, which may be differentially affected in different clinical groups. This review focuses on recent advances in one aspect of social cognition, 'theory of mind' (ToM, representing what people think), and one core clinical group, autism spectrum disorder (ASD). It is 30 years since impaired ToM was proposed as an explanation for ASD social difficulties, and recently there has been a widening of interest to other clinical groups. ToM has been found to be distinct from emotion recognition and empathy. Recent research on ASD has focused increasingly on atypical sensory responses and commonly comorbid conditions. Interventions for social deficits, including ToM training and oxytocin, have shown mixed results to date. Heterogeneity poses a major obstacle to current research. Theoretical and empirical refinements are needed to elucidate neurocognitive and aetiological underpinnings of sociocognitive processes and inform clinical advances.

  2. Influence of cognitive impairment on the management of ischaemic stroke.

    Science.gov (United States)

    Murao, K; Bombois, S; Cordonnier, C; Hénon, H; Bordet, R; Pasquier, F; Leys, D

    2014-03-01

    Because of ageing of the population, it is more and more frequent to treat ischaemic stroke patients with pre-stroke cognitive impairment (PSCI). Currently, there is no specific recommendation on ischaemic stroke management in these patients, both at the acute stage and in secondary prevention. However, these patients are less likely to receive treatments proven effective in randomised controlled trials, even in the absence of contra-indication. To review the literature to assess efficacy and safety of validated therapies for acute ischaemic stroke and secondary prevention in PSCI patients. Most randomised trials did not take into account the pre-stroke cognitive status. The few observational studies conducted at the acute stage or in secondary prevention, did not provide any information that the benefit could be either lost or replaced by harm in the presence of PSCI. There is no reason not to treat ischaemic stroke patients with PSCI according to the currently available recommendations for acute management and secondary prevention. Further observational studies are needed and pre-stroke cognition should be taken into account in future stroke trials. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

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

    Science.gov (United States)

    Freire Pérez, Alberto

    2017-06-01

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

  4. Hippocampal Transcriptomic Profiles: Subfield Vulnerability to Age and Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Lara Ianov

    2017-12-01

    Full Text Available The current study employed next-generation RNA sequencing to examine gene expression differences related to brain aging, cognitive decline, and hippocampal subfields. Young and aged rats were trained on a spatial episodic memory task. Hippocampal regions CA1, CA3, and the dentate gyrus were isolated. Poly-A mRNA was examined using two different sequencing platforms, Illumina, and Ion Proton. The Illumina platform was used to generate seed lists of genes that were statistically differentially expressed across regions, ages, or in association with cognitive function. The gene lists were then retested using the data from the Ion Proton platform. The results indicate hippocampal subfield differences in gene expression and point to regional differences in vulnerability to aging. Aging was associated with increased expression of immune response-related genes, particularly in the dentate gyrus. For the memory task, impaired performance of aged animals was linked to the regulation of Ca2+ and synaptic function in region CA1. Finally, we provide a transcriptomic characterization of the three subfields regardless of age or cognitive status, highlighting and confirming a correspondence between cytoarchitectural boundaries and molecular profiling.

  5. Caregivers in China: Knowledge of Mild Cognitive Impairment

    Science.gov (United States)

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

    2013-01-01

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

  6. 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.

  7. Threat perception in mild cognitive impairment and early dementia.

    Science.gov (United States)

    Henry, Julie D; Thompson, Claire; Ruffman, Ted; Leslie, Felicity; Withall, Adrienne; Sachdev, Perminder; Brodaty, Henry

    2009-09-01

    Mild cognitive impairment (MCI) and dementia affect many aspects of emotion processing. Even though the ability to detect threat is a particularly important aspect of emotion processing, no study to date has assessed threat perception in either of these groups. The purpose of the present study was to test whether individuals with MCI (n = 38) and mild dementia (n = 34) have difficulty differentiating between faces and situations normatively judged to be either high or low in threat relative to age-matched controls (n = 34). To achieve this aim, all participants completed 2 danger rating tasks that involved viewing and rating high- and low-danger images. It was also assessed whether threat perception was related to cognitive functioning and emotion recognition. The results indicated that all 3 groups were accurately, and comparably, able to differentiate high from low-danger faces. However, the dementia group had difficulties differentiating high from low-danger situations, which reflected a bias to overattribute the level of threat posed by normatively judged nonthreatening situations. This difficulty was related to more general cognitive decline.

  8. 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

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

    Science.gov (United States)

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

    2018-01-06

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

  10. Educational differentials in life expectancy with cognitive impairment among the elderly in the United States.

    Science.gov (United States)

    Lièvre, Agnès; Alley, Dawn; Crimmins, Eileen M

    2008-06-01

    This article provides estimates of education differentials in life expectancy with and without cognitive impairment for the noninstitutionalized population aged 70 years and older in the United States. Life expectancy with cognitive impairment was calculated using multistate models, allowing transitions between cognitively intact and cognitively impaired states and from each of these states to death and allowing transition rates to vary across age and education. Four waves of the Assets and Health Dynamics of the Oldest Old survey were used. Those with low levels of education are more likely to become cognitively impaired and do so at an earlier age. After age 70, persons with low educational levels can expect to live 11.6 years, and persons with high education 14.1 years, without cognitive impairment. Length of life with cognitive impairment differs by education (1.6 years and 1.0 years at age 70, respectively) but differs little by age. Although those with higher education have lower rates of both cognitive impairment and mortality, those who do become cognitively impaired appear to be in poorer health, leading to a reduced probability of improved cognition and increased probability of mortality relative to those with lower educational levels.

  11. Positive effects of combined cognitive and physical exercise training on cognitive function in older adults with mild cognitive impairment or dementia : A meta-analysis

    NARCIS (Netherlands)

    Karssemeijer, Esther G. A.; Aaronson, Justine A.; Bossers, Willem J.; Smits, Tara; Rikkert, Marcel G. M. Olde; Kessels, Roy P. C.

    2017-01-01

    Combined cognitive and physical exercise interventions have potential to elicit cognitive benefits in older adults with mild cognitive impairment (MCI) or dementia. This meta-analysis aims to quantify the overall effect of these interventions on global cognitive functioning in older adults with MCI

  12. Examining the nature of impairment in visual paired associate learning in amnestic mild cognitive impairment.

    Science.gov (United States)

    Harel, Brian T; Darby, David; Pietrzak, Robert H; Ellis, Kathryn A; Snyder, Peter J; Maruff, Paul

    2011-11-01

    Visual spatial learning is impaired in mild cognitive impairment (MCI) although the nature of this impairment is not clear. This study investigated the nature and magnitude of errors made by adults with amnestic MCI (aMCI) when learning pattern-location paired associations in a continuous manner. Visual associate learning was measured using the Continuous Paired Associate Learning (CPAL) task in which 30 adults who met clinical criteria for aMCI and 30 matched controls were required to learn a set of associations between patterns and locations across increasing memory loads (two, four, six, and eight). As hypothesized, the aMCI group made more total errors than controls for all memory loads above two. However, the rate of increase in errors with memory load in the aMCI group was approximately twice that for controls. In controls, errors on the CPAL task reflected almost exclusively difficulty in memory. In the aMCI group, errors on the CPAL reflected limitations in associative learning but also in short-term memory and response monitoring. These results suggest that impairments in specific aspects of executive function and working memory might contribute to poor performance on visual paired associate learning in aMCI.

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

    Czech Academy of Sciences Publication Activity Database

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

    2007-01-01

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

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

    Science.gov (United States)

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

    2017-01-01

    There is a need for more sensitive neuropsychological tests to detect subtle cognitive deficits emerging in the preclinical stage of Alzheimer's disease (AD). Associative memory is a cognitive function supported by the hippocampus and affected early in the process of AD. We developed a short computerized face-name associative recognition test (FNART) and tested whether it would detect memory impairment in memory clinic patients with mild cognitive impairment (MCI) and subjective cognitive decline (SCD). We recruited 61 elderly patients with either SCD (n = 32) or MCI (n = 29) and 28 healthy controls (HC) and compared performance on FNART, self-reported cognitive deterioration in different domains (ECog-39), and, in a reduced sample (n = 46), performance on the visual Paired Associates Learning of the CANTAB battery. A significant effect of group on FNART test performance in the total sample was found (p < 0.001). Planned contrasts indicated a significantly lower associative memory performance in the SCD (p = 0.001, d = 0.82) and MCI group (p < 0.001, d = 1.54), as compared to HCs, respectively. The CANTAB-PAL discriminated only between HC and MCI, possibly because of reduced statistical power. Adjusted for depression, performance on FNART was significantly related to ECog-39 Memory in SCD patients (p = 0.024) but not in MCI patients. Associative memory is substantially impaired in memory clinic patients with SCD and correlates specifically with memory complaints at this putative preclinical stage of AD. Further studies will need to examine the predictive validity of the FNART in SCD patients with regard to longitudinal (i.e., conversion to MCI/AD) and biomarker outcomes.

  15. 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.

  16. Simple diagnostic signs in those with cognitive impairment-anything to improve detection of cognitive disorders.

    Science.gov (United States)

    Woodward, Michael C

    2017-11-01

    With now over 50 million people worldwide with dementia (Prince et al., 2013), there are almost certainly well over 100 million people with cognitive concerns and many of these will attend their health professional keen to know what is going on. We need those without intensive training in this field to be more confident and correct in their diagnosis when such a concerned person turns up. Many simple diagnostic tests have been proposed and some assessed - these include the walk and talk (divided attention) test (those who stop when asked a question while walking may be cognitively impaired) (Lamoth et al., 2011), the clock drawing test (Brodaty and Moore, 1997), the "handbag" sign (those clutching their personal possessions are more likely to be cognitively impaired) and the "hippopotamus sign" (calling the rhinoceros, in those tests that include this, a hippopotamus). Simple screening tests have been extensively validated and are important to the clinician in formulating a diagnosis (Lorentz et al., 2002). The "head-turning" and the "attended with/alone" signs are frequently observed, and many clinicians assessing such individuals would be well aware of them and probably even unknowingly factor them into their diagnosis. In this issue, Pinar Soysal and colleagues (Soysal et al., 2017) have evaluated these signs and, in those older people attending with cognitive concerns, found they had quite good diagnostic value. They were not very specific but showed good sensitivity and negative predictive value. Indeed, at the recent Alzheimer's Association International Conference in London there were several posters evaluating "soft but simple" signs although not all performed as expected - one group found gait actually sped up in those with cognitive impairment that were asked a question.

  17. 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

    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. 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. 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. 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.

  18. Cognitive impairment in patients with Fibromyalgia syndrome as assessed by the Mini-Mental State Examination

    Directory of Open Access Journals (Sweden)

    Rejas Javier

    2009-12-01

    Full Text Available Abstract Background This study evaluated the frequency of cognitive impairment in patients with Fibromyalgia syndrome (FMS using the Mini Mental State Examination (MMSE. Methods We analyzed baseline data from all 46 patients with FMS and 92 age- and sex-matched controls per diagnosis of neuropathic (NeP or mixed pain (MP selected from a larger prospective study. Results FMS had a slight but statistically significant lower score in the adjusted MMSE score (26.9; 95% CI 26.7-27.1 than either NeP (27.3; 95% CI 27.2-27.4 or MP (27.3; 27.2-27.5. The percentage of patients with congnitive impairment (adjusted MMSE ≤ 26 was numerically higher in FMS (15%; 95% CI 6.3-29 compared with NeP (5%; 95% CI 1.8-12.2 or MP (5%; 95% CI 1.8-12.2 and higher than in the same age stratum of the general population (0.05%. Conclusions Compared with the population reference value, patients with FMS showed high frequency of cognitive impairment.

  19. Baseline neuropsychiatric symptoms and the risk of incident mild cognitive impairment: a population-based study.

    Science.gov (United States)

    Geda, Yonas E; Roberts, Rosebud O; Mielke, Michelle M; Knopman, David S; Christianson, Teresa J H; Pankratz, Vernon S; Boeve, Bradley F; Sochor, Ondrej; Tangalos, Eric G; Petersen, Ronald C; Rocca, Walter A

    2014-05-01

    The authors conducted a prospective cohort study to estimate the risk of incident mild cognitive impairment in cognitively normal elderly (aged ≥70 years) individuals with or without neuropsychiatric symptoms at baseline. The research was conducted in the setting of the population-based Mayo Clinic Study of Aging. A classification of normal cognitive aging, mild cognitive impairment, and dementia was adjudicated by an expert consensus panel based on published criteria. Hazard ratios and 95% confidence intervals were computed using Cox proportional hazards model, with age as a time scale. Baseline Neuropsychiatric Inventory Questionnaire data were available for 1,587 cognitively normal persons who underwent at least one follow-up visit. The cohort was followed to incident mild cognitive impairment (N=365) or censoring variables (N=179) for a median of 5 years. Agitation (hazard ratio=3.06, 95% CI=1.89-4.93), apathy (hazard ratio=2.26, 95% CI=1.49-3.41), anxiety (hazard ratio=1.87, 95% CI=1.28-2.73), irritability (hazard ratio=1.84, 95% CI=1.31-2.58), and depression (hazard ratio=1.63, 95% CI=1.23-2.16), observed initially, increased risk for later mild cognitive impairment. Delusion and hallucination did not. A secondary analysis, limited in significance by the small number of study participants, showed that euphoria, disinhibition, and nighttime behaviors were significant predictors of nonamnestic mild cognitive impairment but not amnestic mild cognitive impairment. By contrast, depression predicted amnestic mild cognitive impairment (hazard ratio=1.74, 95% CI=1.22-2.47) but not nonamnestic mild cognitive impairment. An increased incidence of mild cognitive impairment was observed in community-dwelling elderly adults who had nonpsychotic psychiatric symptoms at baseline. These baseline psychiatric symptoms were of similar or greater magnitude as biomarkers (genetic and structural MRI) in increasing the risk of incident mild cognitive impairment.

  20. Estimating Alzheimer's disease progression rates from normal cognition through mild cognitive impairment and stages of dementia.

    Science.gov (United States)

    Davis, Matthew; O Connell, Thomas; Johnson, Scott; Cline, Stephanie; Merikle, Elizabeth; Martenyi, Ferenc; Simpson, Kit N

    2018-01-18

    Background Alzheimer's disease (AD) can be conceptualized as a continuum: patients progress from normal cognition to mild cognitive impairment (MCI) due to AD, followed by increasing severity of AD dementia. Prior research has measured transition probabilities among later stages of AD, but not for the complete spectrum. Objective To estimate annual progression rates across the AD continuum and evaluate the impact of a delay in MCI due to AD on the trajectory of AD dementia and clinical outcomes. Methods Patient-level longitudinal data from the National Alzheimer's Coordinating Center for n=18,103 patients with multiple visits over the age of 65 were used to estimate annual, age-specific transitional probabilities between normal cognition, MCI due to AD, and AD severity states (defined by Clinical Dementia Rating score). Multivariate models predicted the likelihood of death and institutionalization for each health state, conditional on age and time from the previous evaluation. These probabilities were used to populate a transition matrix describing the likelihood of progressing to a particular disease state or death for any given current state and age. Finally, a health state model was developed to estimate the expected effect of a reduction in the risk of transitioning from normal cognition to MCI due to AD on disease progression rates for a cohort of 65-year-old patients over a 35-year time horizon. Results Annual transition probabilities to more severe states were 8%, 22%, 25%, 36%, and 16% for normal cognition, MCI due to AD, and mild/moderate/severe AD, respectively, at age 65, and increased as a function of age. Progression rates from normal cognition to MCI due to AD ranged from 4% to 10% annually. Severity of cognitive impairment and age both increased the likelihood of institutionalization and death. For a cohort of 100 patients with normal cognition at age 65, a 20% reduction in the annual progression rate to MCI due to AD avoided 5.7 and 5.6 cases of MCI

  1. Phase measurement of cognitive impairment specific to radiotherapy.

    Science.gov (United States)

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

    2012-07-01

    Memory impairment is an early-delayed effect of radiotherapy (RT). The prospective longitudinal measurement of the cognitive phase effects from RT was conducted on treated and untreated brain tumor patients. The study design investigated semantic vs. perceptual and visual vs. verbal memory to determine the most disease-specific measure of RT-related changes and understanding of the neurotoxicity from RT to the brain. Tests of memory that had previously shown RT-related phasic changes were compared with experimental tests of memory to test hypotheses about cognition targeted to the neural toxicity of RT. The results from 41 irradiated and 29 nonirradiated patients with low-grade, supratentorial tumors were analyzed. The methods controlled for comorbid white matter risk, recurrence, interval after treatment, and age (18-69 years). The effects were examined before RT and at three points after RT to 1 year using a mixed effects model that included interval, group, surgical status, medication use, practice, and individual random effects. Four new tests of memory and other candidate cognitive tests were investigated, and a post hoc analysis of a comprehensive battery of tests was performed to identify the cognitive processes most specific to RT. The RT effects on memory were identified in the treated group only; among the new tests of memory and the complete neurocognitive battery, the RT effects were significant only for delayed recall (p measurement that is brief but specific to neural mechanisms is effective and feasible for studies of RT damage. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. The neuroimaging approach to the assessment of mild cognitive impairment

    Energy Technology Data Exchange (ETDEWEB)

    Lucignani, Giovanni [University of Milan and Unit of Molecular Imaging, Division of Radiation Therapy, European Institute of Oncology, Institute of Radiological Sciences, Milan (Italy)

    2006-06-15

    Imaging techniques, including emission tomography and magnetic resonance imaging, are progressively being exploited for the classification and prognostic evaluation (indispensable for possible treatments) of mild cognitive impairment (MCI). The main traits of MCI and unsolved issues in its assessment are discussed in two review articles by Feldman and Jacova from the Division of Neurology, Dept. of Medicine, Clinic for Alzheimer Disease and Related Disorders, University of British Columbia, in Vancouver, Canada [1] and Chong and Sahadevan from the Department of Geriatric Medicine, Tan Tock Seng Hospital, Jalan Tan Tock Seng, Singapore [2]. Because MCI has different presentations in terms of the type and degree of cognitive deficits observed, several clinical subtypes of MCI besides the amnestic form have now been recognised and characterised on the basis of deficits in different cognitive domains, either in isolation or in combination with amnesia. The different subtypes of MCI suggest that MCI has a heterogeneous nature, with several possible causes that lead to the same symptoms. This is a field in evolution, and a uniform diagnostic classification of MCI has not yet been accomplished. Lopez et al. from the Departments of Neurology and Psychiatry, University of Pittsburgh, School of Medicine,Pittsburgh, Pennsylvania, USA [3] point out that the classification of MCI subtypes is useful to improve prediction of the subsequent risk of dementia and the type of dementia, and that the manner in which MCI subjects are classified into subgroups has implications for the cognitive profile of the group and thus for our inferences about the aetiology and possible clinical course of the disorder.

  3. The neuroimaging approach to the assessment of mild cognitive impairment

    International Nuclear Information System (INIS)

    Lucignani, Giovanni

    2006-01-01

    Imaging techniques, including emission tomography and magnetic resonance imaging, are progressively being exploited for the classification and prognostic evaluation (indispensable for possible treatments) of mild cognitive impairment (MCI). The main traits of MCI and unsolved issues in its assessment are discussed in two review articles by Feldman and Jacova from the Division of Neurology, Dept. of Medicine, Clinic for Alzheimer Disease and Related Disorders, University of British Columbia, in Vancouver, Canada [1] and Chong and Sahadevan from the Department of Geriatric Medicine, Tan Tock Seng Hospital, Jalan Tan Tock Seng, Singapore [2]. Because MCI has different presentations in terms of the type and degree of cognitive deficits observed, several clinical subtypes of MCI besides the amnestic form have now been recognised and characterised on the basis of deficits in different cognitive domains, either in isolation or in combination with amnesia. The different subtypes of MCI suggest that MCI has a heterogeneous nature, with several possible causes that lead to the same symptoms. This is a field in evolution, and a uniform diagnostic classification of MCI has not yet been accomplished. Lopez et al. from the Departments of Neurology and Psychiatry, University of Pittsburgh, School of Medicine,Pittsburgh, Pennsylvania, USA [3] point out that the classification of MCI subtypes is useful to improve prediction of the subsequent risk of dementia and the type of dementia, and that the manner in which MCI subjects are classified into subgroups has implications for the cognitive profile of the group and thus for our inferences about the aetiology and possible clinical course of the disorder

  4. 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.

  5. SCREENING FOR POSTSTROKE COGNITIVE IMPAIRMENT VIA MINI MENTAL STATE EXAMINATION AND MONTREAL COGNITIVE ASSESSMENT SCALE

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    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.

  6. Frontal lobe hypoperfusion in mild cognitive impairment patients

    International Nuclear Information System (INIS)

    Liao, S.Q.; Chung, C.P.; Liao, Y.C.; Wang, P.N.; Lee, Y.C.; Liu, H.C.; Liu, R.S.

    2004-01-01

    Objective: Mild cognitive impairement (MCI) refers to the clinical state of individuals who are memory impaired subjectively but are functioning well and do not meet the criteria of dementia. MCI subjects have a high risk of progressing to Alzheimer's disease (AD). It is important to detect the earliest evidence of AD for clinicians to recognize the high risk subjects and to implicate the therapy. The aim of this study was to assess the early change of regional cerebral blood flow (rCBF) in MCI with high risk of AD by SPECT. Methods: Subjects complained of memory impairment with normal cognitive function and intact daily activities were enrolled. Each patient underwent 99mTc-HMPAO SPECT at the time of initial evaluation. Patients were followed for one to five years. The diagnosis of AD was based on the criteria of the Alzheimer's Disease and Related Disorders Association. There were 8 patients (4 males, 4 females; age range, 64-80 yrs; mean, 73.5 yrs) progressing to AD within one year. Ten gender and age matched normal control subjects (NC) were also included. The SPECT images were analyzed by using SPM 99. The image data were transformed into a standard stereotactic space, using a 12-parameter linear and 2x2x2 nonlinear spatial normalization with the template image. Group comparisons of the SPECT images between the 8 rapid AD converters and 10 NCs were performed on a voxel-by-voxel basis using t test. The t statistics was transformed to a normal statistic yielding a Z score for every voxel. Results: In 8 rapid AD converters, rCBF in the right medial frontal gyms (Brodmann area 10; BA 10), anterior cingulated gyms (BA 32) and middle frontal gyms (BA 46) was significantly lower than in NCs (p<0.001). The neuropsychological performances of these 8 cases revealed decrement in short-term memory, mental manipulation and list-generation frequency. Conclusions: rCBF is decreased in right medial frontal, anterior cingulated and middle frontal gyms in MCI patients who

  7. Different Characteristics of Cognitive Impairment in Elderly Schizophrenia and Alzheimer’s Disease in the Mild Cognitive Impairment Stage

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    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.

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

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    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

  9. The sensitivity and specificity of cognitive screening instruments to detect cognitive impairment in older adults with severe psychiatric illness.

    Science.gov (United States)

    Mackin, R Scott; Ayalon, Liat; Feliciano, Leilani; Areán, Patricia A

    2010-06-01

    Older adults with severe psychiatric illness are often treated at community mental health centers (CMHCs) and these individuals commonly have numerous risk factors for cognitive impairment (CI). Brief cognitive screening instruments are frequently used to evaluate cognitive functioning in CMHCs, but the validity of these measures for detecting CI has not been adequately evaluated in this patient population. To determine the sensitivity and specificity of 2 cognitive screening measures (the Mini-Mental Status Examination [MMSE] and the Stroop Color and Word Test [SCWT]) for detecting CI in a sample of older adults with severe psychiatric illness. Data were collected from 52 older adults receiving services at a CMHC. Diagnosis of CI was made by a neuropsychologist. Sensitivity and specificity coefficients for 2 cutoff scores for the MMSE and the SCWT were calculated. A cutoff score of 25 on the MMSE yielded a sensitivity of 43.3% and a specificity of 90.4% for detecting CI, whereas a cutoff score of 21 yielded sensitivity of 13.1% and 100% specificity. Using an age- and education-corrected scaled score (SS) on the SCWT falling at or below 7 as the criterion the SCWT had 88.8% sensitivity and 36.8% specificity, whereas a cutoff score of 5 or below yielded sensitivity of 59.2% and specificity of 57.8%. Overall, the MMSE was found to be the more clinically useful cognitive screening tool for use in CMHC. Yet, because of the poor sensitivity of the MMSE for detecting CI in this patient population, alternative screening methods should be explored.

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

    International Nuclear Information System (INIS)

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

    2011-01-01

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

  11. 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.

  12. Modeling of cognitive impairment by disease duration in multiple sclerosis: a cross-sectional study.

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    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. 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. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Writing Impairments in Japanese Patients with Mild Cognitive Impairment and with Mild Alzheimer's Disease

    Science.gov (United States)

    Hayashi, Atsuko; Nomura, Hiroshi; Mochizuki, Ruriko; Ohnuma, Ayumu; Kimpara, Teiko; Suzuki, Kyoko; Mori, Etsuro

    2015-01-01

    Background/Aims We investigated writing abilities in patients with the amnestic type of mild cognitive impairment (aMCI) and mild Alzheimer's disease (AD). To examine the earliest changes in writing function, we used writing tests for both words and sentences with different types of Japanese characters (Hiragana, Katakana, and Kanji). Methods A total of 25 aMCI patients, 38 AD patients, and 22 healthy controls performed writing to dictation for Kana and Kanji words, copied Kanji words, and wrote in response to a picture story task. Analysis of variance was used to test the subject group effects on the scores in the above writing tasks. Results For the written Kanji words, the mild AD group performed worse than the aMCI group and the controls, but there was no difference between the aMCI group and the controls. For the picture story writing task, the mild AD and aMCI groups performed worse than the controls, but the difference between the AD and the aMCI groups was not significant. Conclusions The mild AD group showed defects in writing Kanji characters, and the aMCI group showed impairments in narrative writing. Our study suggests that narrative writing, which demands complex integration of multiple cognitive functions, can be used to detect the subtle writing deficits in aMCI patients. PMID:26483830

  15. 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…

  16. Effects of epileptiform EEG discharges on cognitive function: is the concept of "transient cognitive impairment" still valid?

    Science.gov (United States)

    Aldenkamp, Albert P; Arends, Johan

    2004-02-01

    In this article we review the existing evidence on the cognitive impact of interictal epileptiform EEG discharges. Such cognitive impairment occurs exclusively in direct relation to episodes of epileptiform EEG discharges and must be distinguished from (post) ictal seizure effects and from the nonperiodic long-term "stable" interictal effects caused by the clinical syndrome or the underlying etiology. Especially in patients with short nonconvulsive seizures, characterized often by difficult-to-detect symptoms, the ictal or postictal effects may be overlooked and the resulting cognitive effects may be erroneously related to the epileptiform EEG discharges. The existing epidemiological data show that the prevalence of cognitive impairment during epileptiform EEG discharges is low. In one study 2.2% of the patients referred to a specialized epilepsy center for EEG recording showed a definite relationship between epileptiform EEG discharges and cognitive impairments ("transient cognitive impairment"). Several studies have sought to analyze to what extent cognitive impairment can be attributed to epileptiform EEG discharges among the other epilepsy factors (such as the effect of the clinical syndrome). These studies show that epileptiform EEG discharges have an additional and independent effect, but this effect is mild and limited to transient mechanistic cognitive processes (alertness, mental speed). This finding concurs with clinical studies that also reported only mild effects. In only exceptional cases are epileptiform EEG discharges the dominant factor explaining cognitive impairment. In addition, some studies have indicated that such mild effects may accumulate over time (when frequent epileptiform EEG discharges persist over years) and consequently result in effects on stable aspects of cognitive function such as educational achievement and intelligence. Hence, the clinical relevance is that early detection of cognitive effects of epileptiform EEG discharges and

  17. Acetylcholine receptors in dementia and mild cognitive impairment

    Energy Technology Data Exchange (ETDEWEB)

    Sabri, Osama; Kendziorra, Kai [University of Leipzig, Department of Nuclear Medicine, Leipzig (Germany); Wolf, Henrike; Gertz, Hermann-Josef [University of Leipzig, Department of Psychiatry, Leipzig (Germany); Brust, Peter [Institute of Interdisciplinary Isotope Research, Leipzig (Germany)

    2008-03-15

    To clarify whether changes in the cholinergic transmission occur early in the course of Alzheimer's disease (AD), we carried out positron emission tomography (PET) with the radioligand 2-[{sup 18}F]F-A-85380, which is supposed to be specific for {alpha}4{beta}2 nicotinic acetylcholine receptors (nAChRs). We included patients with moderate to severe AD and patients with amnestic mild cognitive impairment (MCI), presumed to present preclinical AD. Both patients with AD and MCI showed significant reductions in {alpha}4{beta}2 nAChRs in brain regions typically affected by AD pathology. These findings indicate that a reduction in {alpha}4{beta}2 nAChRs occurs during early symptomatic stages of AD. The {alpha}4{beta}2 nAChR availability in these regions correlated with the severity of cognitive impairment, indicating a stage sensitivity of the {alpha}4{beta}2 nAChR status. Together, our results provide evidence for the potential of 2-[{sup 18}]F-A-85380 nAChR PET in the diagnosis of patients at risk for AD. Because of the extraordinary long acquisition time with 2-[{sup 18}F]F-A-85380, we developed the new {alpha}4{beta}2 nAChR-specific radioligands (+)- and (-)-[{sup 18}F]norchloro-fluoro-homoepibatidine (NCFHEB) and evaluated them preclinically. (-)-[{sup 18}F]NCFHEB shows twofold higher brain uptake and significantly shorter acquisition times. Therefore, (-)-[{sup 18}F]NCFHEB should be a suitable radioligand for larger clinical investigations. (orig.)

  18. 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.

  19. Advance care planning in people with early cognitive impairment.

    Science.gov (United States)

    Cheong, Kenny; Fisher, Paul; Goh, Jenny; Ng, Lynette; Koh, Hui Mien; Yap, Philip

    2015-03-01

    People with early cognitive impairment (ECI), comprising mild cognitive impairment and early dementia face the risk of diminished mental capacity with progressive disease. Advance care planning (ACP) is advocated as a means to uphold the autonomy of individuals and enable them to express their wishes for the future while they still possess mental capacity. This study aims to explore the perspectives of patients with ECI regarding ACP, and in particular, understand their reasons for resistance. Consecutive patients undergoing a counselling service for persons with ECI who fulfilled inclusion criteria (Mini Mental State Examination score ≥18, Global Clinical Dementia Rating (GCDR)=0.5 or 1 were recruited. Demographic and clinical data was collected and the detailed documentation in the case records of the counselling sessions was subjected to a thematic analysis. Differences between patients who were willing to engage in ACP and those who declined were also analysed. 93 patients (mean age 76, 60.2% female) were recruited of which 38.7% chose to engage further in ACP discussions. GCDR was the only factor that emerged significant on bivariate analysis for willingness to engage in ACP (t (79)=2.191, pdenial during ACP discussions. A large proportion of patients with ECI decline ACP discussions and the reasons are influenced by personal values, coping behaviours and sociocultural norms. These findings have important implications for practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. Prognostic value of posteromedial cortex deactivation in mild cognitive impairment.

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    Jeffrey R Petrella

    2007-10-01

    Full Text Available Normal subjects deactivate specific brain regions, notably the posteromedial cortex (PMC, during many tasks. Recent cross-sectional functional magnetic resonance imaging (fMRI data suggests that deactivation during memory tasks is impaired in Alzheimer's disease (AD. The goal of this study was to prospectively determine the prognostic significance of PMC deactivation in mild cognitive impairment (MCI.75 subjects (34 MCI, 13 AD subjects and 28 controls underwent baseline fMRI scanning during encoding of novel and familiar face-name pairs. MCI subjects were followed longitudinally to determine conversion to AD. Regression and analysis of covariance models were used to assess the effect of PMC activation/deactivation on conversion to dementia as well as in the longitudinal change in dementia measures. At longitudinal follow up of up to 3.5 years (mean 2.5+/-0.79 years, 11 MCI subjects converted to AD. The proportion of deactivators was significantly different across all groups: controls (79%, MCI-Nonconverters (73%, MCI-converters (45%, and AD (23% (p<0.05. Mean PMC activation magnitude parameter estimates, at baseline, were negative in the control (-0.57+/-0.12 and MCI-Nonconverter (-0.33+/-0.14 groups, and positive in the MCI-Converter (0.37+/-0.40 and AD (0.92+/-0.30 groups. The effect of diagnosis on PMC deactivation remained significant after adjusting for age, education and baseline Mini-Mental State Exam (p<0.05. Baseline PMC activation magnitude was correlated with change in dementia ratings from baseline.Loss of physiological functional deactivation in the PMC may have prognostic value in preclinical AD, and could aid in profiling subgroups of MCI subjects at greatest risk for progressive cognitive decline.

  1. Facial emotion recognition in patients with subjective cognitive decline and mild cognitive impairment.

    Science.gov (United States)

    Pietschnig, J; Aigner-Wöber, R; Reischenböck, N; Kryspin-Exner, I; Moser, D; Klug, S; Auff, E; Dal-Bianco, P; Pusswald, G; Lehrner, J

    2016-03-01

    Deficits in facial emotion recognition (FER) have been shown to substantially impair several aspects in everyday life of affected individuals (e.g. social functioning). Presently, we aim at assessing differences in emotion recognition performance in three patient groups suffering from mild forms of cognitive impairment compared to healthy controls. Performance on a concise emotion recognition test battery (VERT-K) of 68 patients with subjective cognitive decline (SCD), 44 non-amnestic (non-aMCI), and 25 amnestic patients (aMCI) with mild cognitive impairment (MCI) was compared with an age-equivalent sample of 138 healthy controls all of which were recruited within the framework of the Vienna Conversion to Dementia Study. Additionally, patients and controls underwent individual assessment using a comprehensive neuropsychological test battery examining attention, executive functioning, language, and memory (NTBV), the Beck Depression Inventory (BDI), and a measure of premorbid IQ (WST). Type of diagnosis showed a significant effect on emotion recognition performance, indicating progressively deteriorating results as severity of diagnosis increased. Between-groups effect sizes were substantial, showing non-trivial effects in all comparisons (Cohen's ds from -0.30 to -0.83) except for SCD versus controls. Moreover, emotion recognition performance was higher in women and positively associated with premorbid IQ. Our findings indicate substantial effects of progressive neurological damage on emotion recognition in patients. Importantly, emotion recognition deficits were observable in non-amnestic patients as well, thus conceivably suggesting associations between decreased recognition performance and global cognitive decline. Premorbid IQ appears to act as protective factor yielding lesser deficits in patients showing higher IQs.

  2. Visual selective attention in amnestic mild cognitive impairment.

    Science.gov (United States)

    McLaughlin, Paula M; Anderson, Nicole D; Rich, Jill B; Chertkow, Howard; Murtha, Susan J E

    2014-11-01

    Subtle deficits in visual selective attention have been found in amnestic mild cognitive impairment (aMCI). However, few studies have explored performance on visual search paradigms or the Simon task, which are known to be sensitive to disease severity in Alzheimer's patients. Furthermore, there is limited research investigating how deficiencies can be ameliorated with exogenous support (auditory cues). Sixteen individuals with aMCI and 14 control participants completed 3 experimental tasks that varied in demand and cue availability: visual search-alerting, visual search-orienting, and Simon task. Visual selective attention was influenced by aMCI, auditory cues, and task characteristics. Visual search abilities were relatively consistent across groups. The aMCI participants were impaired on the Simon task when working memory was required, but conflict resolution was similar to controls. Spatially informative orienting cues improved response times, whereas spatially neutral alerting cues did not influence performance. Finally, spatially informative auditory cues benefited the aMCI group more than controls in the visual search task, specifically at the largest array size where orienting demands were greatest. These findings suggest that individuals with aMCI have working memory deficits and subtle deficiencies in orienting attention and rely on exogenous information to guide attention. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

    Directory of Open Access Journals (Sweden)

    Ricardo F. Allegri

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

  4. 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

  5. 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

  6. Cognitive correlates of narrative impairment in moderate traumatic brain injury.

    Science.gov (United States)

    Marini, Andrea; Zettin, Marina; Galetto, Valentina

    2014-11-01

    Traumatic brain injuries (TBIs) are often associated with communicative deficits. The incoherent and impoverished language observed in non-aphasic individuals with severe TBI has been linked to a problem in the global organization of information at the text level. The present study aimed to analyze the features of narrative discourse impairment in a group of adults with moderate TBI (modTBI). 10 non-aphasic speakers with modTBI and 20 neurologically intact participants were recruited for the experiment. Their cognitive, linguistic and narrative skills were thoroughly assessed. The persons with modTBI exhibited normal phonological, lexical and grammatical skills. However, their narratives were characterized by lower levels of Lexical Informativeness and more errors of both Local and Global Coherence that, at times, made their narratives vague and ambiguous. Significant correlations were found between these narrative difficulties and the production of both perseverative and non-perseverative errors on the WCST. These disturbances confirm previous findings which suggest a deficit at the interface between cognitive and linguistic processing rather than a specific linguistic disturbance in these patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Cognitive impairment in patients with AIDS – prevalence and severity

    Directory of Open Access Journals (Sweden)

    Watkins CC

    2015-01-01

    Full Text Available Crystal C Watkins,1,2 Glenn J Treisman2 1The Memory Center in Neuropsychiatry, Sheppard Pratt Health System, 2Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA Abstract: The advent of highly active antiretroviral therapy has prolonged the life expectancy of HIV patients and decreased the number of adults who progress to AIDS and HIV-associated dementia. However, neurocognitive deficits remain a pronounced consequence of HIV/AIDS. HIV-1 infection targets the central nervous system in subcortical brain areas and leads to high rates of delirium, depression, opportunistic central nervous system infections, and dementia. Long-term HIV replication in the brain occurs in astrocytes and microglia, allowing the virus to hide from antiviral medication and later compromise neuronal function. The associated cognitive disturbance is linked to both viral activity and inflammatory and other mediators from these immune cells that lead to the damage associated with HIV-associated neurocognitive disorders, a general term given for these disturbances. We review the severity and prevalence of the neuropsychiatric complications of HIV including delirium, neurobehavioral impairments (depression, minor cognitive-motor dysfunction, and HIV-associated dementia. Keywords: HIV, delirium, depression, HAND, dementia; HIV-associated neurocognitive disorder

  8. Evaluating brief cognitive impairment screening instruments among African Americans.

    Science.gov (United States)

    Kiddoe, Jared M; Whitfield, Keith E; Andel, Ross; Edwards, Christopher L

    2008-07-01

    This article compared and contrasted the Telephone Interview of Cognitive Status (TICS) to the racially-sensitive Short Portable Mental Status Questionnaire (SPMSQ). The empirical questions addressed was whether the TICS over-represented African American (AA) cognitive impairment (CI) relative to the SPMSQ, if there were age differences in CI prevalence between younger subjects (ages 50-64) and older ones (>64 years) and on accuracy to detect CI in individuals with higher levels of educations (> or =13 years) versus those with lower education levels (TICS at 45.0%. Within the younger group, TICS and CI prevalence was 49.3 and 80% among the older group. Within the younger group SPMSQ and CI prevalence was 14.5 and 53.8% among the older group. Within the higher educated group, TICS and CI prevalence was 36.7 and 51.4% among the lower educated. Within the higher educated group, SPMSQ and CI prevalence was 7.7 and 14.5% among the lower educated. Findings are consistent with our hypotheses that the TICS would be a less accurate assessor of CI among AAs.

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

    Directory of Open Access Journals (Sweden)

    Balsamo S

    2013-05-01

    Full Text Available Sandor Balsamo,1–4 Jeffrey M Willardson,5 Frederico Santos de Santana,1–4 Jonato Prestes,6 Denise Coscrato Balsamo,4 Dahan da Cunha Nascimento,3–6 Leopoldo dos Santos-Neto,1,2 Otávio T Nobrega1 1Graduate Program in Medical Sciences, School of Medicine, University of Brasília, 2Rheumatology Division, University of Brasília Hospital, 3Department of Physical Education, Euro-American University Center, 4GEPEEFS (Strength Training and Health Research Group, Brasília, Brazil; 5Kinesiology and Sports Studies Department, Eastern Illinois University, Charleston, IL, USA; 6Graduate Program in Physical Education and Health, Catholic University of Brasilia, Brasilia, Brazil Abstract: Physical activity has a protective effect on brain function in older people. Here, we briefly reviewed the studies and results related to the effects of exercise on cognitive impairment and Alzheimer's disease. The main findings from the current body of literature indicate positive evidence for structured physical activity (cardiorespiratory and resistance exercise as a promising non-pharmacological intervention for preventing cognitive decline. More studies are needed to determine the mechanisms involved in this preventative effect, including on strength, cardiorespiratory, and other types of exercise. Thus, the prevention of Alzheimer's disease may depend on healthy lifestyle habits, such as a structured physical fitness program. Keywords: randomized controlled trial, memory disorders, healthy lifestyle habits, physical activity

  10. APOE and mild cognitive impairment: the Framingham Heart Study.

    Science.gov (United States)

    Jefferson, Angela L; Beiser, Alexa S; Seshadri, Sudha; Wolf, Philip A; Au, Rhoda

    2015-03-01

    The risk apolipoprotein E-4 (APOE4) poses for mild cognitive impairment (MCI) may vary based on the neuropsychological definition of MCI. A community-based cohort study. Using two psychometric neuropsychological impairment definitions, we examined APOE4 and prevalent MCI among older adults or pre-MCI among middle-aged adults. Neuropsychological, clinical and genetic data were collected on 2,239 Framingham Offspring Cohort participants free from clinical stroke or dementia (62±9 years; 54% women). Prevalent amnestic MCI was defined from neuropsychological performances≥1.5 SD below the mean based on (i) age and education or (ii) age and Wide Range Achievement Test-3 Reading (WRAT-3 Reading) performance adjustment. In the entire sample, multivariable-adjusted logistic regressions found that APOE4 was associated with amnestic MCI when using the age and WRAT Reading definition (odds ratio [OR]=1.7, P=0.002) but not the age and education definition (OR=1.0, P=0.90). Results were modified by age, such that APOE4 was associated with amnestic MCI in participants≥65 years using both the age and WRAT Reading definition (OR=2.4, Pdefinition (OR=1.7, P=0.04). APOE4 risk for prevalent amnestic MCI varies depending on the definition of objective neuropsychological impairment for MCI. Our findings support existing literature emphasising the need to refine MCI neuropsychological profiling methods. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  11. Randomized controlled trials in mild cognitive impairment: Sources of variability.

    Science.gov (United States)

    Petersen, Ronald C; Thomas, Ronald G; Aisen, Paul S; Mohs, Richard C; Carrillo, Maria C; Albert, Marilyn S

    2017-05-02

    To examine the variability in performance among placebo groups in randomized controlled trials for mild cognitive impairment (MCI). Placebo group data were obtained from 2 National Institute on Aging (NIA) MCI randomized controlled trials, the Alzheimer's Disease Cooperative Study (ADCS) MCI trial and the Alzheimer's Disease Neuroimaging Initiative (ADNI), which is a simulated clinical trial, in addition to industry-sponsored clinical trials involving rivastigmine, galantamine, rofecoxib, and donepezil. The data were collated for common measurement instruments. The performance of the placebo participants from these studies was tracked on the Alzheimer's Disease Assessment Scale-cognitive subscale, Mini-Mental State Examination, and Clinical Dementia Rating-sum of boxes, and for progression on these measures to prespecified clinical study endpoints. APOE status, where available, was also analyzed for its effects. The progression to clinical endpoints varied a great deal among the trials. The expected performances were seen for the participants in the 2 NIA trials, ADCS and ADNI, with generally worsening of performance over time; however, the industry-sponsored trials largely showed stable or improved performance in their placebo participants. APOE 4 carrier status influenced results in an expected fashion on the study outcomes, including rates of progression and cognitive subscales. In spite of apparently similar criteria for MCI being adopted by the 7 studies, the implementation of the criteria varied a great deal. Several explanations including instruments used to characterize participants and variability among study populations contributed to the findings. Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

  12. Does sleep deprivation impair orthopaedic surgeons' cognitive and psychomotor performance?

    Science.gov (United States)

    O'Brien, Michael J; O'Toole, Robert V; Newell, Mary Zadnik; Lydecker, Alison D; Nascone, Jason; Sciadini, Marcus; Pollak, Andrew; Turen, Clifford; Eglseder, W Andrew

    2012-11-07

    Sleep deprivation may slow reaction time, cloud judgment, and impair the ability to think. Our purpose was to study the cognitive and psychomotor performances of orthopaedic trauma surgeons on the basis of the amount of sleep that they obtained. We prospectively studied the performances of thirty-two orthopaedic trauma surgeons (residents, fellows, and attending surgeons) over two four-week periods at an urban academic trauma center. Testing sessions used handheld computers to administer validated cognitive and psychomotor function tests. We conducted a multivariate analysis to examine the independent association between test performance and multiple covariates, including the amount of sleep the night before testing. Our analysis demonstrated that orthopaedic surgeons who had slept four hours or less the night before the test had 1.43 times the odds (95% confidence interval, 1.04 to 1.95; p = 0.03) of committing at least one error on an individual test compared with orthopaedic surgeons who had slept more than four hours the previous night. The Running Memory test, which assesses sustained attention, concentration, and working memory, was most sensitive to deterioration in performance in participants who had had four hours of sleep or less; when controlling for other covariates, the test demonstrated a 72% increase in the odds of making at least one error (odds ratio, 1.72 [95% confidence interval, 1.02 to 2.90]; p = 0.04). No significant decrease in performance with sleep deprivation was shown with the other three tests. Orthopaedic trauma surgeons showed deterioration in performance on a validated cognitive task when they had slept four hours or less the previous night. It is unknown how performance on this test relates to surgical performance.

  13. Aerobic exercise to improve cognitive function in older people without known cognitive impairment.

    Science.gov (United States)

    Young, Jeremy; Angevaren, Maaike; Rusted, Jennifer; Tabet, Naji

    2015-04-22

    There is increasing evidence that physical activity supports healthy ageing. Exercise is helpful for cardiovascular, respiratory and musculoskeletal systems, among others. Aerobic activity, in particular, improves cardiovascular fitness and, based on recently reported findings, may also have beneficial effects on cognition among older people. To assess the effect of aerobic physical activity, aimed at improving cardiorespiratory fitness, on cognitive function in older people without known cognitive impairment. We searched ALOIS - the Cochrane Dementia and Cognitive Improvement Group's Specialized Register, the Cochrane Controlled Trials Register (CENTRAL) (all years to Issue 2 of 4, 2013), MEDLINE (Ovid SP 1946 to August 2013), EMBASE (Ovid SP 1974 to August 2013), PEDro, SPORTDiscus, Web of Science, PsycINFO (Ovid SP 1806 to August 2013), CINAHL (all dates to August 2013), LILACS (all dates to August 2013), World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (http://apps.who.int/trialsearch), ClinicalTrials.gov (https://clinicaltrials.gov) and Dissertation Abstracts International (DAI) up to 24 August 2013, with no language restrictions. We included all published randomised controlled trials (RCTs) comparing the effect on cognitive function of aerobic physical activity programmes with any other active intervention, or no intervention, in cognitively healthy participants aged over 55 years. Two review authors independently extracted the data from included trials. We grouped cognitive outcome measures into eleven categories covering attention, memory, perception, executive functions, cognitive inhibition, cognitive speed and motor function. We used the mean difference (or standardised mean difference) between groups as the measure of the treatment effect and synthesised data using a random-effects model. We conducted separate analyses to compare aerobic exercise interventions with no intervention and with other exercise, social or

  14. Preoperative Cognitive Impairment As a Predictor of Postoperative Outcomes in a Collaborative Care Model.

    Science.gov (United States)

    Zietlow, Kahli; McDonald, Shelley R; Sloane, Richard; Browndyke, Jeffrey; Lagoo-Deenadayalan, Sandhya; Heflin, Mitchell T

    2018-01-13

    To compare postoperative outcomes of individuals with and without cognitive impairment enrolled in the Perioperative Optimization of Senior Health (POSH) program at Duke University, a comanagement model involving surgery, anesthesia, and geriatrics. Retrospective analysis of individuals enrolled in a quality improvement program. Tertiary academic center. Older adults undergoing surgery and referred to POSH (N = 157). Cognitive impairment was defined as a score less than 25 out of 30 (adjusted for education) on the St. Louis University Mental Status (SLUMS) Examination. Median length of stay (LOS), mean number of postoperative complications, rates of postoperative delirium (POD, %), 30-day readmissions (%), and discharge to home (%) were compared using bivariate analysis. Seventy percent of participants met criteria for cognitive impairment (mean SLUMS score 20.3 for those with cognitive impairment and 27.7 for those without). Participants with and without cognitive impairment did not significantly differ in demographic characteristics, number of medications (including anticholinergics and benzodiazepines), or burden of comorbidities. Participants with and without cognitive impairment had similar LOS (P = .99), cumulative number of complications (P = .70), and 30-day readmission (P = .20). POD was more common in those with cognitive impairment (31% vs 24%), but the difference was not significant (P = .34). Participants without cognitive impairment had higher rates of discharge to home (80.4% vs 65.1%, P = .05). Older adults with and without cognitive impairment referred to the POSH program fared similarly on most postoperative outcomes. Individuals with cognitive impairment may benefit from perioperative geriatric comanagement. Questions remain regarding the validity of available measures of cognition in the preoperative period. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

  15. Neurocognitive Deficits and Effects of Cognitive Reserve in Mild Cognitive Impairment.

    Science.gov (United States)

    Andrejeva, Nadeshda; Knebel, Maren; Dos Santos, Vasco; Schmidt, Janna; Herold, Christina Josefa; Tudoran, Ruxandra; Wetzel, Petra; Wendelstein, Britta; Meyer-Kühling, Inga; Navratil, Sabrina Dominique; Gorenc-Mahmutaj, Lina; Rosenbaum, Gerd; Pantel, Johannes; Schröder, Johannes

    2016-01-01

    Mild cognitive impairment (MCI) is a frequent syndrome in the older population, which involves an increased risk to develop Alzheimer's disease (AD). The latter can be modified by the cognitive reserve, which can be operationalized by the length of school education. MCI can be differentiated into four subtypes according to the cognitive domains involved: amnestic MCI, multiple-domain amnestic MCI, non-amnestic MCI and multiple-domain non-amnestic MCI. While neurocognitive deficits are a constituent of the diagnosis of these subtypes, the question of how they refer to the cognitive reserve still needs to be clarified. We examined neuropsychological deficits in healthy controls, patients with MCI and patients with mild AD (n = 485) derived from a memory clinic. To reduce the number of neuropsychological variables, a factor analysis with varimax rotation was calculated. In a second step, diagnostic groups including MCI subtypes were compared with respect to their clinical and neuropsychological characteristics including cognitive reserve. Most MCI patients showed the amnestic multiple-domain subtype followed by the pure amnestic subtype, while the non-amnestic subtypes were rare. The amnestic subtype displayed a significantly higher level of cognitive reserve and higher MMSE scores than the amnestic multiple-domain subtype, which was in most cases characterized by additional psychomotor and executive deficits. These findings confirm earlier reports revealing that the amnestic multiple-domain subtype is the most frequent one and indicating that a high cognitive reserve may primarily prevent psychomotor and executive deficits in MCI. © 2016 S. Karger AG, Basel.

  16. Physicians' Perspectives on Caring for Cognitively Impaired Elders.(author Abstract)

    Science.gov (United States)

    Adams, Wendy L.; McIlvain, Helen E.; Geske, Jenenne A.; Porter, Judy L.

    2005-01-01

    Purpose: This study aims to develop ah in-depth understanding of the issues important to primary care physicians in providing care to cognitively impaired elders. Design and Methods: In-depth interviews were conducted with 20 primary care physicians. Text coded as "cognitive impairment" was retrieved and analyzed by use of grounded theory analysis…

  17. 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...

  18. Life expectancy with cognitive impairment in the older population of the United States.

    Science.gov (United States)

    Suthers, Kristen; Kim, Jung Ki; Crimmins, Eileen

    2003-05-01

    This article provides estimates of the prevalence of cognitive impairment by age and sex for a nationally representative sample of the U.S. population aged 70 and over. From these estimates, years of life with and without cognitive impairment are calculated. Using data from the Assets and Health Dynamics of the Oldest Old (AHEAD) survey, the prevalence of cognitive impairment is estimated for a sample representing both the community-dwelling and institutionalized older American population. Sullivan's method is used to calculate the average number of years an elderly person can expect to live with and without cognitive impairment. The prevalence of moderate to severe cognitive impairment in the total U.S. population aged 70 and over is 9.5%. At age 70, the average American can expect 1.5 years with cognitive impairment. Expected length of life with cognitive impairment is longer for women than men because of their longer life expectancy. As total life expectancy continues to increase, the length of life with cognitive impairment for the American population will increase unless age-specific prevalence is reduced. There is great potential for improvement in future early treatment and diagnosis of this condition.

  19. Cognitive Impairment among the Aging Population in a Community in Southwest Nigeria

    Science.gov (United States)

    Adebiyi, Akindele O.; Ogunniyi, Adesola; Adediran, Babatunde A.; Olakehinde, Olaide O.; Siwoku, Akeem A.

    2016-01-01

    Background: Vascular risk models can be quite informative in assisting the clinician to make a prediction of an individual's risk of cognitive impairment. Thus, a simple marker is a priority for low-capacity settings. This study examines the association of selected simple to deploy vascular markers with cognitive impairment in an elderly…

  20. Making Sense of Mild Cognitive Impairment: A Qualitative Exploration of the Patient's Experience

    Science.gov (United States)

    Lingler, Jennifer Hagerty; Nightingale, Marcie C.; Erlen, Judith A.; Kane, April L.; Reynolds, Charles F.; Schulz, Richard; DeKosky, Steven T.

    2006-01-01

    Purpose: 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…

  1. The contribution of MRI in assessing cognitive impairment in multiple sclerosis

    NARCIS (Netherlands)

    Filippi, M.; Rocca, M.A.; Benedict, R.H.B.; DeLuca, J.; Geurts, J.J.G.; Rombouts, S.A.R.B.; Ron, M.; Comi, G.

    2010-01-01

    Cognitive impairment affects a large proportion of patients with multiple sclerosis (MS) and has a profound impact on their daily-life activities. Improving the knowledge of the pathophysiology of cognitive impairment in MS and of the mechanisms responsible for its evolution over time might

  2. Cognitive Ability as a Resource for Everyday Functioning among Older Adults Who Are Visually Impaired

    Science.gov (United States)

    Heyl, Vera; Wahl, Hans-Werner

    2010-01-01

    This article reports on a study that investigated the role of cognitive resources in the everyday functioning of 121 older adults who were visually impaired and 150 sighted older adults, with a mean age of 82 years. Cognitive performance and everyday functioning were most strongly related in the group who were visually impaired. The authors…

  3. Sensitivity and Specificity of the Montreal Cognitive Assessment Modified for Individuals Who Are Visually Impaired

    Science.gov (United States)

    Wittich, Walter; Phillips, Natalie; Nasreddine, Ziad S.; Chertkow, Howard

    2010-01-01

    Evaluating the cognitive status of individuals who are visually impaired is limited by the design of the test that is used. This article presents data on the sensitivity and specificity of the version of the Montreal Cognitive Assessment for people who are visually impaired. The original validation data were reanalyzed, excluding the five visual…

  4. Corpus callosum tissue loss and development of motor and global cognitive impairment

    DEFF Research Database (Denmark)

    Frederiksen, Kristian Steen; Garde, Ellen; Skimminge, Arnold

    2011-01-01

    To examine the impact of corpus callosum (CC) tissue loss on the development of global cognitive and motor impairment in the elderly.......To examine the impact of corpus callosum (CC) tissue loss on the development of global cognitive and motor impairment in the elderly....

  5. Association Between Frailty and Cognitive Impairment: Cross-Sectional Data From Toulouse Frailty Day Hospital.

    Science.gov (United States)

    Fougère, Bertrand; Daumas, Matthieu; Lilamand, Matthieu; Sourdet, Sandrine; Delrieu, Julien; Vellas, Bruno; Abellan van Kan, Gabor

    2017-11-01

    A consensus panel, based on epidemiologic evidence, argued that physical frailty is often associated with cognitive impairment, possibly because of common underlying pathophysiological mechanisms. The concepts of cognitive frailty and motoric cognitive risk were recently proposed in literature and may represent a prodromal stage for neurodegenerative diseases. The purpose of this study was to analyze the relationship between cognition and the components of the physical phenotype of frailty. Participants admitted to the Toulouse frailty day hospital aged 65 years or older were included in this cross-sectional study. Cognitive impairment was identified using the Mini-Mental State Examination (MMSE) and the Clinical Dementia Rating (CDR). Frailty was assessed using the physical phenotype as defined by Fried's criteria. We divided the participants into 2 groups: participants with normal cognition (CDR = 0) and participants who had cognitive impairment (CDR = 0.5). Participants with CDR >0.5 were excluded. Data from 1620 participants, mean age 82 years and 63% of women were analyzed. Cognitive impairment was identified in 52.5% of the participants. Frailty was identified in 44.7% of the sample. There were more frail subjects in the impaired group than the normal cognitive group (51% vs 38%, P impairment [adjusted odds ratio (OR) 1.66, 95% confidence interval (CI) 1.12-2.46]. Subsequent analysis showed that the association between cognitive impairment and frailty was only observed considering one of the 5 frailty criteria: gait speed (adjusted OR 1.89, 95% CI 1.55-2.32). Physical frailty and in particular slow gait speed were associated with cognitive impairment. Future research including longitudinal studies should exploit the association between cognitive impairment and frailty. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  6. Sleep and its associations with perceived and objective cognitive impairment in individuals with multiple sclerosis.

    Science.gov (United States)

    Hughes, Abbey J; Parmenter, Brett A; Haselkorn, Jodie K; Lovera, Jesus F; Bourdette, Dennis; Boudreau, Eilis; Cameron, Michelle H; Turner, Aaron P

    2017-08-01

    Problems with sleep and cognitive impairment are common among people with multiple sclerosis (MS). The present study examined the relationship between self-reported sleep and both objective and perceived cognitive impairment in MS. Data were obtained from the baseline assessment of a multi-centre intervention trial (NCT00841321). Participants were 121 individuals with MS. Nearly half (49%) of participants met the criteria for objective cognitive impairment; however, cognitively impaired and unimpaired participants did not differ on any self-reported sleep measures. Nearly two-thirds (65%) of participants met the criteria for 'poor' sleep, and poorer sleep was significantly associated with greater levels of perceived cognitive impairment. Moreover, the relationships between self-reported sleep and perceived cognitive impairment were significant beyond the influence of clinical and demographic factors known to influence sleep and cognitive functioning (e.g. age, sex, education level, disability severity, type of MS, disease duration, depression and fatigue). However, self-reported sleep was not associated with any measures of objective cognitive impairment. Among different types of perceived cognitive impairment, poor self-reported sleep was most commonly related to worse perceived executive function (e.g. planning/organization) and prospective memory. Results from the present study emphasize that self-reported sleep is significantly and independently related to perceived cognitive impairment in MS. In terms of clinical implications, interventions focused on improving sleep may help improve perceived cognitive function and quality of life in this population; however, the impact of improved sleep on objective cognitive function requires further investigation. © 2017 European Sleep Research Society.

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

    Science.gov (United States)

    Angermann, Susanne; Baumann, Marcus; Wassertheurer, Siegfried; Mayer, Christopher Clemens; Steubl, Dominik; Hauser, Christine; Suttmann, Yana; Reichelt, Anna-Lena; Satanovskij, Robin; Lorenz, Georg; Lukas, Moritz; Haller, Bernhard; Heemann, Uwe; Grimmer, Timo; Schmaderer, Christoph

    2017-07-01

    Cognitive impairment in hemodialysis patients is common and associated with adverse outcomes. So far, the underlying pathogenesis remains unclear. Therefore, we examined the potential relationship between cognitive impairment and three different categories of risk factors with particular focus on arterial stiffness measured by pulse wave velocity (PWV). A total of 201 chronic hemodialysis patients underwent cognitive testing under standardized conditions using the Montreal Cognitive Assessment (MoCA). Demographic data including cardiovascular risk factors, dialysis-associated factors as well as factors related to chronic kidney disease (CKD) were analyzed. To account for arterial stiffness, PWV was measured by ambulatory blood pressure monitoried with an oscillometric device that records brachial blood pressure along with pulse waves. In our cohort, 60.2% of patients showed pathological MoCA test results indicating cognitive impairment. PWV was significantly associated with cognitive impairment apart from age, educational level, diabetes, and hypercholesterolemia. High prevalence of cognitive impairment in hemodialysis patients was confirmed. For the first time, an association between cognitive impairment and arterial stiffness was detected in a larger cohort of hemodialysis patients. Concerning the underlying pathogenesis of cognitive impairment, current results revealed a potential involvement of arterial stiffness, which has to be further evaluated in future studies. © 2017 The Author(s). Published by Portland Press Limited on behalf of the Biochemical Society.

  8. Prevalence of cognitive impairment in patients attending pre-dialysis clinic.

    Science.gov (United States)

    Nulsen, Rebekah S; Yaqoob, M Magdi; Mahon, Althea; Stoby-Fields, Meagan; Kelly, Mike; Varagunam, Mira

    2008-09-01

    Approximately 20-30% of patients on renal replacement therapy (RRT) have cognitive impairment. Less is known about the prevalence of cognitive impairment in patients with advanced kidney disease awaiting the initiation of dialysis. Routine cognitive assessment was implemented in the pre-dialysis clinic, which enabled the Nephrologist and Pre-dialysis Nurse to identify those patients with impaired cognitive function and utilise this information to assess the suitability for self-care treatments, such as peritoneal dialysis, as well as to adapt information to meet their needs. Subsequently, a cross-sectional single-centre audit was undertaken to identify the prevalence of cognitive impairment in 132 consecutive new referrals to the pre-dialysis clinic using the Mini-mental State Examination (MMSE). Twenty percent (95% CI = 0.13, 0.27) were classified as cognitively impaired. Those with cognitive impairment were significantly older, and had lower eGFR and higher serum creatinine. It can be concluded that approximately 1 in 5 patients attending the pre-dialysis clinic has cognitive impairment, which may not be apparent on a routine clinical history. Cognitive function assessment is recommended for all, but particularly to the older patient, before advising on choice of dialysis modality or opting for conservative treatment.

  9. Validity of a short computerized assessment battery for moderate cognitive impairment and dementia.

    Science.gov (United States)

    Dwolatzky, Tzvi; Dimant, Luba; Simon, Ely S; Doniger, Glen M

    2010-08-01

    Computerized cognitive assessment tools have been developed to make precise neuropsychological assessment readily available to clinicians. Mindstreams batteries for mild impairment have been validated previously. We examined the validity of a Mindstreams battery designed specifically for evaluating those with moderate cognitive impairment. 170 participants over the age of 60 years performed the computerized battery in addition to standard clinical evaluation. The battery consists of six technician-administered tests and one patient-administered interactive test sampling the cognitive domains of orientation (to time and place), memory, executive function, visual spatial processing, and verbal function. Staging was according to the Clinical Dementia Rating Scale (CDR) on the basis of clinical data but independent of computerized cognitive testing results, thus serving as the gold standard for evaluating the discriminant validity of the computerized measures. Seven participants received a global CDR score of 0 (not impaired), 76 were staged as CDR 0.5 (very mildly impaired), 58 as CDR 1 (mildly impaired), 26 as CDR 2 (moderately impaired), and 3 as CDR 3 (severely impaired). Mindstreams Global Score performance was significantly different across CDR groups (p impairment. This was also true for the domain summary scores, with Executive Function (d = 0.67) and Memory (d = 0.65) distinguishing best between CDR 0.5 and 1, and Orientation best differentiating among CDR 1 and 2 (d = 1.20). The Mindstreams battery for moderate impairment differentiates among varying degrees of cognitive impairment in older adults, providing detailed and distinct cognitive profiles.

  10. Gait and Cognition in Parkinson’s Disease: Cognitive Impairment Is Inadequately Reflected by Gait Performance during Dual Task

    Directory of Open Access Journals (Sweden)

    Heiko Gaßner

    2017-10-01

    Full Text Available IntroductionCognitive and gait deficits are common symptoms in Parkinson’s disease (PD. Motor-cognitive dual tasks (DTs are used to explore the interplay between gait and cognition. However, it is unclear if DT gait performance is indicative for cognitive impairment. Therefore, the aim of this study was to investigate if cognitive deficits are reflected by DT costs of spatiotemporal gait parameters.MethodsCognitive function, single task (ST and DT gait performance were investigated in 67 PD patients. Cognition was assessed by the Montreal Cognitive Assessment (MoCA followed by a standardized, sensor-based gait test and the identical gait test while subtracting serial 3’s. Cognitive impairment was defined by a MoCA score <26. DT costs in gait parameters [(DT − ST/ST × 100] were calculated as a measure of DT effect on gait. Correlation analysis was used to evaluate the association between MoCA performance and gait parameters. In a linear regression model, DT gait costs and clinical confounders (age, gender, disease duration, motor impairment, medication, and depression were correlated to cognitive performance. In a subgroup analysis, we compared matched groups of cognitively impaired and unimpaired PD patients regarding differences in ST, DT, and DT gait costs.ResultsCorrelation analysis revealed weak correlations between MoCA score and DT costs of gait parameters (r/rSp ≤ 0.3. DT costs of stride length, swing time variability, and maximum toe clearance (|r/rSp| > 0.2 were included in a regression analysis. The parameters only explain 8% of the cognitive variance. In combination with clinical confounders, regression analysis showed that these gait parameters explained 30% of MoCA performance. Group comparison revealed strong DT effects within both groups (large effect sizes, but significant between-group effects in DT gait costs were not observed.ConclusionThese findings suggest that DT gait performance is not indicative

  11. Higher Self-Control Capacity Predicts Lower Anxiety-Impaired Cognition During Math Examinations

    Directory of Open Access Journals (Sweden)

    Alex eBertrams

    2016-03-01

    Full Text Available We assumed that self-control capacity, self-efficacy, and self-esteem would enable students to keep attentional control during tests. Therefore, we hypothesized that the three personality traits would be negatively related to anxiety-impaired cognition during math examinations. Secondary school students (N = 158 completed measures of self-control capacity, self-efficacy, and self-esteem at the beginning of the school year. Five months later, anxiety-impaired cognition during math examinations was assessed. Higher self-control capacity, but neither self-efficacy nor self-esteem, predicted lower anxiety-impaired cognition five months later, over and above baseline anxiety-impaired cognition. Moreover, self-control capacity was indirectly related to math grades via anxiety-impaired cognition. The findings suggest that improving self-control capacity may enable students to deal with anxiety-related problems during school tests.

  12. Functional Components of Cognitive Impairment in Multiple Sclerosis: A Cross-Sectional Investigation.

    Science.gov (United States)

    Matias-Guiu, Jordi A; Cortés-Martínez, Ana; Valles-Salgado, María; Oreja-Guevara, Celia; Pytel, Vanesa; Montero, Paloma; Moreno-Ramos, Teresa; Matias-Guiu, Jorge

    2017-01-01

    Cognitive impairment is frequent and disabling in multiple sclerosis (MS). Changes in information processing speed constitute the most important cognitive deficit in MS. However, given the clinical and topographical variability of the disease, cognitive impairment may vary greatly and appear in other forms in addition to slower information processing speed. Our aim was to determine the frequency of cognitive impairment, the principal cognitive domains, and components involved in MS and to identify factors associated with presence of cognitive impairment in these patients in a large series of patients. Cross-sectional study of 311 patients with MS [236 with relapsing-remitting MS (RRMS), 52 with secondary progressive MS (SPMS), and 23 with primary progressive MS (PPMS)]. Patients' cognitive function was assessed with a comprehensive neuropsychological assessment protocol. Patients displaying deficits in 2 or more cognitive domains were considered to have cognitive impairment associated with MS. We conducted a principal component analysis to detect different cognitive patterns by identifying clusters of tests highly correlated to one another. Cognitive impairment was detected in 41.5% of the sample, and it was more frequent in patients with SPMS and PPMS ( P  = 0.002). Expanded Disability Status Scale scores and education were independent predictors of cognitive impairment. Principal component analysis identified seven clusters: attention and basic executive function (including information processing speed), planning and high-level executive function, verbal memory and language, executive and visuospatial performance time, fatigue-depression, visuospatial function, and basic attention and verbal/visual working memory. Mean scoring of components 2 (high-order executive functioning) and 3 (verbal memory-language) was higher in patients with RRMS than in those with PPMS (component 2) and SPMS (component 3). MS is linked to multiple cognitive profiles and

  13. Functional Components of Cognitive Impairment in Multiple Sclerosis: A Cross-Sectional Investigation

    Directory of Open Access Journals (Sweden)

    Jordi A. Matias-Guiu

    2017-11-01

    Full Text Available BackgroundCognitive impairment is frequent and disabling in multiple sclerosis (MS. Changes in information processing speed constitute the most important cognitive deficit in MS. However, given the clinical and topographical variability of the disease, cognitive impairment may vary greatly and appear in other forms in addition to slower information processing speed. Our aim was to determine the frequency of cognitive impairment, the principal cognitive domains, and components involved in MS and to identify factors associated with presence of cognitive impairment in these patients in a large series of patients.MethodsCross-sectional study of 311 patients with MS [236 with relapsing-remitting MS (RRMS, 52 with secondary progressive MS (SPMS, and 23 with primary progressive MS (PPMS]. Patients’ cognitive function was assessed with a comprehensive neuropsychological assessment protocol. Patients displaying deficits in 2 or more cognitive domains were considered to have cognitive impairment associated with MS. We conducted a principal component analysis to detect different cognitive patterns by identifying clusters of tests highly correlated to one another.ResultsCognitive impairment was detected in 41.5% of the sample, and it was more frequent in patients with SPMS and PPMS (P = 0.002. Expanded Disability Status Scale scores and education were independent predictors of cognitive impairment. Principal component analysis identified seven clusters: attention and basic executive function (including information processing speed, planning and high-level executive function, verbal memory and language, executive and visuospatial performance time, fatigue-depression, visuospatial function, and basic attention and verbal/visual working memory. Mean scoring of components 2 (high-order executive functioning and 3 (verbal memory-language was higher in patients with RRMS than in those with PPMS (component 2 and SPMS (component 3.ConclusionMS is linked to

  14. Effects of hearing and vision impairments on the Montreal Cognitive Assessment.

    Science.gov (United States)

    Dupuis, Kate; Pichora-Fuller, M Kathleen; Chasteen, Alison L; Marchuk, Veronica; Singh, Gurjit; Smith, Sherri L

    2015-01-01

    Many standardized measures of cognition include items that must be seen or heard. Nevertheless, it is not uncommon to overlook the possible effects of sensory impairment(s) on test scores. In the current study, we investigated whether sensory impairments could affect performance on a widely used screening tool, the Montreal Cognitive Assessment (MoCA). Three hundred and one older adults (mean age = 71 years) completed the MoCA and also hearing and vision tests. Half of the participants had normal hearing and vision, 38% impaired hearing, 5% impaired vision, and 7% had dual-sensory impairment. More participants with normal sensory acuity passed the MoCA compared to those with sensory loss, even after modifying scores to adjust for sensory factors. The results suggest that cognitive abilities may be underestimated if sensory problems are not considered and that people with sensory loss are at greater risk of cognitive decline.

  15. Depression and cognitive impairment among newly admitted nursing home residents in the USA.

    Science.gov (United States)

    Ulbricht, Christine M; Rothschild, Anthony J; Hunnicutt, Jacob N; Lapane, Kate L

    2017-11-01

    The objective of this study is to describe the prevalence of depression and cognitive impairment among newly admitted nursing home residents in the USA and to describe the treatment of depression by level of cognitive impairment. We identified 1,088,619 newly admitted older residents between 2011 and 2013 with an active diagnosis of depression documented on the Minimum Data Set 3.0. The prevalence of receiving psychiatric treatment was estimated by cognitive impairment status and depression symptoms. Binary logistic regression using generalized estimating equations provided adjusted odds ratios and 95% confidence intervals for the association between level of cognitive impairment and receipt of psychiatric treatment, adjusted for clustering of residents within nursing homes and resident characteristics. Twenty-six percent of newly admitted residents had depression; 47% of these residents also had cognitive impairment. Of those who had staff assessments of depression, anhedonia, impaired concentration, psychomotor disturbances, and irritability were more commonly experienced by residents with cognitive impairment than residents without cognitive impairment. Forty-eight percent of all residents with depression did not receive any psychiatric treatment. Approximately one-fifth of residents received a combination of treatment. Residents with severe cognitive impairment were less likely than those with intact cognition to receive psychiatric treatment (adjusted odds ratio = 0.95; 95% confidence interval: 0.93-0.98). Many newly admitted residents with an active diagnosis of depression are untreated, potentially missing an important window to improve symptoms. The extent of comorbid cognitive impairment and depression and lack of treatment suggest opportunities for improved quality of care in this increasingly important healthcare setting. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  16. Gray matter volume and dual-task gait performance in mild cognitive impairment.

    Science.gov (United States)

    Doi, Takehiko; Blumen, Helena M; Verghese, Joe; Shimada, Hiroyuki; Makizako, Hyuma; Tsutsumimoto, Kota; Hotta, Ryo; Nakakubo, Sho; Suzuki, Takao

    2017-06-01

    Dual-task gait performance is impaired in older adults with mild cognitive impairment, but the brain substrates associated with dual-task gait performance are not well-established. The relationship between gray matter and gait speed under single-task and dual-task conditions (walking while counting backward) was examined in 560 seniors with mild cognitive impairment (non-amnestic mild cognitive impairment: n = 270; mean age = 72.4 yrs., 63.6 % women; amnestic mild cognitive impairment: n = 290; mean age = 73.4 yrs., 45.4 % women). Multivariate covariance-based analyses of magnetic resonance imaging data, adjusted for potential confounders including single-task gait speed, were performed to identify gray matter patterns associated with dual-task gait speed. There were no differences in gait speed or cognitive performance during dual-task gait between individuals with non-amnestic mild cognitive impairment and amnestic mild cognitive impairment. Overall, increased dual-task gait speed was associated with a gray matter pattern of increased volume in medial frontal gyrus, superior frontal gyrus, anterior cingulate, cingulate, precuneus, fusiform gyrus, middle occipital gyrus, inferior temporal gyrus and middle temporal gyrus. The relationship between dual-task gait speed and brain substrates also differed by mild cognitive impairment subtype. Our study revealed a pattern of gray matter regions associated with dual-task performance. Although dual-task gait performance was similar in amnestic and non-amnestic mild cognitive impairment, the gray matter patterns associated with dual-task gait performance differed by mild cognitive impairment subtype. These findings suggest that the brain substrates supporting dual-task gait performance in amnestic and non-amnestic subtypes are different, and consequently may respond differently to interventions, or require different interventions.

  17. Association of Visual Acuity and Cognitive Impairment in Older Individuals: Fujiwara-kyo Eye Study

    Directory of Open Access Journals (Sweden)

    Masashi Mine

    2016-08-01

    Full Text Available Both visual impairment and cognitive impairment are essential factors that determine the quality of life in the aged population. The aim of this study was to determine if a correlation existed between visual acuity and cognitive impairment in an elderly Japanese population. The Fujiwara-kyo Eye Study was a cross-sectional study of individuals aged ≥68 years who lived in Nara Prefecture of Japan. Participants underwent ophthalmological examinations and cognitive function test. A mild visual impairment was defined as having a best corrected visual acuity (BCVA >0.2 logarithm of the minimum angle of resolution (logMAR units in the better eye. Cognitive impairment was defined as having a Mini-Mental State Examination (MMSE score of ≤23 points. A total to 2818 individuals completed the examinations. The mean age of the participants was 76.3 ± 4.8 years (mean ± standard deviation. The mean BCVA of the better eye was −0.02 ± 0.13 logMAR units and 6.6% subjects were classified as being mildly visually impaired. The mean MMSE score was 27.3 ± 2.3 and 5.7% subjects were classified as being cognitively impaired. The proportion of subjects with cognitive or moderate visual impairment increased with age, and there was a significant correlation between the visual acuity and MMSE score (r = −0.10, p < 0.0001. Subjects with mild visual impairments had 2.4 times higher odds of having cognitive impairment than those without visual impairment (odds ratio 2.4, 95% confidence interval, 1.5–3.8, p < 0.001 after adjusting for age, sex, and length of education. We conclude that it may be important to maintain good visual acuity to reduce the risk of having cognitive impairment.

  18. Association of Visual Acuity and Cognitive Impairment in Older Individuals: Fujiwara-kyo Eye Study.

    Science.gov (United States)

    Mine, Masashi; Miyata, Kimie; Morikawa, Masayuki; Nishi, Tomo; Okamoto, Nozomi; Kawasaki, Ryo; Yamashita, Hidetoshi; Kurumatani, Norio; Ogata, Nahoko

    2016-01-01

    Both visual impairment and cognitive impairment are essential factors that determine the quality of life in the aged population. The aim of this study was to determine if a correlation existed between visual acuity and cognitive impairment in an elderly Japanese population. The Fujiwara-kyo Eye Study was a cross-sectional study of individuals aged ≥68 years who lived in Nara Prefecture of Japan. Participants underwent ophthalmological examinations and cognitive function test. A mild visual impairment was defined as having a best corrected visual acuity (BCVA) >0.2 logarithm of the minimum angle of resolution (logMAR) units in the better eye. Cognitive impairment was defined as having a Mini-Mental State Examination (MMSE) score of ≤23 points. A total to 2818 individuals completed the examinations. The mean age of the participants was 76.3 ± 4.8 years (mean ± standard deviation). The mean BCVA of the better eye was -0.02 ± 0.13 logMAR units and 6.6% subjects were classified as being mildly visually impaired. The mean MMSE score was 27.3 ± 2.3 and 5.7% subjects were classified as being cognitively impaired. The proportion of subjects with cognitive or moderate visual impairment increased with age, and there was a significant correlation between the visual acuity and MMSE score (r = -0.10, p visual impairments had 2.4 times higher odds of having cognitive impairment than those without visual impairment (odds ratio 2.4, 95% confidence interval, 1.5-3.8, p education. We conclude that it may be important to maintain good visual acuity to reduce the risk of having cognitive impairment.

  19. Quantifying cognition and behavior in normal aging, mild cognitive impairment, and Alzheimer's disease

    Science.gov (United States)

    Giraldo, Diana L.; Sijbers, Jan; Romero, Eduardo

    2017-11-01

    The diagnosis of Alzheimer's disease (AD) and mild cognitive impairment (MCI) is based on neuropsychological evaluation of the patient. Different cognitive and memory functions are assessed by a battery of tests that are composed of items devised to specifically evaluate such upper functions. This work aims to identify and quantify the factors that determine the performance in neuropsychological evaluation by conducting an Exploratory Factor Analysis (EFA). For this purpose, using data from the Alzheimer's Disease Neuroimaging Initiative (ADNI), EFA was applied to 67 item scores taken from the baseline neuropsychological battery of the three phases of ADNI study. The found factors are directly related to specific brain functions such as memory, behavior, orientation, or verbal fluency. The identification of factors is followed by the calculation of factor scores given by weighted linear combinations of the items scores.

  20. Clinical and biological predictors of Alzheimer's disease in patients with amnestic mild cognitive impairment

    OpenAIRE

    Forlenza,Orestes V.; Diniz,Breno S.; Talib,Leda L.; Radanovic,Marcia; Yassuda,Monica S.; Ojopi,Elida B.; Gattaz,Wagner F.

    2010-01-01

    OBJECTIVE: To identify predictors of the progression from pre-dementia stages of cognitive impairment in Alzheimer's disease is relevant to clinical management and to substantiate the decision of prescribing antidementia drugs. METHOD: Longitudinal study of a cohort of elderly adults with amnestic mild cognitive impairment and healthy controls, carried out to estimate the risk and characterize predictors of the progression to Alzheimer's disease. RESULTS: Patients with amnestic mild cognitive...

  1. Resting-state global functional connectivity as a biomarker of cognitive reserve in mild cognitive impairment.

    Science.gov (United States)

    Franzmeier, N; Caballero, M Á Araque; Taylor, A N W; Simon-Vermot, L; Buerger, K; Ertl-Wagner, B; Mueller, C; Catak, C; Janowitz, D; Baykara, E; Gesierich, B; Duering, M; Ewers, M

    2017-04-01

    Cognitive reserve (CR) shows protective effects in Alzheimer's disease (AD) and reduces the risk of dementia. Despite the clinical significance of CR, a clinically useful diagnostic biomarker of brain changes underlying CR in AD is not available yet. Our aim was to develop a fully-automated approach applied to fMRI to produce a biomarker associated with CR in subjects at increased risk of AD. We computed resting-state global functional connectivity (GFC), i.e. the average connectivity strength, for each voxel within the cognitive control network, which may sustain CR due to its central role in higher cognitive function. In a training sample including 43 mild cognitive impairment (MCI) subjects and 24 healthy controls (HC), we found that MCI subjects with high CR (> median of years of education, CR+) showed increased frequency of high GFC values compared to MCI-CR- and HC. A summary index capturing such a surplus frequency of high GFC was computed (called GFC reserve (GFC-R) index). GFC-R discriminated MCI-CR+ vs. MCI-CR-, with the area under the ROC = 0.84. Cross-validation in an independently recruited test sample of 23 MCI subjects showed that higher levels of the GFC-R index predicted higher years of education and an alternative questionnaire-based proxy of CR, controlled for memory performance, gray matter of the cognitive control network, white matter hyperintensities, age, and gender. In conclusion, the GFC-R index that captures GFC changes within the cognitive control network provides a biomarker candidate of functional brain changes of CR in patients at increased risk of AD.

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

    Directory of Open Access Journals (Sweden)

    Michele Pistacchi

    2015-01-01

    Full Text Available Background: Mild cognitive impairment (MCI is rapidly becoming one of the most common clinical manifestations affecting the elderly and represents an heterogeneous clinical syndrome that can be ascribed to different etiologies; the construct of MCI in Parkinson′s disease (PD (MCI-PD is more recent but the range of deficits is still variable. Early recognition and accurate classification of MCI-PD could offer opportunities for novel therapeutic interventions to improve the natural pathologic course. Objective: To investigate the clinical phenotype of amnestic mild cognitive impairment (aMCI and in patients with PD and MCI (MCI-PD. Materials and Methods: Seventy-three patients with aMCI and in 38 patients with MCI-PD were enrolled. They all underwent Mini-mental State Examination (MMSE, the Rey auditory-verbal learning test and the immediate visual memory (IVM item of the Mental Deterioration Battery, the Rey auditory-verbal learning test included the Rey-immediate (Rey-I, and the delayed recall of the word list (Rey test deferred, Rey-D. The Geriatric Depression Scale (GDS was used for mood assessment. Results: The results of the Rey-I and Rey-D and of the IVM item showed statistically significant differences between the aMCI and the MCI-PD group. The mean Rey-I and Rey-D score was significantly lower as well as the IVM score was higher in patients with aMCI than in those with MCI-PD, aMCI patients showed greater impairment in long-term memory, whereas more aMCI than MCI-PD patients had preserved attention, computation, praxis, and conceptualization. Conclusions: Our findings demonstrate that the cognitive deficit profile is specific for each of the two disorders: Memory impairment was a typical feature in aMCI patients while MCI-PD patients suffered from executive functions and visuospatial attention deficits.

  3. Moving along the Mental Number Line: Interactions between Whole-Body Motion and Numerical Cognition

    Science.gov (United States)

    Hartmann, Matthias; Grabherr, Luzia; Mast, Fred W.

    2012-01-01

    Active head turns to the left and right have recently been shown to influence numerical cognition by shifting attention along the mental number line. In the present study, we found that passive whole-body motion influences numerical cognition. In a random-number generation task (Experiment 1), leftward and downward displacement of participants…

  4. Clinical characteristics and quality of life of older adults with cognitive impairment in Macao.

    Science.gov (United States)

    Lam Nogueira, Bernice O C; Li, Lu; Meng, Li-Rong; Ungvari, Gabor S; Ng, Chee H; Chiu, Helen F K; Kuok, Kenny C F; Tran, Linda; Xiang, Yu-Tao

    2018-02-06

    Little is known about the characteristics of older adults with cognitive impairment in Macao. This study aimed to determine the prevalence of cognitive impairment and the quality of life (QOL) of older adults living in the community and nursing homes. A consecutive sample of 413 subjects (199 from the community; 214 from nursing homes) was recruited and interviewed using standardized instruments. Cognition was measured with the Repeatable Battery for the Assessment of Neuropsychological Status and QOL with the brief version of the World Health Organization Quality of Life instrument. Altogether 87 subjects (21.0%) had cognitive impairment. On multivariate analyses, advanced age (P impairment. Married marital status (P = 0.01, OR = 0.3, 95%CI: 0.1-0.7) and higher education level (P impairment. After the confounders were controlled for, cognitive impairment was significantly associated with the lower psychological (F (11,412)  = 6.3, P = 0.01) and social relationship domains of QOL (F (11,412)  = 4.0, P = 0.04). Cognitive impairment was found to be common in community-dwelling and nursing home resident older adults in Macao. Given cognitive impairment's negative impact on QOL, appropriate strategies should be implemented to improve access to treatment in this population. © 2018 Japanese Psychogeriatric Society.

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

    Science.gov (United States)

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

    2017-07-01

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

  6. [Predictors of cognitive impairment in population over 64 years institutionalized and non-institutionalized].

    Science.gov (United States)

    Leiva-Saldaña, Antonio; Sánchez-Ramos, José Luis; León-Jariego, José Carlos; Palacios-Gómez, Leopoldo

    2016-01-01

    Describe the factors which can be associated with cognitive impairment in institutionalized and non-institutionalized elderly. Cross-sectional study of 200 people aged over 64 in Huelva (Spain) in 2014. Of these, 100 people were institutionalized in a residential facility and 100 were not. Cognitive impairment was assessed using the Mini-Mental State Examination (MMSE-35), basic activities of daily living by Barthel index, general health through the Goldberg GHQ-28 and social, clinical and behavioural variables were contemplated in the study. The association of cognitive impairment with all the variables was analysed using Chi-square test. Finally, a multivariate analysis was performed using logistic regression to identify possible joint influence of variables to study on the cognitive impairment. The prevalence of cognitive impairment in those institutionalized was 47%, higher than that of non-institutionalized group which was only 8% (p<.001). The dependence for basic activities for daily living and learning activities were the only variables in both groups which were associated with the cognitive impairment. Institutionalization (OR=5.368), age (OR=1.066) and dependence for basic activities (OR=5.036) were negatively associated with CI, while learning activities (OR=.227) were associated in a positive way. Conducting learning activities and the promotion of personal autonomy can delay cognitive impairment in older people. It is important to include cognitive stimulation programs aimed at the old population, especially in residential institutions. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  7. Does physical and mental activity prevent cognitive impairment? Evidence from animal research

    Directory of Open Access Journals (Sweden)

    Azucena Begega

    2013-12-01

    Full Text Available In recent decades, several pharmacological strategies have been developed to prevent age-related cognitive impairment. However, the ineffectiveness of the majority of these strategies has led to growing interest in behavioural intervention. Cognitive stimulation and physical activity have been shown to provide significant benefits by counteracting cognitive impairment and dementia. Animal models have provided information on the neurobiological mechanisms that mediate the formation of cognitive and brain reserve. This paper reviews several studies on aged rodents showing the positive effects of environmental enrichment and aerobic exercise on brain and cognitive function of these animals. The implications of this research for human aging is discussed.

  8. Brain magnetic resonance imaging correlates of impaired cognition in patients with type 2 diabetes.

    NARCIS (Netherlands)

    Manschot, S.M.; Brands, A.M.; Grond, J. van der; Kessels, R.P.C.; Algra, A.; Kappelle, L.J.; Biessels, G.J.

    2006-01-01

    The structural correlates of impaired cognition in type 2 diabetes are unclear. The present study compared cognition and brain magnetic resonance imaging (MRI) between type 2 diabetic patients and nondiabetic control subjects and assessed the relationship between cognition and MRI findings and blood

  9. Cognitive impairment related changes in the elemental concentration in the brain of old rat

    Energy Technology Data Exchange (ETDEWEB)

    Serpa, R.F.B. [Federal University of Rio de Janeiro/COPPE, Nuclear Instrumentation Laboratory, P.O. Box: 68509, Zip Code: 21941-972, Rio de Janeiro (Brazil)]. E-mail: renata@lin.ufrj.br; Jesus, E.F.O. de [University of Rio de Janeiro State, Physics Institute, RJ (Brazil); Anjos, M.J. [Federal University of Rio de Janeiro/COPPE, Nuclear Instrumentation Laboratory, P.O. Box: 68509, Zip Code: 21941-972, Rio de Janeiro (Brazil); University of Rio de Janeiro State, Physics Institute, RJ (Brazil); Lopes, R.T. [Federal University of Rio de Janeiro/COPPE, Nuclear Instrumentation Laboratory, P.O. Box: 68509, Zip Code: 21941-972, Rio de Janeiro (Brazil); Carmo, M.G.T. do [Federal University of Rio de Janeiro, Nutrition Institute, RJ (Brazil); Rocha, M.S. [Federal University of Rio de Janeiro, Department of Basics and Clinic Pharmacy, RJ (Brazil); Rodrigues, L.C. [Federal University of Rio de Janeiro, Department of Basics and Clinic Pharmacy, RJ (Brazil); Moreira, S. [University of Campinas State, Civil Engineering Department, SP (Brazil); Martinez, A.M.B. [Federal University of Rio de Janeiro, Department of Histology and Embryology, RJ (Brazil)

    2006-11-15

    In order to evaluate the elemental concentration as a function of learning and memory deficiency, six different structures of the brain were analyzed by total reflection X-ray fluorescence spectrometry with synchrotron radiation (SR-TXRF). To evaluate the cognitive processes, the animals were tested in an adaptation of the Morris water maze. After the test, the animals were divided into two groups: cognitively healthy (control group) and cognitively impaired. The measurements were carried out at XRF beam line at Light Synchrotron Brazilian laboratory, Campinas, Brazil. The following elements were identified: Al, P, S, Cl, K, Ca, Ti, Cr, Fe, Cu, Zn, Br and Rb. K concentration was higher in all regions of the brain studied for control group than the cognitively impaired group. Moreover, the control group presented higher levels for P and Fe in the entorhinal cortex, in the temporal cortex (only P), in the hypothalamus and in the thalamus, than the cognitively impaired group. Br concentration in the animals which presented cognitive impairment was three times larger in the hypothalamus and thalamus, twice larger in temporal cortex and higher in visual cortex than the cognitively healthy group. Cu was more remarkable in the hippocampus and hypothalamus from the animals with cognitive impairment than the control group. We observed that the cognitively impaired group presented highest concentrations of Br and Cu in certain areas than the control group, on the other hand, this group presented highest levels of K for all brain areas studied.

  10. Cognitive impairment related changes in the elemental concentration in the brain of old rat

    International Nuclear Information System (INIS)

    Serpa, R.F.B.; Jesus, E.F.O. de; Anjos, M.J.; Lopes, R.T.; Carmo, M.G.T. do; Rocha, M.S.; Rodrigues, L.C.; Moreira, S.; Martinez, A.M.B.

    2006-01-01

    In order to evaluate the elemental concentration as a function of learning and memory deficiency, six different structures of the brain were analyzed by total reflection X-ray fluorescence spectrometry with synchrotron radiation (SR-TXRF). To evaluate the cognitive processes, the animals were tested in an adaptation of the Morris water maze. After the test, the animals were divided into two groups: cognitively healthy (control group) and cognitively impaired. The measurements were carried out at XRF beam line at Light Synchrotron Brazilian laboratory, Campinas, Brazil. The following elements were identified: Al, P, S, Cl, K, Ca, Ti, Cr, Fe, Cu, Zn, Br and Rb. K concentration was higher in all regions of the brain studied for control group than the cognitively impaired group. Moreover, the control group presented higher levels for P and Fe in the entorhinal cortex, in the temporal cortex (only P), in the hypothalamus and in the thalamus, than the cognitively impaired group. Br concentration in the animals which presented cognitive impairment was three times larger in the hypothalamus and thalamus, twice larger in temporal cortex and higher in visual cortex than the cognitively healthy group. Cu was more remarkable in the hippocampus and hypothalamus from the animals with cognitive impairment than the control group. We observed that the cognitively impaired group presented highest concentrations of Br and Cu in certain areas than the control group, on the other hand, this group presented highest levels of K for all brain areas studied

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

    Science.gov (United States)

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

    2017-04-01

    Standard replacement therapy for Addison's disease (AD) does not restore a normal circadian rhythm. Periods of sub- and supra- physiological cortisol levels experienced by patients with AD likely induce disrupted sleep. Given that healthy sleep plays an important role in memory consolidation, the novelty of the current study was to characterise, using objective measures, the relationship between sleep and memory in patients with AD, and to examine the hypothesis that poor sleep is a biological mechanism underlying memory impairment in those patients. We used a within-subjects design. Ten patients with AD and 10 matched healthy controls completed standardised neuropsychological tests assessing declarative memory (Rey Auditory Verbal Learning Test) and procedural memory (Finger Tapping Task) before and after a period of actigraphy-measured sleep, and before and after a period of waking. Relative to healthy controls, patients with AD experienced disrupted sleep characterised by poorer sleep efficiency and more time spent awake. Patients also showed impaired verbal learning and memory relative to healthy controls (p=0.007). Furthermore, whereas healthy controls' declarative memory performance benefited from a period of sleep compared to waking (p=0.032), patients with AD derived no such benefit from sleep (p=0.448). Regarding the procedural memory task, analyses detected no significant between-group differences (all p'ssleep-enhanced performance. We demonstrated, using actigraphy and standardized measures of memory performance, an association between sleep disturbances and cognitive deficits in patients with AD. These results suggest that, in patients with AD, the source of memory deficits is, at least to some extent, disrupted sleep patterns that interfere with optimal consolidation of previously-learned declarative information. Hence, treating the sleep disturbances that are frequently experienced by patients with AD may improve their cognitive functioning. Copyright

  12. Category verbal fluency performance may be impaired in amnestic mild cognitive impairment

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    Márcio Luiz Figueredo Balthazar

    Full Text Available Abstract To study category verbal fluency (VF for animals in patients with amnestic mild cognitive impairment (aMCI, mild Alzheimer disease (AD and normal controls. Method: Fifteen mild AD, 15 aMCI, and 15 normal control subjects were included. Diagnosis of AD was based on DSM-IV and NINCDS-ADRDA criteria, while aMCI was based on the criteria of the International Working Group on Mild Cognitive Impairment, using CDR 0.5 for aMCI and CDR 1 for mild AD. All subjects underwent testing of category VF for animals, lexical semantic function (Boston Naming-BNT, CAMCOG Similarities item, WAIS-R forward and backward digit span, Rey Auditory Verbal Learning (RAVLT, Mini-Mental Status Examination (MMSE, and other task relevant functions such as visual perception, attention, and mood state (with Cornell Scale for Depression in Dementia. Data analysis used ANOVA and a post-hoc Tukey test for intergroup comparisons, and Pearson's coefficient for correlations of memory and FV tests with other task relevant functions (statistical significance level was p<0.05. Results: aMCI patients had lower performance than controls on category VF for animals and on the backward digit span subtest of WAIS-R but higher scores compared with mild AD patients. Mild AD patients scored significantly worse than aMCI and controls across all tests. Conclusion: aMCI patients may have poor performance in some non-memory tests, specifically category VF for animals in our study, where this could be attributable to the influence of working memory.

  13. Cognitive impairment and its consequences in everyday life: experiences of people with mild cognitive impairment or mild dementia and their relatives.

    Science.gov (United States)

    Johansson, Maria M; Marcusson, Jan; Wressle, Ewa

    2015-06-01

    The aim of this study was to explore experiences of cognitive impairment, its consequences in everyday life and need for support in people with mild cognitive impairment (MCI) or mild dementia and their relatives. A qualitative approach with an explorative design with interviews was chosen. The participants included five people with MCI and eight people with mild dementia and their relatives. All participants were recruited at a geriatric memory clinic in Sweden. The Grounded Theory method was used. The following categories emerged: noticing cognitive changes; changed activity patterns; coping strategies; uncertainty about own ability and environmental reactions; support in everyday life; support from the healthcare system; consequences in everyday life for relatives; and support for relatives. The main findings were that people with MCI and dementia experienced cognitive changes that could be burdensome and changed activity patterns. Most of them, however, considered themselves capable of coping on their own. The relatives noticed cognitive changes and activity disruptions to a greater extent and tried to be supportive in everyday life. Degree of awareness varied and lack of awareness could lead to many problems in everyday life. Perceived cognitive impairment and its consequences in everyday life were individual and differed among people with MCI or dementia and their relatives. Thus, healthcare professionals must listen to both people with cognitive impairment and their relatives for optimal individual care planning. Support such as education groups and day care could be more tailored towards the early stages of dementia.

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  15. The Characterization of Biological Rhythms in Mild Cognitive Impairment

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    Elisabet Ortiz-Tudela

    2014-01-01

    Full Text Available Introduction. Patients with dementia, especially Alzheimer’s disease, present several circadian impairments related to an accelerated perturbation of their biological clock that is caused by the illness itself and not merely age-related. Thus, the objective of this work was to elucidate whether these circadian system alterations were already present in patients with mild cognitive impairment (MCI, as compared to healthy age-matched subjects. Methods. 40 subjects (21 patients diagnosed with MCI, 74.1 ± 1.5 y.o., and 19 healthy subjects, 71.7 ± 1.4 y.o. were subjected to ambulatory monitoring, recording wrist skin temperature, motor activity, body position, and the integrated variable TAP (including temperature, activity, and position for one week. Nonparametrical analyses were then applied. Results. MCI patients exhibited a significant phase advance with respect to the healthy group for the following phase markers: temperature M5 (mean ± SEM: 04:20 ± 00:21 versus 02:52 ± 00:21 and L10 (14:35 ± 00:27 versus 13:24 ± 00:16 and TAP L5 (04:18 ± 00:14 versus 02:55 ± 00:30 and M10 (14:30 ± 00:18 versus 13:28 ± 00:23. Conclusions. These results suggest that significant advances in the biological clock begin to occur in MCI patients, evidenced by an accelerated aging of the circadian clock, as compared to a healthy population of the same age.

  16. Cerebral blood flow alterations as assessed by 3D ASL in cognitive impairment in patients with subcortical vascular cognitive impairment: A marker for disease severity

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    Yawen Sun

    2016-08-01

    Full Text Available Abnormal reductions in cortical cerebral blood flow (CBF have been identified in subcortical vascular cognitive impairment (SVCI. However, little is known about the pattern of CBF reduction in relation with degree of cognitive impairment. CBF measured with 3D Arterial Spin Labeling (ASL perfusion MRI helps detect functional changes in subjects with SVCI. We aimed to compare CBF maps in subcortical ischemic vascular disease (SIVD subjects with and without cognitive impairment and to detect the relationship of the regions of CBF reduction in the brain with the degree of cognitive impairment according to the z-score. A total of 53 subjects with SVCI and 23 matched SIVD subjects without cognitive impairment (controls underwent a whole-brain 3D ASL MRI in the resting state. Regional CBF (rCBF was compared voxel wise by using an analysis of variance design in a statistical parametric mapping program, with patient age and sex as covariates. Correlations were calculated between the rCBF value in the whole brain and the z-score in the 53 subjects with SVCI. Compared with the control subjects, SVCI group demonstrated diffuse decreased CBF in the brain. Significant positive correlations were determined in the rCBF values in the left hippocampus, left superior temporal pole gyrus, right superior frontal orbital lobe, right medial frontal orbital lobe, right middle temporal lobe, left thalamus, and right insula with the z-scores in SVCI group. The noninvasively quantified resting CBF demonstrated altered CBF distributions in the SVCI brain. The deficit brain perfusions in the temporal and frontal lobe, hippocampus, thalamus, and insula was related to the degree of cognitive impairment. Its relationship to cognition indicates the clinical relevance of this functional marker. Thus, our results provide further evidence for the mechanism underlying the cognitive deficit in patients with SVCI.

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

    Science.gov (United States)

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

    2014-10-01

    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 parameters in subcortical vCIND in comparison with amnestic multidomain mild cognitive impairment to determine the additional diagnostic value of quantitative EEG in this setting. Fifty-seven community-residing patients with an uneventful central neurologic history and first presentation of cognitive decline without dementia were included. Neuropsychological test results were correlated with EEG parameters. Predictive values for vCIND and amnestic multidomain mild cognitive impairment were calculated using receiver operating characteristic curves and logistic regression modeling. Vascular cognitive impairment, no dementia and amnestic multidomain mild cognitive impairment differed with regard to the EEG (delta + theta)/(alpha + beta) ratio (DTABR) and pairwise derived brain symmetry index. We found statistically significant correlations between pairwise derived brain symmetry index and immediate verbal memory, immediate global memory, verbal recognition, working memory, and mean memory score in vCIND. Verbal fluency (odds ratio: 1.54, 95% confidence interval: 1.04-2.28, P = 0.033) and (delta + theta)/(alpha + beta) ratio (odds ratio: 2.28, 95% confidence interval: 1.06-4.94, P = 0.036) emerged as independent diagnostic predictors for vCIND with an overall correct classification rate of 95.0%. Our data indicate that EEG is of additional value in the differential diagnosis and follow-up of patients presenting with cognitive decline. These findings may have an impact on memory care.

  18. Different Functional and Microstructural Changes Depending on Duration of Mild Cognitive Impairment in Parkinson Disease.

    Science.gov (United States)

    Shin, N-Y; Shin, Y S; Lee, P H; Yoon, U; Han, S; Kim, D J; Lee, S-K

    2016-05-01

    The higher cortical burden of Lewy body and Alzheimer disease-type pathology has been reported to be associated with a faster onset of cognitive impairment of Parkinson disease. So far, there has been a few studies only about the changes of gray matter volume depending on duration of cognitive impairment in Parkinson disease. Therefore, our aim was to evaluate the different patterns of structural and functional changes in Parkinson disease with mild cognitive impairment according to the duration of parkinsonism before mild cognitive impairment. Fifty-nine patients with Parkinson disease with mild cognitive impairment were classified into 2 groups on the basis of shorter (parkinsonism before mild cognitive impairment. Fifteen drug-naïve patients with de novo Parkinson disease with intact cognition were included for comparison. Cortical thickness, Tract-Based Spatial Statistics, and seed-based resting-state functional connectivity analyses were performed. Age, sex, years of education, age at onset of parkinsonism, and levodopa-equivalent dose were included as covariates. The group with shorter duration of parkinsonism before mild cognitive impairment showed decreased fractional anisotropy and increased mean and radial diffusivity values in the frontal areas compared with the group with longer duration of parkinsonism before mild cognitive impairment (corrected P parkinsonism before mild cognitive impairment showed decreased resting-state functional connectivity in the default mode network area when the left or right posterior cingulate was used as a seed, and in the dorsolateral prefrontal areas when the left or right caudate was used as a seed (corrected P parkinsonism before mild cognitive impairment showed decreased resting-state functional connectivity mainly in the medial prefrontal cortex when the left or right posterior cingulate was used as a seed, and in the parieto-occipital areas when the left or right caudate was used as a seed (corrected P Parkinson

  19. Chronic kidney disease-related physical frailty and cognitive impairment: a systemic review.

    Science.gov (United States)

    Shen, Zhiyuan; Ruan, Qingwei; Yu, Zhuowei; Sun, Zhongquan

    2017-04-01

    The objective of this review was to assess chronic kidney disease-related frailty and cognitive impairment, as well as their probable causes, mechanisms and the interventions. Studies from 1990 to 2015 were reviewed to evaluate the relationship between chronic kidney disease and physical frailty and cognitive impairment. Of the 1694 studies from the initial search, longitudinal studies (n = 22) with the keywords "Cognitive and CKD" and longitudinal or cross-sectional studies (n = 5) with the keywords "Frailty and CKD" were included in final analysis. By pooling current research, we show clear evidence for a relationship between chronic kidney disease and frailty and cognitive impairment in major studies. Vascular disease is likely an important mediator, particularly for cognitive impairment. However, non-vascular factors also play an important role. Many of the other mechanisms that contribute to impaired cognitive function and increased frailty in CKD remain to be elucidated. In limited studies, medication therapy did not obtain the ideal effect. There are limited data on treatment strategies, but addressing the vascular disease risk factors earlier in life might decrease the subsequent burden of frailty and cognitive impairment in this population. Multidimensional interventions, which address both microvascular health and other factors, may have substantial benefits for both the cognitive impairments and physical frailty in this vulnerable population. Chronic kidney disease is a potential cause of frailty and cognitive impairment. Vascular and non-vascular factors are the possible causes. The mechanism of chronic kidney disease-induced physical frailty and cognitive impairment suggests that multidimensional interventions may be effective therapeutic strategies in the early stage of chronic kidney disease. Geriatr Gerontol Int 2017; 17: 529-544. © 2016 Japan Geriatrics Society.

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

    Directory of Open Access Journals (Sweden)

    Wang Q

    2014-02-01

    Full Text Available Qiumei Wang,1 Zhenxin Zhang,2 Ling Li,2 Hongbo Wen,2 Qun Xu3,4 1Department of Geriatrics, 2Department of Neurology, 3School of Basic Medicine, Peking Union Medical College Hospital, 4Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing, People's Republic of China Background: Although Parkinson's disease (PD is clinically characterized by motor symptoms, cognitive impairment is one of the most disabling non-motor symptoms. Despite it attracting increasing attention worldwide, less is known about its prevalence in the Chinese population. The objective of this study was to assess cognitive impairment and related risk factors in Chinese PD patients. Methods: We collected the demographic, diagnostic, and treatment information of 901 PD patients from 42 centers throughout the People's Republic of China, then administered a battery of neuropsychological tests, to assess motor, cognitive, and neuropsychiatric symptoms. Results: Overall, 193 of 901 (21.4% PD patients met the criteria for dementia (PD-D, and 206 (22.8% met the criteria for mild cognitive impairment (PD-MCI. Visuospatial dysfunction and attention/executive impairment predominated. Increased severity of cognitive impairment was associated with greater motor impairment. Patients with psychiatric symptoms, such as depression and hallucinations, were more likely to have dementia. Potentially, the younger-aged and more educated are shown less cognitive impairment, but age at onset, and levodopa equivalent dose, were not associated with the presence of cognitive dysfunction. Conclusion: The prevalence and profile of cognitive impairment in Chinese PD patients, as well as the risk factors, are similar as those reported for other races, but the frequency of nonamnestic cognitive domains differs. Keywords: cognitive impairment, risk factor, prevalence, Parkinson's disease

  1. Gray matter trophism, cognitive impairment, and depression in patients with multiple sclerosis.

    Science.gov (United States)

    Pravatà, Emanuele; Rocca, Maria A; Valsasina, Paola; Riccitelli, Gianna C; Gobbi, Claudio; Comi, Giancarlo; Falini, Andrea; Filippi, Massimo

    2017-12-01

    Cognitive impairment and depression frequently affects patients with multiple sclerosis (MS). However, the relationship between the occurrence of depression and cognitive impairment and the development of cortical atrophy has not been fully elucidated yet. To investigate the association of cortical and deep gray matter (GM) volume with depression and cognitive impairment in MS. Three-dimensional (3D) T1-weighted scans were obtained from 126 MS patients and 59 matched healthy controls. Cognitive impairment was assessed using the Brief Repeatable Battery of Neuropsychological Tests and depression with the Montgomery-Asberg Depression Rating Scale (MADRS). Using FreeSurfer and FIRST software, we assessed cortical thickness (CTh) and deep GM volumetry. Magnetic resonance imaging (MRI) variables explaining depression and cognitive impairment were investigated using factorial and classification analysis. Multivariate regression models correlated GM abnormalities with symptoms severity. Compared with controls, MS patients exhibited widespread bilateral cortical thinning involving all brain lobes. Depressed MS showed selective CTh decrease in fronto-temporal regions, whereas cognitive impairment MS exhibited widespread fronto-parietal cortical and subcortical GM atrophy. Frontal cortical thinning was the best predictor of depression ( C-statistic = 0.7), whereas thinning of the right precuneus and high T2 lesion volume best predicted cognitive impairment ( C-statistic = 0.8). MADRS severity correlated with right entorhinal cortex thinning, whereas cognitive impairment severity correlated with left entorhinal and thalamus atrophy. MS-related depression is linked to circumscribed CTh changes in areas deputed to emotional behavior, whereas cognitive impairment is correlated with cortical and subcortical GM atrophy of circuits involved in cognition.

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

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    K. M. Volkers

    2014-01-01

    Full Text Available Background. Physical performances and cognition are positively related in cognitively healthy people. The aim of this study was to examine whether physical performances are related to specific cognitive functioning in older people with mild to severe cognitive impairment. Methods. This cross-sectional study included 134 people with a mild to severe cognitive impairment (mean age 82 years. Multiple linear regression was performed, after controlling for covariates and the level of global cognition, with the performances on mobility, strength, aerobic fitness, and balance as predictors and working memory and episodic memory as dependent variables. Results. The full models explain 49–57% of the variance in working memory and 40–43% of episodic memory. Strength, aerobic fitness, and balance are significantly associated with working memory, explaining 3–7% of its variance, irrespective of the severity of the cognitive impairment. Physical performance is not related to episodic memory in older people with mild to severe cognitive impairment. Conclusions. Physical performance is associated with working memory in older people with cognitive impairment. Future studies should investigate whether physical exercise for increased physical performance can improve cognitive functioning. This trial is registered with ClinicalTrials.gov NTR1482.

  3. Social and nonsocial cognition in bipolar disorder and schizophrenia: relative levels of impairment.

    Science.gov (United States)

    Lee, Junghee; Altshuler, Lori; Glahn, David C; Miklowitz, David J; Ochsner, Kevin; Green, Michael F

    2013-03-01

    This study aimed to determine the relative extent of impairment in social and nonsocial cognitive domains in patients with bipolar disorder compared with schizophrenia patients and healthy comparison subjects. Sixty-eight clinically stable outpatients with bipolar disorder, 38 clinically stable outpatients with schizophrenia, and 36 healthy comparison subjects completed a range of social (facial affect perception, emotional regulation, empathic accuracy, mental state attribution, and self-referential memory) and nonsocial (speed of processing, attention/vigilance, working memory, verbal memory, visual memory, and reasoning/problem solving) cognitive tasks. For each social cognitive task, patients with bipolar disorder did not differ significantly from comparison subjects, and both groups performed better than schizophrenia patients. Within the bipolar group, clinical features and medication status were not related to social cognitive performance. Bipolar patients showed performance patterns across tasks (i.e., profiles) that were similar to those of comparison subjects on both social and nonsocial cognitive domains, whereas both groups differed from schizophrenia patients for both domains. Regarding relative impairment across the two cognitive domains, results revealed a significant group-by-domain interaction in which bipolar patients showed less impaired social than nonsocial cognition, while schizophrenia patients showed the opposite pattern. Bipolar patients showed less impairment on social relative to nonsocial cognitive performance, whereas schizophrenia patients showed more impairment on social relative to nonsocial cognitive performance. These results suggest that these two cognitive domains play different roles in bipolar disorder compared with in schizophrenia.

  4. Association between intake of B vitamins and cognitive function in elderly Koreans with cognitive impairment.

    Science.gov (United States)

    Kim, Hyesook; Kim, Ggotpin; Jang, Won; Kim, Seong Yoon; Chang, Namsoo

    2014-12-17

    It is possible that blood B vitamins level and cognitive function may be affected by dietary intake of these vitamins, no study however has yet been conducted on relationships between B vitamins intake and cognitive function among elderly population in Korea. This study examined the relationship between B vitamins intake and cognitive function among elderly in South Korea. Participants consisted of 100 adults with mild cognitive impairment (MCI), 100 with Alzheimer's disease (AD), and 121 normal subjects. Dietary intake data that included the use of dietary supplements were obtained using a 24-hour recall method by well-trained interviewers. Plasma folate and vitamin B12 concentrations were analyzed by radioimmunoassay, and homocysteine (Hcy) was assessed by a high performance liquid chromatography-fluorescence method. Plasma levels of folate and vitamin B12 were positively correlated with B vitamins intake; and plasma Hcy was negatively correlated with total intake of vitamin B2, vitamin B6, vitamin B12 and folate. In the AD group, a multiple regression analysis after adjusting for covariates revealed positive relationships between vitamin B2 intake and test scores for the MMSE-KC, Boston Naming, Word Fluency, Word List Memory and Constructional Recall Tests; and between vitamin B6 intake and the MMSE-KC, Boston Naming, Word Fluency, Word List Memory, Word List Recognition, Constructional Recall and Constructional Praxis Tests. Positive associations were observed between vitamin B12 intake and the MMSE-KC, Boston Naming, Constructional Recall and Constructional Praxis Tests, and between folate intake and the Constructional Recall Test. In the MCI group, vitamin B2 intake was positively associated with the MMSE-KC and Boston Naming Test, vitamin B6 intake was positively associated with the Boston Naming Test, and folate intake was positively associated with the MMSE-KC and Word List Memory test. No associations were observed in the normal group. These results

  5. Effects of Cognitive Leisure Activity on Cognition in Mild Cognitive Impairment: Results of a Randomized Controlled Trial.

    Science.gov (United States)

    Doi, Takehiko; Verghese, Joe; Makizako, Hyuma; Tsutsumimoto, Kota; Hotta, Ryo; Nakakubo, Sho; Suzuki, Takao; Shimada, Hiroyuki

    2017-08-01

    To test the hypothesis that a long-term, structured cognitive leisure activity program is more effective than a health education program at reducing the risk of further cognitive decline in older adults with mild cognitive impairment syndrome (MCI), a high risk for dementia. A 3-arm, single-blind randomized controlled trial. Community. A total of 201 Japanese adults with MCI (mean age: 76.0 years, 52% women). Participants were randomized into 1 of 2 cognitive leisure activity programs (60 minutes weekly for 40 weeks): dance (n = 67) and playing musical instruments (n = 67), or a health education control group (n = 67). Primary outcomes were memory function changes at 40 weeks. Secondary outcomes included changes in Mini-Mental State Examination and nonmemory domain (Trail Making Tests A and B) scores. At 40 weeks, the dance group showed improved memory recall scores compared with controls [mean change (SD): dance group 0.73 (1.9) vs controls 0.01 (1.9); P = .011], whereas the music group did not show an improvement compared with controls (P = .123). Both dance [mean change (SD): 0.29 (2.6); P = .026] and music groups [mean change (SD): 0.46 (2.1); P = .008] showed improved Mini-Mental State Examination scores compared with controls [mean change (SD): -0.36 (2.3)]. No difference in the nonmemory cognitive tests was observed. Long-term cognitive leisure activity programs involving dance or playing musical instruments resulted in improvements in memory and general cognitive function compared with a health education program in older adults with MCI. UMIN-CTR UMIN000014261. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  6. Effect of Common Neuropathologies on Progression of Late Life Cognitive Impairment

    Science.gov (United States)

    Yu, Lei; Boyle, Patricia A.; Leurgans, Sue; Schneider, Julie A.; Kryscio, Richard J.; Wilson, Robert S.; Bennett, David A.

    2015-01-01

    Brain pathologies of Alzheimer’s, cerebrovascular and Lewy body diseases are common in old age, but the relationship of these pathologies with progression from normal cognitive function to the various stages of cognitive impairment is unknown. In this study, we fit latent Markov models from longitudinal cognitive data to empirically derive three latent stages corresponding to no impairment, mild impairment, and moderate impairment; then, we examined the associations of common neuropathologies with the rates of transition among these stages. Cognitive and neuropathological data were available from 653 autopsied participants in two ongoing cohort studies of aging who were cognitively healthy at baseline (mean baseline age 79.1 years) and had longitudinal cognitive data. On average, participants in these analyses developed mild impairment 5 years after enrollment, progressed to moderate impairment after an additional 3.4 years, and stayed impaired for 2.8 years until death. AD and chronic macroscopic infarcts were associated with a higher risk of progression to mild impairment and subsequently to moderate impairment. By contrast, Lewy bodies were associated only with progression from mild to moderate impairment. The 5-year probability of progression to mild or moderate impairment was 20% for persons without any of these three pathologies, 38% for AD only, 51% for AD and macroscopic infarcts, and 56% for AD, infarcts and Lewy bodies. Thus, the presence of AD pathology alone nearly doubles the risk of developing cognitive impairment in late life, and the presence of multiple pathologies further increases this risk over multiple years prior to death. PMID:25976345

  7. Walking or vitamin B for cognition in older adults with mild cognitive impairment? A randomised controlled trial

    NARCIS (Netherlands)

    Uffelen, J.G.Z. van; Chinapaw, M.J.M.; Mechelen, W. van; Hopman-Rock, M.

    2008-01-01

    Objective: To examine the effects of aerobic exercise or vitamin B supplementation on cognitive function in older adults with mild cognitive impairment (MCI). Design: Randomised placebo-controlled trial. Setting: General community. Participants: Community-dwelling adults aged 70-80 with MCI.

  8. The influence of impaired processing speed on cognition in first-episode antipsychotic-naive schizophrenic patients

    DEFF Research Database (Denmark)

    Andersen, Rune; Fagerlund, Birgitte; Rasmussen, Hans

    2013-01-01

    , processing speed, sustained attention, working memory, reasoning and problem solving, verbal learning and memory, visual learning and memory, and reaction time. All these significant differences, except for verbal intelligence and global cognition, disappeared when processing speed was included......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...

  9. Reverters from PD-MCI to cognitively intact are at risk for future cognitive impairment: Analysis of the PPMI cohort.

    Science.gov (United States)

    Jones, Jacob D; Kuhn, Taylor P; Szymkowicz, Sarah M

    2018-02-01

    Past studies have shown that a large portion of individuals with Parkinson's disease (PD) and mild cognitive impairment (MCI) will revert to a cognitively intact (CI) status in the future. Aging studies have shown that individuals who revert from MCI to CI are at increased risk for reconverting to MCI or dementia in the future. The current study examined if individuals who revert from PD-mild cognitive impairment (PD-MCI) to CI will be at increased risk for future PD-MCI and Parkinson's disease dementia (PDD). The study utilized data from the Parkinson's Progression Markers Initiative (PPMI). The sample included 364 newly diagnosed PD participants who were followed annually for up to 4 years. Based on the first and second assessments, we identified individuals who were CI at each assessment (CI-Stable) and individuals who were PD-MCI at baseline but then reverted to CI (Reversion). Analyses examined if participants in the Reversion group were at greater risk, relative to the CI-Stable group, for cognitive impairment at future assessments. Participants in the Reversion group were at greater risk for future cognitive impairment (PD-MCI or PDD) at the 2nd, 3rd and 4th annual follow-up, relative to the CI-Stable group. The Reversion group continued to be at increased risk for future cognitive impairment when adjusting for age, gender, education, depressive symptoms, and motor severity. A large proportion of individuals with PD-MCI will not show evidence of cognitive impairment within a year. However, these "reverters" continue to be at risk for future development of cognitive impairment. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Impaired Sleep Predicts Cognitive Decline in Old People: Findings from the Prospective KORA Age Study

    Science.gov (United States)

    Johar, Hamimatunnisa; Kawan, Rasmila; Emeny, Rebecca Thwing; Ladwig, Karl-Heinz

    2016-01-01

    Study Objectives: To investigate the association between sleep-related characteristics and cognitive change over 3 years of follow up in an aged population. Methods: Sleep characteristics and covariates were assessed at baseline in a standardized interview and clinical examination of the population-based KORA Age Study (n = 740, mean age = 75 years). Cognitive score (determined by telephone interview for cognitive status, TICS-m) was recorded at baseline and 3 years later. Results: At baseline, 82.83% (n = 613) of participants had normal cognitive status, 13.51% (n = 100) were classified with mild cognitive impairment (MCI), and 3.64% (n = 27) with probable dementia. The effect of three distinct patterns of poor sleep (difficulties initiating [DIS] or maintaining sleep [DMS], daytime sleepiness [DS] or sleep duration) were considered on a change in cognitive score with adjustments for potential confounders in generalized linear regression models. Cognitive decline was more pronounced in individuals with DMS compared to those with no DMS (β = 1.33, 95% CI = 0.41–2.24, P sleep duration increased the risk for cognitive decline in cognitively impaired elderly (β = 1.86, 95% CI = 0.15–3.57, P = 0.03). Other sleep characteristics (DIS and DS) were not significantly associated with cognitive decline. Conclusions: DMS and long sleep duration were associated with cognitive decline in normal and cognitively impaired elderly, respectively. The identification of impaired sleep quality may offer intervention strategies to deter cognitive decline in the elderly with normal cognitive function. Citation: Johar H, Kawan R, Emeny RT, Ladwig KH. Impaired sleep predicts cognitive decline in old people: findings from the prospective KORA age study. SLEEP 2016;39(1):217–226. PMID:26414903

  11. Impaired Sleep Predicts Cognitive Decline in Old People: Findings from the Prospective KORA Age Study.

    Science.gov (United States)

    Johar, Hamimatunnisa; Kawan, Rasmila; Emeny, Rebecca Thwing; Ladwig, Karl-Heinz

    2016-01-01

    To investigate the association between sleep-related characteristics and cognitive change over 3 years of follow up in an aged population. Sleep characteristics and covariates were assessed at baseline in a standardized interview and clinical examination of the population-based KORA Age Study (n = 740, mean age = 75 years). Cognitive score (determined by telephone interview for cognitive status, TICS-m) was recorded at baseline and 3 years later. At baseline, 82.83% (n = 613) of participants had normal cognitive status, 13.51% (n = 100) were classified with mild cognitive impairment (MCI), and 3.64% (n = 27) with probable dementia. The effect of three distinct patterns of poor sleep (difficulties initiating [DIS] or maintaining sleep [DMS], daytime sleepiness [DS] or sleep duration) were considered on a change in cognitive score with adjustments for potential confounders in generalized linear regression models. Cognitive decline was more pronounced in individuals with DMS compared to those with no DMS (β = 1.33, 95% CI = 0.41-2.24, P cognition and not impaired subjects at baseline. Prolonged sleep duration increased the risk for cognitive decline in cognitively impaired elderly (β = 1.86, 95% CI = 0.15-3.57, P = 0.03). Other sleep characteristics (DIS and DS) were not significantly associated with cognitive decline. DMS and long sleep duration were associated with cognitive decline in normal and cognitively impaired elderly, respectively. The identification of impaired sleep quality may offer intervention strategies to deter cognitive decline in the elderly with normal cognitive function. © 2016 Associated Professional Sleep Societies, LLC.

  12. 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.

  13. Remote ischemic conditioning: A treatment for vascular cognitive impairment

    Directory of Open Access Journals (Sweden)

    David C Hess

    2015-01-01

    Full Text Available There is a strong link between hypoperfusion and white matter (WM damage in patients with leukoaraiosis and vascular cognitive impairment (VCI. Other than management of vascular risk factors, there is no treatment for WM damage and VCI that delays progression of the disease process to dementia. Observational studies suggest that exercise may prevent or slow down the progression of Alzheimer′s disease (AD and VCI. However, getting patients to exercise is challenging, especially with advancing age and disability. Remote ischemic conditioning, an "exercise equivalent," allows exercise to be given with a "device" at home for long periods of time. Since remote ischemic conditioning (RIC increases cerebral blood flow (CBF in preclinical studies and in humans, RIC may be an ideal therapy to treat VCI and WM disease and perhaps even sporadic AD. By using magnetic resonance imaging (MRI imaging of WM progression, a sample size in the range of about 100 subjects per group could determine if RIC has activity in WM disease and VCI.

  14. The effect of bilingualism on amnestic mild cognitive impairment.

    Science.gov (United States)

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

    2013-01-01

    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. 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. 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). 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.

  15. Memantine Attenuates Alzheimer's Disease-Like Pathology and Cognitive Impairment.

    Directory of Open Access Journals (Sweden)

    Xiaochuan Wang

    Full Text Available Deficiency of protein phosphatase-2A is a key event in Alzheimer's disease. An endogenous inhibitor of protein phosphatase-2A, inhibitor-1, I1PP2A, which inhibits the phosphatase activity by interacting with its catalytic subunit protein phosphatase-2Ac, is known to be upregulated in Alzheimer's disease brain. In the present study, we overexpressed I1PP2A by intracerebroventricular injection with adeno-associated virus vector-1-I1PP2A in Wistar rats. The I1PP2A rats showed a decrease in brain protein phosphatase-2A activity, abnormal hyperphosphorylation of tau, neurodegeneration, an increase in the level of activated glycogen synthase kinase-3beta, enhanced expression of intraneuronal amyloid-beta and spatial reference memory deficit; littermates treated identically but with vector only, i.e., adeno-associated virus vector-1-enhanced GFP, served as a control. Treatment with memantine, a noncompetitive NMDA receptor antagonist which is an approved drug for treatment of Alzheimer's disease, rescued protein phosphatase-2A activity by decreasing its demethylation at Leu309 selectively and attenuated Alzheimer's disease-like pathology and cognitive impairment in adeno-associated virus vector-1-I1PP2A rats. These findings provide new clues into the possible mechanism of the beneficial therapeutic effect of memantine in Alzheimer's disease patients.

  16. Retrospective analysis of guardians' perceptions of cognitively impaired elderly.

    Science.gov (United States)

    Weisensee, M G; Kjervik, D K; Anderson, J B

    1992-01-01

    The increased number of elderly persons who will become cognitively impaired in the near future is a cause for concern to all in the health care professions. Even though the final determination of incapacity and incompetency is a legal decision, input from health care professionals is weighed heavily by courts. Health professionals can have influence at the clinical level and also at the level of influencing social policy. Nurses rely on input from the assessments of informal caregivers. This research was conducted to determine guardians' perceptions of important criteria on the Incompetency Assessment Scale. Eleven guardians, a majority of whom were daughters of the elderly wards, perceived 9 of the 22 criteria on the IAS as important or very important to the question of incompetency. All nine criteria are found in Minnesota's statutory definition of incompetency, and also appear in the first two levels of the Maslow hierarchy of needs. Further research is recommended to develop a weighting or clustering of criteria to more accurately ascertain the way that incompetency judgments are made by guardians and other caregivers.

  17. Illness severity, trait anxiety, cognitive impairment and heart rate variability in bipolar disorder.

    Science.gov (United States)

    Levy, Boaz

    2014-12-30

    Numerous studies have documented a significant association between symptom severity and cognitive functioning in bipolar disorder (BD). These findings advanced speculations about a potential link between the physiological stress associated with illness severity and cognitive dysfunction. To explore this hypothesis, the current study employed heart rate variability (HRV) as a physiological measure that is sensitive to the effects of chronic stress, and a scale of trait anxiety for assessing a psychological condition that is correlated with hyper sympathetic arousal. Analyses indicated that BD patients with High Illness Severity reported more symptoms of trait-anxiety (i.e., State Trait Anxiety Inventory), performed more poorly on a computerized neuropsychological battery (i.e., CNS Vital Signs), and exhibited a more constricted HRV profile (i.e., lower SDNN with elevated LF/HF ratio) than patients with Low Illness Severity. Illness severity was determined by a history of psychosis, illness duration, and number of mood episodes. A third group of healthy controls (n=22) performed better on the neuropsychological battery and exhibited a healthier HRV profile than the BD groups. This study provides preliminary evidence that illness severity and cognitive impairment in BD may be associated with state anxiety and neuro-cardiac alterations that are sensitive to physiological stress. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. The association between disability and cognitive impairment in an elderly Tanzanian population

    Directory of Open Access Journals (Sweden)

    Catherine L. Dotchin

    2015-03-01

    Full Text Available Cognitive impairment is thought to be a major cause of disability worldwide, though data from sub-Saharan Africa (SSA are sparse. This study aimed to investigate the association between cognitive impairment and disability in a cohort of community-dwelling older adults living in Tanzania. The study cohort of 296 people aged 70 years and over was recruited as part of a dementia prevalence study. Subjects were diagnosed as having dementia or mild cognitive impairment according to the DSM-IV criteria. Disability level was assessed according to the WHO Disability Assessment Schedule, version 2.0 (WHODAS. A higher WHODAS score indicates greater disability. The median WHODAS in the background population was 25.0; in those with dementia and in those with mild cognitive impairment, 72 of 78 (92.3% and 41 of 46 (89.1%, respectively, had a WHODAS score above this level. The presence of dementia, mild cognitive impairment, hearing impairment, being unable to walk without an aid and not having attended school were independent predictors of having a WHODAS score above 25.0, though age and gender were not. In summary, cognitive impairment is a significant predictor of disability in elderly Tanzanians. Screening for early signs of cognitive decline would allow management strategies to be put in place that may reduce the associated disability burden.

  19. The association between disability and cognitive impairment in an elderly Tanzanian population.

    Science.gov (United States)

    Dotchin, Catherine L; Paddick, Stella-Maria; Gray, William K; Kisoli, Aloyce; Orega, Golda; Longdon, Anna R; Chaote, Paul; Dewhurst, Felicity; Dewhurst, Matthew; Walker, Richard W

    2015-03-01

    Cognitive impairment is thought to be a major cause of disability worldwide, though data from sub-Saharan Africa (SSA) are sparse. This study aimed to investigate the association between cognitive impairment and disability in a cohort of community-dwelling older adults living in Tanzania. The study cohort of 296 people aged 70years and over was recruited as part of a dementia prevalence study. Subjects were diagnosed as having dementia or mild cognitive impairment according to the DSM-IV criteria. Disability level was assessed according to the WHO Disability Assessment Schedule, version 2.0 (WHODAS). A higher WHODAS score indicates greater disability. The median WHODAS in the background population was 25.0; in those with dementia and in those with mild cognitive impairment, 72 of 78 (92.3%) and 41 of 46 (89.1%), respectively, had a WHODAS score above this level. The presence of dementia, mild cognitive impairment, hearing impairment, being unable to walk without an aid and not having attended school were independent predictors of having a WHODAS score above 25.0, though age and gender were not. In summary, cognitive impairment is a significant predictor of disability in elderly Tanzanians. Screening for early signs of cognitive decline would allow management strategies to be put in place that may reduce the associated disability burden. Copyright © 2014 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

  20. Identification of the predictors of cognitive impairment in patients with cancer in palliative care

    DEFF Research Database (Denmark)

    Kurita, Geana Paula; Benthien, Kirstine Skov; Sjøgren, Per

    2017-01-01

    care. METHODS: Prospective longitudinal investigation derived from the European Palliative Care Cancer Symptom study (2011-2013) including patients with cancer in palliative care, ≥18 years, and with at least one assessment post-inclusion. For cognitive assessment, a 4-item version of the Mini Mental......) showed that those with low KPS (OR = 1.6, 95% CI 1.0-2.5) most often developed cognitive impairment, while patients with breast cancer (OR = 0.4, 95% CI 0.2-0.7) had lower odds for impairment. CONCLUSIONS: During palliative care, a substantial number of patients remained cognitively impaired or developed......PURPOSE: Studies with neuropsychological assessments in patients with cancer are sparse, and the evidence is very limited regarding their status of cognitive function over time. This study aimed at assessing the prevalence and predictors of cognitive impairment in patients with cancer in palliative...

  1. Folate and MMA predict cognitive impairment in elderly stroke survivors: A cross sectional study.

    Science.gov (United States)

    Pascoe, Michaela C; Linden, Thomas

    2016-09-30

    Elderly stroke survivors are at risk of malnutrition and long-term cognitive impairment. Vitamin B-related metabolites, folate and methylmalonic acid, have been implicated in cognitive function. We conducted a study exploring the relationship between blood folate, methylmalonic acid and post-stroke cognitive impairment. This is a cross sectional study of elderly Swedish patients (n=149) 20 months post-stroke, assessed using the Mini Mental State Examination, serum blood levels of methylmalonic acid and red blood cell levels of folate. Linear modeling indicated that low levels of blood folate and elevated methylmalonic acid significantly contributed to cognitive impairment in stroke survivors. Half of the stroke survivors were shown to have folate deficiency at 20 months after stroke. Folate deficiency is common long term after stroke and both low folate and elevated methylmalonic acid appear to be associated with long term cognitive impairment, in elderly Swedish stroke survivors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2014-01-01

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

  3. Anxiety is associated with cognitive impairment in newly-diagnosed Parkinson's disease.

    Science.gov (United States)

    Dissanayaka, Nadeeka N W; Lawson, Rachael A; Yarnall, Alison J; Duncan, Gordon W; Breen, David P; Khoo, Tien K; Barker, Roger A; Burn, David J

    2017-03-01

    Anxiety and mild cognitive impairment (MCI) are prevalent non-motor manifestations of Parkinson's disease (PD). While few studies have demonstrated a possible link between cognitive dysfunction and anxiety in PD, to our knowledge, no studies have directly examined the association between them. This study investigated the association between anxiety and cognitive deficits in newly diagnosed PD patients. Patients with newly diagnosed PD (N = 185) were recruited from community and outpatient clinics. Anxiety was assessed using the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) clinician rated anxiety item, which has previously been validated against a standardized criteria for the diagnosis of anxiety disorders in PD. Participants scoring ≥2 were classified as anxious. A threshold of 1 SD below normative values (obtained from controls) was used to define cognitive impairment. Impairments in specific cognitive domains were identified as being >1 SD below controls in ≥1 test per domain. After controlling for age, education and motor severity, patients with anxiety were three times more likely to have cognitive impairment compared to those without anxiety (OR = 3.0, 95% CI = 1.2-7.3, p impairment due to impairment in the memory domain compared with PD without anxiety (OR = 2.3, 95% CI = 1.0-5.1, p impairment (specifically memory impairment). Examining the neural basis of this association warrants future research in this developing field. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. Neuroticism modifies the association of vision impairment and cognition among community-dwelling older adults.

    Science.gov (United States)

    Gaynes, Bruce I; Shah, Raj; Leurgans, Sue; Bennett, David

    2013-01-01

    Vision impairment (best-corrected binocular visual acuity worse than 20/40) is a common age-related health condition requiring adaptation to maintain well-being. Whether neuroticism, a personality trait associated with decreased ability to adapt to change, modifies the association of vision impairment with worse cognition is uncertain. Using baseline visual acuity, neuroticism and cognitive function data from 714 community-dwelling, older participants in the Rush Memory and Aging Project, we examined whether self-reported neuroticism level modified the cross-sectional association between vision impairment and lower cognitive level. Women represented 76% of the participants. The mean age was 79.6 (SD = 6.9) years and the mean education level was 14.6 (SD = 2.9) years; 26% of the participants had vision impairment. In a linear regression model adjusted for age, sex and education, each unit higher in neuroticism level worsened the association between vision impairment and lower global cognitive function level (parameter estimate for vision impairment and neuroticism interaction term = -0.017; standard error = 0.005; p = 0.001). For participants with vision impairment, a high neuroticism level (50th percentile or above) was associated with a mean global cognitive score that was 0.297 z-score units lower than for participants with a low neuroticism level (p persons, neuroticism modifies the association between vision impairment and cognitive function level. Copyright © 2012 S. Karger AG, Basel.

  5. Assessment of verbal and visuospatial working memory in mild cognitive impairment and Alzheimer's dementia

    OpenAIRE

    Kessels, Roy P.C.; Overbeek, Anouk; Bouman, Zita

    2015-01-01

    In addition to episodic memory impairment, working memory may also be compromised in mild cognitive impairment (MCI) or Alzheimer's dementia (AD), but standard verbal and visuospatial span tasks do not always detect impairments. Objective: To examine whether more complex verbal and visuospatial working memory tasks result in more reliable impairment detection. Methods: The Digit Span (forward, backward and sequencing), Spatial Span (forward and backward) and Spatial Addition test from the W...

  6. Cognitive impairment is undetected in medical inpatients: a study of mortality and recognition amongst healthcare professionals

    Directory of Open Access Journals (Sweden)

    Torisson Gustav

    2012-08-01

    Full Text Available Abstract Background Detecting cognitive impairment in medical inpatients is important due to its association with adverse outcomes. Our aim was to study recognition of cognitive impairment and its association with mortality. Methods 200 inpatients aged over 60 years were recruited at the Department of General Internal Medicine at University Hospital MAS in Malmö, Sweden. The MMSE (Mini-Mental State Examination and the CDT (Clock-Drawing Test were performed and related to recognition rates by patients, staff physicians, nurses and informants. The impact of abnormal cognitive test results on mortality was studied using a multivariable Cox proportional hazards regression. Results 55 patients (28% had no cognitive impairment while 68 patients (34% had 1 abnormal test result (on MMSE or CDT and 77 patients (39% had 2 abnormal test results. Recognition by healthcare professionals was 12% in the group with 1 abnormal test and 44-64% in the group with 2 abnormal test results. In our model, cognitive impairment predicted 12-month mortality with a hazard ratio (95% CI of 2.86 (1.28-6.39 for the group with 1 abnormal cognitive test and 3.39 (1.54-7.45 for the group with 2 abnormal test results. Conclusions Cognitive impairment is frequent in medical inpatients and associated with increased mortality. Recognition rates of cognitive impairment need to be improved in hospitals.

  7. Comorbid cognitive impairment and functional trajectories in low vision rehabilitation for macular disease.

    Science.gov (United States)

    Whitson, Heather E; Ansah, Deidra; Sanders, Linda L; Whitaker, Diane; Potter, Guy G; Cousins, Scott W; Steffens, David C; Landerman, Lawrence R; Pieper, Carl F; Cohen, Harvey Jay

    2011-01-01

    Comorbid cognitive impairment is common among visually impaired older adults. This study investigated whether baseline cognitive status predicts functional trajectories among older adults in low vision rehabilitation (LVR) for macular disease. The Telephone Interview for Cognitive Status - modified (TICS-m) was administered to macular disease patients aged ≥ 65 years receiving outpatient LVR. Mixed models assessed the rate of change in instrumental activities of daily living and visual function measures over a mean follow-up of 115 days. Of 91 participants, 17 (18.7%) had cognitive impairment (TICS-m score ≤ 27) and 23 (25.3%) had marginal impairment (TICS-m scores 28 to 30). Controlling for age and gender, baseline cognitive status did not predict most functional outcomes. However, participants with marginal cognitive impairment experienced worse functional trajectories in ability to prepare meals (p=0.03) and activities that require distance vision (p=0.05). Patients with mild to moderate cognitive impairment should not be excluded from LVR, but programs should be prepared to detect and accommodate a range of cognitive ability.

  8. Domain-specific cognitive impairment in patients with COPD and control subjects

    Directory of Open Access Journals (Sweden)

    Cleutjens FAHM

    2016-12-01

    Full Text Available Fiona AHM Cleutjens,1 Frits ME Franssen,1 Martijn A Spruit,1 Lowie EGW Vanfleteren,1 Candy Gijsen,1 Jeanette B Dijkstra,2 Rudolf WHM Ponds,2 Emiel FM Wouters,1,3 Daisy JA Janssen1 1Department of Research and Education, CIRO, Centre of Expertise for Chronic Organ Failure, Horn, 2Department of Medical Psychology, Maastricht UMC+/School for Mental Health and Neurosciences (MHeNS, 3Department of Respiratory Medicine, Maastricht UMC+, Maastricht, the Netherlands Abstract: 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. Keywords

  9. European palliative care guidelines: how well do they meet the needs of people with impaired cognition?

    Science.gov (United States)

    Sampson, E L; van der Steen, J T; Pautex, S; Svartzman, P; Sacchi, V; Van den Block, L; Van Den Noortgate, N

    2015-09-01

    Numbers of people dying with cognitive impairment (intellectual disability (ID), dementia or delirium) are increasing. We aimed to examine a range of European national palliative care guidelines to determine if, and how well, pain detection and management for people dying with impaired cognition are covered. Questionnaires were sent to 14 country representatives of the European Pain and Impaired Cognition (PAIC) network who identified key national palliative care guidelines. Data was collected on guideline content: inclusion of advice on pain management, whether cognitively impaired populations were mentioned, assessment tools and management strategies recommended. Quality of guideline development was assessed with the Appraisal of Guidelines Research and Evaluation (AGREE) instrument. 11 countries identified palliative care guidelines, 10 of which mentioned pain management in general. Of these, seven mentioned cognitive impairment (3 dementia, 2 ID and 4 delirium). Half of guidelines recommended the use of pain tools for people with cognitive impairment; recommended tools were not all validated for the target populations. Guidelines from the UK, the Netherlands and Finland included most information on pain management and detection in impaired cognition. Guidelines from Iceland, Norway and Spain scored most highly on AGREE rating in terms of developmental quality. European national palliative care guidelines may not meet the needs of the growing population of people dying with cognitive impairment. New guidelines should consider suggesting the use of observational pain tools for people with cognitive impairment. Better recognition of their needs in palliative care guidelines may drive improvements in care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. Cognitive function affects trainability for physical performance in exercise intervention among older adults with mild cognitive impairment.

    Science.gov (United States)

    Uemura, Kazuki; Shimada, Hiroyuki; Makizako, Hyuma; Doi, Takehiko; Yoshida, Daisuke; Tsutsumimoto, Kota; Anan, Yuya; Suzuki, Takao

    2013-01-01

    Although much evidence supports the hypothesis that cognitive function and physical function are interrelated, it is unclear whether cognitive decline with mild cognitive impairment influences trainability of physical performance in exercise intervention. The purpose of this study was to examine the association between cognitive function at baseline and change in physical performance after exercise intervention in older adults with mild cognitive impairment. Forty-four older adults diagnosed with mild cognitive impairment based on the Peterson criteria (mean age 74.8 years) consented to and completed a 6-month twice weekly exercise intervention. The Timed Up and Go (TUG) test was used as a measure of physical performance. The Mini-Mental State Examination (MMSE), Trail Making Test Part B, Geriatric Depression Scale, baseline muscle strength of knee extension, and attendance rate of intervention, were measured as factors for predicting trainability. In the correlation analysis, the change in TUG showed modest correlations with attendance rate in the exercise program (r = -0.354, P = 0.027) and MMSE at baseline (r = -0.321, P = 0.034). A multiple regression analysis revealed that change in TUG was independently associated with attendance rate (β = -0.322, P = 0.026) and MMSE score (β = -0.295, P = 0.041), controlling for age and gender. General cognitive function was associated with improvements in physical performance after exercise intervention in subjects with mild cognitive impairment. Further research is needed to examine the effects of exercise programs designed to address cognitive obstacles in older adults with mild cognitive impairment.

  11. Cognitive impairment in the Age-Related Eye Disease Study: AREDS report no. 16.

    Science.gov (United States)

    Clemons, Traci E; Rankin, Molly W; McBee, Wendy L

    2006-04-01

    To investigate potential associations between cognitive function and/or impairment and age-related macular degeneration (AMD) and visual impairment in the Age-Related Eye Disease Study (AREDS). The AREDS is an 11-center natural history study of AMD and age-related cataract. The AREDS Cognitive Function Battery was administered to 2946 participants. The battery consists of 6 neuropsychological tests measuring performance in several cognitive domains. The Dunnett multiple comparison test was used to identify differences by AMD and visual acuity severity. The relationship with cognitive impairment was also assessed using logistic regression. Mean scores of instruments in the AREDS Cognitive Function Battery declined with increased macular abnormalities and reduced visual acuity. After adjustment for age, sex, race, education, smoking status, diabetes mellitus, hypertension, and depression, increased macular abnormalities (trend P value cognitive function scores as measured by the Modified Mini-Mental State Examination and the Wechsler Logical Memory Scale. Reduced vision was found to be associated with reduced mean cognitive function scores as measured by the Modified Mini-Mental State Examination and letter and verbal fluency tasks. Persons with vision worse than 20/40 OU were more likely to be cognitively impaired (Modified Mini-Mental State Examination score cognitive impairment in older persons.

  12. A pilot randomized trial of two cognitive rehabilitation interventions for mild cognitive impairment: caregiver outcomes.

    Science.gov (United States)

    Cuc, Andrea V; Locke, Dona E C; Duncan, Noah; Fields, Julie A; Snyder, Charlene Hoffman; Hanna, Sherrie; Lunde, Angela; Smith, Glenn E; Chandler, Melanie

    2017-12-01

    This study aims to provide effect size estimates of the impact of two cognitive rehabilitation interventions provided to patients with mild cognitive impairment: computerized brain fitness exercise and memory support system on support partners' outcomes of depression, anxiety, quality of life, and partner burden. A randomized controlled pilot trial was performed. At 6 months, the partners from both treatment groups showed stable to improved depression scores, while partners in an untreated control group showed worsening depression over 6 months. There were no statistically significant differences on anxiety, quality of life, or burden outcomes in this small pilot trial; however, effect sizes were moderate, suggesting that the sample sizes in this pilot study were not adequate to detect statistical significance. Either form of cognitive rehabilitation may help partners' mood, compared with providing no treatment. However, effect size estimates related to other partner outcomes (i.e., burden, quality of life, and anxiety) suggest that follow-up efficacy trials will need sample sizes of at least 30-100 people per group to accurately determine significance. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  13. [Workshops for cognitive stimulation adapted for elderly illiterate individuals with mild cognitive impairment].

    Science.gov (United States)

    dos Santos, Izabel Borges; Gomes, Lucy; de Matos, Neuza Moreira; do Vale, Maria Sueli; dos Santos, Fernando Borges; Cardenas, Carmen Jansen; Alves, Vicente Paulo

    2012-01-01

    The aim of this study was to assess the self-perception of memory in elderly illiterate with mild cognitive impairment, before and after workshops of cognitive stimulation adapted for illiterate individuals. The research was qualitative, held at the Health Unit of Taguatinga-DF, involving 63 elderly illiterate: 22 in the experimental group (EG), with 10 workshops; 21 in control group 1 (CG1), with 10 lectures; and 20 in the control group 2 (GC2), without intervention. Semi-structured interviews were carried on before and after the interventions, asking about memory status. The activities offered weekly to EG and CG1 have had two hours of duration. The mean age of the participants was 72.8 years, and 92% were female. In pre-intervention, 82% reported worsening memory during the last year. In post-intervention, CG1 and CG2 kept memory changes, while EG improved cognition. One concludes that the provided workshops and lectures improved functionality and socialization / integration.

  14. 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.

  15. Profile of cognitive impairment and underlying pathology in multiple system atrophy.

    Science.gov (United States)

    Koga, Shunsuke; Parks, Adam; Uitti, Ryan J; van Gerpen, Jay A; Cheshire, William P; Wszolek, Zbigniew K; Dickson, Dennis W

    2017-03-01

    The objectives of this study were to elucidate any potential association between α-synuclein pathology and cognitive impairment and to determine the profile of cognitive impairment in multiple system atrophy (MSA) patients. To do this, we analyzed the clinical and pathologic features in autopsy-confirmed MSA patients. We retrospectively reviewed medical records, including neuropsychological test data, in 102 patients with autopsy-confirmed MSA in the Mayo Clinic brain bank. The burden of glial cytoplasmic inclusions and neuronal cytoplasmic inclusions were semiquantitatively scored in the limbic regions and middle frontal gyrus. We also assessed concurrent pathologies potentially causing dementia including Alzheimer's disease, hippocampal sclerosis, and cerebrovascular pathology. Of 102 patients, 33 (32%) were documented to have cognitive impairment. Those that received objective testing, deficits primarily in processing speed and attention/executive functions were identified, which suggests a frontal-subcortical pattern of dysfunction. Of these 33 patients with cognitive impairment, 8 patients had concurrent pathologies of dementia. MSA patients with cognitive impairment had a greater burden of neuronal cytoplasmic inclusions in the dentate gyrus than patients without cognitive impairment, both including and excluding patients with concurrent pathologies of dementia. The cognitive deficits observed in this study were more evident on neuropsychological assessment than with cognitive screens. Based on these findings, we recommend that clinicians consider more in-depth neuropsychological assessments if patients with MSA present with cognitive complaints. Although we did not identify the correlation between cognitive deficits and responsible neuroanatomical regions, a greater burden of neuronal cytoplasmic inclusions in the limbic regions was associated with cognitive impairment in MSA. © 2016 International Parkinson and Movement Disorder Society. © 2016

  16. Cognitive complaints and cognitive impairment in patients with chronic daily headache

    Directory of Open Access Journals (Sweden)

    V. A. Golovacheva

    2017-01-01

    Full Text Available Comorbidities in chronic daily headache (CDH include emotional disorders (depression, anxiety, insomnia, and musculoskeletal pain at other sites. In CDH, the most common type is a subjective  (according to patients themselves and/or objective (based on the  results of cognitive tests reduction in cognitive functions, which can  be caused by emotional disorders, insomnia and/or brain diseases,  and a negative effect of chronic pain on cognitive functions.Objective: to analyze cognitive complaints and their changes in patients with CDH.Patients and methods. Subjective complaints and cognitive functions were evaluated in 90 patients (76 women and 14 men aged 23 to 78 years (mean age, 46.7±12.0 years with primary  forms of CDH according to the Montreal Cognitive Assessment (MCA for 12 months. The majority (68.9% of patients with CHD  complained of diminished memory; however, its mild disorders (25– 26 MCA scores were found in only a small proportion (23.3%. All  patients with subjective diminished memory were ascertained to  have neurotic disorders (depression, anxiety disorder and/or insomnia or a concurrence of mental disorder and insomnia.Results and discussion. All the patients received treatment options, including optimal pharmacotherapy for headache and concomitant diseases, an educational conversation, cognitive- behavioral therapy, and therapeutic exercises. In cognitive  impairment (CI, cognitive training was used and Ginkgo biloba  extract (EGb 761® prescribed; in sleep disorders, sleep hygiene  rules were explained. Therapy declined the mean number of  headache days a month from 29.1±2.03 (at baseline to 9.3±9.35  (at 12-month follow-up (p=0.002; while the subjective complaints regressed in the majority of patients; mild MCA changes persisted only in 6.7% of the patients. Management tactics for CHD patients  having mild CI and cardiovascular risk factors and the use of EGb  761® to improve cognitive

  17. Relationship between cognitive anxiety level and client variables at initial consultation for adults with hearing impairment.

    Science.gov (United States)

    Kelly-Campbell, R J; Parry, D C

    2014-01-01

    The purpose of this study was to use the Cognitive Anxiety Scale (CAS) to investigate relationships between state-anxiety level (cognitive anxiety) and audiometric variables in adults with hearing impairment at their initial consultation. Thirty-five adults with hearing impairment who consulted an audiologist for the first time participated in this study. An interview to obtain information about cognitive anxiety was conducted prior to the audiological assessment. The results indicated that cognitive anxiety was significantly related to an ability to understand speech in noise. Further, cognitive anxiety and ability to understand speech in noise significantly contributed to the classification of hearing aid adopters and non-adopters. These results indicate that the measure of cognitive anxiety may have clinical applications in the future. The reader will be able to: (1) discuss the relationship between anxiety and hearing impairment; (2) define cognitive anxiety; (3) state the relationship between cognitive anxiety and audiometric variables; (4) state the relationship between cognitive anxiety and the decision to adopt hearing aids; (5) identify signs of cognitive anxiety in adults with hearing impairment. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Cognitive Strategy Use and Measured Numeric Ability in Immediate- and Long-Term Recall of Everyday Numeric Information

    Science.gov (United States)

    Bermingham, Douglas; Hill, Robert D.; Woltz, Dan; Gardner, Michael K.

    2013-01-01

    The goals of this study were to assess the primary effects of the use of cognitive strategy and a combined measure of numeric ability on recall of every-day numeric information (i.e. prices). Additionally, numeric ability was assessed as a moderator in the relationship between strategy use and memory for prices. One hundred participants memorized twelve prices that varied from 1 to 6 digits; they recalled these immediately and after 7 days. The use of strategies, assessed through self-report, was associated with better overall recall, but not forgetting. Numeric ability was not associated with either better overall recall or forgetting. A small moderating interaction was found, in which higher levels of numeric ability enhanced the beneficial effects of strategy use on overall recall. Exploratory analyses found two further small moderating interactions: simple strategy use enhanced overall recall at higher levels of numeric ability, compared to complex strategy use; and complex strategy use was associated with lower levels of forgetting, but only at higher levels of numeric ability, compared to the simple strategy use. These results provide support for an objective measure of numeric ability, as well as adding to the literature on memory and the benefits of cognitive strategy use. PMID:23483964

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

    Directory of Open Access Journals (Sweden)

    Youhua Xu

    2017-04-01

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

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

    Science.gov (United States)

    Xu, Youhua; Zhou, Hua; Zhu, Quan

    2017-01-01

    Progressive cognitive dysfunction is a central characteristic of diabetic encephalopathy (DE). With an aging population, the incidence of DE is rising and it has become a major threat that seriously affects public health. Studies within this decade have indicated the important role of risk factors such as oxidative stress and inflammation on the development of cognitive impairment. With the recognition of the two-way communication between gut and brain, recent investigation suggests that “microbiota-gut-brain axis” also plays a pivotal role in modulating both cognition function and endocrine stability. This review aims to systemically elucidate the underlying impact of diabetes on cognitive impairment. PMID:28496408

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

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    Komal Chauhan

    2016-09-01

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

  2. Physical activity and physical fitness of nursing home residents with cognitive impairment: A pilot study.

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    Marmeleira, José; Ferreira, Soraia; Raimundo, Armando

    2017-12-15

    Physical activity and physical fitness are important for health, functional mobility and performance of everyday activities. To date, little attention has been given to physical activity and physical fitness among nursing home residents with cognitive impairment. Therefore, the main aim of this study was to examine physical activity behavior and physical fitness of institutionalized older adults with cognitive impairment and to investigate their interrelations. Forty-eight older adults with cognitive impairment (83.9±7.7years; 72.9% women) and 22 without cognitive impairment (82.2±8.8years; 54.5% women) participated. Physical activity was objectively assessed with accelerometers and physical fitness components (muscular strength, flexibility, balance, body composition and reaction time) were evaluated with physical fitness field tests. Nursing home residents with cognitive impairment spent only ~1min per day in moderate physical activity and ~89min in light physical activity. In average they accumulated 863 (±599) steps per day and spent 87.2% of the accelerometer wear time in sedentary behavior. Participants' physical fitness components were markedly low and according to the cut-offs used for interpreting the results a great number of nursing home residents had an increased risk of associated health problems, functional impairment and of falling. The performance in some physical fitness tests was positively associated with physical activity. Participants without cognitive impairment had higher levels of physical activity and physical fitness than their counterparts with cognitive impairment. These results indicate that nursing home residents, especially those with cognitive impairment, have low levels of physical activity, spent a high proportion of daytime in sedentary behavior and have low physical fitness. Nursing homes should implement health promotion strategies targeting physical activity and physical fitness of their residents. Copyright © 2017 Elsevier

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

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    Ana Paula Oliveira Borges

    Full Text Available ABSTRACT INTRODUCTION: Elderly people with cognitive impairment are at greater risk for falls; thus, an understanding of the earliest stages of cognitive decline is necessary. OBJECTIVE: To compare postural balance between elderly people with and without mild cognitive impairment using a three-dimensional system. METHODS: 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. RESULTS: 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. CONCLUSION: 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.

  4. Factors affecting the quality of life of homebound elderly hemiparetic stroke patients with cognitive impairment.

    Science.gov (United States)

    Takemasa, Seiichi; Nakagoshi, Ryoma; Uesugi, Masayuki; Inoue, Yuri; Gotou, Makoto; Koeda, Hideki; Naruse, Susumu

    2016-12-01

    [Purpose] This study examined the quality of life of homebound elderly hemiparetic stroke patients with cognitive impairment and the factors affecting their quality of life. [Subjects and Methods] The subjects of the study were 17 home-based elderly hemiparetic stroke patients with cognitive impairment (8 males and 9 females, average age: 76.3 ± 10.5 years old). Their physical and psychological conditions, quality of life and other items were investigated. Nishimura's Mental State Scale for the Elderly was used for the cognitive impairment assessment. The Functional Independence Measure was used to assess activities of daily living, and the Japanese Quality of Life Inventory for the Elderly with Dementia was used to assess quality of life. [Results] The subjects' quality of life was affected by their cognitive impairment level and independence of activities of daily living. However, no correlations were observed between the quality of life of the homebound elderly hemiparetic stroke patients with cognitive impairment, age, gender or care-need level. [Conclusion] In order to improve the quality of life of homebound elderly hemiparetic stroke patients with cognitive impairment, assistance helping them to maintain their cognitive abilities and on-going rehabilitation for improving activities of daily living independence are required.

  5. 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.

  6. Understanding the cognitive underpinnings of functional impairments in early dementia: a review.

    Science.gov (United States)

    Giebel, Clarissa M; Challis, David; Montaldi, Daniela

    2015-01-01

    Early dementia is marked by cognitive and functional impairments, and although studies indicate an association between these, detailed analyses exploring this relationship are rare. It is crucial to understand how specific cognitive deficits underlie functional deficits to develop successful cognitive interventions. This paper reviews the evidence of impairment in everyday functioning and in working, long-term and prospective memory in early dementia. Findings are evaluated with respect to the relationship between cognitive and functional impairments. From the literature searches, 17 studies on everyday functioning and 40 studies on memory were obtained. Studies were only included if patients had an official diagnosis and were in the early stages of dementia. Complex instrumental activities of daily living were subject to greater impairment than basic activities of daily living. In particular, early dementia patients struggle with finance tasks; a deficit linked to impaired working memory. Regarding cognition, long-term memory is the earliest form of memory to decline as is well recognised. Evidence also indicates deficits in working and prospective memory, with inconsistent evidence about impairments of the former. A major limitation of the literature is a lack of studies assessing individual everyday activities and the associated error patterns that might occur. This review critically assesses the status of translational research for everyday activities in early dementia, an area with critical implications for cognitive-based rehabilitation. Further research is required into the detailed assessment of individual everyday activity and specific memory deficits, in order to effectively map cognitive functions onto functional performance.

  7. Association of metabolic syndrome and 25-hydroxyvitamin D with cognitive impairment among elderly Koreans.

    Science.gov (United States)

    Lee, Eun Young; Lee, Su Jin; Kim, Kyoung Min; Yun, Young Mi; Song, Bo Mi; Kim, Jong Eun; Kim, Hyeon Chang; Rhee, Yumie; Youm, Yoosik; Kim, Chang Oh

    2017-07-01

    Metabolic syndrome and vitamin D deficiency are prevalent in older adults, and are considered risk factors for cognitive impairment. We investigated the combined effects of MetS and serum 25-hydroxyvitamin D (25[OH]D) levels on cognitive function in older adults. We studied 2940 participants aged ≥65 years from the Korean Urban Rural Elderly cohort study. Metabolic syndrome was defined according to the updated Adult Treatment Panel III criteria. Serum 25(OH)D levels were categorized into four groups: metabolic syndrome prevalence and lower serum 25(OH)D levels than those without cognitive impairment. In univariate analysis, both metabolic syndrome and low 25(OH)D levels were associated with cognitive impairment. These associations remained unchanged after adjusting for potential confounders including age, sex, season and education. In addition, participants with metabolic syndrome and low 25(OH)D had significantly increased odds for cognitive impairment (odds ratio 3.06, 95% CI 1.61-5.80) when compared with those with no metabolic syndrome and high 25(OH)D. Metabolic syndrome was associated with cognitive impairment, and this risk was synergistically increased when metabolic syndrome was combined with low 25(OH)D. A focus on individuals with metabolic syndrome and low 25(OH)D might be helpful to identify older adults who are at risk of cognitive impairment. Geriatr Gerontol Int 2017; 17: 1069-1075. © 2016 Japan Geriatrics Society.

  8. COPD and cognitive impairment: the role of hypoxemia and oxygen therapy

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    Neeta Thakur

    2010-08-01

    Full Text Available Neeta Thakur1, Paul D Blanc2, Laura J Julian1, Edward H Yelin3, Patricia P Katz3, Stephen Sidney4, Carlos Iribarren4, Mark D Eisner1,21Department of Medicine, 2Division of Occupational and Environmental Medicine and Division of Pulmonary and Critical Care Medicine, 3Institute for Health Policy Studies, Department of Medicine, University of California, San Francisco, CA, USA, 4Division of Research, Kaiser Permanente, Oakland, CA, USABackground: Several studies have shown an association between chronic obstructive pulmonary disease (COPD and cognitive impairment. These studies have been limited by methodological issues such as diagnostic uncertainty, cross-sectional design, small sample size, or lack of appropriate referent group. This study aimed to elucidate the association between COPD and the risk of cognitive impairment compared to referent subjects without COPD. In patients with established COPD, we evaluated the impact of disease severity and impairment of respiratory physiology on cognitive impairment and the potential mitigating role of oxygen therapy.Methods: We used the Function, Living, Outcomes and Work (FLOW cohort study of adults with COPD (n = 1202 and referent subjects matched by age, sex, and race (n = 302 to study the potential risk factors for cognitive impairment among subjects with COPD. Cognitive impairment was defined as a Mini-Mental State Exam score of <24 points. Disease severity was using Forced Expiratory Volume in one second (FEV1; the validated COPD Severity Score; and the BMI (Body Mass Index, Obstruction, Dyspnea, Exercise Capacity (BODE Index. Multivariable analysis was used to control for confounding by age, sex, race, educational attainment, and cigarette smoking.Results: COPD was associated with a substantive risk of cognitive impairment compared to referent subjects (odds ratio [OR] 2.42; 95% confidence interval [CI] 1.043–6.64. Among COPD patients, none of the COPD severity measures were associated with the

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

    Science.gov (United States)

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

    2017-05-01

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

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

    Science.gov (United States)

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

    2013-03-01

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

  11. Cognitive impairment in schizophrenia and affective psychoses: implications for DSM-V criteria and beyond.

    Science.gov (United States)

    Bora, Emre; Yücel, Murat; Pantelis, Christos

    2010-01-01

    It has recently been suggested that the diagnostic criteria of schizophrenia should include specific reference to cognitive impairments characterizing the disorder. Arguments in support of this assertion contend that such inclusion would not only serve to increase the awareness of cognitive deficits in affected patients, among both clinicians and researchers alike, but also increase the "point of rarity" between schizophrenia and mood disorders. The aim of the current article is to examine this latter assertion in light of the recent opinion piece provided by Keefe and Fenton (Keefe RSE, Fenton WS. How should DSM-V criteria for schizophrenia include cognitive impairment? Schizophr Bull. 2007;33:912-920). Through literature review, we explore the issue of whether cognitive deficits do in fact differentiate the major psychoses. The overall results of this inquiry suggest that inclusion of cognitive impairment criteria in Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-V) would not provide a major advancement in discriminating schizophrenia from bipolar disorder and affective psychoses. Therefore, while cognitive impairment should be included in DSM-V, it should not dictate diagnostic specificity--at least not until more comprehensive evidence-based reviews of the current diagnostic system have been undertaken. Based on this evidence, we consider several alternatives for the DSM-V definition of cognitive impairment in schizophrenia, including (1) the inclusion of cognitive impairment as a specifier and (2) the definition of cognitive impairment as a dimension within a hybrid categorical-dimensional system. Given the state of current evidence, these possibilities appear to represent the most parsimonious approaches to the inclusion of cognitive deficits in the diagnostic criteria of schizophrenia and, potentially, of mood disorders.

  12. GRK5 deficiency leads to susceptibility to intermittent hypoxia-induced cognitive impairment.

    Science.gov (United States)

    Singh, Prabhakar; Peng, Wei; Zhang, Qiang; Ding, XueFeng; Suo, William Z

    2016-04-01

    Obstructive sleep apnea (OSA) leads to cognitive impairment in about 25% patients, though it remains elusive what makes one more susceptible than the other to be cognitively impaired. G protein-coupled receptor kinase-5 (GRK5) deficiency is recently found to render subjects more susceptible to cognitive impairment triggered by over-expression of Swedish mutant ß-amyloid precursor protein. This study is to determine whether GRK5 deficiency also renders subjects more susceptible to the OSA-triggered cognitive impairment. Both wild type (WT) and GRK5 knockout (KO) mice were placed in conditions absence and presence of intermittent hypoxia (IH) with 8%/21% O2 90-s cycle for 8h a day for a month, and then followed by behavioral assessments with battery of tasks. We found that the selected IH condition only induced marginally abnormal behavior (slightly elevated anxiety with most others unchanged) in the WT mice but it caused significantly more behavioral deficits in the KO mice, ranging from elevated anxiety, impaired balancing coordination, and impaired short-term spatial memory. These results suggest that GRK5 deficiency indeed makes the mice more susceptible to wide range of behavioral impairments, including cognitive impairments. Published by Elsevier B.V.

  13. The longitudinal impact of hearing impairment on cognition differs according to cognitive domain

    Directory of Open Access Journals (Sweden)

    Yasue Uchida

    2016-08-01

    Full Text Available Identification and modification of the risk factors for cognitive decline throughout the adult life span are priority subjects in a progressively aging society; however, much remains to be learned. The aim of this study was to understand whether changes in cognitive function can be affected by hearing impairment (HI and whether the impact of HI differs depending on the cognitive domain. A total of 1,109 individuals aged 60 – 79 years at baseline who participated in the Longitudinal Study of Aging at the National Institute for Longevity Sciences (NILS-LSA was followed up for a maximum of 13.3 years. Cognitive function was evaluated using four subtests of the Japanese Wechsler Adult Intelligence Scale-Revised Short Forms: namely, Information, Similarities, Picture Completion, and the Digit Symbol Substitution subtests. The HI was defined as a pure-tone average of the better ear greater than 25 dB. A longitudinal analysis was performed of 4,437 observations obtained during a follow-up period of approximately 12 years. We estimated linear changes in subtest scores by HI status, using the time-varying mixed-effects regression model, which included fixed terms for the intercept, HI status at baseline, time (years elapsed since baseline, and an HI × time interaction term adjusted for age at baseline, sex, education, and other possible confounders. There were significant main effects of HI on the scores of the four subtests after adjustment. The HI × time interaction was significant for the scores of the Information (p = 0.001 and Digit Symbol Substitution subtests (p = 0.001. The scores of the HI group declined faster in the Information and Digit Symbol Substitution subtests compared to those of the no-HI group. The model-predicted 12-year slope using a mean baseline age (68.7 years indicated no significant decline in the individuals without HI at baseline for the Information and Similarities subtests, however, this tolerance was lost in the

  14. Periodontitis Is Associated with Cognitive Impairment in Elderly Koreans: Results from the Yangpyeong Cohort Study.

    Science.gov (United States)

    Shin, Hye-Sun; Shin, Myung-Seop; Ahn, Yoo-Been; Choi, Bo-Youl; Nam, Jung-Hyun; Kim, Hyun-Duck

    2016-01-01

    To investigate the association between periodontitis and cognitive impairment in elderly Koreans. Cross-sectional study with age- and sex-matched case-control selection. The Yangpyeong cardiovascular cohort (YCC), a part of the Korean Genome Epidemiologic Study (KoGES), Yangpyeong, South Korea. Individuals with cognitive impairment (n=65) and cognitively normal controls (n=124) aged 60 and older from the YCC. Alveolar bone loss was assessed on dental panoramic radiographs to categorize the cumulative history of periodontitis (HOP) into three groups: normal, moderate periodontitis, severe periodontitis. The Mini-Mental State Examination (MMSE) was used to categorize participants as cognitively normal or cognitively impaired. Age- and sex-matched conditional logistic regression models were used for analysis. Confounders considered in the analysis were age, sex, drinking, smoking, exercise, total cholesterol, total protein, body mass index, fasting plasma glucose, intima-media thickness, hypertension medication, and depression. Participants with HOP were more likely to have cognitive impairment than those without (odds ratio=2.14, 95% confidence interval=1.04-4.41). The interaction effect of smoking and exercise on periodontitis highlighted the link. Periodontitis was independently associated with cognitive impairment after controlling for various confounders. Further longitudinal research is needed to determine whether periodontitis plays a role in cognitive decline in older adults. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  15. Trait neuroticism, extraversion, and conscientiousness in multiple sclerosis: Link to cognitive impairment?

    Science.gov (United States)

    Roy, Shumita; Drake, Allison S; Eizaguirre, María Bárbara; Zivadinov, Robert; Weinstock-Guttman, Bianca; Chapman, Benjamin P; Benedict, Ralph Hb

    2018-02-01

    Previous research suggests that patients with multiple sclerosis (MS) have higher neuroticism, lower extraversion, and lower conscientiousness relative to healthy controls (HCs). However, the prevalence of this maladaptive profile in MS and its relation to cognition is unknown. Determine prevalence of maladaptive personality among MS patients, compared to HCs, and examine how it relates to cognitive dysfunction. A sample of 275 MS patients and 55 HCs completed neuroperformance measures of information processing speed and memory. Self and informant ratings were obtained on the NEO Five-Factor Inventory. MS patients had higher neuroticism and lower extraversion than HCs. Cognitively impaired patients were also lower in conscientiousness. Cluster analysis revealed a configuration of these same three traits, representing a maladaptive profile. This profile was found in 50% of the overall MS sample, compared to 24% of HCs. However, only cognitively impaired MS patients had a higher prevalence of maladaptive personality compared to HCs. Among cognitively impaired patients, those with maladaptive traits were impaired in more cognitive domains than those with more adaptive traits. Cognitively impaired MS patients have a higher prevalence of seemingly maladaptive traits compared to HCs, demonstrating an association between cognition and personality in MS.

  16. Cognitive Impairment in Adult ADHD-Perspective Matters!

    NARCIS (Netherlands)

    Fuermaier, Anselm B.M.; Tucha, Lara; Koerts, Janneke; Hauser, Joachim; Kaunzinger, Ivo; Aschenbrenner, Steffen; Weisbrod, Matthias; Lange, Klaus W.; Tucha, Oliver

    2015-01-01

    Objective: The assessment of cognitive functions of adults with attention deficit hyperactivity disorder (ADHD) comprises self-ratings of cognitive functioning (subjective assessment) as well as psychometric testing (objective neuropsychological assessment). The aim of the present study was to

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

    Science.gov (United States)

    Byun, Eeeseung; Kim, Jinyoung; Riegel, Barbara

    2017-01-01

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

  18. Predicting Stability of Mild Cognitive Impairment (MCI): Findings of a Community Based Sample

    NARCIS (Netherlands)

    Ellendt, S.; Vobeta, B.; Kohn, N.; Wagels, L.; Goerlich, K.S.; Drexler, E.; Schneider, F.; Habel, U.

    2017-01-01

    BACKGROUND: Mild Cognitive Impairment (MCI) is a risk factor for Alzheimer's disease (AD) and other forms of dementia. However, much heterogeneity concerning neuropsychological measures, prevalence and progression rates impedes distinct diagnosis and treatment implications. OBJECTIVE: Aim of the

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

    Science.gov (United States)

    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

  20. Effectiveness of Cognitive-Behavioral Group Therapy on Self-Concept of Visually Impaired Adolescents

    Directory of Open Access Journals (Sweden)

    Mahmood Yaghotian

    2016-03-01

    Discussion: Cognitive-behavioral group counseling sessions can improve the self-concept of visually impaired adolescents. Moreover, positive self-concept will increase their social interaction and mental health.

  1. Cognitive impairment and major depressive disorder in HIV infection and cerebrospinal fluid biomarkers

    Directory of Open Access Journals (Sweden)

    Sergio Monteiro de Almeida

    2013-09-01

    Full Text Available Cognitive impairment and major depressive disorder (MDD are common HIV-1 central nervous system (CNS complications. Their frequencies in AIDS patients are 36% and 45%, respectively. The diagnoses of HIV cognitive impairment are made by clinical criteria, no single laboratory test or biomarker establishes the diagnosis. Factors of indirect neuronal injury related with the pathophysiology of the HIV infection in the CNS, are the factors studied as biomarkers. In the present no biomarker is established to the diagnosis of HIV cognitive impairment, much still needs to be done. We review in this paper some biomarkers in cerebrospinal fluid that could be valuable to the diagnosis of HIV cognitive impairment. Diagnosing depression in the context of HIV can be challenging, to identify a biomarker that could help in the diagnosis would be very important, although MDD risks and neurobiology are still poorly understood.

  2. Cognitive impairment and major depressive disorder in HIV infection and cerebrospinal fluid biomarkers.

    Science.gov (United States)

    Almeida, Sérgio Monteiro de

    2013-09-01

    Cognitive impairment and major depressive disorder (MDD) are common HIV-1 central nervous system (CNS) complications. Their frequencies in AIDS patients are 36% and 45%, respectively. The diagnoses of HIV cognitive impairment are made by clinical criteria, no single laboratory test or biomarker establishes the diagnosis. Factors of indirect neuronal injury related with the pathophysiology of the HIV infection in the CNS, are the factors studied as biomarkers. In the present no biomarker is established to the diagnosis of HIV cognitive impairment, much still needs to be done. We review in this paper some biomarkers in cerebrospinal fluid that could be valuable to the diagnosis of HIV cognitive impairment. Diagnosing depression in the context of HIV can be challenging, to identify a biomarker that could help in the diagnosis would be very important, although MDD risks and neurobiology are still poorly understood.

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

    NARCIS (Netherlands)

    Guo, Shengwen; Lai, Chunren; Wu, Congling; Cen, Guiyin; Hariharan, A.; Vijayakumari, Anupa A.; Aarabi, Mohammad Hadi; Aballi, John; Nour, Abd Elazeim Abd Alla Mohamed; Abdelaziz, Mohammed; Abdolalizadeh, AmirHussein; Abdollahi, Mahsa; Abdul Aziz, Siti Aishah; Salam, Amritha Abdul; Abdulaziz, Nidhal; Abdulkadir, Ahmed; Abdullah, Sachal; Abdullah, Osama; Abrigo, Jill; Adachi, Noriaki; Adamson, Christopher; Adduru, Viraj; Adel, Tameem; Aderghal, Karim; Ades-Aron, Benjamin; Adeyosoye, Michael; Adlard, Paul; Srinivasa, Ag; Aganj, Iman; Agarwal, Ayush; Agarwal, Anupam; Agarwal, Anchit; Aguero, Cinthya; Aguiar, Pablo; Ahdidan, Jamila; Ahmad, Fayyaz; Ahmad, Rziwan; Ahmadi, Hessam; Ahmed, Nisar; Sid, Farid Ahmed; Ai, Edward; Ai, Qing; Aicha, Benyahia; Aitharaju, Sai; Aiyer, Aditya; Akkus, Zeynettin; Akodad, Sanae; Akramifard, Hamid; Aksman, Leon; Aktas, Said; Al-Janabi, Omar; Al-Nuaimi, Ali; AlAila, BahaaEddin; Alakwaa, Fadhl; Alam, Saruar; Alam, Fakhre; Alam Zaidi, Syed Farhan; Alan, Wiener; Alansari, Mukhtar; Alareqi, Ebrahim; Alberdi, Ane; Albsoul, Mohammad; Alderson, Thomas; Aleem, Hassan; Alex, Aishwarya; Alexander, Jacob; Alexopoulos, Panagiotis; Alfoldi, Jessica; Ali, Ayesha; Ali, Imdad; Alimoradian, Shirin; Aljabar, Paul; Aljabbouli, Hasan; Aljovic, Almir; Allen, Genevera; Alliende, Luz Maria; Almaguel, Frankis; Almgren, Hannes; Montes, Carmen Alonso; Alowaisheq, Tasneem; Alryalat, Saif Aldeen; Alsado, Majd; Alsaedi, Abdalrahman; Alshehri, Haifa; Altaf, Tooba; Altendahl, Marie; Altmann, Andre; Alvand, Ashkan; Filho, Manoel Alves; Alzubi, Raid; Amaral, Robert; Ambatipudi, Mythri; Amernath, Remya; Amlien, Inge; Amoroso, Nicola; Amri, Hakima; Anastasiou, Athanasios; Anbarasi, Jani; Anbarjafari, Gholamreza; Anderson, Wes; Anderson, Jeff; Anderson, Valerie; Anderson, Loretta; Andonov, Jovan; Andova, Vesna; Andreopoulou, Irene; Andrews, K. 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Maritza; Doyle, Senan; Doyle, Andrew; Dragan, Matthew; Draganski, Bogdan; Draghici, Sorin; Dragomir, Andrei; Drake, Derek; Drake, Erin; Drd, Shilpa; Dronkers, Nina; Drozdowski, Madelyn; Du, Changde; Du, Yuhui; Du, Lei; Du, Guangwei; Du, Xingqi; Duan, Fang; Duan, Yuzhuo; Duan, Kuaikuai; Duchesne, Simon; Duggento, Andrea; Dukart, Juergen; Dumont, Matthieu; Dunn, Ruth; Duong, Vu; Duraisamy, Baskar; Duran, Tugce; Durrleman, Stanley; Dutta, Joyita; Dyrba, Martin; Dyvorne, Hadrien; R, Amulya E.; Eads, Jennifer; Eastman, Jennifer; Eaton, Susan; Edlund, Christopher; Edmonds, Emily; Edmondson, Mackenzie; Ehsan, Fatima; El-Gabalawy, Fady; Elander, Annie; Elango, Vidhya E.; Eldeeb, Ghaidaa; Elgamal, Fatmaelzahraa; Rodrigues, Yuri Elias; Elman, Jeremy; Elrakaiby, Nada; Emahazion, Tesfai; Emami, Behnaz; Embrechts, Jurriën; Emran Khan Emon, Mohammad Asif; Emrani, Saba; Emrani, Asieh; Emri, Miklós; Engelhardt, Barbara; Engle, Bob; Epstein, Noam; Er, Fusun; Erhardt, Erik; Eriksson, Oscar; Omay, Zeynep Erson; Escudero, Javier; Eshleman, Jason; Eskildsen, Simon; Espinosa, Luis; Essex, Ryan; Esteban, Oscar; Estrada, Karol; Ethell, Douglas; Ethridge, Kimberly; Ettehadi, Seyedrohollah; Eva, Bouguen; Evenden, Dave; Evtikheeve, Rina; Ewert, Siobhan; Fague, Scot; Fahmi, Rachid; Faizal, Sherin; Falahati, Farshad; Fan, Li; Fan, Zhen; Fan, Yong; Fan, Maohua; Fan, Yonghui; Fan, Sili; Fan, Ruzong; Fang, Chen; Fang, Xiaoling; Fanjul-Vélez, Félix; Fanti, Alessandro; Far, Bab; Farah, Martha; Farahani, Naemeh; Farahibozorg, Seyedehrezvan; Farahnak, Farhood; Farajpour, Maryam; Fardo, David; Farkhani, Sadaf; Farnsworth, Bryn; Farooq, Hamza; Farooq, Ammarah; Farouk, Yasmeen; Farrar, Danielle; Farrer, Lindsay; Fatemehh, Fatemeh; Fatemizadeh, Emad; Fatfat, Kim; Fatima, Shizza; Faux, Noel; Favan-Niven, Anne; Favary, Clélia; Fazlollahi, Amir; Fei, Gao; Feingold, Franklin; Feizi, Soheil; Félix, Eloy; Femminella, Grazia Daniela; Feng, Zijun; Feng, Ao; Feng, Brad; Feng, Xinyang; Feragen, Aasa; Fereidouni, Marzieh; Fernandes, Miguel; Fernández, Víctor; Ferrari, Ricardo; Ferraris, Sebastiano; Ferreira, Francisco; Ferreira, Luiz Kobuti; Ferreira, Hugo; Fiecas, Mark; Fieremans, Els; Fiford, Cassidy; Figurski, Michal; Filippi, Massimo; Filshtein, Teresa; Findley, Caleigh; Finger, Elizabeth; Firth, Nicholas; Fischer, Christopher; Fischer, Florian; Fitall, Simon; Fleet, Blair; Fleishman, Greg; Flokas, Lambros; Flores, Alberto; Focke, Niels; Fok, Wai Yan; Foldi, Nancy; Fôlego, Guilherme; Forero, Aura; Fornage, Myriam; Fos Guarinos, Belén; Founshtein, Gregory; Franc, Benjamin; Francois, Clement; Franke, Katja; Fraser, Mark; Frasier, Mark; Frederick, Blaise; Freitas, Fernandho; Escalin, Frency Jj; Freudenberg-Hua, Yun; Friedman, Brad; Friedmann, Theodore; Friedrich, Christoph M.; Frings, Lars; Frisoni, Giovanni; Fritzsche, Klaus; Frolov, Alexander; Frost, Robert; Fu, Ling; Fu, Zening; Fudao, Ke; Fuentes, Emmanuel; Fujishima, Motonobu; Fujiwara, Ken; Fukami, Tadanori; Funk, Cory; Furcila, Diana; Fuselier, Jessica; Nagarjuna Reddy, G.; Gaasterland, Terry; Gabelle, Audrey; Gahm, Jin; Gaiteri, Chris; Gajawelli, Niharika; Galantino, Alexis; Galarza Hernández, Javier; Galasko, Douglas; Galea, Liisa; Galisot, Gaetan; Sánchez, Antonio Javier Gallego; Gallins, Paul; Gamberger, Dragan; Gan, Hong Seng; Gan, Gavin; Ganapathi, Subha; Gancayco, Christina; Gangishetti, Umesh; Ganzetti, Marco; Gao, Fei; Gao, Jingjing; Gao, Linlin; Gao, Tianxiang; Gao, Yuanyuan; Gao, Xiaohong; Garani, Ranjini; Garbarino, Sara; Garcia, Ivan; Garcia, Xiadnai; Garcia, Jorge; Garcia, Tanya; Garcia Arias, Hernan Felipe; de La Garza, Angel Garcia; Gaig, Mireia Garcia; Novoa, Jorge Garcia; Valero, Mar Garcia; Garcia-Ojalvo, Jord; García-Polo, Pablo; Garg, Rahul; Garg, Gaurav; Garg, Divya; Garibotto, Valentina; Garvey, Matthew; Garza-Villarreal, Eduardo; Gaubert, Malo; Gauthier, Serge; Gavett, Brandon; Gavidia, Giovana; Gavtash, Barzin; Gawryluk, Jodie; Gbah, Messon; Ge, Tian; Geerts, Hugo; Geisser, Niklaus; Geng, Junxian; Gentili, Claudio; Gess, Felix; Ghaderi, Halleh; Ghahari, Shabnam; Ghanbari, Yaghoob; Ghazi-Saidi, Ladan; Ghodrati, Mojgan; Ghorbani, Behnaz; Ghoreishiamiri, Reyhaneh; Ghosal, Sayan; Ghosh, Sukanta; Ghosh, Saheb; Ghosh, Sreya; Ghoshal, Ankur; Giannicola, Galetta; Gibert, Karina; Gibson, Gary; Gieschke, Ronald; Gil Valencia, Jorge Mario; Gillen, Daniel; Giordani, Alessandro; Giraldo, Diana; Gispert, Juan D.; Gitelman, Darren; Giuffrida, Mario Valerio; Madhu, G. K.; Glass, Jesse; Glazier, Brad; Gleason, Carey; Glerean, Enrico; Glozman, Tanya; Godbey, Michael; Goettlich, Martin; Gogoi, Minakshi; Gola, Kelly; Golbabaei, Soroosh; Golden, Daniel; Goldstein, Felicia; Gomes, Carlos; de Olivera, Ramon Gomes Durães; Gomez, Isabel; Gomez Gonzalez, Juan Pablo; Gomez-Verdejo, Vanessa; Gong, Weikang; Gong, Enhao; Gong, Kuang; Gonneaud, Julie; Gonzalez, Clio; Gonzalez, Evelio; Gonzalez, Gerardo; Moreira, Eduardo Gonzalez; Goodman, James; Gopinath, Srinath; Gopu, Anusharani; Gordon, Brian; Gordon, David; Gordon, Mark; Gorriz, Juan Manuel; Gors, Dorothy; Göttler, Jens; Gounari, Xanthippi; Goyal, Devendra; Graf, John; Graff, Ariel; Graham, Leah; Graham, Jinko; Grajski, Kamil; Grami, Maziyar; Grand'Maison, Marilyn; Grant, Kiran; Grassi, Elena; Gray, Katherine; Grecchi, Elisabetta; Green, Robert; Green, Elaine; Greenberg, Jonathan; Greening, Steven; Greenwood, Bryson; Gregori, Johannes; Gregory, Michael; Greicius, Michael; Greve, Douglas; Griffin, Jason; Grill, Joshua; Grodner, Kelsey; Grolmusz, Vince; Groot, Perry; Groothuis, Irme; Gross, Alden; Grundstad, Arne; Grundy, Edward; Grzegorczyk, Tomasz; Nandith, G. S.; Gu, David; Gu, Jiena; Gu, Yun; Gu, Ginam; Guan, Sheng; Guan, Yuanfang; Guennel, Tobias; Guerin, Laurent; Guerrero, Ricardo; Guerrier, Laura; Guevara, Pamela; Guggari, Shankru; Roy, Abhijit Guha; Guidotti, Roberto; Guillon, Jérémy; Gulcher, Jeff; Gulia, Sarita; Gumedze, Freedom; Gunawardena, Nishan; Gunn, Roger; Guo, Michael; Guo, Xiao; Guo, Xingzhi; Guo, Yi; Kai, Zhang Guo; Zhao, Ma Guo; Gupta, Navin; Gupta, Anubha; Gupta, Ishaan; Guren, Onan; Gurnani, Ashita; Gurol, Mahmut Edip; Guzman, Gloria; Gyy, Gyy; Rajanna, Vanamala H.; Ha, Seongwook; Haacke, Ewart; Haaksma, Miriam; Habadi, Maryam; Habeck, Christian; Habes, Mohamad; Hackspiel Zarate, Maria Mercedes; Hadimani, Ravi; Hahn, William; Hahn, Tim; Haight, Thaddeus; Hair, Nicole; Haixing, Wang; Hajarolasvadi, Noushin; Hajjar, Ihab; Hajjo, Rima; Halchenko, Yaroslav; Hall, Anette; Hallock, Kevin; Hamdi, Shah Muhammad; Hameed, Farhan; Hamidian, Hajar; Han, Dong; Han, Yang; Han, Hio-Been; Han, Qingchang; Han, Beomsoo; Han, Duke; Han, Shizhong; Han, Xiaoxia; Han, Peipei; Han, Joo Yoon; Han, Dong-Sig; Handsaker, Robert; Hanna-Pladdy, Brenda; Hanseeuw, Bernard; Hansson, Björn; Hao, Yang; Hao, Jhon; Happ, Clara; Harischandra, Dilshan; Haritaoglu, Esin; Harris, Richard; Harris, Breanna; Hart, Brian; Hartzell, James; Harvey, Danielle; Hashimoto, Tsuyoshi; Hasooni, Hossein; Hassan, Moaied; Hassan, Mehdi; Hassanzadeh, Hamid Reza; Hassanzadeh, Oktie; Hatton, Sean; Hawchar, Jinan; Hayashi, Toshihiro; Hayashi, Norio; Hayes, Jasmeet; Hayete, Boris; Haynor, David; He, Linchen; He, Yan; He, Yao; He, Huiguang; Heegaard, Niels; Hefny, Mohamed; Heil, Julius; Heindel, William; Henderson, Samuel; Henf, Judith; Henriquez, Claudio; Herholz, Karl; Hermessi, Haithem; Hernandez, Monica; Herrera, Luis; Hibar, Derrek; Hidane, Moncef; Higuchi, Satomi; Hind, Jade; Hives, Florent; Hoang, Mimi; Hobel, Zachary; Hoffman, John; Hofmeister, Jeremy; Hohman, Timothy; Holder, Daniel; Holguin, Jess; Holmes, Robin; Hong, John; Hongliang, Zou; Hongyu, Guo; Hopkins, Paul; Hor, Soheil; Hornbeck, Russ; Horng, Andy; Horton, Wesley; Hosny, Khalid; Hosseini, Eghbal; Hosseini, Hadi; Hosseini, Zahra; Asl, Ehsan Hosseini; Hou, Beibei; Houghton, Richard; Houghton, Katherine; Householder, Erin; Howlett, James; Hsiao, John; Hsiao, Ing-Tsung; Hsu, Chih-Chin; Hu, Xixi; Hu, Lingjing; Hu, Nan; Hu, Kun; Hu, Tao; Hu, Li; Hu, Xiaolan; Hua, Fei; Huang, Marissa; Huang, Qi; Huang, Michelle; Huang, Chao; Huang, JunMing; Huang, Xingyuan; Huang, Yuhan; Huang, Sing-Hang; Huang, Shuai; Huang, Peiyu; Huang, Chun-Chao; Huang, Zhiyue; Huang, Meiyan; Huang, Zhiwen; Hubrich, Markus; Huestis, Michael; Huey, Edward; Hufton, Andrew; Huijbers, Willem; Huisman, Sjoerd; Hung, Joe; Hunsaker, Naomi; Hunt, Fostor; Huppertz, Hans-Jürgen; Huser, Vojtech; Hussain, Lal; Hutchison, R. Matthew; Hutton, Alexandre; Huyck, Els; Hwang, Jihye; Hyun, JungMoon; Iakovakis, Dimitris; Ibañez, Victoria; Ide, Kayoko; Igarashi, Takuma; Iglesias, Juan Eugenio; Muñoz, Laura Igual; Iidaka, Tetsuya; Ikeuchi, Takeshi; Ikhena, John; Ikuta, Toshikazu; Im, Hyung-Jun; Insausti, Ana; Insel, Philip; Invernizzi, Azzurra; Iosif, Ana-Maria; Ip, Nancy; Irizarry, Sierra; Irmak, Emrah; Irwin, David; Isaza, Mariano; Ishii, Makoto; Ishii, Kenji; Islam, Jyoti; Israel, Ariel; Isufi, Elvin; Ito, Kaori; Ito, Masato; Izquierdo, Walter; Alphin, J.; Akhila, J. A.; Jaberzadeh, Amir; Jackowiak, Edward; Jackson, Eric; Jackson, Chris; Jackson, Jonathan; Jacob, Samson; Jacobsen, Nina; Jacobsen, Jörn; Jacquemont, Thomas; Jacques, Nerline; Jaeger, Ralf; Jafari, Tahere; Jafari-Khouzani, Kourosh; Jagadish, Akshay Kumar; Jagtap, Priti; Jagust, William; Jahr, Joseph; Jain, Shubhankar; Jain, Shubham; Jaiswal, Ayush; Jaiswal, Akshay; Jait, Amine; Jakkoju, Chetan; Jakobsson, Andreas; James, Olga; James, Oliver; Jamlai, Maedeh; Jammeh, Emmanuel; Janardhana, Lajavanthi; Jang, Jinseong; Jang, Jae-Won; Jang, Jinhee; Jang, Hyesue; Janghel, Rekh Ram; Jawahar, Shasvat; Jean, Kharne; Jean-Baptiste, Schiratti; Jedynak, Bruno; Jefferson, Angela; Jennings, Danna; Jennings, Dominique; Jeon, Seun; Jeong, Yong; Jester, Charles; Jethwa, Ketan; Jha, Debesh; Ji, Gong-Jun; Ji, Chong; Ji, Jin; Jia, Bowen; Jiacheng, Lee; Jiajia, Guo; Jian, Weijian; Jiang, Shan; Jiang, Chunxiang; Jianhua, Gao; Jiao, Zhuqing; Jiao, Zeyu; Jiao, Du; Jimenez Alaniz, Juan Ramon; Gomez, Carolina Jimenez; Jiménez-Huete, Adolfo; Jimura, Koji; Jin, Yan; Jin, Zhu; Jogia, Jigar; Johansson, Per; John, Kimberley; Johnsen, Stian; Johnson, Leonard; Johnson, Sterling; Johnson, Kent; Johnston, Jane; Johnston, Stephen; Jomeiri, Alireza; Jonas, Katherine; Jones, Richard; Jones-Davis, Dorothy; Jönsson, Linus; Joseph, Jane; Joshi, Himanshu; Joshi, Shantanu; Joshi, Abhinay; Joyce, Katherine; Juengling, Freimut; Jung, Youngjin; Junker, Viv; Junwei, Ding; Jyothi, Singaraju; Jyotiyana, Monika; Sarthaj, K.; Kachouane, Mouloud; Kadian, Amit; Kaewaramsri, Yothin; Kaicheng, Li; Kaiser, Marcus; Kakinami, Lisa; Kalra, Sanjay; Kam, Hye Jin; Kamarudin, Nur Shazwani; Kaminker, Josh; Kandel, Benjamin; Kandiah, Nagaendran; Kaneko, Tomoki; Kang, Yun Seok; Kang, Ju Hee; Kang, Hakmook; Kang, Jian; Kansal, Anuraag; Kaouache, Mohammed; Kaplan, Adam; Kottaram, Akhil Karazhma; Karim, Faizan; Karimi-Mostowfi, Nicki; Karjoo, Mahboobe; Karlin, Daniel; Karp, Juliana; Karray, Chiheb; Kartsonis, Nick; Karu, Naama; Kasa, Jaya; Kasiri, Keyvan; Katako, Audrey; Kato, Ryo; Katsonis, Panagiotis; Katti, Hkkatti; Kaur, Prabhjot; Kauwe, John; Kawaguchi, Atsushi; Kazemi, Samaneh; Kazemi, Yosra; Rijan, K. C.; Kechin, Andrey; Kelkhoff, Douglas; Kelleher, Thomas; Kellner-Weldon, Frauke; Kennion, Oliver; Kerr, Daniel; Kesler, Shelli; Kesselman, Carl; Kessler, Daniel; Keuken, Max; Keyvanfard, Farzaneh; Khademi, April; Khajehnejad, Moein; Khan, Wasim; Khan, Tabrej; Khan, Hikmat; Khan, Anzalee; Khan, Samreen; Khanmohammadi, Sina; Khasanova, Tatiana; Khazaee, Ali; Khazan, Lenny; Kherif, Ferath; Khl, Aym; KHlif, Mohamed Salah; Khondoker, Mizanur; Khoo, Sok Kean; Khosrowabadi, Reza; Khurshid, Kiran; Kianfard, Reihaneh; Kida, Satoshi; Kiddle, Steven; Kikuchi, Masashi; Killiany, Ron; Kim, Jeongchul; Kim, Jong Hun; Kim, Hyunwoo; Kim, Jongin; Kim, Yeo Jin; Kim, Jung-Jae; Kim, Hang-Rai; Kim, Jaeyeol; Kim, Ki Hwan; Kim, Joseph; Kim, Younghoon; Kim, Mijung; Kim, Jeongsik; Kim, Bohyun; Kim, Taehyun; Kim, Heeyoung; Kim, Seonjik; Kim, Nakyoung; Kim, Byeongnam; Kim, ChanMi; Kim, Jeonghun; Kim, Seong Yoon; Kim, Sunhee; Kingery, Lisle; Kinnunen, Kirsi; Kinomes, Marie; Kirchner, Jan Hendrik; Caldwell, Jessica Kirkland; Kirwan, Brock; Kitamura, Chiemi; Kitty, Kitty; Kiviat, David; Kiyasova, Vera; Klein, Richard; Klein, Alison; Klein, Gregory; Klein, Jan; Kleinman, Aaron; Kling, Mitchel; Klinger, Joern; Klinger, Rebecca; Klink, Katharina; Kocaturk, Mustafa; Koch, Philipp Johannes; Kochova, Elena; Koenig, Loren; Koh, Natalie; Köhler, Jens Erik; Koikkalainen, Juha; Koini, Marisa; Kolachalama, Vijaya; Koncz, Rebecca; Kong, Xiang-Zhen; Kong, Vincent; Kong, Xiangzhen; Kong, Dehan; Kong, Linglong; Konukoglu, Ender; Kopeinigg, Daniel; Kopera, Krzysztof; Koppers, Simon; Korb, Matheus; Korfiatis, Panagiotis; Korolev, Igor; Korolev, Sergey; Korostyshevskiy, Valeriy; Koshiya, Heena; Kost, James; Kotari, Vikas; Koutra, Danai; Koychev, Ivan; Kruthika, K. R.; Krahnke, Tillmann; Krause, Matthew; Kraybill, Matt; Kriebel, Martin; Hari Krishna, M.; Krohn, Stephan; Kruggel, Frithjof; Kuceyeski, Amy; Kuhl, Donald; Kulshreshtha, Devang; Kumar, Santosh; Kumar, Sambath; Kumar, Kuldeep; Kumar, Anil; Kumar, Abhishek; Kumar, A.; Kumar, Saurabh; Kumar, Ashwani; Kumar, Ambar; Kumar, Dinesh; Kumar, Rishab; Kumarasinghe, Janaka; Kundu, Suprateek; Kung, Te-Han; Kuo, Li-Wei; Kuo, Phillip; Channappa, Usha Kuppe; Kuriakose, Elmy; Kurian, P.; Kwan, Kenneth; Kwasigroch, Arkadiusz; Kwon, Young Hye; Kyeong, Sunghyon; Fleur, Claire La; Wungo, Supriyadi La; Labbe, Tomas; Lacombe, Daniel; Lad, Meher; Lahoti, Geet; Lai, Ying Liang; Lai, Catherine; Lai, Dongbing; Laird, Dillon; Lakatos, Anita; Lam, Alice; Lama, Ramesh; Lambert, Christian; Landau, Susan; Landman, Bennett; Landre, Victor; Lane, Elizabeth; Lange, Catharina; Langenieux, Alexandre; Lareau, Caleb; Larson, Katelyn; Latif, Ghazanfar; Lauber, Ross; Lawliet, Z. H.; Lawrence, Emma; Lazar, Anca; Le, Ngan; Le, Thi Khuyen; Le, Matthieu; Guen, Yann Le; Scouiller, Stephanie Le; Leandrou, Stephanos; Leatherday, Christopher; Leavitt, Mackenzie; Ledbetter, Christina; Lee, Hyekyoung; Lee, Wook; Lee, Annie; Lee, Jaehong; Lee, Dongyoung; Lee, Joel; Lee, Song-Ting; Lee, Kuo-Jung; Lee, Subin; Lee, Jaeho; Lee, Catherine; Lee, Gyungtae; Lee, Suzee; Lee, Erik; Lee, Yunseong; Lee, Sang-Gil; Lee, Seonjoo; Lee, Peng Jung; Lee, Hyunna; Lee, Cheng-Hsien; Lee, Hengtong; Lee, Mi Ri; Lee, Ilgu; Lee, Qixiang; Lefterov, Iliya; Leger, Charlie; Lehallier, Benoit; Lei, B.; Lei, Shi; Lei, Hongxing; Lei, Haoyun; Leong, Tze Yun; Leong, Sharlene; Leoutsakos, Jeannie-Marie; Lepore, Natasha; Lerch, Ondrej; Leung, Yip Sang; Leung, Yuk Yee; Leung, Shuyu; Leung, Hoi-Chung; Leung, Ming-Ying; Levakov, Gidon; Levine, Abraham; Li, Chawn; Li, Miranda; Li, Huijie; Li, Junning; Li, Xiaofeng; Li, Yi; Li, Jinchao; Li, Tianhong; Li, Yongming; Li, Xiangrui; Li, Tieqiang; Li, Yan; Li, Fuhai; Li, Feijiang; Li, Shuyang; Li, Zhi; Li, Xing; Li, Rongjian; Li, Rui; Li, Y. U.; Li, Kang; Li, Zhenzhen; Li, Qingqin; Li, Wenjun; Li, Yang; Li, Jialu; Li, Guangyu; Li, Michelle; Li, Yibai; Li, Yupeng; Li, Tao; Li, Zhujun; Li, Yafen; Li, Muwei; Li, Xuan; Li, Yi-Ju; Li, Cen Sing; Li, X. W.; Li, Yingjie; Li, Lin; Li, Yihan Jessie; Li, Yaqing; Li, Xiantao; Li, Xingfeng; Li, Chenxi; Li, Chao; Li, Jicong; Li, Jiewei; Li, Tengfei; Li, Wei; Li, Xinzhong; Li, Nannan; Li, Chunfei; Li, Yeshu; Liang, Chen; Liang, Nanying; Liang, Jingjing; Liang, Shengxiang; Liang, Xiaoyun; Liang, Xia; Liang, Ying; Liberman, Sofia; Libon, David; Liébana, Sergio; Liedes, Hilkka; Lim, Wee Keong; Lim, Yen Ying; Lin, Yenching; Lin, Katherine; Lin, Ming; Lin, Ai-Ling; Lin, Ching-Heng; Lin, Bing; Lin, Lin; Lin, Jyh-Miin; Lin, W. M.; Lin, Chien-Tong; Lin, Liyan; Lin, Jing; Lindberg, Olof; Linesch, Paul; Linn, Kristin; Lippert, Christoph; Litovka, Nikita; Little, Graham; Liu, Man-Yun; Liu, Jin; Liu, Chin-Fu; Liu, Zhaowen; Liu, Eulanca; Liu, Weixiang; Liu, K. E.; Liu, Hao Chen; Liu, Jia; Liu, Richann; Liu, Dongbo; Liu, Victor; Liu, Wenjie; Liu, Tao; Liu, Xiaoli; Liu, Yong; Liu, Lin; Liu, Dan; Liu, Xiuwen; Liu, Mengmeng; Liu, Chia-Shang; Liu, Ying; Liu, Yan; Liu, Xueqing; Liu, Han; Liu, Chien-Liang; Liu, Sidong; Liu, Jundong; Liu, Yang; Liu, Tianming; Liu, Tingshan; Liu, Ning; Liu, Lan; Liuyu, Liuyu; Lizarraga, Gabriel; Llido, Jerome; Lobach, Iryna; Lockhart, Samuel; Loft, Henrik; Lohr, Kelly; Lon, Hoi Kei; Lone, Kashif Javed; Long, Ziyi; Long, Xiaojing; Longo, Frank; Alves, Isadora Lopes; Lopez, Guadalupe; Lorenzi, Marco; Lotan, Eyal; Louie, Gregory; Louis, Maxime; Loukas, Andreas; Love, Seth; Lowe, Deborah; Lu, Bin; Lu, Chia-Feng; Lu, Zixiang; Lu, Lijun; Lu, Pascal; Lu, Shen; Lu, Qing; Lu, Zheshen; Lu, Chuan; Lu, Patty; Lu, Hangquan; Lu, Bo; Luktuke, Yadnyesh; Luo, Wei; Luo, Suhuai; Luo, Sheng; Luo, Shaojun; Luo, Peggy; Luo, Shan; Luo, Weidong; Luo, Liao; Luo, Xiao; Lupton, Michelle; Lutz, Michael; Lv, Eric; Lyu, Juan; Angshul, M.; Radha, M. R.; Dinesh, M. S.; Ma, Xiangyu; Ma, Chao; Ma, Li; Ma, Yu; Ma, Qianli; MacArthur, Daniel; Macey, Paul; Mach, Eric; MacPhee, Imola; Madadi, Mahboubeh; Madan, Christopher; Madan, Bharat; Madero, Giovanny; Madhavan, Radhika; Madhyastha, Tara; Maeno, Nobuhisa; Magsood, Hamzah; Mah, Linda; Mahdavi, Shirin; Mahdavi, Asef; Mahmoud, Abeer; Mahmoud, Hentati; Mahmoud, Kariman; Mahmoudi, Ahmad; Dehkordi, Siamak Mahmoudian; Mahor, Monika; Mahseredjian, Taleen; Mai, Cha; Maia, Rui; Maiti, Taps; Maj, Carlo; Maji, Pradipta; Majidpour, Jafar; Makhlouf, Laouchedi; Makino, Satoshi; Makrievski, Stefan; Makse, Hernan; Malagi, Archana; Malakhova, Katerina; Malamon, John; Malashenkova, Irina; Malchano, Zach; Maleki-Balajoo, Somayeh; Malik, Sadia; Malik, Tamoor; Mallik, Abhirup; Malm, Tarja; Malpas, Charles; Malpica, Norberto; Malviya, Meenakshi; Mamandi, A.; Manandhar, Abinash; Mandal, Pravat; Mandali, Alekhya; Mane, Prajakta; Manning, Emily; Manoufali, Mohamed; Manser, Paul; Mantini, Dante; Mantri, Ninad; Manyakov, Nikolay; Manzak, Dİlek; Mao, Shuai; Maoyu, Tian; Maple Grødem, Jodi; Maravilla, Kenneth; Marco, Simonetti; Marcus, Daniel; Margetis, John; Margolin, Richard; Mariano, Laura; Marinescu, Razvan Valentin; Markett, Sebastian; Markiewicz, Pawel; Marnane, Michael; Maroof, Asif; Marple, Laura; Marques, Cristiane; Marrakchi, Linda; Marshall, Gad; Märtens, Kaspar; Mårtensson, Gustav; Marti, Cristian; Martin, Harold; Martinaud, Olivier; Martinez, Victor; Martinez, Oliver; Martinez, Jesus; Martinez, Carlos; Abadías, Neus Martinez; Torteya, Antonio Martinez; Martini, Jean-Baptiste; Martins, Samuel; Masciotra, Viviane; Masmoudi, Ahmed; Masny, Aliaksandr; Shah, Pir Masoom; Massaro, Tyler; Masumoto, Jun; Matan, Cristy; Mate, Karen; Mateus, Pedro; Mather, Mara; Mather, Karen; Mathew, Jesia; Mathias, Samuel; Mathiyalagan, Tamilalaghan; Matloff, Will; Matsubara, Keisuke; Matsubara, Takashi; Matsuda, Yukihisa; Matthews, Dawn; Mattis, Paul; May, Patrick; Mayburd, Anatoly; Mayo, Chantel; Mayordomo, Elvira; Mbuyi, Gaylord; McCallum, Colleen; McCann, Bryony; McCollough, Todd; McCormick, Shannon; McCurdy, Sean; McDonald, Carrie; McEligot, Archana; McEvoy, Linda; McGeown, William; McGinnis, Scott; McHugh, Thomas; McIntosh, Elissa; McIntosh, Randy; McKenzie, Andrew; McLaren, Donald; McMillan, Corey; McMillan, Alan; McPherson, Brent; McRae-McKee, Kevin; Zaini, Muhammad Hafiz Md; Meadowcroft, Mark; Mecca, Adam; Meda, Shashwath; Medikonda, Venkata Srinu; Meeker, Karin; Megherbi, Thinhinane; Mehmood, Anum; Mehrtash, Alireza; Meiberth, Dix; Meier, Dominik; Meijerman, Antoine; Mejia, Jose; Mekkayil, Lasitha; Meles, Sanne; Melie-Garcia, Lester; Melo, Hans; Melrose, Rebecca; Melzer, Corina; Mendes, Aline; Leon, Ricardo Antonio Mendoza; Gonzalez, Manuel Menendez; Meng, Dewen; Meng, Xianglai; Meng, Guilin; Mengel, David; Menon, Ramesh; Menon, Ravi; Mercado, Flavio; Messick, Viviana; Meyer, Pierre-Francois; Meyer, Carsten; Mezher, Adam; Mi, Liang; Miao, Hongyu; Michailovich, Oleg; Michels, Lars; Mickael, Guedj; Mikhail, Mark; Mikhno, Arthur; Milana, Diletta; Miller, Rachel; Miller, Brendan; Millikin, Colleen; Min, Byung Wook; Minadakis, George; Minghui, Hu; Chinh, Truong Minh; Minkova, Lora; Miranda, Michelle; Misevic, Dusan; Mishra, Amit; Mishra, Chetan; Mishra, Shiwangi; Mishra, Ashutosh; Mishra, Krishna; Misquitta, Karen; Mitchell, Brian; Mithawala, Keyur; Mitnitski, Arnold; Mitra, Sinjini; Mittal, Gaurav; Mittner, Matthias; Miyapuram, Krishna Prasad; Mlalazi, Rebaone; Mo, Daojun; Moghekar, Abhay; Moguilner, Sebastian; Moh, Heba; Mohabir, Mark; Mohajer, Bahram; Mohamed, Moataz; Mohammadi, Sadeq; Mohammadi-Nejad, Ali-Reza; Mohammady, Saed; Taqi, Arwa Mohammed; Mohan, Kishore Kumar; Mohy-Ud-Din, Hassan; Moitra, Dipanjan; Mojaradi, Mehdi; Mojtabavi, Alireza; Molina, Helena; Mollon, Jennifer; Molteni, Erika; Montajabi, Mohaddeseh; Montal, Victor; Montazami, Aram; Monté-Rubio, Gemma; Montembeault, Maxime; Montero-Odasso, Manuel; Montillo, Albert; Moon, Byung-Seung; Moon, Chan; Moon, Chooza; Moore, Archer; Morabito, Francesco C.; Moradi, Masoud; Moraes, Renato; Ballesteros, Orlando Morales; Morales-Henriquez, Daniela; Moratal, David; Moreno, Herman; Morihara, Ryuta; Mormino, Elizabeth; Morris, Jeffrey; Mortamet, Bénédicte; Morton, John; Moscato, Pablo; Rial, Alexis Moscoso; Mossa, Abdela Ahmed; Mottaghi, Setare; Mouelhi, Aymen; Moussavi, Arezou; Moustafa, Ahmed; Mowrey, Wenzhu; Mtetwa, Lungile; Muehlboeck, Sebastian; Mueller, Susanne; Mueller-Sarnowski, Felix; Mufidah, Ratna; Mukherjee, Rik; Mukherjee, Shubhabrata; Müller, Christian; Müller, Hans-Peter; Mullins, Paul; Mullins, Roger; Muncy, Nathan; Munir, Akhtar; Munirathinam, Ramesh; Munoz, David; Munro, Catherine; Muranevici, Gabriela; Rendon, Santiago Murillo; Murilo, Robson; Murphy, Sonya; Muscio, Cristina; Musso, Gabriel; Mustafa, Yasser; Myall, Daniel; Gayathri, N.; Nabavi, Shahab; Nabeel, Eman; Nagele, Robert; Naghshbandi, Hane; Naik, Shruti; Najmitabrizi, Neda; Nakawah, Mohammad Obadah; Nalls, Mike; Namboori, Krishnan; Nancy, Annie; Napolitano, Giulio; Narayan, Manjari; Narkhede, Atul; Naseri, Mahsa; Nasrallah, Ilya; Nasrallah, Fatima; Nassif, Rana; Nath, Sruthi R.; Nathoo, Farouk; Nation, Daniel; Naughton, Brian; Nault, Larry; Nautiyal, Deeksha; Nayak, Deepak Ranjan; Naz, Mufassra; Nazemian, Shayan; Nazeri, Arash; Neckoska, Emilija; Neelamegam, Malinee; Nehary, Ebrahim; Nelson, Peter; Nelson, Linda; Nematzadeh, Hosein; Nerur, Shubha; Nesteruk, Thomas; Neu, Scott; Ng, Yen-Bee; Nguyen, Tin; Nguyen, Thanh; Nguyen, Harrison; Nguyen, Nghi; Trung, Hieu Nguyen; Ni, Lucy; Nian, Yongjian; Nichols, Thomas; Nicodemus, Kristin; Nie, Yunlong; Nielsen, Casper; Nikolov, Robert; Nila, Jessica; Nishioka, Christopher; Njeh, Ines; Njie, Emalick; Nobakht, Samaneh; Noble, Andrew; Noda, Art; Noroozi, Ali; Norton, Derek; Nosarti, Chiara; Nosheny, Rachel; Notsu, Akifumi; Novak, Gerald; Nozadi, Seyed Hossein; Nu, Fen; Nudelman, Kelly; Nunes, Adonay; Nunes, Ana; Núñez, Christian; Nuno, Michelle; Nuriel, Tal; Nygaard, Haakon; Nyquist, Paul; O'Bott, Jacob; O'Charoen, Sirimon; O'Neill, William; O'Rawe, Jonathan; Obrzut, Grzegorz; Och, Ganzorig; Odaibo, David; Odry, Benjamin; Oehmichen, Axel; Ofori, Edward; Ogunsanmi, Abdulfatai; Oguz, Kaya; Oh, Jungsu; Oh, Minyoung; Oh, Hwamee; Ohigashi, Hironori; Oishi, Kenichi; Oishi, Naoya; Okhravi, Hamid; Okonkwo, Ozioma; Okyay, Savaş; Oliveira, Cyrill; Oliveira, João; Oliveira, Francisco; Oliver, Ruth; Olmos, Salvador; Olszowy, Wiktor; Oltra-Cucarella, Javier; Önen, Zehra; Ong, Rowena; Onoda, Keiichi; Onyike, Chiadi; Operto, Grégory; Oppedal, Ketil; Orejuela, Juan; Orhon, Atila; Orozco, Max; Ortuño, Juan; Osadebey, Michael; Osborn, Joseph; Osoba, Osonde; Ostadrahimi, Hamid; Ostovari, Parisa; Otis, Sarah; Overgaard, Shauna; Owen, Catrin Elin; Oxtoby, Neil; Öziç, Muhammet Üsame; Ozkaya, Gorkem; Okur, Ozlem Ozmen; Ozsolak, Fatih; Ozyildirim, Melis; Pa, Judy; Pacheco, Joe; Pack, Gary; Padilla, Daniel; Cerezo, Berizohar Padilla; Padovese, Bruno; Pae, Chongwon; Pagano, Gennaro; Pahuja, Gunjan; Pai, Shraddha; Pajavand, S