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Sample records for subjective cognitive impairment

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

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    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.

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

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    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.

  3. 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.

  4. Cortical phase changes measured using 7-T MRI in subjects with subjective cognitive impairment, and their association with cognitive function

    NARCIS (Netherlands)

    Rooden, van Sanneke; Buijs, Mathijs; Vliet, van Marjolein E.; Versluis, Maarten J.; Webb, Andrew G.; Oleksik, Ania M.; Wiel, van de Lotte; Middelkoop, Huub A.M.; Blauw, Gerard Jan; Weverling-Rynsburger, Annelies W.E.; Goos, Jeroen D.C.; Flier, van der Wiesje M.; Koene, Ted; Scheltens, Philip; Barkhof, Frederik; Nieuwerth-van de Rest, Ondine; Slagboom, P.E.; Buchem, van Mark A.; Grond, van der Jeroen

    2016-01-01

    Studies have suggested that, in subjects with subjective cognitive impairment (SCI), Alzheimer's disease (AD)-like changes may occur in the brain. Recently, an in vivo study has indicated the potential of ultra-high-field MRI to visualize amyloid-beta (Aβ)-associated changes in the cortex in

  5. 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...

  6. The relationship between subjective perception of cognitive impairment and objective neuropsychological performance

    OpenAIRE

    Marková, Hana

    2014-01-01

    This diploma thesis deals with the topic of Subjective memory complaints (SMC) in elderly population in relation to early diagnostics of Alzheimer's Disease (AD). The term of SMC describes patients with subjective perception of cognitive impairment which is not objectivized during a complex neuropsychological assessment. The character of their subjective complaints has not been thoroughly examined, despite their increased risk to develop cognitive impairment, most likely due to AD (Reisberg, ...

  7. 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.

  8. Association between cognitive impairment and eating habits in elderly Chinese subjects over 90 years of age.

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    Gao, Lingyun; Dong, Birong; Hao, Qiu Kui; Ding, Xiang

    2013-08-01

    Eating habits may have a key influence on cognitive function, however, the relationship between dietary intake and cognitive impairment in the elderly Chinese population has not been explored. The present study investigated the association between cognitive impairment and eating habits in elderly Chinese subjects >90 years of age. This study comprised data from subjects included in the 2005 Project of Longevity and Ageing in Dujiangyan, China. Subjects were divided into two groups: cognitive impairment group and normal group. Sociodemographic and dietary habit data were collected and cognitive function was assessed in all subjects using the Mini-Mental State Examination. Data from 763 subjects (249 men, 514 women) were included. There was no statistically significant difference in eating habits between the two groups. Education level in the cognitive impairment group was significantly lower than in the normal group. Significant between-group differences were detected in factors relating to subjects' professions. Eating habits were not related to cognitive impairment in elderly Chinese people >90 years of age.

  9. 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.

  10. Morphometric connectivity analysis to distinguish normal, mild cognitive impaired, and Alzheimer subjects based on brain MRI

    DEFF Research Database (Denmark)

    Erleben, Lene Lillemark; Sørensen, Lauge; Mysling, Peter

    2013-01-01

    This work investigates a novel way of looking at the regions in the brain and their relationship as possible markers to classify normal control (NC), mild cognitive impaired (MCI), and Alzheimer Disease (AD) subjects. MRI scans from a subset of 101 subjects from the ADNI study at baseline was used...

  11. Aortic stiffness and hypotension episodes are associated with impaired cognitive function in older subjects with subjective complaints of memory loss.

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    Scuteri, Angelo; Tesauro, Manfredi; Guglini, Letizia; Lauro, Davide; Fini, Massimo; Di Daniele, Nicola

    2013-11-20

    Though CV risk factors and markers of arterial aging are recognized risky for cognition, no study has simultaneously investigated the impact of multiple cardiac, arterial (large and small vessels), and hemodynamic parameters on cognitive function in older subjects. Two hundred eighty older subjects with subjective complaints of memory loss and no previous stroke (mean age 78.3 ± 6.3 years) were studied. Global cognitive function was evaluated with the Mini-Mental State Examination (MMSE). Cognitive impairment was defined as a MMSE < 21. We measured: traditional CV risk factors; aorta stiffness (Pulse Wave Velocity, PWV); LV mass; presence of WML at neuroimaging; episodes of hypotension (SBP <100 mmHg during 24 h Ambulatory Blood Pressure Monitoring). In both cross-sectional and longitudinal analyses PWV, WML, and episodes of hypotension were significantly associated with poorer cognitive function-controlling for age, sex, education, depression, traditional CV risk factors, and medications. LV mass was no longer associated with cognition in multiple regression. Older subjects with stiffer arteries or episodes of hypotension presented a 4-fold and an 11-fold, respectively, greater odds for progression from normal cognitive function to cognitive impairment. A synergistic effect between PWV, WML, and hypotension was observed: the occurrence of any two of PWV, WML, or hypotension was accompanied by lower MMSE; in the presence of all three factors, a further significant decline in cognitive function was observed. Systemic hemodynamic parameters (higher PWV and hypotension) together with cerebral microvascular damage (WML) are significantly associated with poorer cognitive function and may identify older subjects with subjective complaints of memory loss at higher risk of cognitive decline. © 2013.

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

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    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.

  13. Self-report instruments of cognitive failures as screening tools for Subjective Cognitive Impairment in older adults.

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    Papaliagkas, Vasileios; Papantoniou, G; Tsolaki, Magda; Moraitou, Despina

    2017-01-01

    The term "Subjective Cognitive Impairment (SCI)" is the most widely accepted term for cognitive complaints of otherwise apparently healthy older adults. It is presently clear that SCI might be a risk factor for the development of Mild Cognitive Impairment and dementia. As regards SCI measurement and potential diagnosis, several studies showed that SCI is a condition in which people score in the normal range on common tests but believe they experience cognitive decline. Hence, to assess the characteristic of the SCI subtle cognitive decline, self-report measures were developed to estimate "self-experience" of minimal decline in cognition seem the most appropriate tools. In this vein, the present study aimed at examining the capacity of the Greek version of two self-report instruments of the aforementioned type to detect SCI in community dwelling older adults. The study sample consisted of 295 participants, who were allocated into four age-groups: young adults, middle-aged adults, older adults and older-old adults. The first three groups were gender and education-matched. The participants were examined via two objective tests of the Delis-Kaplan Executive Function System (D-KEFS) which is a neuropsychological battery designed to measure executive functions. In specific, they were tested via the D-KEFS Tower Test (TT) which mainly measures "planning" function, and the D-KEFS Color-Word Interference Test (C-WIT) which primarily measures "inhibition" and "switching" functions. Both tests consist of four conditions. The participants were also asked to answer to: (a) the Cognitive Failures Questionnaire (CFQ), and (b) the Prospective and Retrospective Memory Questionnaire (PRMQ), which were designed to assess subjective estimations of everyday slips of actions and cognitive failures, and episodic memory slips in everyday life, respectively. As concerns the psychometric qualities of the two questionnaires, a single-factor structure of the Greek versions of the CFQ and the

  14. Time Perception in Mild Cognitive Impairment: Interval Length and Subjective Passage of Time.

    Science.gov (United States)

    Coelho, Sara; Guerreiro, Manuela; Chester, Catarina; Silva, Dina; Maroco, João; Coelho, Miguel; Paglieri, Fabio; de Mendonça, Alexandre

    2016-08-01

    Patients with mild cognitive impairment (MCI) may have difficulties in time perception, which in turn might contribute to some of their symptoms, especially memory deficits. The aim of this study was to evaluate perception of interval length and subjective passage of time in MCI patients as compared to healthy controls. Fifty-five MCI patients and 57 healthy controls underwent an experimental protocol for time perception on interval length, a questionnaire for the subjective passage of time and a neuropsychological evaluation. MCI patients presented no changes in the perception of interval length. However, for MCI patients, time seemed to pass more slowly than it did for controls. This experience was significantly correlated with memory deficits but not with performance in executive tests, nor with complaints of depression or anxiety. Memory deficits do not affect the perception of interval length, but are associated with alterations in the subjective passage of time. (JINS, 2016, 22, 755-764).

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

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    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

  16. A fuzzy-based system reveals Alzheimer's Disease onset in subjects with Mild Cognitive Impairment.

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    Tangaro, Sabina; Fanizzi, Annarita; Amoroso, Nicola; Bellotti, Roberto

    2017-06-01

    Alzheimer's Disease (AD) is the most frequent neurodegenerative form of dementia. Although dementia cannot be cured, it is very important to detect preclinical AD as early as possible. Several studies demonstrated the effectiveness of the joint use of structural Magnetic Resonance Imaging (MRI) and cognitive measures to detect and track the progression of the disease. Since hippocampal atrophy is a well known biomarker for AD progression state, we propose here a novel methodology, exploiting it as a searchlight to detect the best discriminating features for the classification of subjects with Mild Cognitive Impairment (MCI) converting (MCI-c) or not converting (MCI-nc) to AD. In particular, we define a significant subdivision of the hippocampal volume in fuzzy classes, and we train for each class Support Vector Machine SVM classifiers on cognitive and morphometric measurements of normal controls (NC) and AD patients. From the ADNI database, we used MRI scans and cognitive measurements at baseline of 372 subjects, including 98 subjects with AD, and 117 NC as a training set, 86 with MCI-c and 71 with MCI-nc as an independent test set. The accuracy of early diagnosis was evaluated by means of a longitudinal analysis. The proposed methodology was able to accurately predict the disease onset also after one year (median AUC=88.2%, interquartile range 87.2%-89.0%). Besides its robustness, the proposed fuzzy methodology naturally incorporates the uncertainty degree intrinsically affecting neuroimaging features. Thus, it might be applicable in several other pathological conditions affecting morphometric changes of the brain. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  17. Prevalence and correlates of mild cognitive impairment in adults aged over 50 years with subjective cognitive complaints in primary care centers.

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    Juncos-Rabadán, Onésimo; Pereiro, Arturo X; Facal, David; Lojo, Cristina; Caamaño, Juan A; Sueiro, Jesús; Bóveda, Julia; Eiroa, Peregrina

    2014-07-01

    To examine the prevalence and correlates of mild cognitive impairment in adults aged over 50 years attending primary care centers with complaints of cognitive failure. A sample of 689 individuals aged ≥ 50 years with no previous diagnosis of dementia was assessed by use of the Mini-Mental State Examination, the Cambridge Cognitive Examination-Revised and the California Verbal Learning Test--to evaluate the mild cognitive impairment as dependent variables--and administration of a questionnaire on cognitive complaints and other instruments--to measure correlates. The prevalence of mild cognitive impairment was 31.40%, and positive associations were found for age, occupation, subjective memory complaints, reading habits and level of vocabulary. In the logistic regression, modeled mild cognitive impairment was associated with age (70 years or older), subjective cognitive complaints and level of vocabulary. Almost one-third of the adults aged ≥ 50 years attending primary care centers with subjective cognitive complaints were affected by mild cognitive impairment. Early evaluation of cognitive functioning is essential to establish adequate preventive and intervention strategies. © 2013 Japan Geriatrics Society.

  18. A score based on screening tests to differentiate mild cognitive impairment from subjective memory complaints

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    Fábio Henrique de Gobbi Porto

    2013-09-01

    Full Text Available It is not easy to differentiate patients with mild cognitive impairment (MCI from subjective memory complainers (SMC. Assessments with screening cognitive tools are essential, particularly in primary care where most patients are seen. The objective of this study was to evaluate the diagnostic accuracy of screening cognitive tests and to propose a score derived from screening tests. Elderly subjects with memory complaints were evaluated using the Mini Mental State Examination (MMSE and the Brief Cognitive Battery (BCB. We added two delayed recalls in the MMSE (a delayed recall and a late-delayed recall, LDR, and also a phonemic fluency test of letter P fluency (LPF. A score was created based on these tests. The diagnoses were made on the basis of clinical consensus and neuropsychological testing. Receiver operating characteristic curve analyses were used to determine area under the curve (AUC, the sensitivity and specificity for each test separately and for the final proposed score. MMSE, LDR, LPF and delayed recall of BCB scores reach statistically significant differences between groups (P=0.000, 0.03, 0.001 and 0.01, respectively. Sensitivity, specificity and AUC were MMSE: 64%, 79% and 0.75 (cut off <29; LDR: 56%, 62% and 0.62 (cut off <3; LPF: 71%, 71% and 0.71 (cut off <14; delayed recall of BCB: 56%, 82% and 0.68 (cut off <9. The proposed score reached a sensitivity of 88% and 76% and specificity of 62% and 75% for cut off over 1 and over 2, respectively. AUC were 0.81. In conclusion, a score created from screening tests is capable of discriminating MCI from SMC with moderate to good accurancy.

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

    DEFF Research Database (Denmark)

    Mattila, Jussi; Soininen, Hilkka; Koikkalainen, Juha

    2012-01-01

    In the diagnostic process of Alzheimer's disease (AD), there may be considerable delays between first contact to outpatient services and a final, definitive diagnosis. In Europe the average delay is 20 months. Nevertheless, patient data preceding clinical AD diagnoses often contains early signs...... of the disease. Several studies have analyzed data of mild cognitive impairment (MCI) subjects, showing that conversion from MCI to AD can be predicted with a classification accuracy of 60-80%. This accuracy may not be high enough for influencing diagnostic decisions. In this work, the prediction problem...... is approached differently; a target prediction accuracy is defined first and is then used for identifying MCI patients for whom the required accuracy can be reached. The process uses a novel disease state index method in which patient data are statistically compared to a high number of previously diagnosed...

  20. Cognitive response to fish oil, blueberry, and combined supplementation in older adults with subjective cognitive impairment.

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    McNamara, Robert K; Kalt, Wilhelmina; Shidler, Marcelle D; McDonald, Jane; Summer, Suzanne S; Stein, Amanda L; Stover, Amanda N; Krikorian, Robert

    2018-04-01

    Given evidence that eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and anthocyanin-rich blueberries provide neurocognitive benefit, we investigated long-term supplementation in older adults with cognitive complaints. In a 24-week randomized, double-blind, placebo-controlled trial, elderly men and women received daily fish oil (FO) or blueberry (BB) or both. Diet records confirmed that participants reduced background consumption of EPA, DHA, and anthocyanins as prescribed. Erythrocyte EPA + DHA composition increased in the FO groups (p = 0.0001). Total urinary anthocyanins did not differ between the groups after supplementation but glycoside and native (food) forms increased only in the BB-supplemented groups. The FO (p = 0.03) and BB (p = 0.05) groups reported fewer cognitive symptoms, and the BB group showed improved memory discrimination (p = 0.04), indicating that supplementation improved cognition. Cognitive benefit in the BB group was associated with the presence of urinary anthocyanins reflecting recent BB intake but not with anthocyanin metabolites. However, combined FO + BB treatment was not associated with cognitive enhancement as expected. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Neural Basis of Cognitive Assessment in Alzheimer Disease, Amnestic Mild Cognitive Impairment, and Subjective Memory Complaints.

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    Matías-Guiu, Jordi A; Cabrera-Martín, María Nieves; Valles-Salgado, María; Pérez-Pérez, Alicia; Rognoni, Teresa; Moreno-Ramos, Teresa; Carreras, José Luis; Matías-Guiu, Jorge

    2017-07-01

    Interpreting cognitive tests is often challenging. The same test frequently examines multiple cognitive functions, and the functional and anatomical basis underlying test performance is unknown in many cases. This study analyses the correlation of different neuropsychological test results with brain metabolism in a series of patients evaluated for suspected Alzheimer disease. 20 healthy controls and 80 patients consulting for memory loss were included, in which cognitive study and 18 F-fluorodeoxyglucose PET were performed. Patients were categorized according to Reisberg's Global Deterioration Scale. Voxel-based analysis was used to determine correlations between brain metabolism and performance on the following tests: Free and Cued Selective Reminding Test (FCSRT), Boston Naming Test (BNT), Trail Making Test, Rey-Osterrieth Complex Figure test, Visual Object and Space Perception Battery (VOSP), and Tower of London (ToL) test. Mean age in the patient group was 73.9 ± 10.6 years, and 47 patients were women (58.7%). FCSRT findings were positively correlated with metabolism in the medial and anterior temporal region bilaterally, the left precuneus, and posterior cingulate. BNT results were correlated with metabolism in the middle temporal, superior, fusiform, and frontal medial gyri bilaterally. VOSP results were related to the occipital and parietotemporal regions bilaterally. ToL scores were correlated to metabolism in the right temporoparietal and frontal regions. These results suggest that different areas of the brain are involved in the processes required to complete different cognitive tests. Ascertaining the functional basis underlying these tests may prove helpful for understanding and interpreting them. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  2. Effects of cognitive training on gray matter volumes in memory clinic patients with subjective memory impairment.

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    Engvig, Andreas; Fjell, Anders M; Westlye, Lars T; Skaane, Nina V; Dale, Anders M; Holland, Dominic; Due-Tønnessen, Paulina; Sundseth, Oyvind; Walhovd, Kristine B

    2014-01-01

    Subjective memory impairment (SMI) is a common risk factor for Alzheimer's disease, with few established options for treatment. Here we investigate the effects of two months episodic memory training on regional brain atrophy in 19 memory clinic patients with SMI. We used a sensitive longitudinal magnetic resonance imaging protocol and compared the patients with 42 matched healthy volunteers randomly assigned to a group performing the same training, or a no-training control group. Following intervention, the SMI sample exhibited structural gray matter volume increases in brain regions encompassing the episodic memory network, with cortical volume expansion of comparable extent as healthy training participants. Further, we found significant hippocampal volume increases in the healthy training group but not in the SMI group. Still, individual differences in left hippocampal volume change in the patient group were related to verbal recall improvement following training. The present results reinforce earlier studies indicating intact brain plasticity in aging, and further suggest that training-related brain changes can be evident also in the earliest form of cognitive impairment.

  3. SUBJECTIVE COGNITIVE COMPLAINTS IN A PATIENT WITH KERATOCONUS: COGNITIVE IMPAIRMENT OR

    Directory of Open Access Journals (Sweden)

    Ara G. Kaprelyan

    2012-11-01

    Full Text Available Keratoconus is a disorder affecting the cornea, characterized by its variably progressive central thinning, which results in conically shaped protrusion. Patients with keratoconus are sometimes described as having peculiar personality characteristics. We present the case of a patient with keratoconus, complaining of impairment of concentration and memory disturbances. He reported slow progression of the complaints but was fully capable of performing his professional and social activities. Neuropsychological assessment confirmed fluctuations of active attention and diminished concentration. Long term memory was within normal limits, but closer to the lower level. MMSE score was 27. No significant changes were observed one year after baseline assessment. No major psychiatric disorder was found. In this clinical case we are tempted to discuss the possible role of keratoconus, which, as it has been described in the literature, could lead to some slight changes of behavior, forming a "keratoconic personality".

  4. Anxiety and depression symptoms among caregivers of care-recipients with subjective cognitive decline and cognitive impairment.

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    Liang, Xiaoniu; Guo, Qihao; Luo, Jianfeng; Li, Fang; Ding, Ding; Zhao, Qianhua; Hong, Zhen

    2016-10-03

    Caregivers of care-recipients with mild cognitive impairment (MCI) or dementia experience high caregiver burden; however, the psychiatric burden of caregivers of care-recipients with subjective cognitive decline (SCD) has not been investigated. We aimed to explore the prevalence of and risk factors for anxiety and depression symptoms among the caregivers of care-recipients with SCD and cognitive impairment. The Hospital Anxiety and Depression Scale (HADS) was used to examine the anxiety and depression symptoms among the caregivers of 343 care-recipients (84 with SCD, 120 with MCI and 139 with dementia) treated at the Memory Clinic of Huashan Hospital in Shanghai, China from May 2012 to October 2014. A logistic regression was used to explore the factors associated with caregiver's anxiety and depression symptoms. In total, 26.5 % of caregivers had anxiety symptoms, and 22.4 % had depression symptoms. Totals of 17.9, 30.0 and 28.8 % of caregivers of care-recipients with SCD, MCI or dementia, respectively, had anxiety symptoms (P = 0.1140), whereas 22.6, 24.2 and 20.9 %, respectively, had depression symptoms (P = 0.8165). The risk factors for caregiver's anxiety symptoms were increased caregiver age as well as having care-recipients who were male, had higher Cohen Mansfield Agitation Inventory (CMAI) scores, and higher Geriatric Depression Scale (GDS) scores. The risk factors for caregiver's depression symptoms were increased caregiver age as well as caring for care-recipients with MCI or SCD, those with lower Toronto Empathy Questionnaire (TEQ) scores, and those with higher GDS scores. Caregivers of care-recipients with SCD showed the same level of depression symptoms as those of care-recipients with MCI. Caregiver's depression and anxiety symptoms were associated with their care-recipients' psychiatric and behavioral syndromes.

  5. Subjective Memory Complaints are Associated with Incident Dementia in Cognitively Intact Older People, but Not in Those with Cognitive Impairment: A 24-Month Prospective Cohort Study.

    Science.gov (United States)

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

    2017-06-01

    Although subjective memory complaints (SMCs) are considered a risk factor for incident dementia in older people, the effect might differ based on cognitive function. The aim of the present study was to investigate whether the effect of SMCs on the incidence of dementia in older people differed based on cognitive function. A 24-month follow-up cohort study. Japanese community. Prospective, longitudinal data for incident dementia were collected for 3,672 participants (mean age: 71.7 years; 46.5% men) for up to 24 months. Baseline measurements included covariates for incident dementia, SMCs, and cognitive function. Associations between SMCs, cognitive impairment, and incident dementia were examined using Cox proportional hazards models. Incidences of dementia in the cognitively intact without SMC, cognitively intact with SMC, cognitive impairment without SMC, and cognitive impairment with SMC groups were 0.3%, 1.8%, 3.4%, and 4.8%, respectively. In the cognitively intact participants, SMCs were associated with a significantly higher risk of dementia (hazard ratio [HR]: 4.95, 95% confidence interval [CI]: 1.52-16.11, p = 0.008). Incident dementia with cognitive impairment was not significantly different based on SMC presence (p = 0.527). Participants with cognitive impairment in multiple domains had a significantly higher risk of incident dementia (HR: 2.07, 95% CI: 1.01-4.24, p = 0.046) CONCLUSION: SMCs were related with dementia in cognitively intact older people, but not in those with cognitive impairment.Multiple domains of cognitive impairment were associated with a higher risk of incident dementia. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  6. The Apathy Evaluation Scale: A Comparison of Subject, Informant, and Clinician Report in Cognitively Normal Elderly and Mild Cognitive Impairment.

    Science.gov (United States)

    Guercio, Brendan J; Donovan, Nancy J; Munro, Catherine E; Aghjayan, Sarah L; Wigman, Sarah E; Locascio, Joseph J; Amariglio, Rebecca E; Rentz, Dorene M; Johnson, Keith A; Sperling, Reisa A; Marshall, Gad A

    2015-01-01

    Apathy is a common neuropsychiatric symptom in Alzheimer's disease (AD) dementia and mild cognitive impairment (MCI). Detecting apathy accurately may facilitate earlier diagnosis of AD. The Apathy Evaluation Scale (AES) is a promising tool for measurement of apathy in prodromal and possibly preclinical AD. To compare the three AES sub-scales - subject-reported (AES-S), informant-reported (AES-I), and clinician-reported (AES-C) - over time in individuals at risk for AD due to MCI and advanced age (cognitively normal [CN] elderly). Mixed effects longitudinal models were used to assess predictors of score for each AES sub-scale. Cox proportional hazards models were used to assess which AES sub-scales predict progression from MCI to AD dementia. Fifty-seven MCI and 18 CN subjects (ages 53-86) were followed for 1.4 ± 1.2 years and 0.7 ± 0.7 years, respectively. Across the three mixed effects longitudinal models, the common findings were associations between greater apathy and greater years in study, a baseline diagnosis of MCI (compared to CN), and male gender. CN elderly self-reported greater apathy compared to that reported by informants and clinicians, while individuals with MCI under-reported their apathy compared to informants and clinicians. Of the three sub-scales, the AES-C best predicted transition from MCI to AD dementia. In a sample of CN elderly and elderly with MCI, apathy increased over time, particularly in men and those with MCI. AES-S scores may be more sensitive than AES-I and AES-C scores in CN elderly, but less reliable if subjects have MCI. Moreover, the AES-C sub-scale predicted progression from MCI to AD dementia.

  7. Measurements of medial temporal lobe atrophy for prediction of Alzheimer's disease in subjects with mild cognitive impairment

    NARCIS (Netherlands)

    Clerx, L.; van Rossum, I.A.; Burns, L.; Knol, D.L.; Scheltens, P.; Verhey, F.; Aalten, P.; Lapuerta, P.; van de Pol, L.A.; van Schijndel, R.A.; Jong, R.; Barkhof, F.; Wolz, R.; Rueckert, D.; Bocchetta, M.; Tsolaki, M.; Nobili, F.; Wahlund, L.O.; Minthon, L.; Frolich, L.; Hampel, H.; Soininen, H.; Visser, P.J.

    2013-01-01

    Our aim was to compare the predictive accuracy of 4 different medial temporal lobe measurements for Alzheimer's disease (AD) in subjects with mild cognitive impairment (MCI). Manual hippocampal measurement, automated atlas-based hippocampal measurement, a visual rating scale (MTA-score), and lateral

  8. ADAM10 gene expression in the blood cells of Alzheimer's disease patients and mild cognitive impairment subjects

    NARCIS (Netherlands)

    Manzine, Patricia Regina; Marcello, Elena; Borroni, Barbara; Kamphuis, Willem; Hol, Elly; Padovani, Alessandro; Nascimento, Carla Crispim; De Godoy Bueno, Patricia; Assis Carvalho Vale, Francisco; Iost Pavarini, Sofia Cristina; Di Luca, Monica; Cominetti, Márcia Regina

    2015-01-01

    ADAM10 is a potential biomarker for Alzheimer's disease (AD). ADAM10 protein levels are reduced in platelets of AD patients. The aim was to verify the total blood and platelet ADAM10 gene expression in AD patients and to compare with mild cognitive impairment (MCI) and healthy subjects. No

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

    Directory of Open Access Journals (Sweden)

    Jennifer N Vega

    2016-09-01

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

  10. 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 ...

  11. 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 ...

  12. A pilot study of a new method of cognitive stimulation using abacus arithmetic in healthy and cognitively impaired elderly subjects.

    Science.gov (United States)

    Matías-Guiu, J A; Pérez-Martínez, D A; Matías-Guiu, J

    2016-06-01

    This study explores the applicability of a cognitive stimulation method based on abacus arithmetic in elderly people with and without cognitive impairment. This observational and prospective pilot study was performed in 2 hospitals. The study assessed the applicability of a programme of arithmetic training developed for use in the elderly population. The primary endpoint was an evaluation of the stimulation programme, in terms of usability, satisfaction, and participation, in healthy elderly controls and elderly patients with mild cognitive impairment or Alzheimer disease. Secondary endpoints were family satisfaction, caregiver burden, and the behaviour and cognition of patients. Usability, satisfaction, and degree of participation were high. The Mini-Mental State Examination showed significant changes (23.1±4.8 before the intervention vs 24.9±4.2 afterwards, P=.002); there were no changes on the Trail Making Test parts A and B, Yesavage Geriatric Depression scale, and Zarit caregiver burden scale. The study suggests that cognitive stimulation with abacus arithmetic may be used in elderly people with and without cognitive impairment. Further studies will be needed to evaluate the efficacy of this kind of programmes. Copyright © 2014 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  13. Using functional Magnetic Resonance Imaging to differentiate between Healthy Aging subjects, Mild Cognitive Impairment, and Alzheimer’s Patients

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Oghabian

    2010-01-01

    Full Text Available

    Back ground: Alzheimer's disease is the most common form of dementia which is still difficult to be differentiated from other types of brain disorders. Moreover, Mild Cognitive Impairment refers to the presence of cognitive impairments that is not severe enough to meet the criteria of dementia, and its diagnosis in early stages is so critical. There is currently no distinct method available for diagnosing Alzheimer's or Mild Cognitive Impairment, and their diagnosis needs a combination of different methods and assessments.

    Methods: Our goal in this study was to evaluate the effectiveness of fMRI imaging in differentiating between Alzheimer's, Mild Cognitive Impairment (MCI and Healthy Aging. To prove fMRI's ability, we compared resting-state brain activation patterns between these three groups of subjects using Independent Component Algorithm (ICA. We examined 40 age- and sex-matched subjects, 15 elderly, 11 MCI and 14 Alzheimer's subjects.

    Results: The results show that during a certain resting-state session, healthy aging brain benefits from larger area and greater intensity of activation (compared with MCI and Alzheimer's group in Posterior Cingulate Cortex (PCC region of the brain, as part of Default Mode Network.

    Conclusion: This difference in activation pattern can be used as a diagnostic criterion in using fMRI for differentiating between Alzheimer's disease (AD, MCI and Healthy Aging.


    Keywords: fMRI, Default Mode Network, Alzheimer's, Mild Cognitive Impairment, Resting-State

  14. Erythropoietin prevents cognitive impairment and oxidative parameters in Wistar rats subjected to pneumococcal meningitis.

    Science.gov (United States)

    Barichello, Tatiana; Simões, Lutiana R; Generoso, Jaqueline S; Sangiogo, Gustavo; Danielski, Lucineia Gainski; Florentino, Drielly; Dominguini, Diogo; Comim, Clarissa M; Petronilho, Fabricia; Quevedo, João

    2014-05-01

    Pneumococcal meningitis is characterized by a severe inflammatory reaction in the subarachnoid and ventricular space of the brain, disruption of the blood-brain barrier, hearing loss, and neurologic sequelae in as many as 27% of surviving patients. Several experimental studies have shown that erythropoietin (EPO) and its receptor are expressed in the central nervous system and have neuroprotective properties through the inhibition of apoptosis, as well as anti-inflammatory, antioxidant, angiogenic, and neurotrophic effects. In the current study, we demonstrated the effect of erythropoietin (EPO) on lipid peroxidation, protein carbonylation, superoxide dismutase (SOD), catalase (CAT), myeloperoxidase (MPO), and behavioral parameters in rats with pneumococcal meningitis. EPO decreased lipid peroxidation and protein carbonylation, and it prevented protein degradation in the hippocampus and frontal cortex. MPO activity was decreased, and both SOD and CAT activity were increased in the first 6 hours after pneumococcal meningitis induction. Novel object recognition memory was impaired in the meningitis group; however, adjuvant treatment with EPO prevented memory impairment during both the short- and long-term retention tests. The meningitis group showed no difference in motor and exploratory activity between training and test sessions in the open-field task, which indicates that habituation memory was impaired; however, adjuvant treatment with EPO prevented habituation memory impairment. Although there are some limitations with respect to the animal model of pneumococcal meningitis, this study suggests that adjuvant treatment with EPO contributed to decreased oxidative stress and prevented cognitive impairment. Copyright © 2014 Mosby, Inc. All rights reserved.

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

    Science.gov (United States)

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

    2017-11-28

    Subjective cognitive impairment can be a significant and prevalent problem for gynaecological cancer survivors. The aims of this study were to assess subjective cognitive functioning in gynaecological cancer survivors after primary cancer treatment, and to investigate the impact of cancer treatment on brain structural networks and its association with subjective cognitive impairment. This was a cross-sectional survey using a self-reported questionnaire by the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) to assess subjective cognitive functioning, and applying DTI (diffusion tensor imaging) and graph theoretical analyses to investigate brain structural networks after primary cancer treatment. A total of 158 patients with gynaecological cancer (mean age, 45.86 years) and 130 age-matched non-cancer controls (mean age, 44.55 years) were assessed. Patients reported significantly greater subjective cognitive functioning on the FACT-Cog total score and two subscales of perceived cognitive impairment and perceived cognitive ability (all p values impairment (r = -0.388, p = 0.034). When compared with non-cancer controls, a considerable proportion of gynaecological cancer survivors may exhibit subjective cognitive impairment. This study provides the first evidence of brain structural network alteration in gynaecological cancer patients at post-treatment, and offers novel insights regarding the possible neurobiological mechanism of cancer-related cognitive impairment (CRCI) in gynaecological cancer patients. As primary cancer treatment can result in a more random organisation of structural brain networks, this may reduce brain functional specificity and segregation, and have implications for cognitive impairment. Future prospective and longitudinal studies are needed to build upon the study findings in order to assess potentially relevant clinical and psychosocial variables and brain network measures, so as to more accurately understand the

  16. EEG upper/low alpha frequency power ratio and the impulsive disorders network in subjects with mild cognitive impairment.

    Science.gov (United States)

    Moretti, Davide V; Paternicò, Donata; Binetti, Giuliano; Zanetti, Orazio; Frisoni, Giovanni B

    2014-02-01

    The ventral striatum-nucleus accumbens network has been associated with impulsive behavior in subjects with early cognitive impairment; in Alzheimer's disease (AD) modifications of basal ganglia have been also demonstrated. Moreover, the increase of EEG alpha3/alpha2 frequency power ratio has been investigated as EEG marker in subjects with mild cognitive impairment (MCI) who will develop AD. In the present study we have detected the relationship between upper alpha/low alpha ferquency power ratio and specific gray matter (GM) changes in the basal ganglia in subjects with MCI. Electroencefalographic (EEG) recording and high resolution 3D magnetic resonance imaging (MRI) were taken in 74 MCI subjects. In each subject the alpha3/alpha2 EEG frequency power ratio was estimated as EEG biomarker. Three groups were obtained according to increasing tertiles values of the biomarker. Through the Voxel Based Morphometry (VBM) technique, GM density differences between groups were evaluated. Results show that subjects with lower a3/a2 and middle a3/a2 ratio ratio showed greater gray matter reduction in the Nucleus Accumbens and the head of Caudate Nucleus as compared to subjects with higher a3/a2 ratio. Our study indicates that the a3/a2 frequency power ratio was associated with increase of grey matter density inside the impulsivity network of MCI patients more likely develop AD.

  17. Using virtual reality to distinguish subjects with multiple- but not single-domain amnestic mild cognitive impairment from normal elderly subjects.

    Science.gov (United States)

    Mohammadi, Alireza; Kargar, Mahmoud; Hesami, Ehsan

    2018-03-01

    Spatial disorientation is a hallmark of amnestic mild cognitive impairment (aMCI) and Alzheimer's disease. Our aim was to use virtual reality to determine the allocentric and egocentric memory deficits of subjects with single-domain aMCI (aMCIsd) and multiple-domain aMCI (aMCImd). For this purpose, we introduced an advanced virtual reality navigation task (VRNT) to distinguish these deficits in mild Alzheimer's disease (miAD), aMCIsd, and aMCImd. The VRNT performance of 110 subjects, including 20 with miAD, 30 with pure aMCIsd, 30 with pure aMCImd, and 30 cognitively normal controls was compared. Our newly developed VRNT consists of a virtual neighbourhood (allocentric memory) and virtual maze (egocentric memory). Verbal and visuospatial memory impairments were also examined with Rey Auditory-Verbal Learning Test and Rey-Osterrieth Complex Figure Test, respectively. We found that miAD and aMCImd subjects were impaired in both allocentric and egocentric memory, but aMCIsd subjects performed similarly to the normal controls on both tasks. The miAD, aMCImd, and aMCIsd subjects performed worse on finding the target or required more time in the virtual environment than the aMCImd, aMCIsd, and normal controls, respectively. Our findings indicated the aMCImd and miAD subjects, as well as the aMCIsd subjects, were more impaired in egocentric orientation than allocentric orientation. We concluded that VRNT can distinguish aMCImd subjects, but not aMCIsd subjects, from normal elderly subjects. The VRNT, along with the Rey Auditory-Verbal Learning Test and Rey-Osterrieth Complex Figure Test, can be used as a valid diagnostic tool for properly distinguishing different forms of aMCI. © 2018 Japanese Psychogeriatric Society.

  18. Serial position effects in patients with mild cognitive impairment and early and moderate Alzheimer's disease compared with healthy comparison subjects.

    Science.gov (United States)

    Moser, B; Deisenhammer, E A; Marksteiner, J; Papousek, I; Fink, A; Weiss, E M

    2014-01-01

    This study aimed to investigate whether the serial position effects in memory can differentiate patients with different subtypes of mild cognitive impairment (MCI) from healthy controls and patients with different stages of Alzheimer's disease (AD). The serial position effects was tested with the CERAD word list task in 184 persons (39 healthy control subjects, 15 amnestic MCI single domain subjects, 23 amnestic MCI multiple domain subjects, 31 nonamnestic MCI subjects, 45 early or mild AD patients, and 31 moderate AD patients). With progression of dementia, memory deficits increased and the impairment in the primacy effect during the learning trials advanced, whereas the recall of recent items was less impaired. The serial position profile of nonamnestic MCI patients resembled that of healthy control subjects, whereas amnestic MCI patients showed poorer performance in all 3 positions but no significant difference as a function of serial word position. Analyses of the serial position effect may be a useful complement to clinical neuropsychological measures for distinguishing amnestic MCI patients from normal aging and patients with different stages of dementia. © 2013 S. Karger AG, Basel.

  19. Benefits in cognitive function, blood pressure, and insulin resistance through cocoa flavanol consumption in elderly subjects with mild cognitive impairment: the Cocoa, Cognition, and Aging (CoCoA) study.

    Science.gov (United States)

    Desideri, Giovambattista; Kwik-Uribe, Catherine; Grassi, Davide; Necozione, Stefano; Ghiadoni, Lorenzo; Mastroiacovo, Daniela; Raffaele, Angelo; Ferri, Livia; Bocale, Raffaella; Lechiara, Maria Carmela; Marini, Carmine; Ferri, Claudio

    2012-09-01

    Flavanol consumption is favorably associated with cognitive function. We tested the hypothesis that dietary flavanols might improve cognitive function in subjects with mild cognitive impairment. We conducted a double-blind, parallel arm study in 90 elderly individuals with mild cognitive impairment randomized to consume once daily for 8 weeks a drink containing ≈990 mg (high flavanols), ≈520 mg (intermediate flavanols), or ≈45 mg (low flavanols) of cocoa flavanols per day. Cognitive function was assessed by Mini Mental State Examination, Trail Making Test A and B, and verbal fluency test. At the end of the follow-up period, Mini Mental State Examination was similar in the 3 treatment groups (P=0.13). The time required to complete Trail Making Test A and Trail Making Test B was significantly (Ptest score was significantly (Pelderly subjects with mild cognitive impairment. This effect appears mediated in part by an improvement in insulin sensitivity.

  20. The impact of depressive symptoms on health-related quality of life in patients with subjective cognitive decline, mild cognitive impairment, and Alzheimer's disease.

    Science.gov (United States)

    Pusswald, G; Moser, D; Pflüger, M; Gleiss, A; Auff, E; Stögmann, E; Dal-Bianco, P; Lehrner, J

    2016-12-01

    Health-related quality of life (HRQOL) is an important issue in the context of dementia care. The purpose of this study was to investigate the association between HRQOL and depressive symptoms in patients with subjective cognitive decline (SCD) and subtypes of mild cognitive impairment (MCI) and Alzheimer´s disease (AD). In this cross-sectional, observational study, a control group and four experimental groups (SCD, non-amnestic MCI, amnesticMCI, AD) were compared. Neuropsychological measurers (NTBV) and psychological questionnaires were used for data collection. The control group scored higher than patients with SCD, naMCI, aMCI, or AD for the Mental Health Component Score (MHCS) of the Short Form of the Health Survey (SF-36). The Physical Health Component Score (PHCS) of the SF-36 differed only between some groups. Furthermore, cognitive variables were more strongly associated with the physical aspects of HRQOL, whereas depressive symptoms were more strongly related with the mental aspects of HRQOL. HRQOL and depressive symptoms are closely related in patients with cognitive impairments. Therefore, it is of great importance to assess patients with subjective impairment carefully in terms of depressive symptoms.

  1. Recurrent syncope in a hypertensive subject with vascular cognitive impairment and permanent pacemaker

    Directory of Open Access Journals (Sweden)

    Alberto Mazza

    2012-09-01

    Full Text Available Syncope following permanent pacemaker (PM implantation is a nightmare for electrophysiologists. We describe a case of daily recurrent syncope in an 84-year-old man having a dual-chamber pacemaker implanted for complete atrio-ventricular block occurred 4 years before the admission to our department. He had a history of arterial hypertension, parossistic atrial fibrillation, chronic obstructive pulmonary disease, stage-III chronic renal failure, mild vascular cognitive impairment and glaucoma. The initial work-up including electrocardiogram (ECG, repeated PM inter- rogations, Holter electrocardiogram, blood pressure measurement in orthostatic position, complete blood count, serum glycaemia, electrolytes and thyroid function tests showed normal findings. Syncope occurred in lying position and during 90° left clockwise neck rotation and was associated to pallor, sweating, tonic-clonic seizures and transient self-limited loss of consciousness lasting a few seconds. Electroencephalogram was normal. During continuous ECG monitoring, the right rotation of the head determined a ventricular asystolic pause lasting 9 seconds associated with loss of consciousness. Restoration of sinus rhythm was observed after bringing back the head in axis. The PM interrogation, performed during pacing failure, recorded low impedance of bipolar ventricular lead, suggesting a damage in lead insulation. It is likely that lead movements during clockwise neck rotation produced an intermittent short circuit that prevented sufficient energy delivery to the myocardium with a consequence of sudden loss of capture.

  2. Depressive Symptoms are the Main Predictor for Subjective Sleep Quality in Patients with Mild Cognitive Impairment--A Controlled Study.

    Science.gov (United States)

    Seidel, Stefan; Dal-Bianco, Peter; Pablik, Eleonore; Müller, Nina; Schadenhofer, Claudia; Lamm, Claus; Klösch, Gerhard; Moser, Doris; Klug, Stefanie; Pusswald, Gisela; Auff, Eduard; Lehrner, Johann

    2015-01-01

    Controlled data on predictors of subjective sleep quality in patients with memory complaints are sparse. To improve the amount of comprehensive data on this topic, we assessed factors associated with subjective sleep quality in patients from our memory clinic and healthy individuals. Between February 2012 and August 2014 patients with mild cognitive impairment (MCI) and subjective cognitive decline (SCD) from our memory clinic and healthy controls were recruited. Apart from a detailed neuropsychological assessment, the subjective sleep quality, daytime sleepiness and depressive symptoms were assessed using the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS) and the Beck Depression Inventory (BDI-II). One hundred fifty eight consecutive patients (132 (84%) MCI patients and 26 (16%) SCD patients) and 75 healthy controls were included in the study. Pairwise comparison of PSQI scores showed that non-amnestic MCI (naMCI) patients (5.4 ± 3.5) had significantly higher PSQI scores than controls (4.3 ± 2.8, p = .003) Pairwise comparison of PSQI subscores showed that naMCI patients (1.1 ± 0.4) had significantly more "sleep disturbances" than controls (0.9 ± 0.5, p = .003). Amnestic MCI (aMCI) (0.8 ± 1.2, p = .006) and naMCI patients (0.7 ± 1.2, p = .002) used "sleep medication" significantly more often than controls (0.1 ± 0.6) Both, aMCI (11.5 ± 8.6, p sleep quality was predicted by depressive symptoms in aMCI (p sleep quality. In aMCI patients we also found a significant interaction between depressive symptoms and global cognitive function (p = .002). Depressive symptoms were the main predictor of subjective sleep quality in MCI patients and controls, but not in SCD patients. Better global cognitive function ameliorated the negative effect of depressive symptoms on the subjective sleep quality in aMCI patients.

  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. Cognitive effects of a dietary supplement made from extract of Bacopa monnieri, astaxanthin, phosphatidylserine, and vitamin E in subjects with mild cognitive impairment: a noncomparative, exploratory clinical study

    Directory of Open Access Journals (Sweden)

    Zanotta D

    2014-02-01

    Full Text Available Danilo Zanotta, Silvana Puricelli, Guido Bonoldi Unità Operativa di Medicina 2, Ospedale di Circolo di Busto Arsizio, Varese, Italy Abstract: A prospective cohort, noncomparative, multicenter trial was conducted to explore the potential of a phytotherapeutic compound, available as a dietary supplement and containing extracts of Bacopa monnieri and Haematococcus pluvialis (astaxanthin plus phosphatidylserine and vitamin E, in improving cognition in subjects diagnosed with mild cognitive impairment. Enrolled subjects (n=104 were aged 71.2±9.9 years and had a mini-mental state examination score of 26.0±2.0 (mean ± standard deviation. They underwent the Alzheimer’s Disease Assessment Scale-cognitive subscale (ADAS-cog test and the clock drawing test at baseline and upon completion of a 60-day period of dietary supplementation with one tablet daily of the tested compound. In 102 assessable subjects, total ADAS-cog scores improved from 13.7±5.8 at baseline to 9.7±4.9 on day 60, and the clock drawing test scores improved from 8.5±2.3 to 9.1±1.9. Both changes were statistically significant (P<0.001. Memory tasks were the individual components of ADAS-cog showing the largest improvements. In a multivariate analysis, larger improvements in total ADAS-cog score were associated with less compromised baseline mini-mental state examination scores. Perceived efficacy was rated as excellent or good by 62% of study subjects. The tested compound was well tolerated; one nonserious adverse event was reported in the overall study population, and perceived tolerability was rated excellent or good by 99% of the subjects. In conclusion, dietary supplementation with the tested compound shows potential for counteracting cognitive impairment in subjects with mild cognitive impairment and warrants further investigation in adequately controlled, longer-term studies. Keywords: mild cognitive impairment, Bacopa monnieri, astaxanthin, ADAS-cog test, clock drawing

  5. Subjective memory impairment, objective cognitive functioning and social activity in French older people: findings from the Three Cities study.

    Science.gov (United States)

    Genziani, Mirella; Stewart, Robert; Béjot, Yannick; Amieva, Hélène; Artero, Sylvaine; Ritchie, Karen

    2013-01-01

    To investigate the association between subjective memory impairment (SMI) and objective cognitive impairment in later life, and to ascertain whether this is modified by level of social activity, education or living alone. Data were analyzed from three French community surveys carried out in Bordeaux, Dijon and Montpellier. Representative samples of 9294 residents aged 65 years and over were included in the study. SMI was ascertained and investigated in relation to performance on the Benton Visual Retention Test (BVRT), the Isaac Set Test (IST) and Trail Making Test B (TMT). Adjustments were made for age, sex, education, depressive symptoms (Centre for Epidemiological Depression scale), site where study was carried out and living alone. Stratified analyses investigated modification by high or low social activity, education or living arrangement. SMI was reported by 21.9% of the sample, and was significantly associated with lower scores on BVRT and TMT after adjustment for age, sex, education, depressive symptoms, site and living alone. These associations were not significantly modified by social activity, education or living alone. Worse subjective memory was associated independently with worse performance on two tests of cognitive function; however, in these cohorts, no evidence was found for modification of associations by social activity/support or education. © 2012 Japan Geriatrics Society.

  6. Depressive Symptoms are the Main Predictor for Subjective Sleep Quality in Patients with Mild Cognitive Impairment--A Controlled Study.

    Directory of Open Access Journals (Sweden)

    Stefan Seidel

    Full Text Available Controlled data on predictors of subjective sleep quality in patients with memory complaints are sparse. To improve the amount of comprehensive data on this topic, we assessed factors associated with subjective sleep quality in patients from our memory clinic and healthy individuals.Between February 2012 and August 2014 patients with mild cognitive impairment (MCI and subjective cognitive decline (SCD from our memory clinic and healthy controls were recruited. Apart from a detailed neuropsychological assessment, the subjective sleep quality, daytime sleepiness and depressive symptoms were assessed using the Pittsburgh Sleep Quality Index (PSQI, the Epworth Sleepiness Scale (ESS and the Beck Depression Inventory (BDI-II.One hundred fifty eight consecutive patients (132 (84% MCI patients and 26 (16% SCD patients and 75 healthy controls were included in the study. Pairwise comparison of PSQI scores showed that non-amnestic MCI (naMCI patients (5.4 ± 3.5 had significantly higher PSQI scores than controls (4.3 ± 2.8, p = .003 Pairwise comparison of PSQI subscores showed that naMCI patients (1.1 ± 0.4 had significantly more "sleep disturbances" than controls (0.9 ± 0.5, p = .003. Amnestic MCI (aMCI (0.8 ± 1.2, p = .006 and naMCI patients (0.7 ± 1.2, p = .002 used "sleep medication" significantly more often than controls (0.1 ± 0.6 Both, aMCI (11.5 ± 8.6, p < .001 and naMCI (11.5 ± 8.6, p < .001 patients showed significantly higher BDI-II scores than healthy controls (6.1 ± 5.3. Linear regression analysis showed that the subjective sleep quality was predicted by depressive symptoms in aMCI (p < .0001 and naMCI (p < .0001 patients as well as controls (p < .0001. This means, that more depressive symptoms worsened subjective sleep quality. In aMCI patients we also found a significant interaction between depressive symptoms and global cognitive function (p = .002.Depressive symptoms were the main predictor of subjective sleep quality in MCI

  7. High Prevalence of Stress and Low Prevalence of Alzheimer Disease CSF Biomarkers in a Clinical Sample with Subjective Cognitive Impairment.

    Science.gov (United States)

    Eckerström, Marie; Berg, Anne Ingeborg; Nordlund, Arto; Rolstad, Sindre; Sacuiu, Simona; Wallin, Anders

    2016-01-01

    Subjective cognitive impairment (SCI) is a trigger for seeking health care in a possible preclinical phase of Alzheimer's disease (AD), although the characteristics of SCI need clarification. We investigated the prevalence of psychosocial stress, depressive symptoms and CSF AD biomarkers in SCI and MCI (mild cognitive impairment). Memory clinic patients (SCI: n = 90; age: 59.8 ± 7.6 years; MCI: n = 160; age: 63.7 ± 7.0 years) included in the Gothenburg MCI study were examined at baseline. Variables were analyzed using logistic regression with SCI as dependent variable. Stress was more prevalent in SCI (51.1%) than MCI (23.1%); p patients had more previous depressive symptoms (p = 0.006), but showed no difference compared to MCI patients considering current depressive symptoms. A positive CSF AD profile was present in 14.4% of SCI patients and 35.0% of MCI patients (p = 0.001). Stress (p = 0.002), previous stress/depressive symptoms (p = 0.006) and a negative CSF AD profile (p = 0.036) predicted allocation to the SCI group. Psychosocial stress is more prevalent in SCI than previously acknowledged. The high prevalence and long-term occurrence of stress/depressive symptoms in SCI in combination with a low prevalence of altered CSF AD biomarkers strengthens the notion that AD is not the most likely etiology of SCI. © 2016 S. Karger AG, Basel.

  8. The clinical significance of subjective memory complaints in the diagnosis of mild cognitive impairment and dementia: a meta-analysis.

    Science.gov (United States)

    Mitchell, Alex J

    2008-11-01

    Subjective memory complaints (SMC) are frequently reported by individuals with objective evidence of cognitive decline although the exact rate of complaints and their diagnostic value is uncertain. A meta-analysis was conducted for all studies examining SMC and either concurrent dementia or mild cognitive impairment (MCI). Eight studies reported the rate of SMC in dementia, seven studies reported the rate of SMC in MCI and of these four compared the rate of SMC in dementia and MCI head-to-head. SMC were present in 42.8% of those with dementia and 38.2% of those with MCI. Across all levels of cognitive impairments 39.8% of people had SMC compared with 17.4% in healthy elderly controls (Relative Risk 2.3). In head-to-head studies there was a significantly higher rate of SMC in dementia vs MCI (48.4% vs 35.1%). Examining the diagnostic value of SMC in dementia, the meta-analytic pooled sensitivity was 43.0% and specificity was 85.8%. For MCI, meta-analytic pooled sensitivity was 37.4% and specificity was 86.9%. In community studies with a low prevalence the positive and negative predictive values were 18.5% and 93.7% for dementia and 31.4% and 86.9% for MCI. The clinical utility index which calculates the value of a diagnostic method suggested 'poor' value for ruling in a diagnosis of dementia but 'good' value for ruling out a diagnosis. When assessed by simple questions, SMC appear to be present in the minority of those with mild cognitive impairment and dementia. In cross-sectional community settings, even when people agree that they have SMC there is only a 20% or 30% chance that dementia or MCI are present, respectively. Despite this, the absence of SMC may be a reasonable method of excluding dementia and MCI and could be incorporated into short screening programs for dementia and MCI but replication is required in clinical settings. Copyright (c) 2008 John Wiley & Sons, Ltd.

  9. Cortical atrophy rates in Alzheimer's patients and subjects with mild cognitive impairment from the AddNeuroMed data collection

    DEFF Research Database (Denmark)

    Eskildsen, Simon Fristed; Westman, Eric; Gwadry-Sridhar, Femida

    2010-01-01

    Background: The AddNeuroMed project is a multi-centre European project which aims to identify biomarkers in Alzheimer's disease (AD). In this study we measured the rate of cortical atrophy in AD patients, subjects with mild cognitive impairment (MCI), and healthy controls (HC) using MRI. Methods...... higher atrophy rates in the left and right occipital lobes compared to HC at three months follow-up (p accelerated atrophy...... rates can be found in AD patients compared to HC and MCI. Even three months after baseline accelerated atrophy can be observed in AD compared to HC, however, the results indicate that three months is too short a period to distinguish the atrophy rates in AD and MCI. The results suggest that atrophy...

  10. Reduced Sympathetic Response to Head-Up Tilt in Subjects with Mild Cognitive Impairment or Mild Alzheimer's Dementia

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    Marte Rognstad Mellingsæter

    2015-03-01

    Full Text Available Background: Hemodynamic control was compared in patients with mild cognitive impairment (MCI or mild Alzheimer's dementia (AD as well as in healthy elderly subjects. Methods: Noninvasive, continuous hemodynamic recordings were obtained from 14 patients and 48 controls during supine rest (tilt of 30 and 70°. Cardiac output, end-diastolic volume, total peripheral resistance, heart rate variability (HRV, systolic blood pressure variability (SBPV, and baroreceptor sensitivity were calculated. Results: At 70° tilt, the HRV indices differed significantly, with higher high-frequency (HF variability as well as lower low-frequency (LF variability and LF/HF ratios in the patients. The patients had significantly lower SBPV in the LF range at 30° tilt. Conclusions: The results indicate a poorer sympathetic response to orthostatic stress in MCI and mild AD.

  11. Symptoms of apathy are associated with progression from mild cognitive impairment to Alzheimer's disease in non-depressed subjects

    NARCIS (Netherlands)

    Richard, E.; Schmand, B.; Eikelenboom, P.; Yang, S.C.; Ligthart, S.A.; Moll van Charante, E.P.; van Gool, W.A.

    2012-01-01

    Background: Apathy is a common symptom in various neuropsychiatric diseases including mild cognitive impairment (MCI) and dementia. Apathy may be associated with an increased risk of cognitive decline. The objective of this study was to investigate if apathy predicts the progression from MCI to

  12. Symptoms of Apathy Are Associated with Progression from Mild Cognitive Impairment to Alzheimer's Disease in Non-Depressed Subjects

    NARCIS (Netherlands)

    Richard, E.; Schmand, B.; Eikelenboom, P.; Yang, S. C.; Ligthart, S. A.; Moll van Charante, E. P.; van Gool, W. A.

    2012-01-01

    Background: Apathy is a common symptom in various neuropsychiatric diseases including mild cognitive impairment (MCI) and dementia. Apathy may be associated with an increased risk of cognitive decline. The objective of this study was to investigate if apathy predicts the progression from MCI to

  13. Digit span and verbal fluency tests in patients with mild cognitive impairment and normal subjects in Thai-community.

    Science.gov (United States)

    Muangpaisan, Weerasak; Intalapaporn, Somboon; Assantachai, Prasert

    2010-02-01

    Far too little attention has been paid to the difference of Digit Span test and category verbal fluency test (CVFT) between normal and mild cognitive impairment (MCI) subjects. To investigate the difference of Digit Span test and CVFT between normal subjects and patients with MCI and study the influence of age, gender, and education on the task performance. The authors collected data of 77 participants diagnosed with amnestic MCI (from 517 participants screened) and 30 normal subjects aged 50 or over enrolled from communities in Bangkok. The Digit Span test and CVFT (semantic fluency and Controlled word association test for letter fluency) were used to evaluate the subjects. MCI patients had significantly lower digit span score, in both Digits Forward and Digits Backward, poorer performance on semantic fluency for animals and fruits and letter fluency test. The logistic regression model of MCI diagnosis showed that only Digits Backward score was a predictor of MCI diagnosis (OR 0.643 for each increment of 1 digit, p = 0.009, 95% confidence interval 0.462-0.896). The cut-off point of Digit Backward score was 4 and yielded sensitivity of 77% and specificity of 57%. Females had lower scores than males in every test except semantic fluency for fruits. The digit span and semantic fluency scores decreased as age increased but letter fluency increased correspondently with age. The digit span and CVFT scores increased in parallel with the increase of education. MCI patients had poorer performance on the Digit Span and CVFT tests than normal age and education matched subjects. Digits Backward test can predict the MCI diagnosis. Age, gender and education have an impact on the performance of the tests.

  14. Arterial stiffness and cognitive impairment.

    Science.gov (United States)

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

    2017-09-15

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

  15. Kinetics of the Tau PET Tracer 18F-AV-1451 (T807) in Subjects with Normal Cognitive Function, Mild Cognitive Impairment, and Alzheimer Disease.

    Science.gov (United States)

    Shcherbinin, Sergey; Schwarz, Adam J; Joshi, Abhinay; Navitsky, Michael; Flitter, Matthew; Shankle, William R; Devous, Michael D; Mintun, Mark A

    2016-10-01

    We report kinetic modeling results of dynamic acquisition data from 0 to 100 min after injection with the tau PET tracer 18 F-AV-1451 in 19 subjects. Subjects were clinically diagnosed as 4 young cognitively normal, 5 old cognitively normal, 5 mild cognitive impairment, and 5 Alzheimer disease (AD). Kinetic modeling was performed using Logan graphical analysis with the cerebellum crus as a reference region. Voxelwise binding potential ([Formula: see text]) and SUV ratio ([Formula: see text]) images were compared. In AD subjects, slower and spatially nonuniform clearance from cortical regions was observed as compared with the controls, which led to focal uptake and elevated retention in the imaging data from 80 to 100 min after injection. BP from the dynamic data from 0 to 100 min correlated strongly (R 2 > 0.86) with corresponding regional [Formula: see text] values. In the putamen, the observed kinetics (positive [Formula: see text] at the tracer delivery stage and plateauing time-SUVR curves for all diagnostic categories) may suggest either additional off-target binding or a second binding site with different kinetics. The kinetics of the 18 F-AV-1451 tracer in cortical areas, as examined in this small group of subjects, differed by diagnostic stage. A delayed 80- to 100-min scan provided a reasonable substitute for a dynamic 0- to 100-min acquisition for cortical regions although other windows (e.g., 75-105 min) may be useful to evaluate. © 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

  16. Learning and error patterns in the Chinese Verbal Learning Test in subjects with mild cognitive impairment and normal elderly.

    Science.gov (United States)

    Chen, Nai-Ching; Lin, Yu-Ing; Chang, Chiung-Chih; Lin, Ker-Neng; Chuang, Yao-Chung; Chen, Ching; Tu, Ming-Chien; Wang, Pei-Ning

    2011-06-01

    The discrimination between normal elderly (NC) and those with mild cognitive impairment (MCI) is of clinical relevance since the conversion from MCI to Alzheimer dementia (AD) is high. This study enrolled 216 amnestic MCI patients and 103 NC from our memory clinics and assessed whether the learning curve, recall and cued scores, as well as error patterns from the Chinese Version Verbal Learning Test (CVVLT) helped to distinguish between these two groups. Our results revealed that subjects with MCI had a lower rate of acquisition and deceleration of learning in the learning curve. The MCI group also showed a lower retention rate and recall scores as compared with the NC group. Further, the error patterns offered discrimination values between the two groups in total number of perseverations, intrusion in the cued recall, as well as prototypic and unrelated errors in recognition. An inverse correlation was seen between memory scores and error patterns. This study suggests that by combining the learning and error patterns from the verbal memory test, patients with MCI can be better differentiated from normal elderly.

  17. Vascular cognitive impairment

    Directory of Open Access Journals (Sweden)

    N.V. Vakhnina

    2014-01-01

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

  18. MRI Volumetry of Hippocampus and Amygdala in Normal Aging, Mild Cognitive Impairment and Alzheimer's Disease Subjects

    International Nuclear Information System (INIS)

    Suphaphong, S.; Tritanon, O.; Laothamatas, J.; Sungkarat, W.

    2012-01-01

    The Alzheimer's disease (AD) and mild cognitive impairment (MCI) can affect memory and daily living. Non- invasive diagnostic tools such as MRI can be useful to discriminate the patients from normal group.This study aims to compare the relative volumes of hippocampus and amygdala, to suggest the relative normal volumes, and to evaluate MRI automatic volumetry as a diagnostic tool. The MRI images of 130 subjects were retrospectively studied (Turbo field echo (TFE), acquired with a 3-Tesla Philips scanner). The image data were processed with Free Surfer (automatic segmentation and volumetry). The resultant volumes were corrected for brain size differences with intracranial volumes (ICV), and then analysed with SPSS (v. 17.0). There are differences of hippocampus and amygdala relative volumes between normal, MCI, and AD subjects at p < 0.001. The volume reductions of hippocampus in MCI and AD groups compared to normal group are about 8 % and 28 %, while those of amygdala are about 10 % and 34 %, respectively. The relative volumes of hippocampus (compared to ICV) in normal aging are 0.002617 ± 0.000278 (right) and 0.002553 ± 0.000257 (left), while those of amygdala are 0.001231 ± 0.000165 (right) and 0.001096 ± 0.000144 (left). There are no differences of relative volumes affected by gender in normal, MCI, and AD. There is a highly significant difference of relative volume affected by brain side in normal group (p < 0.001) but not in MCI (p = 0.119 and 0.077) and AD (p = 0.713 and 0.250), for hippocampus and amygdala, respectively. These results demonstrate that there are volume losses of hippocampus and amygdala in both diseases. Automatically measured hippocampus and amygdala volumes can be used as a measure indicating MCI and AD. The abnormal disturbance of volume affected by brain side may indicate the progression of both diseases. The hippocampus and amygdala volumes can be used as one of diagnostic tools to confirm the diagnosis of MCI or AD. The volume

  19. Subjective Cognitive Impairment Is a Predominantly Benign Condition in Memory Clinic Patients Followed for 6 Years: The Gothenburg-Oslo MCI Study

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    Erik Hessen

    2017-02-01

    Full Text Available Background/Aims: In the quest for prevention or treatment, there is a need to find early markers for preclinical dementia. This study observed memory clinic patients with subjective cognitive impairment (SCI and normal cognitive function at baseline. The primary aim was to address SCI as a potential risk factor for cognitive decline. The secondary aim was to address a potential relation between (1 baseline cerebrospinal fluid biomarkers and (2 a decline in memory performance over the first 2 years of follow-up, with a possible cognitive decline after 6 years. Methods: Eighty-one patients (mean age 61 years were recruited from university memory clinics and followed up for 6 years. Results: Eighty-six percent of the cohort remained cognitively stable or improved, 9% developed mild cognitive impairment, and only 5% (n = 4 developed dementia. Regression analysis revealed that low levels of Aβ42 at baseline and memory decline during the first 2 years predicted dementia. When combined, these variables were associated with a 50% risk of developing dementia. Conclusions: Cognitive stability for 86% of the cohort suggests that SCI is predominantly a benign condition with regard to neuropathology. The low number of individuals who developed dementia limits the generalizability of the results and discussion of progression factors.

  20. Subjective Cognitive Impairment Is a Predominantly Benign Condition in Memory Clinic Patients Followed for 6 Years: The Gothenburg-Oslo MCI Study.

    Science.gov (United States)

    Hessen, Erik; Eckerström, Marie; Nordlund, Arto; Selseth Almdahl, Ina; Stålhammar, Jacob; Bjerke, Maria; Eckerström, Carl; Göthlin, Mattias; Fladby, Tormod; Reinvang, Ivar; Wallin, Anders

    2017-01-01

    In the quest for prevention or treatment, there is a need to find early markers for preclinical dementia. This study observed memory clinic patients with subjective cognitive impairment (SCI) and normal cognitive function at baseline. The primary aim was to address SCI as a potential risk factor for cognitive decline. The secondary aim was to address a potential relation between (1) baseline cerebrospinal fluid biomarkers and (2) a decline in memory performance over the first 2 years of follow-up, with a possible cognitive decline after 6 years. Eighty-one patients (mean age 61 years) were recruited from university memory clinics and followed up for 6 years. Eighty-six percent of the cohort remained cognitively stable or improved, 9% developed mild cognitive impairment, and only 5% ( n = 4) developed dementia. Regression analysis revealed that low levels of Aβ 42 at baseline and memory decline during the first 2 years predicted dementia. When combined, these variables were associated with a 50% risk of developing dementia. Cognitive stability for 86% of the cohort suggests that SCI is predominantly a benign condition with regard to neuropathology. The low number of individuals who developed dementia limits the generalizability of the results and discussion of progression factors.

  1. Mild cognitive impairment

    Directory of Open Access Journals (Sweden)

    Pavlović Dragan M.

    2009-01-01

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

  2. Cognitive impairment and pragmatics.

    Science.gov (United States)

    Gutiérrez-Rexach, Javier; Schatz, Sara

    2016-01-01

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

  3. Intracranial stenosis in cognitive impairment and dementia.

    Science.gov (United States)

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

    2017-06-01

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

  4. Changes in cognitive function and brain glucose metabolism in elderly women with subjective memory impairment: a 24-month prospective pilot study.

    Science.gov (United States)

    Jeong, H S; Park, J S; Song, I U; Chung, Y A; Rhie, S J

    2017-01-01

    Subjective memory impairment (SMI) may precede mild cognitive impairment (MCI) stage and would offer an earlier therapeutic opportunity than MCI would. However, it is not clear whether complaints of forgetfulness are truly reflective of objective memory dysfunction or of impairments in other cognitive domains. The aim of this current longitudinal study was to investigate changes in various cognitive functions and in regional cerebral metabolic rate of glucose (rCMRglc) among elderly women with SMI. Clinical evaluation, comprehensive neuropsychological test, and 18 F-fluoro-2-deoxyglucose positron emission tomography scans were conducted on 24 women with SMI at the baseline and 24-month follow-up. Changes in the cognitive domain scores and rCMRglc were assessed, and the relationships between them were analyzed. All participants stayed in SMI all the way till the follow-up, not converted to MCI or dementia. A significant reduction in executive function was found (mean difference in z-score: -0.21, P = 0.02) without changes in other cognitive domains. Declines in rCMRglc were detected in the left superior temporal gyrus, right posterior cingulate gyrus, left parahippocampal gyrus, right lingual gyrus, and right angular gyrus. The change in executive function had a positive correlation with the percent change of rCMRglc in the right posterior cingulate gyrus (β = 0.43, P = 0.02). Our findings suggest that elderly women with SMI symptoms should be carefully monitored for declines in executive function and related brain glucose metabolism over time. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Inhibition of indoleamine 2,3-dioxygenase prevented cognitive impairment in adult Wistar rats subjected to pneumococcal meningitis.

    Science.gov (United States)

    Barichello, Tatiana; Generoso, Jaqueline S; Simões, Lutiana R; Elias, Samuel G; Tashiro, Michael H; Dominguini, Diogo; Comim, Clarissa M; Vilela, Márcia Carvalho; Teixeira, Antonio Lucio; Quevedo, João

    2013-12-01

    Streptococcus pneumoniae is a common cause of forms of bacterial meningitis that have a high mortality rate and cause long-term neurologic sequelae. We evaluated the effects of an indoleamine 2,3-dioxygenase (IDO) inhibitor on proinflammatory mediators and memory in Wistar rats subjected to pneumococcal meningitis. The animals were divided into 4 groups: sham, sham treated with IDO inhibitor, meningitis, and meningitis treated with IDO inhibitor. During the first experiment, the animals were killed 24 hours later, and the hippocampus was isolated for the analysis of tumor necrosis factor (TNF)-α, interleukin (IL)-4, IL-6, IL-10, and cytokine-induced neutrophil chemoattractant 1 (CINC-1) levels. The survival rate was 56.296% in the meningitis group and 29.616% in the meningitis group with IDO inhibitor. In the control group, we found a mean of 14.29 white blood cells/mL cerebrospinal fluid, whereas the mean was 80.00 white blood cells/mL cerebrospinal fluid in the sham IDO inhibitor group, 1167.00 white blood cells/mL cerebrospinal fluid in the meningitis group, and 286.70 white blood cells/mL cerebrospinal fluid in the meningitis IDO inhibitor group. In the meningitis group with IDO inhibitor, the levels of TNF-α and CINC-1 were reduced. In the second experiment, animals were subjected to a behavioral task and cytokine analysis 10 days after meningitis induction. In the meningitis group, there was an impairment of aversive memory. However, in the meningitis group that received adjuvant treatment with the IDO inhibitor, animals demonstrated preservation of aversive memory. These findings showed dual effects of the IDO inhibitor on a pneumococcal meningitis animal model because the inhibitor impaired survival but also produced beneficial effects, including anti-inflammatory activity and neuroprotection against the latter behavioral deficits. Copyright © 2013 Mosby, Inc. All rights reserved.

  6. Nutrition and cognitive impairment

    Science.gov (United States)

    Hernando-Requejo, Virgilio

    2016-07-12

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

  7. The Subject in Cognitive Psychotherapy

    Directory of Open Access Journals (Sweden)

    Isabel Caro-Gabalda

    2015-05-01

    Full Text Available This paper discusses the various subjects embedded in cognitive psychotherapy. The cognitive model developed by Beck, considered as a rationalist and modernist model, will exemplify these subjects. Cognitive therapy should be placed in the modernist historical context and related to a subject characterized as having rationality and the ability to observe and detect cognitions, emotions and behaviors. The paper develops this background introducing three main subject types. The first is the introspective and conscious subject, who is able to observe what is within oneself, has free access, and is conscious of one's cognitive world. The second is the cognitive miser that describes the subject who enters into therapy. The final subject identified, is the trained scientist who is able to develop a more objective knowledge, changing faulty schemas and cognitive distortions. This subject is the one most looked for in cognitive therapy. We could connect these subjects to some of the main elements of cognitive therapy such as the concept of ABC, assessment procedures, cognitive techniques or the relevance of schemas. Finally, the paper suggests some issues for study that could contribute to the theoretical and clinical evolution of cognitive psychotherapy.

  8. Analysis of Grey Matter in Thalamus and Basal Ganglia Based on EEG α3/α2 Frequency Ratio Reveals Specific Changes in Subjects with Mild Cognitive Impairment

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    Davide V Moretti

    2012-11-01

    Full Text Available GM (grey matter changes of thalamus and basal ganglia have been demonstrated to be involved in AD (Alzheimer's disease. Moreover, the increase of a specific EEG (electroencephalogram marker, α3/α2, have been associated with AD-converters subjects with MCI (mild cognitive impairment. To study the association of prognostic EEG markers with specific GM changes of thalamus and basal ganglia in subjects with MCI to detect biomarkers (morpho-physiological early predictive of AD and non-AD dementia. Seventy-four adult subjects with MCI underwent EEG recording and high-resolution 3D MRI (three-dimensional magnetic resonance imaging. The α3/α2 ratio was computed for each subject. Three groups were obtained according to increasing tertile values of α3/α2 ratio. GM density differences between groups were investigated using a VBM (voxel-based morphometry technique. Subjects with higher α3/α2 ratios when compared with subjects with lower and middle α3/α2 ratios showed minor atrophy in the ventral stream of basal ganglia (head of caudate nuclei and accumbens nuclei bilaterally and of the pulvinar nuclei in the thalamus; The integrated analysis of EEG and morpho-structural markers could be useful in the comprehension of anatomo-physiological underpinning of the MCI entity.

  9. Cognitive and Learning Impairments

    Science.gov (United States)

    Lewis, Clayton

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

  10. 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

  11. Epigenetic treatments for cognitive impairments.

    Science.gov (United States)

    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.

  12. Examining Internet and eHealth Practices and Preferences: Survey Study of Australian Older Adults With Subjective Memory Complaints, Mild Cognitive Impairment, or Dementia.

    Science.gov (United States)

    LaMonica, Haley M; English, Amelia; Hickie, Ian B; Ip, Jerome; Ireland, Catriona; West, Stacey; Shaw, Tim; Mowszowski, Loren; Glozier, Nick; Duffy, Shantel; Gibson, Alice A; Naismith, Sharon L

    2017-10-25

    Interest in electronic health (eHealth) technologies to screen for and treat a variety of medical and mental health problems is growing exponentially. However, no studies to date have investigated the feasibility of using such e-tools for older adults with mild cognitive impairment (MCI) or dementia. The objective of this study was to describe patterns of Internet use, as well as interest in and preferences for eHealth technologies among older adults with varying degrees of cognitive impairment. A total of 221 participants (mean age=67.6 years) attending the Healthy Brain Ageing Clinic at the University of Sydney, a specialist mood and memory clinic for adults ≥50 years of age, underwent comprehensive clinical and neuropsychological assessment and completed a 20-item self-report survey investigating current technology use and interest in eHealth technologies. Descriptive statistics and Fisher exact tests were used to characterize the findings, including variability in the results based on demographic and diagnostic factors, with diagnoses including subjective cognitive impairment (SCI), MCI, and dementia. The sample comprised 27.6% (61/221) SCI, 62.0% (137/221) MCI, and 10.4% (23/221) dementia (mean Mini-Mental State Examination=28.2). The majority of participants reported using mobile phones (201/220, 91.4%) and computers (167/194, 86.1%) routinely, with most respondents having access to the Internet at home (204/220, 92.6%). Variability was evident in the use of computers, mobile phones, and health-related websites in relation to sociodemographic factors, with younger, employed respondents with higher levels of education being more likely to utilize these technologies. Whereas most respondents used email (196/217, 90.3%), the use of social media websites was relatively uncommon. The eHealth intervention of most interest to the broader sample was memory strategy training, with 82.7% (172/208) of participants reporting they would utilize this form of intervention

  13. Parkinson's Disease and Cognitive Impairment.

    Science.gov (United States)

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

    2016-01-01

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

  14. Patients With Very Mild Dementia May Confuse Objective Cognitive Impairments With Subjective Physical Health of Quality of Life: The Tome City Project in Japan

    Directory of Open Access Journals (Sweden)

    Mari Kasai

    2018-04-01

    Full Text Available Many elderly people with cognitive dysfunction may observe a decrease in their health levels and quality of life (QOL. The basic concept of QOL consists of several categories including physical functions and mental health. The QOL domain that is most important for elderly people is physical health and, to a lesser extent, psychological health, social relationships, and/ or the environment. Our aim was to explore the relationships between the subjective measure of QOL, an abbreviated version of the World Health Organization Quality of Life (WHOQOL-BREF scale, and the objective measure of impairment, Clinical Dementia Rating (CDR, among elderly people in a community. Totally, 178 community dwellers aged 75 years and above agreed to participate and completed the WHOQOL-BREF; 66 (32 males, 34 females scored a CDR of 0 (healthy, 86 (33, 53 scored a CDR of 0.5 (questionable dementia or very mild dementia, and 26 (12, 14 scored a CDR of 1 and above (dementia. According to Pearson’s correlation coefficient analysis (significance level, p < 0.05, the physical domain of the WHOQOL-BREF had significant statistical negative correlations with all CDR subscales. The CDR subscale of memory impairment had a significant statistical negative correlation with the WHOQOL-BREF subscales of the physical (r = -0.151, p = 0.044 and psychological (r = -0.232, p < 0.002 domains. The CDR subscale of home and hobbies impairment had significant statistical negative correlations with all WHOQOL-BREF subscales including the physical (r = -0.226, p = 0.002, psychological (r = -0.226, p = 0.002, social (r = -0.167, p = 0.026, and environmental (r = -0.204, p = 0.006 domains. Patients with very mild dementia may confuse cognitive impairment and physical disabilities. In the future, we need to systematically combine memory clinics and all departments related to the elderly for the successful early detection and rehabilitation of, and long-term care for, dementia.

  15. Cognitive impairment in Parkinson's disease

    Directory of Open Access Journals (Sweden)

    Jing YUAN

    2017-07-01

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

  16. Predicting Prodromal Alzheimer's Disease in Subjects with Mild Cognitive Impairment Using Machine Learning Classification of Multimodal Multicenter Diffusion-Tensor and Magnetic Resonance Imaging Data

    NARCIS (Netherlands)

    Dyrba, M.; Barkhof, F.; Fellgiebel, A.; Filippi, M.; Hausner, L.; Hauenstein, K.; Kirste, T.; Teipel, S.J

    2015-01-01

    BACKGROUND: Alzheimer's disease (AD) patients show early changes in white matter (WM) structural integrity. We studied the use of diffusion tensor imaging (DTI) in assessing WM alterations in the predementia stage of mild cognitive impairment (MCI). METHODS: We applied a Support Vector Machine (SVM)

  17. Optimizing power to track brain degeneration in Alzheimer's disease and mild cognitive impairment with tensor-based morphometry: an ADNI study of 515 subjects.

    Science.gov (United States)

    Hua, Xue; Lee, Suh; Yanovsky, Igor; Leow, Alex D; Chou, Yi-Yu; Ho, April J; Gutman, Boris; Toga, Arthur W; Jack, Clifford R; Bernstein, Matt A; Reiman, Eric M; Harvey, Danielle J; Kornak, John; Schuff, Norbert; Alexander, Gene E; Weiner, Michael W; Thompson, Paul M

    2009-12-01

    Tensor-based morphometry (TBM) is a powerful method to map the 3D profile of brain degeneration in Alzheimer's disease (AD) and mild cognitive impairment (MCI). We optimized a TBM-based image analysis method to determine what methodological factors, and which image-derived measures, maximize statistical power to track brain change. 3D maps, tracking rates of structural atrophy over time, were created from 1030 longitudinal brain MRI scans (1-year follow-up) of 104 AD patients (age: 75.7+/-7.2 years; MMSE: 23.3+/-1.8, at baseline), 254 amnestic MCI subjects (75.0+/-7.2 years; 27.0+/-1.8), and 157 healthy elderly subjects (75.9+/-5.1 years; 29.1+/-1.0), as part of the Alzheimer's Disease Neuroimaging Initiative (ADNI). To determine which TBM designs gave greatest statistical power, we compared different linear and nonlinear registration parameters (including different regularization functions), and different numerical summary measures derived from the maps. Detection power was greatly enhanced by summarizing changes in a statistically-defined region-of-interest (ROI) derived from an independent training sample of 22 AD patients. Effect sizes were compared using cumulative distribution function (CDF) plots and false discovery rate methods. In power analyses, the best method required only 48 AD and 88 MCI subjects to give 80% power to detect a 25% reduction in the mean annual change using a two-sided test (at alpha=0.05). This is a drastic sample size reduction relative to using clinical scores as outcome measures (619 AD/6797 MCI for the ADAS-Cog, and 408 AD/796 MCI for the Clinical Dementia Rating sum-of-boxes scores). TBM offers high statistical power to track brain changes in large, multi-site neuroimaging studies and clinical trials of AD.

  18. Optimizing power to track brain degeneration in Alzheimer’s disease and mild cognitive impairment with tensor-based morphometry: An ADNI study of 515 subjects

    Science.gov (United States)

    Hua, Xue; Lee, Suh; Yanovsky, Igor; Leow, Alex D.; Chou, Yi-Yu; Ho, April J.; Gutman, Boris; Toga, Arthur W.; Jack, Clifford R.; Bernstein, Matt A.; Reiman, Eric M.; Harvey, Danielle J.; Kornak, John; Schuff, Norbert; Alexander, Gene E.; Weiner, Michael W.; Thompson, Paul M.

    2010-01-01

    Tensor-based morphometry (TBM) is a powerful method to map the 3D profile of brain degeneration in Alzheimer’s disease (AD) and mild cognitive impairment (MCI). We optimized a TBM-based image analysis method to determine what methodological factors, and which image-derived measures, maximize statistical power to track brain change. 3D maps, tracking rates of structural atrophy over time, were created from 1030 longitudinal brain MRI scans (1-year follow-up) of 104 AD patients (age: 75.7 ± 7.2 years; MMSE: 23.3 ± 1.8, at baseline), 254 amnestic MCI subjects (75.0 ± 7.2 years; 27.0 ± 1.8), and 157 healthy elderly subjects (75.9 ± 5.1 years; 29.1 ± 1.0), as part of the Alzheimer’s Disease Neuroimaging Initiative (ADNI). To determine which TBM designs gave greatest statistical power, we compared different linear and nonlinear registration parameters (including different regularization functions), and different numerical summary measures derived from the maps. Detection power was greatly enhanced by summarizing changes in a statistically-defined region-of-interest (ROI) derived from an independent training sample of 22 AD patients. Effect sizes were compared using cumulative distribution function (CDF) plots and false discovery rate methods. In power analyses, the best method required only 48 AD and 88 MCI subjects to give 80% power to detect a 25% reduction in the mean annual change using a two-sided test (at α = 0.05). This is a drastic sample size reduction relative to using clinical scores as outcome measures (619 AD/6797 MCI for the ADAS-Cog, and 408 AD/796 MCI for the Clinical Dementia Rating sum-of-boxes scores). TBM offers high statistical power to track brain changes in large, multi-site neuroimaging studies and clinical trials of AD. PMID:19615450

  19. Prediction Model of Conversion to Dementia Risk in Subjects with Amnestic Mild Cognitive Impairment: A Longitudinal, Multi-Center Clinic-Based Study.

    Science.gov (United States)

    Jang, Hyemin; Ye, Byoung Seok; Woo, Sookyoung; Kim, Sun Woo; Chin, Juhee; Choi, Seong Hye; Jeong, Jee Hyang; Yoon, Soo Jin; Yoon, Bora; Park, Kyung Won; Hong, Yun Jeong; Kim, Hee Jin; Lockhart, Samuel N; Na, Duk L; Seo, Sang Won

    2017-01-01

    Patients with amnestic mild cognitive impairment (aMCI) have an increased risk of dementia. However, conversion rate varies. Therefore, predicting the dementia conversion in these patients is important. We aimed to develop a nomogram to predict dementia conversion in aMCI subjects using neuropsychological profiles. A total of 338 aMCI patients from two hospital-based cohorts were used in analysis. All patients were classified into 1) verbal, visual, or both, 2) early or late, and 3) single or multiple-domain aMCI according to the modality, severity of memory dysfunction, and multiplicity of involved cognitive domains, respectively. Patients were followed up, and conversion to dementia within 3 years was defined as the primary outcome. Our patients were divided into a training data set and a validation data set. The associations of potential covariates with outcome were tested, and nomogram was constructed by logistic regression model. We also developed another model with APOE data, which included 242 patients. In logistic regression models, both modalities compared with visual only (OR 4.44, 95% CI 1.83-10.75, p = 0.001), late compared to early (OR 2.59, 95% CI 1.17-5.72, p = 0.019), and multiple compared to single domain (OR 3.51, 95% CI 1.62-7.60, p = 0.002) aMCI were significantly associated with dementia conversion within 3 years. A nomogram incorporating these clinical variables was constructed on the training data set and validated on the validation data set. Both nomograms with and without APOE data showed good prediction performance (c-statistics ≥ 0.75). This study showed that several neuropsychological profiles of aMCI are significantly associated with imminent dementia conversion, and a nomogram incorporating these clinical subtypes is simple and useful to help to predict disease progression.

  20. Vascular cognitive impairment in dementia.

    Science.gov (United States)

    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.

  1. Prediction of Alzheimer’s disease in subjects with mild cognitive impairment from the ADNI cohort using patterns of cortical thinning

    Science.gov (United States)

    Eskildsen, Simon F.; Coupé, Pierrick; García-Lorenzo, Daniel; Fonov, Vladimir; Pruessner, Jens C.; Collins, D. Louis

    2014-01-01

    Predicting Alzheimer’s disease (AD) in individuals with some symptoms of cognitive decline may have great influence on treatment choice and disease progression. Structural magnetic resonance imaging (MRI) has the potential of revealing early signs of neurodegeneration in the human brain and may thus aid in predicting and diagnosing AD. Surface-based cortical thickness measurements from T1-weighted MRI have demonstrated high sensitivity to cortical gray matter changes. In this study we investigated the possibility for using patterns of cortical thickness measurements for predicting AD in subjects with mild cognitive impairment (MCI). We used a novel technique for identifying cortical regions potentially discriminative for separating individuals with MCI who progress to probable AD, from individuals with MCI who do not progress to probable AD. Specific patterns of atrophy were identified at four time periods before diagnosis of probable AD and features were selected as regions of interest within these patterns. The selected regions were used for cortical thickness measurements and applied in a classifier for testing the ability to predict AD at the four stages. In the validation, the test subjects were excluded from the feature selection to obtain unbiased results. The accuracy of the prediction improved as the time to conversion from MCI to AD decreased, from 70% at 3 years before the clinical criteria for AD was met, to 76% at 6 months before AD. By inclusion of test subjects in the feature selection process, the prediction accuracies were artificially inflated to a range of 73% to 81%. Two important results emerge from this study. First, prediction accuracies of conversion from MCI to AD can be improved by learning the atrophy patterns that are specific to the different stages of disease progression. This has the potential to guide the further development of imaging biomarkers in AD. Second, the results show that one needs to be careful when designing training

  2. Cognitive Impairment in Infratentorial Strokes

    Directory of Open Access Journals (Sweden)

    Melek Kandemir

    2009-12-01

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

  3. 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

  4. My mind is as clear as it used to be: A pilot study illustrating the difficulties of employing a single-item subjective screen to detect cognitive impairment in outpatients with cancer.

    Science.gov (United States)

    Kibiger, Gail; Kirsh, Kenneth L; Wall, Jacqueline R; Passik, Steven D

    2003-08-01

    Oncology patients often complain that their "mind does not seem to be clear." This subjective perception, sometimes referred to as "chemo brain," may be due to situational stressors, psychological disorders, organic factors, or effects of neurotoxic medications. Cognitive decline cannot only diminish quality of life, but can also interfere with a patient's ability to make decisions regarding complex treatment issues. The current study investigated the utility of using item 11 of the Zung Self-Rating Depression Screen (ZSDS) as a cognitive screen. A sample of 61 ambulatory cancer patients completed this study. Participants were recruited from four sites of Community Cancer Care, Inc., in Indiana. A battery of cognitive instruments and psychosocial inventories was administered in a standardized order. The sample had a mean age of 58.6 years and comprised 57.4% (n=35) women and 42.6% (n=26) men. Item 11 of the ZSDS was not significantly correlated to the cognitive measures. Correlates of the perception of cognitive impairment were the Dementia Rating Scale (DRS) Attention Scale (r=-0.26, PStroop test (F=19.8, Pspecificity indicated that the single-item screen used in this study is not an accurate means for identifying oncology patients with actual cognitive impairment. We conclude that while the perception of cognitive impairment is common in cancer patients, there may be problems in interpreting the nature of these complaints, particularly in separating them from depressive preoccupation.

  5. Cognitive Impairment in Heart Failure

    Directory of Open Access Journals (Sweden)

    Efthimios Dardiotis

    2012-01-01

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

  6. Cognitive impairment in Wilson's disease

    Directory of Open Access Journals (Sweden)

    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.

  7. 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.

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

    Science.gov (United States)

    Bora, Emre; Yener, Görsev G

    2017-07-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  10. Optimising screening for cognitive dysfunction in bipolar disorder: Validation and evaluation of objective and subjective tools

    DEFF Research Database (Denmark)

    Jensen, Johan Høy; Støttrup, Mette Marie; Nayberg, Emilie

    2015-01-01

    by correlation with established objective and subjective cognitive measures, and decision validity was determined with Receiver-Operating-Characteristic analyses. Correlations and linear regression analyses were conducted to determine the associations between objective and subjective cognitive impairment......Introduction Cognitive impairment is common in bipolar disorder and contributes to socio-occupational difficulties. The objective was to validate and evaluate instruments to screen for and monitor cognitive impairments, and improve the understanding of the association between cognitive measures...

  11. 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.

  12. 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.

  13. 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.

  14. Association of Lower Spiritual Well-Being, Social Support, Self-Esteem, Subjective Well-Being, Optimism and Hope Scores With Mild Cognitive Impairment and Mild Dementia.

    Science.gov (United States)

    Dos Santos, Sabrina B; Rocha, Gabrielli P; Fernandez, Liana L; de Padua, Analuiza C; Reppold, Caroline T

    2018-01-01

    Introduction: Positive psychology (PP) constructs contribute significantly to a better quality of life for people with various diseases. There are still few studies that have evaluated the evolution of these aspects during the progression of dementia. Objective: To compare the scores for self-esteem, life satisfaction, affect, spirituality, hope, optimism and perceived support network between elderly people with mild cognitive impairment (MCI), mild dementia and moderate dementia and control group. Methods: Cross-sectional study. The sample consisted of 66 healthy controls, 15 elderly people with MCI, 25 with mild dementia and 22 with moderate dementia matched by age, gender, and schooling. The instruments used were: Spirituality Self Rating Scale (SSRS), Rosenberg Self-Esteem Scale, Medical Outcomes Study's Social Support Scale, Life Satisfaction Scale (LSS), Positive and Negative Affect Schedule (PANAS), Revised Life Orientation Test (LOT-R), and Adult Dispositional Hope Scale (ADHS). Results: The scores for spiritual well-being, social support, self-esteem, life satisfaction, positive affect, optimism, negative affect, and hope differed significantly between the groups ( p social support, self-esteem, life satisfaction, positive affect, optimism and hope scores, and higher negative affect scores compared with the controls. The scores for PP constructs did not differ between the group of people with moderate dementia and the control group. Conclusion: Dementia was found to impact several PP constructs in the early stages of the disease. For individuals with greater cognitive impairment, anosognosia appears to suppress the disease's impact on these constructs.

  15. Cognitive impairment in COPD: a systematic review

    Directory of Open Access Journals (Sweden)

    Irene Torres-Sánchez

    2015-04-01

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

  16. 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.

  17. Current therapy for cognitive impairments

    Directory of Open Access Journals (Sweden)

    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.

  18. Arthritis and cognitive impairment in older adults.

    Science.gov (United States)

    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.

  19. Endocrine Risk Factors for Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    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.

  20. Association of Lower Spiritual Well-Being, Social Support, Self-Esteem, Subjective Well-Being, Optimism and Hope Scores With Mild Cognitive Impairment and Mild Dementia

    Directory of Open Access Journals (Sweden)

    Sabrina B. dos Santos

    2018-04-01

    Full Text Available Introduction: Positive psychology (PP constructs contribute significantly to a better quality of life for people with various diseases. There are still few studies that have evaluated the evolution of these aspects during the progression of dementia.Objective: To compare the scores for self-esteem, life satisfaction, affect, spirituality, hope, optimism and perceived support network between elderly people with mild cognitive impairment (MCI, mild dementia and moderate dementia and control group.Methods: Cross-sectional study. The sample consisted of 66 healthy controls, 15 elderly people with MCI, 25 with mild dementia and 22 with moderate dementia matched by age, gender, and schooling. The instruments used were: Spirituality Self Rating Scale (SSRS, Rosenberg Self-Esteem Scale, Medical Outcomes Study’s Social Support Scale, Life Satisfaction Scale (LSS, Positive and Negative Affect Schedule (PANAS, Revised Life Orientation Test (LOT-R, and Adult Dispositional Hope Scale (ADHS.Results: The scores for spiritual well-being, social support, self-esteem, life satisfaction, positive affect, optimism, negative affect, and hope differed significantly between the groups (p < 0.05. The individuals with MCI and mild dementia had lower spiritual well-being, social support, self-esteem, life satisfaction, positive affect, optimism and hope scores, and higher negative affect scores compared with the controls. The scores for PP constructs did not differ between the group of people with moderate dementia and the control group.Conclusion: Dementia was found to impact several PP constructs in the early stages of the disease. For individuals with greater cognitive impairment, anosognosia appears to suppress the disease’s impact on these constructs.

  1. 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...

  2. Does subjective sleep affect cognitive function in healthy elderly subjects? The Proof cohort.

    Science.gov (United States)

    Saint Martin, Magali; Sforza, Emilia; Barthélémy, Jean Claude; Thomas-Anterion, Catherine; Roche, Frédéric

    2012-10-01

    Some epidemiological data are available on the association between sleep duration and sleep quality, sleep complaints, and the aging related cognitive impairment in the elderly. In this study we examined a large sample of healthy elderly subjects to assess the relationship between sleep quality, subjective cognitive complaints, and neuropsychological performance. A total of 272 elderly subjects (mean age 74.8 ± 1.1 years) were recruited from a population-based cross-sectional study on aging and cardiovascular morbidity. All subjects filled in self-assessment questionnaires evaluating cognitive function, anxiety, depression, sleep-related parameters, and the Pittsburgh Sleep Quality Index (PSQI). Ambulatory polygraphy and extensive neuropsychological tests were also performed. Based on the total PSQI score, subjects were classified as good sleepers (GS, PSQIsleep did not affect the subjective cognitive function score, subjective cognitive impairment being mainly related to anxiety, depression, and sleep medication intake. No significant differences were seen between GS and PS in any of the objective cognitive function tests except for the Trail Making Test A (TMA-A), processing speed being longer in the PS group (psleep-related breathing disorders nor gender affected cognitive performance. Our results suggest that in healthy elderly subjects, subjective sleep quality and duration did not significantly affect subjective and objective cognitive performances, except the attention level, for that the interference of sleep medication should be considered. Copyright © 2012 Elsevier B.V. All rights reserved.

  3. 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.

  4. Social Cognition in Children with Visual Impairments.

    Science.gov (United States)

    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…

  5. 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

  6. 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

  7. 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.

  8. 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.

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

    Science.gov (United States)

    Ramos Cordero, Primitivo; Yubero, Raquel

    2016-06-01

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

  10. Cognitive impairment in multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Kutashov V.A.

    2016-06-01

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

  11. 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.

  12. Subjective cognitive decline: The first clinical manifestation of Alzheimer's disease?

    Directory of Open Access Journals (Sweden)

    Adalberto Studart Neto

    Full Text Available ABSTRACT Background: Mild cognitive impairment is considered as the first clinical manifestation of Alzheimer's disease (AD, when the individual exhibits below performance on standardized neuropsychological tests. However, some subjects before having a lower performance on cognitive assessments already have a subjective memory complaint. Objective: A review about subjective cognitive decline, the association with AD biomarkers and risk of conversion to dementia. Methods: We performed a comprehensive non-systematic review on PubMed. The keywords used in the search were terms related to subjective cognitive decline. Results: Subjective cognitive decline is characterized by self-experience of deterioration in cognitive performance not detected objectively through formal neuropsychological testing. However, various terms and definitions have been used in the literature and the lack of a widely accepted concept hampers comparison of studies. Epidemiological data have shown that individuals with subjective cognitive decline are at increased risk of progression to AD dementia. In addition, there is evidence that this group has a higher prevalence of positive biomarkers for amyloidosis and neurodegeneration. However, Alzheimer's disease is not the only cause of subjective cognitive decline and various other conditions can be associated with subjective memory complaints, such as psychiatric disorders or normal aging. The features suggestive of a neurodegenerative disorder are: onset of decline within the last five years, age at onset above 60 years, associated concerns about decline and confirmation by an informant. Conclusion: These findings support the idea that subjective cognitive complaints may be an early clinical marker that precedes mild cognitive impairment due to Alzheimer's disease.

  13. 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.

  14. 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.

  15. 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.

  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 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.

  18. 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.

  19. 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...

  20. 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

  1. 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.

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

    Czech Academy of Sciences Publication Activity Database

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

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

  3. Extended Cognitive System and Epistemic Subject

    Directory of Open Access Journals (Sweden)

    Trybulec Barbara

    2015-03-01

    Full Text Available The concept of an extended cognitive system is central to contemporary studies of cognition. In the paper I analyze the place of the epistemic subject within the extended cognitive system. Is it extended as well? In answering this question I focus on the differences between the first and the second wave of arguments for the extended mind thesis. I argue that the position of Cognitive Integration represented by Richard Menary is much more intuitive and fruitful in analyses of cognition and knowledge than the early argument formulated by Andy Clark and David Chalmers. Cognitive Integration is compatible with virtue epistemology of John Greco’s agent reliabilism. The epistemic subject is constituted by its cognitive character composed of an integrated set of cognitive abilities and processes. Some of these processes are extended, they are a manipulation of external informational structures and, as such, they constitute epistemic practices. Epistemic practices are normative; to conduct them correctly the epistemic subject needs to obey epistemic norms embedded in the cultural context. The epistemic subject is not extended because of the casual coupling with external informational artifacts which extend his mind from inside the head and into the world. Rather, cognitive practices constitute the subject’s mind, they transform his cognitive abilities, and this is what makes the mind and epistemic subject “extended”.

  4. 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...

  5. 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.

  6. 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...

  7. 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.

  8. A Link between Subjective Perceptions of Memory and Physical Function: Implications for Subjective Cognitive Decline.

    Science.gov (United States)

    Cosentino, Stephanie; Devanand, Davangere; Gurland, Barry

    2018-01-01

    Subjective impairment in memory is a frequently defining feature of subjective cognitive decline (SCD), a state hypothesized to precede objectively apparent cognitive symptoms of Alzheimer's disease (AD) and to hold promise as a non-invasive, inexpensive, preclinical indicator of AD. However, a full model of the factors that contribute to subjective memory (SM), and therefore to SCD, has yet to be articulated. While SM impairment is widely known to be associated with negative affect, the extent to which SM functioning may also reflect other factors, particularly subjective beliefs or perceptions about one's health, is not known. To examine the extent to which SM is associated with subjective perceptions of health more broadly, the current study investigated the link between SM and subjective physical functioning (independent of depressive affect, and objective cognitive and physical function) in an ethnically diverse sample of 471 older adults enrolled in the population-based Northern Manhattan Aging Project. 199 (42%) participants endorsed no difficulty on a 5-point SM index while 272 (58%) endorsed some degree of difficulty. As hypothesized, SM correlated with both depression and subjective physical function, but not with age, education, global cognition, or objective physical function. When objective and subjective physical function were entered in two separate, adjusted linear regressions predicting SM, only subjective physical function and depressive affect independently predicted SM. Subjective perceptions of memory appear to reflect individuals' broader health perceptions in part. Articulating the various correlates of SM will improve identification of SCD specific to preclinical AD.

  9. 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.

  10. 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

  11. 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

  12. 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.

  13. Pilot feasibility and safety study examining the effect of medium chain triglyceride supplementation in subjects with mild cognitive impairment: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Candida J. Rebello

    2015-06-01

    Conclusions: Consumption of 56 g/day of MCTs for 24 weeks increases serum ketone concentrations and appears to be a candidate for larger randomized control trials in the future that quantify the modulation of cognitive function through supplementation with ketone precursors, in patients with MCI.

  14. 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.

  15. 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.

  16. Impaired Cardiac Function and Cognitive Brain Aging.

    Science.gov (United States)

    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. 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.

  18. 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.)

  19. 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.

  20. Cognitive impairment in elderly women

    DEFF Research Database (Denmark)

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

    2006-01-01

    a modified version of the Blessed test. Participants were also subjected to a general clinical examination and they were interviewed to collect information on lifestyle practices and comorbid disorders. Genotypes for the apolipoprotein E (APOE) epsilon4, catechol-O-methyltransferase (COMT) Val/Met, and brain...

  1. 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.

  2. 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.

  3. 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

  4. 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.

  5. 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.

  6. 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…

  7. 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

  8. 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.

  9. Subjective cognitive decline and fall risk in community-dwelling older adults with or without objective cognitive decline.

    Science.gov (United States)

    Shirooka, Hidehiko; Nishiguchi, Shu; Fukutani, Naoto; Tashiro, Yuto; Nozaki, Yuma; Aoyama, Tomoki

    2017-07-19

    The association between subjective cognitive decline and falls has not been clearly determined. Our aim was to explore the effect of subjective cognitive decline on falls in community-dwelling older adults with or without objective cognitive decline. We included 470 older adults (mean age 73.6 ± 5.2; 329 women) living in the community and obtained data on fall history directly from the participants. Subjective cognitive decline was assessed using a self-administered question. Objective cognitive function was measured using the Mini-Mental State Examination. Statistical analyses were carried out separately for participants with objective cognitive decline and those without. A multiple logistic regression analysis showed that, among participants without objective cognitive decline, subjective cognitive decline was positively associated with falls [OR 1.91; 95% confidence interval (CI) 1.17-3.12; p = 0.01). Conversely, among participants with objective cognitive decline, subjective cognitive decline was negatively associated with falls (OR 0.07; 95% CI 0.01-0.85, p = 0.04). The result suggests that the objective-subjective disparity may affect falls in community-dwelling older adults. The presence of subjective cognitive decline was significantly positively associated with falls among cognitively intact older adults. However, among their cognitively impaired peers, the absence of subjective cognitive decline was positively associated with falls.

  10. 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

  11. 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

  12. 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

  13. 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.

  14. 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

  15. 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

  16. 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

  17. Head-to-head comparison of 11C-PiB and 18F-FC119S for Aβ imaging in healthy subjects, mild cognitive impairment patients, and Alzheimer's disease patients.

    Science.gov (United States)

    Byun, Byung Hyun; Kim, Byung Il; Park, Su Yeon; Ko, In Ok; Lee, Kyo Chul; Kim, Kyeong Min; Kim, Yu Kyeong; Lee, Jun-Young; Bu, Seon Hee; Kim, Jung Hwa; Chi, Dae Yoon; Ha, Jeong Ho; Lim, Sang Moo

    2017-03-01

    As a new beta amyloid (Aβ) positron emission tomography (PET) tracer, F-FC119S has shown higher cortical uptake in patients with Alzheimer's disease (AD) than that in healthy control subjects without adverse effects in a previous preliminary study. The aim of this study was to compare F-FC119S PET and C-PiB PET in healthy control (HC) subjects, mild cognitive impairment (MCI) patients, and AD patients.A total of 48 subjects, including 28 HC subjects, 10 MCI patients, and 10 AD patients, underwent static F-FC119S PET (30 minutes after intravenous [i.v.] injection) and C-PiB PET (40 minutes after i.v. injection) on the same day. Both PET images were visually and quantitatively assessed. Standardized uptake value ratios (SUVRs) were calculated for each brain region using the cerebellar cortex as a reference region.None (0%) of the 28 HC subjects and 4 (40%) of 10 MCI patients had positive scans on both PET images. Of the 10 AD patients, 7 (70%) had positive scans on C-PiB PET while 6 (60%) had positive scans on F-FC119S PET. Overall, 47 (98%) of 48 participants showed identical results based on visual analysis. Cortical SUVR of F-FC119S was higher in AD patients (1.38 ± 0.16), followed by that in MCI patients (1.24 ± 0.10) and in HC subjects (1.14 ± 0.05). Compared with C-PiB PET, F-FC119S PET yielded a higher effect size (d = 2.02 vs. 1.67) in AD patients and a slightly lower effect size (d = 1.26 vs. 1.38) in MCI patients. In HC subjects, the nonspecific binding of F-FC119S to white matter (with the frontal cortex-to-white matter SUV ratio of 0.76) was slightly lower than that of C-PiB (ratio of 0.73). There was a significant linear correlation (slope = 0.41, r = 0.78, P PiB and F-FC119S cortical SUVR.We could safely obtain images similar to C-PiB PET imaging Aβ in the brain using F-FC119S PET. Therefore, F-FC119S might be suitable for imaging Aβ deposition.

  18. 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.

  19. 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.

  20. 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

  1. 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.

  2. 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.

  3. 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.

  4. 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.

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

    Directory of Open Access Journals (Sweden)

    Juliana Yumi Tizon Kasai

    2010-03-01

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

  6. 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

  7. Aging, mobility impairments and subjective wellbeing.

    Science.gov (United States)

    Freedman, Vicki A; Carr, Deborah; Cornman, Jennifer C; Lucas, Richard E

    2017-10-01

    Wellbeing is often described as U-shaped over the life course, suggesting an apparent paradox that wellbeing remains high at older ages despite increases in impairments. We explore associations among age, lower body impairments-one of the most common late-life impairments-and three measures of wellbeing: life satisfaction, emotional wellbeing and somatic wellbeing. We hypothesize that age effects are positive, become stronger once lower body impairments are controlled, and are concentrated among those who have maintained their mobility. Net of confounding factors, we hypothesize that lower body impairments are associated with worse wellbeing and these effects diminish with advancing age. We analyze the 2013 Disability and Use of Time supplement to the Panel Study of Income Dynamics (N = 1607 adults ages 60 and older). We estimate nested regression models that include age, severity of lower body impairments and confounding demographic, psychological, and socioeconomic factors and activities; test age-impairment interactions; and estimate age- and impairment-stratified models. Positive age effects were observed after controlling for lower body impairments for life satisfaction (β = 0.90; p wellbeing, adjusted age effects were negative (β = -0.05; p wellbeing in adjusted models. These effects were strongest for somatic wellbeing, especially for 65-74 year olds. Our study challenges the notion that wellbeing is U-shaped throughout the life course and underscores the critical role of mobility across wellbeing domains in later life. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  10. 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.

  11. 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 ...

  12. 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.

  13. 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.

  14. The Walking Trail-Making Test is an early detection tool for mild cognitive impairment.

    Science.gov (United States)

    Perrochon, Anaick; Kemoun, Gilles

    2014-01-01

    Executive function impairment (in particular, mental flexibility) in the elderly, and in patients with mild cognitive impairment (MCI), is strongly correlated with difficulties in performing complex walking tasks. The aim of this study was to determine if the adaptation of a neuropsychological test (the Trail-Making Test), to evaluate executive functions during walking, can be an early detection tool for cognitive impairment. Fifty subjects (15 young, 20 older, presumably healthy, and 15 MCI) were first evaluated for cognitive functions (Mini-Mental State Examination, Frontal Assessment Battery, and Trail-Making Test) and motor functions (10-meter walking test). All subjects then performed a spatial navigation, or a complex walking test (the Walking Trail-Making Test: [WTMT]), and their spatiotemporal walking variables were analyzed using cluster analysis. Following evaluation of WTMT locomotor performance, cluster analysis revealed three groups that were distinctly different in age and cognitive abiliTIES: a group of young subjects, a group of healthy older subjects, MCI subjects with amnestic impairment, and a group of MCI subjects with executive function impairment. The WTMT enabled early detection, (ie, borderline MCI) of dysexecutive impairment, with 78% sensitivity and 90% specificity. The WTMT is of interest in that it can help provide early detection of dysexecutive cognitive impairment.

  15. 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.

  16. Specific subjective memory complaints in older persons may indicate poor cognitive function.

    Science.gov (United States)

    Amariglio, Rebecca England; Townsend, Mary K; Grodstein, Francine; Sperling, Reisa A; Rentz, Dorene M

    2011-09-01

    To examine the association between the type and number of subjective memory complaints (SMCs) and performance on objective cognitive tests. Cross-sectional. Nurses' Health Study. Sixteen thousand nine hundred sixty-four women (mean age 74) who provided information on SMCs. Telephone cognitive assessments and seven questions regarding SMCs were administered. Cognitive impairment was defined as a score of less than 31 on the Telephone Interview for Cognitive Status (TICS) and below the 10th percentile on other cognitive measures. To assess associations with SMCs, multivariable logistic regression was used to calculate odds ratios for cognitive impairment and multivariable linear regression to calculate mean differences in cognitive test scores, adjusting for age and depressive symptoms. Some SMCs, such as trouble following a group conversation or finding one's way around familiar streets, were more highly associated than others with odds of cognitive impairment. The complaint of forgetting things from one second to the next, generally considered part of normal aging, was not associated with cognitive impairment. In addition, there were strong, linear trends of increasingly worse scores on cognitive tests with increasing numbers of memory complaints. For each additional SMC endorsed, the odds of cognitive impairment increased approximately 20% when each SMC was weighted equally. SMCs are associated with objective cognitive status and may be considered by primary care physicians in determining whether follow-up is warranted. © 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.

  17. Implementation of Subjective Cognitive Decline criteria in research studies

    Science.gov (United States)

    Molinuevo, José L; Rabin, Laura A.; Amariglio, Rebecca; Buckley, Rachel; Dubois, Bruno; Ellis, Kathryn A.; Ewers, Michael; Hampel, Harald; Klöppel, Stefan; Rami, Lorena; Reisberg, Barry; Saykin, Andrew J.; Sikkes, Sietske; Smart, Colette M.; Snitz, Beth E.; Sperling, Reisa; van der Flier, Wiesje M.; Wagner, Michael; Jessen, Frank

    2017-01-01

    INTRODUCTION Subjective Cognitive Decline (SCD) manifesting prior to clinical impairment could serve as a target population for early intervention trials in Alzheimer’s disease (AD). A working group, the Subjective Cognitive Decline Initiative (SCD-I), published SCD research criteria in the context of preclinical AD. To successfully apply them, a number of issues regarding assessment and implementation of SCD needed to be addressed. METHODS Members of the SCD-I met to identify and agree upon topics relevant to SCD criteria operationalization in research settings. Initial ideas and recommendations were discussed with other SCD-I working group members and modified accordingly. RESULTS Topics included SCD inclusion and exclusion criteria, together with the informant’s role in defining SCD presence and the impact of demographic factors. DISCUSSION Recommendations for the operationalization of SCD in differing research settings, with the aim of harmonization of SCD measurement across studies are proposed, to enhance comparability and generalizability across studies. PMID:27825022

  18. 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...

  19. 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

  20. The Use of Multi-Criteria Decision Analysis Weight Elicitation Techniques in Patients with Mild Cognitive Impairment

    NARCIS (Netherlands)

    van Til, Janine Astrid; Dolan, James G.; Stiggelbout, Anne M.; Groothuis-Oudshoorn, Catharina Gerarda Maria; IJzerman, Maarten Joost

    2008-01-01

    Objective: To test the applicability of multi-criteria decision analysis preference elicitation techniques in cognitively impaired individuals. - Method: A convenience sample of 16 cognitively impaired subjects and 12 healthy controls was asked to participate in a small pilot study. The subjects

  1. The Use of Multi-Criteria Decision Analysis Weight Elicitation Techniques in Patients with Mild Cognitive Impairment : A Pilot Study

    NARCIS (Netherlands)

    van Til, Janine A.; Dolan, James G.; Stiggelbout, Anne M.; Groothuis, Karin C.G.M.; IJzerman, Maarten J.

    2008-01-01

    Objective: To test the applicability of multi-criteria decision analysis preference elicitation techniques in cognitively impaired individuals. Method: A convenience sample of 16 cognitively impaired subjects and 12 healthy controls was asked to participate in a small pilot study. The subjects

  2. 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

  3. [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

  4. 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,

  5. 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.

  6. 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.

  7. 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

  8. 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....

  9. 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.

  10. 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

  11. 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.

  12. [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.

  13. Pharmacokinetics of tedizolid in subjects with renal or hepatic impairment.

    Science.gov (United States)

    Flanagan, S; Minassian, S L; Morris, D; Ponnuraj, R; Marbury, T C; Alcorn, H W; Fang, E; Prokocimer, P

    2014-11-01

    Two open-label, single-dose, parallel-group studies were conducted to characterize the pharmacokinetics of the novel antibacterial tedizolid and the safety of tedizolid phosphate, its prodrug, in renally or hepatically impaired subjects. Tedizolid pharmacokinetics in subjects with severe renal impairment without dialysis support was compared with that of matched control subjects with normal renal function. Effects of hemodialysis on tedizolid pharmacokinetics were determined in a separate cohort of subjects undergoing long-term hemodialysis. Effects of hepatic impairment on tedizolid pharmacokinetics were determined in subjects with moderate or severe hepatic impairment and compared with those of matched control subjects with normal hepatic function. Each participant received a single oral (hepatic impairment) or intravenous (renal impairment) dose of tedizolid phosphate at 200 mg; hemodialysis subjects received two doses (separated by 7 days), before and after dialysis, in a crossover fashion. The pharmacokinetics of tedizolid was similar in subjects with severe renal impairment and controls (∼8% lower area under the concentration-time curve [AUC], with a nearly identical peak concentration) and in subjects undergoing hemodialysis before and after tedizolid phosphate administration (∼9% lower AUC, with a 15% higher peak concentration); Tedizolid pharmacokinetics was only minimally altered in subjects with moderate or severe hepatic impairment; the AUC was increased approximately 22% and 34%, respectively, compared with that of subjects in the control group. Tedizolid phosphate was generally well tolerated in all participants. These results suggest that tedizolid phosphate dose adjustments are not necessary in patients with any degree of renal or hepatic impairment. (This study has been registered at ClinicalTrials.gov under registration numbers NCT01452828 [renal study] and NCT01431833 [hepatic study].). Copyright © 2014, American Society for Microbiology

  14. 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.

  15. Assessment of subjective and objective cognitive function in bipolar disorder

    DEFF Research Database (Denmark)

    Demant, Kirsa M; Vinberg, Maj; Kessing, Lars V

    2015-01-01

    Cognitive dysfunction is prevalent in bipolar disorder (BD). However, the evidence regarding the association between subjective cognitive complaints, objective cognitive performance and psychosocial function is sparse and inconsistent. Seventy seven patients with bipolar disorder who presented...

  16. Behavioral symptoms in mild cognitive impairment as compared with Alzheimer's disease and healthy older adults

    NARCIS (Netherlands)

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

    BACKGROUND: Mild cognitive impairment (MCI) is a clinical concept that categorizes subjects who are in an intermediate cognitive state between normal aging and dementia. The aim of this study is to characterize behavior in MCI compared with Alzheimer's disease (AD) and healthy older patients.

  17. 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

  18. COPD and cognitive impairment: the role of hypoxemia and oxygen therapy

    Directory of Open Access Journals (Sweden)

    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

  19. 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…

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

    DEFF Research Database (Denmark)

    Vogel, Asmus; Stokholm, Jette; Gade, Anders

    2004-01-01

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

  1. 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…

  2. 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 ...

  3. Severe carotid stenosis and impaired cerebral hemodynamics can influence cognitive deterioration.

    Science.gov (United States)

    Balestrini, Simona; Perozzi, Cecilia; Altamura, Claudia; Vernieri, Fabrizio; Luzzi, Simona; Bartolini, Marco; Provinciali, Leandro; Silvestrini, Mauro

    2013-06-04

    To evaluate whether severe carotid stenosis and related hemodynamics impairment may increase the risk of cognitive deterioration in asymptomatic subjects. A total of 210 subjects with unilateral asymptomatic severe carotid stenosis and 109 healthy controls were included and prospectively evaluated for a 36-month period. At entry, demographics, vascular risk profile, and pharmacologic treatments were defined. Cerebral hemodynamics was assessed by transcranial Doppler-based breath-holding index (BHI) test. Cognitive status was evaluated with the Mini-Mental State Examination (MMSE) at entry and at the end of the follow-up period. Cognitive deterioration was defined as a decrease in the MMSE score of 3 points or more during the overall follow-up period. Subjects with carotid stenosis showed an increased probability of developing cognitive deterioration compared with the group without stenosis (odds ratio [OR] 4.16 [95% confidence interval (CI) 1.89-9.11]; p < 0.001). The presence of an impaired BHI ipsilateral to the stenosis was associated with an increased incidence of reduction in cognitive performance (OR 14.66 [95% CI 7.51-28.59]; p < 0.001). Our findings show that the presence of a severe carotid stenosis influences cognitive deterioration over a 36-month period in asymptomatic subjects. An associated hemodynamic impairment significantly increases the risk. Evaluation of functional consequences of carotid stenosis may offer the opportunity to select a group with an increased risk of developing cognitive impairment from subjects with asymptomatic severe carotid stenosis.

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

    Directory of Open Access Journals (Sweden)

    Jeffrey R Petrella

    2007-10-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  7. 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.

  8. 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.

  9. The Walking Trail-Making Test is an early detection tool for mild cognitive impairment

    Directory of Open Access Journals (Sweden)

    Perrochon A

    2014-01-01

    Full Text Available Anaick Perrochon, Gilles Kemoun Laboratoire Mobilité, Vieillissement, Exercice (MOVE, EA 6314, Faculté des Sciences du Sport, Université de Poitiers, 8 Allée Jean Monnet, 86000 Poitiers, France; ISIS, Research Institute on Handicap and Aging, Paris, France Background: Executive function impairment (in particular, mental flexibility in the elderly, and in patients with mild cognitive impairment (MCI, is strongly correlated with difficulties in performing complex walking tasks. The aim of this study was to determine if the adaptation of a neuropsychological test (the Trail-Making Test, to evaluate executive functions during walking, can be an early detection tool for cognitive impairment. Methods: Fifty subjects (15 young, 20 older, presumably healthy, and 15 MCI were first evaluated for cognitive functions (Mini-Mental State Examination, Frontal Assessment Battery, and Trail-Making Test and motor functions (10-meter walking test. All subjects then performed a spatial navigation, or a complex walking test (the Walking Trail-Making Test: [WTMT], and their spatiotemporal walking variables were analyzed using cluster analysis. Results: Following evaluation of WTMT locomotor performance, cluster analysis revealed three groups that were distinctly different in age and cognitive abilities: a group of young subjects, a group of healthy older subjects, MCI subjects with amnestic impairment, and a group of MCI subjects with executive function impairment. The WTMT enabled early detection, (ie, borderline MCI of dysexecutive impairment, with 78% sensitivity and 90% specificity. Conclusion: The WTMT is of interest in that it can help provide early detection of dysexecutive cognitive impairment. Keywords: spatial navigation, walking, trail making test, detection, mild cognitive impairment

  10. 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.

  11. 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.

  12. [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

  13. 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...

  14. Increased prolactin levels are associated with impaired processing speed in subjects with early psychosis.

    Directory of Open Access Journals (Sweden)

    Itziar Montalvo

    Full Text Available Hyperprolactinaemia, a common side effect of some antipsychotic drugs, is also present in drug-naïve psychotic patients and subjects at risk for psychosis. Recent studies in non-psychiatric populations suggest that increased prolactin may have negative effects on cognition. The aim of our study was to explore whether high plasma prolactin levels are associated with poorer cognitive functioning in subjects with early psychoses. We studied 107 participants: 29 healthy subjects and 78 subjects with an early psychosis (55 psychotic disorders with <3 years of illness, 23 high-risk subjects. Cognitive assessment was performed with the MATRICS Cognitive Consensus Cognitive Battery, and prolactin levels were determined as well as total cortisol levels in plasma. Psychopathological status was assessed and the use of psychopharmacological treatments (antipsychotics, antidepressants, benzodiazepines recorded. Prolactin levels were negatively associated with cognitive performance in processing speed, in patients with a psychotic disorder and high-risk subjects. In the latter group, increased prolactin levels were also associated with impaired reasoning and problem solving and poorer general cognition. In a multiple linear regression analysis conducted in both high-risk and psychotic patients, controlling for potential confounders, prolactin and benzodiazepines were independently related to poorer cognitive performance in the speed of processing domain. A mediation analysis showed that both prolactin and benzodiazepine treatment act as mediators of the relationship between risperidone/paliperidone treatment and speed of processing. These results suggest that increased prolactin levels are associated with impaired processing speed in early psychosis. If these results are confirmed in future studies, strategies targeting reduction of prolactin levels may improve cognition in this population.

  15. 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

  16. 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.

  17. 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.

  18. Divergent Roles of Vascular Burden and Neurodegeneration in the Cognitive Decline of Geriatric Depression Patients and Mild Cognitive Impairment Patients.

    Science.gov (United States)

    Ye, Qing; Su, Fan; Gong, Liang; Shu, Hao; Liao, Wenxiang; Xie, Chunming; Zhou, Hong; Zhang, Zhijun; Bai, Feng

    2017-01-01

    Both geriatric depression and mild cognitive impairment (MCI) confer an increased risk for the development of dementia. The mechanisms underlying the development of cognitive impairment in geriatric depression patients remain controversial. The present study aimed to explore the association of cognitive decline with vascular risk, white matter hyperintensity (WMH) burden and hippocampal volume in both remitted geriatric depression (RGD) subjects and amnestic mild cognitive impairment (aMCI) subjects. Forty-one RGD subjects, 51 aMCI subjects, and 64 healthy elderly subjects underwent multimodal MRI scans and neuropsychological tests at both baseline and a 35-month follow-up. According to the changing patterns (declining or stable) of global cognitive function during the follow-up period, each group was further divided into a declining subgroup and a stable subgroup. The Framingham 10-year cardiovascular risk, WMH volume and hippocampal volume were measured to assess vascular pathology and neurodegeneration, respectively. The RGD declining group displayed a higher vascular risk and greater WMH volume than the RGD stable group, whereas no such difference was found in the aMCI subjects. In contrast, the aMCI declining group displayed a smaller left hippocampal volume than the aMCI stable group, whereas no such difference was found in the RGD subjects. Furthermore, greater increases in the WHM volume correlated with greater decreases in global cognitive function in the RGD declining group, and greater decreases in the left hippocampal volume correlated with greater decreases in global cognitive function in the aMCI declining group. In conclusion, the cognitive decline in RGD patients is associated with vascular burden, whereas the cognitive decline in aMCI patients is associated with neurodegeneration. These findings could contribute to a better understanding of the specific mechanisms of the development of dementia in each condition.

  19. 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.

  20. Association between sleep quality and cognitive impairment among Chinese nonagenarians/centenarians.

    Science.gov (United States)

    Chang-Quan, Huang; Bi-Rong, Dong; Yan, Zhou

    2012-06-01

    The authors examined the individual association between sleep quality and cognitive function among the very elderly. The present study analyzed data from a survey that was conducted on all residents aged 90 years or older in a district; there were 2,311,709 inhabitants in 2005. Cognitive function and sleep quality were measured using the 30-item Mini-Mental State Examination and the Pittsburgh Sleep Quality Index, respectively. The subjects included in the statistical analysis were 216 men and 444 women. Subjects with poor sleep quality had significant lower cognitive function scores (P = 0.007) and higher prevalence of cognitive impairment (P = 0.035). Subjects with cognitive impairment had longer sleep latency (P sleep efficiency percentage (P = 0.006) and more likely reported with poor quality (P = 0.035). Multiple logistic regressions showed that poor sleep quality was a risk factor for cognitive impairment (unadjusted odds ratio, 1.719; 95% confidence interval, 1.138-2.597; adjusted odds ratio, 1.759; 95% confidence interval, 1.012-3.057). Among longevity Chinese, there is an association between sleep quality and cognitive function, and cognitive impairment is associated with poor quality, longer sleep latency, and lower sleep efficiency percentage.

  1. 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).

  2. 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.

  3. 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

  4. 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.

  5. 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.

  6. Verbal fluency, naming and verbal comprehension: three aspects of language as predictors of cognitive impairment.

    Science.gov (United States)

    Maseda, Ana; Lodeiro-Fernández, Leire; Lorenzo-López, Laura; Núñez-Naveira, Laura; Balo, Aránzazu; Millán-Calenti, Jose C

    2014-01-01

    To establish the possible relationship among three components of language (verbal fluency, naming and comprehension) and cognitive impairment as well as to determine the usefulness of language assessment tests to predict or monitor the development of cognitive impairment. A comparative, descriptive and cross-sectional study was performed on 82 subjects ≥ 65 years of age who were cognitively assessed with the Mini Mental State Examination and were divided into two groups: Group A comprised of subjects classified as levels 1, 2 and 3 on the Reisberg's Global Deterioration Scale (GDS) and group B comprised of subjects at levels 4 and 5 of the GDS. Language skills were assessed by the Verbal Fluency Test, Boston Naming Test and Token Test. An inverse relationship between performance on language tests and cognitive impairment level was observed with a more pronounced effect observed on fluency and comprehension tests. Language assessments, especially fluency and comprehension, were good indicators of cognitive impairment. The use of these assessments as predictors of the degree of cognitive impairment is discussed in-depth.

  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. 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.

  9. 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.

  10. 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.

  11. 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.

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

    Directory of Open Access Journals (Sweden)

    Mirena Valkova

    2012-10-01

    Full Text Available Objective: The aim of our study is to examine cognitive performance after mild stroke via Mini Mental State Examination (MMSE and Montreal cognitive assessment scale (MoCA and to compare the results.Material and methods: We examined 54 patients with mild stroke (aged 52 to 72 (mean 63.17, SD 5.96; 34 males and 20 females and 54 controls, adjusted by age, sex and education level. All subjects were tested via MMSE (Bulgarian version and MoCa (Bulgarian version. Data was collected in the single step model at the 90th day after stroke incident for patients and at the day of obtaining informed consent for controls. Results: Patients have poorer performance on both MMSE and MoCa than controls. MoCa has comparatively good discriminative validity and sensitivity.Conclusions: Although MMSE is one of the classical screening tools for cognitive impairment widely used in Bulgaria, other screening tools should not be ignored. On the basis of our results, MoCa is also a good screening instrument, especially for poststroke cognitive impairment.

  13. Self-administered Gerocognitive Examination (SAGE): a brief cognitive assessment Instrument for mild cognitive impairment (MCI) and early dementia.

    Science.gov (United States)

    Scharre, Douglas W; Chang, Shu-Ing; Murden, Robert A; Lamb, James; Beversdorf, David Q; Kataki, Maria; Nagaraja, Haikady N; Bornstein, Robert A

    2010-01-01

    To develop a self-administered cognitive assessment instrument to facilitate the screening of mild cognitive impairment (MCI) and early dementia and determine its association with gold standard clinical assessments including neuropsychologic evaluation. Adults aged above 59 years with sufficient vision and English literacy were recruited from geriatric and memory disorder clinics, educational talks, independent living facilities, senior centers, and memory screens. After Self-administered Gerocognitive Examination (SAGE) screening, subjects were randomly selected to complete a clinical evaluation, neurologic examination, neuropsychologic battery, functional assessment, and mini-mental state examination (MMSE). Subjects were identified as dementia, MCI, or normal based on standard clinical criteria and neuropsychologic testing. Two hundred fifty-four participants took the SAGE screen and 63 subjects completed the extensive evaluation (21 normal, 21 MCI, and 21 dementia subjects). Spearman rank correlation between SAGE and neuropsychologic battery was 0.84 (0.76 for MMSE). SAGE receiver operating characteristics on the basis of clinical diagnosis showed 95% specificity (90% for MMSE) and 79% sensitivity (71% for MMSE) in detecting those with cognitive impairment from normal subjects. This study suggests that SAGE is a reliable instrument for detecting cognitive impairment and compares favorably with the MMSE. The self-administered feature may promote cognitive testing by busy clinicians prompting earlier diagnosis and treatment.

  14. Volume changes in Alzheimer's disease and mild cognitive impairment: cognitive associations

    International Nuclear Information System (INIS)

    Evans, Matthew C.; Barnes, Josephine; Nielsen, Casper; Clegg, Shona L.; Blair, Melanie; Douiri, Abdel; Boyes, Richard G.; Fox, Nick C.; Kim, Lois G.; Leung, Kelvin K.; Ourselin, Sebastien

    2010-01-01

    To assess the relationship between MRI-derived changes in whole-brain and ventricular volume with change in cognitive scores in Alzheimer's disease (AD), mild cognitive impairment (MCI) and control subjects. In total 131 control, 231 MCI and 99 AD subjects from the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort with T1-weighted volumetric MRIs from baseline and 12-month follow-up were used to derive volume changes. Mini mental state examination (MMSE), Alzheimer's disease assessment scale (ADAS)-cog and trails test changes were calculated over the same period. Brain atrophy rates and ventricular enlargement differed between subject groups (p < 0.0005) and in MCI and AD were associated with MMSE changes. Both measures were additionally associated with ADAS-cog and trails-B in MCI patients, and ventricular expansion was associated with ADAS-cog in AD patients. Brain atrophy (p < 0.0005) and ventricular expansion rates (p = 0.001) were higher in MCI subjects who progressed to AD within 12 months of follow-up compared with MCI subjects who remained stable. MCI subjects who progressed to AD within 12 months had similar atrophy rates to AD subjects. Whole-brain atrophy rates and ventricular enlargement differed between patient groups and healthy controls, and tracked disease progression and psychological decline, demonstrating their relevance as biomarkers. (orig.)

  15. Safety and Pharmacokinetics of Solithromycin in Subjects with Hepatic Impairment.

    Science.gov (United States)

    Jamieson, Brian D; Ciric, Sabrina; Fernandes, Prabhavathi

    2015-08-01

    Solithromycin, a new macrolide and the first fluoroketolide, is in late-stage clinical development and, like older macrolides, is primarily metabolized and excreted through liver-dependent mechanisms. This study evaluated the safety and pharmacokinetics of solithromycin in patients with chronic liver disease. This open-label, multiple-dose study in subjects with hepatic impairment and in healthy control subjects (matched for age, weight, and sex) enrolled 8 Child-Pugh class A (mild), 8 class B (moderate), and 8 class C (severe) patients and 9 healthy controls. Subjects (n = 33) received one 800-mg dose on day 1 followed by once-daily doses of 400 mg on days 2 through 5. The most commonly reported adverse events were mild diarrhea and mild headache, and no significant differences were noted between hepatically impaired subjects and healthy controls. The pharmacokinetics of plasma solithromycin in subjects with mild and moderate impairment was similar to that in control subjects. In subjects with severe impairment, total exposure to solithromycin at steady state (area under the plasma concentration-time curve [AUC0-tau]) was decreased compared to that in control subjects, which may have been related to the higher body mass index of individuals in this group. No greater accumulation was noted in any hepatically impaired cohort on day 5 compared to that in control subjects. No decrease in dosage is therefore needed when administering solithromycin to patients with mild, moderate, or severe hepatic impairment. Solithromycin was well tolerated in this patient population, and no significant differences in safety, compared to healthy controls, were noted. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  16. 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.

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

    Science.gov (United States)

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

    2015-05-27

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

  18. Association of Fatigue Intensification with Cognitive Impairment during Radiation Therapy for Prostate Cancer.

    Science.gov (United States)

    Feng, Li Rebekah; Espina, Alexandra; Saligan, Leorey N

    2018-03-07

    Cancer-related fatigue is a common complaint during cancer treatment and is often associated with cognitive impairment. This study examined cognitive deficits that were associated with fatigue symptoms during external-beam radiation therapy (EBRT) in men with localized prostate cancer. A total of 36 participants were enrolled and followed up at baseline, 24 h, 7 days, 14 days after EBRT initiation, at midpoint, and at completion of EBRT. Fatigue was measured by self-report using the Functional Assessment of Cancer Therapy - Fatigue (FACT-F), and cognitive impairment by the Computer Assessment of Mild Cognitive Impairment (CAMCI®). Subjects with increased fatigue during EBRT reported a significant decline in cognitive function and had difficulties with CAMCI®'s route finding and item recall tasks during EBRT. Increased fatigue during EBRT was associated with perceived cognitive difficulties in executive function and recognition memory, but not with attention or verbal memory. Our results suggest that there might be specific cognitive domains that are associated with increased fatigue during EBRT. These findings will provide important information for targeting specific cognitive domains using pharmacotherapy or behavioral interventions. CAMCI® is a valuable tool for psycho social providers to detect subtle cognitive impairment in fatigued cancer patients in a clinical setting. © 2018 S. Karger AG, Basel.

  19. 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.

  20. Diagnostic accuracy of 18 F-FDG and 11 C-PIB-PET for prediction of short-term conversion to Alzheimer's disease in subjects with mild cognitive impairment.

    Science.gov (United States)

    Zhang, S; Han, D; Tan, X; Feng, J; Guo, Y; Ding, Y

    2012-02-01

    In recent years, the role of PET imaging in the prediction of mild cognitive impairment (MCI) to Alzheimer's disease (AD) conversion has been the subject of many longitudinal studies. The purpose of this study was to perform a meta-analysis to estimate the diagnostic accuracy of (18) F-fluoro-2-deoxyglucose-positron emission tomography (FDG-PET) and (11) C-Pittsburgh Compound B-positron emission tomography (PIB-PET) for prediction of short-term conversion to AD in patients with MCI. The MEDLINE and EMBASE databases were systematically searched for relevant studies. Methodological quality of the included studies was assessed. Sensitivities and specificities of PET in individual studies were calculated and meta-analysis was undertaken with a random-effects model. A summary receiver operating characteristic (SROC) curve was constructed with the Moses-Shapiro-Littenberg method. Heterogeneity was tested, and the presence of publication bias was assessed. Potential sources for heterogeneity were explored by assessing whether or not certain covariates significantly influenced the relative diagnostic odds ratio (DOR). Pooled estimates of sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR-), DOR and the SROC curve of each PET imaging were determined. A total of 13 research studies (seven FDG-PET and six PIB-PET) met inclusion criteria and had sufficient data for statistical analysis. FDG-PET pooled estimates had 78.7% sensitivity (95% CI, 68.7-86.6%),74.0% specificity (95% CI, 67.0-80.3%), 18.1 LR+(95% CI, 7.3-45.0) and 0.32 LR-(95% CI, 0.16-0.61); and PIB-PET pooled estimates had 93.5% sensitivity (95%CI, 71.3-99.9%), 56.2% specificity (95% CI, 47.2-64.8%), 2.01 LR+ (95% CI, 1.57-2.58) and 0.17 LR-(95% CI, 0.08-0.36). Overall DOR was 17.3 (95% CI, 5.08-59.2) for FDG-PET and 12.8 (95% CI, 5.35-30.54) for PIB-PET. Area under the SROC curve was 0.88 ± 0.05 for FDG-PET and 0.85 ± 0.04 for PIB-PET. The data from FDG-PET research studies

  1. 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.

  2. 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.

  3. [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.

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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.

  10. 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...

  11. 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.

  12. Factors contributing to impaired self-awareness of cognitive functioning in an HIV positive and at-risk population.

    Science.gov (United States)

    Juengst, Shannon; Skidmore, Elizabeth; Pramuka, Michael; McCue, Michael; Becker, James

    2012-01-01

    To examine the association between self-awareness of cognitive impairment and age, selected mood disorders, and type and severity of cognitive impairment in a sample of individuals with HIV/AIDS and at risk for HIV. 75 subjects, 52 HIV+ and 23 at risk for HIV completed a psychosocial interview, the Patient's Assessment of Own Functioning (PAOF) questionnaire, and a battery of neuropsychological tests. Based upon the differences between their clinical impairment and self-reported impairment, subjects were classified as being "Underestimators", "Good Awareness", or "Impaired Awareness" with regard to self-awareness. Those with more severe cognitive impairment were less aware than those with normal or borderline cognitive impairment. A one-way ANOVA suggested that the Impaired Awareness group differed significantly from the Underestimators on the Rey Figure Immediate and Delayed Recall tasks, and from both the Underestimators and Good Awarenesss groups on the Digit Symbol Substitution Task. There were significant differences among all awareness groups on the test of Simple Reaction Time. Furthermore there is some suggestion that age may contribute to impaired self-awareness. The role of HIV in self-awareness remains unclear, as both, individuals with HIV and at risk, demonstrated impaired self-awareness. Overall, impaired awareness was associated with poorer test performance, suggesting a relationship between awareness and sustained complex attention and visual spatial processing. This research has implications for understanding factors contributing to poor awareness among individuals with cognitive impairment.

  13. 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.

  14. [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...

  15. The Subjective Cognitive Decline Questionnaire (SCD-Q): a validation study.

    Science.gov (United States)

    Rami, Lorena; Mollica, Maria A; García-Sanchez, Carmen; Saldaña, Judith; Sanchez, Belen; Sala, Isabel; Valls-Pedret, Cinta; Castellví, Magda; Olives, Jaume; Molinuevo, Jose L

    2014-01-01

    Subjective cognitive decline (SCD) is gaining importance as a focus of investigation, but adequate tools are needed for its quantification. To develop and validate a questionnaire to quantify SCD, termed the Subjective Cognitive Decline Questionnaire (SCD-Q). 124 controls (CTR), 144 individuals with SCD, 83 mild cognitive impairment subjects, 46 Alzheimer's disease patients, and 397 informants were included. The SCD-Q contains: part I, named MyCog, which is answered by the subject; and part II, TheirCog, which includes the same questions and is answered by the informant or caregiver. The 24 SCD-Q items assess the perceived subjective decline in memory, language, and executive functions in the last two years. The MyCog scores of controls differed significantly from those of the other groups (p subjects' objective cognitive performance, and discriminated between subjects with or without cognitive impairment. The SCD-Q is a useful tool to measure self-perceived cognitive decline incorporating the decliner and the informant perspective.

  16. Cognitive complaints correlate with depression rather than concurrent objective cognitive impairment in the successful aging evaluation baseline sample.

    Science.gov (United States)

    Zlatar, Zvinka Z; Moore, Raeanne C; Palmer, Barton W; Thompson, Wesley K; Jeste, Dilip V

    2014-09-01

    Whether subjective cognitive complaints are suggestive of depression or concurrent cognitive impairment in older adults without dementia remains unclear. The current study examined this question in a large (N = 1000), randomly selected, community-based sample of adults aged 51 to 99 years without a formal diagnosis of dementia (Successful AGing Evaluation [SAGE] study). The modified Telephone Interview for Cognitive Status (TICS-m) measured objective cognitive function, the Cognitive Failures Questionnaire (CFQ) measured subjective cognitive complaints, and the 9-item Patient Health Questionnaire (PHQ-9) measured depression. Spearman ρ correlations and linear regression models were conducted to examine the relationship among variables in the baseline SAGE sample. There was a weak association between TICS-m and CFQ scores (ρ = -.12); however, a moderate to large association was observed for CFQ and PHQ-9 (ρ = .44). Scores on the CFQ were not associated with TICS-m scores (β = -.03, P = .42) after controlling for PHQ-9 and variables of interest, such as age, gender, ethnicity, and physical functioning, while PHQ-9 was significantly associated with CFQ scores (β = .46, P cognitive complaints are more likely related to symptoms of depression rather than concurrent cognitive impairment in a large cross-section of community-dwelling adults without a formal diagnosis of dementia. © The Author(s) 2014.

  17. 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

  18. [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.

  19. 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

  20. 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.

  1. Prevalence of cognitive impairment: effects of level of education, age, sex and associated factors.

    Science.gov (United States)

    Millán-Calenti, José C; Tubío, Javier; Pita-Fernández, Salvador; González-Abraldes, Isabel; Lorenzo, Trinidad; Maseda, Ana

    2009-01-01

    To examine the prevalence of cognitive impairment in a Spanish elderly population and to analyse its association with some social and medical factors. We randomly selected a representative sample (n = 600) of people over 65 from Narón Council (A Coruña). Socio-demographic and biomedical data were collected and cognitive status was assessed using the Mini-Mental State Examination (MMSE). We determined variations in the prevalence from 35.2%, when age or level of education distribution was not applied, to 22.2% when they were applied. Women showed a higher probability of cognitive impairment than men. Negative correlation was observed between the age of the subject and the MMSE score (Spearman correlation rho = -0.45, p Knowledge of the real prevalence rates, together with the establishment of adequate preventive and intervention measures, can be factors that may diminish the socio-sanitary impact of cognitive impairment. Copyright 2009 S. Karger AG, Basel.

  2. 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

  3. 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...

  4. 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.

  5. Subjective cognitive complaints included in diagnostic evaluation of dementia helps accurate diagnosis in a mixed memory clinic cohort

    DEFF Research Database (Denmark)

    Salem, L C; Vogel, Asmus Mejling; Ebstrup, J

    2015-01-01

    OBJECTIVE: Our objective was to examine the quantity and profile of subjective cognitive complaints in young patients as compared with elderly patients referred to a memory clinic. METHODS: Patients were consecutively recruited from the Copenhagen University Hospital Memory Clinic at Rigshospitalet....... In total, 307 patients and 149 age-matched healthy controls were included. Patients were classified in 4 diagnostic groups: dementia, mild cognitive impairment, affective disorders and no cognitive impairment. Subjective memory was assessed with subjective memory complaints (SMC) scale. Global cognitive...... with dementia have a significantly higher level and a different profile of subjective cognitive complaints as compared with elderly patients with dementia. Furthermore, young patients, diagnosed with an affective disorder, had the highest level of subjective cognitive complaints of all patients in a memory...

  6. Vascular risk factors aggravate cognitive impairment in first-ever young ischaemic stroke patients.

    Science.gov (United States)

    Lu, D; Ren, S; Zhang, J; Sun, D

    2016-05-01

    Young ischaemic stroke patients often suffer from cognitive impairment after stroke. However, the risk factors of cognitive impairment are still unclear. This study examined the impact of vascular risk factors (VRFs) on cognitive impairment in first-ever young ischaemic stroke patients. Subjects were divided into low (0-1 VRF, n = 27), medium (2-3 VRFs, n = 45) and high-risk (≥4 VRFs, n = 12) groups according to their number of VRFs. The following VRFs were collected: hypertension, diabetes mellitus, dyslipidaemia, atrial fibrillation, obesity, smoking, excess alcohol consumption, coronary heart disease and hyperhomocysteinaemia. A battery of cognitive assessments was executed 2 weeks after stroke. Differences of cognitive performances between groups were compared. The correlation between VRFs and cognitive function was investigated with an emphasis on discovering the main VRFs. Eighty-four patients were enrolled in this study eventually. Compared with the low-risk group, the high-risk group had significantly worse performance in most of the cognitive domains. VRFs had a correlation with general cognition, executive function, attention and verbal fluency. After adjusting the covariates, VRFs showed a linear correlation with global cognitive function (R = 0.640, P = 0.000), verbal fluency (R = 0.372, P = 0.000), delayed memory (R = 0.327, P = 0.002), visual attention (R = 0.290, P = 0.007) and executive function (R = 0.266, P = 0.015). Amongst all the VRFs, hypertension, hyperlipidaemia, smoking and hyperhomocysteinaemia were the main influencing VRFs. Vascular risk factors aggravate cognitive impairment after young ischaemic stroke. Effective management of VRFs in young adults is urgent and this may reduce the cognitive impairment. © 2016 EAN.

  7. A clinical index to predict progression from mild cognitive impairment to dementia due to Alzheimer's disease.

    Directory of Open Access Journals (Sweden)

    Sei J Lee

    Full Text Available Mild cognitive impairment is often a precursor to dementia due to Alzheimer's disease, but many patients with mild cognitive impairment never develop dementia. New diagnostic criteria may lead to more patients receiving a diagnosis of mild cognitive impairment.To develop a prediction index for the 3-year risk of progression from mild cognitive impairment to dementia relying only on information that can be readily obtained in most clinical settings.382 participants diagnosed with amnestic mild cognitive impairment enrolled in the Alzheimer's Disease Neuroimaging Initiative (ADNI, a multi-site, longitudinal, observational study.Demographics, comorbid conditions, caregiver report of participant symptoms and function, and participant performance on individual items from basic neuropsychological scales.Progression to probable Alzheimer's disease.Subjects had a mean (SD age of 75 (7 years and 43% progressed to probable Alzheimer's disease within 3 years. Important independent predictors of progression included being female, resisting help, becoming upset when separated from caregiver, difficulty shopping alone, forgetting appointments, number of words recalled from a 10-word list, orientation and difficulty drawing a clock. The final point score could range from 0 to 16 (mean [SD]: 4.2 [2.9]. The optimism-corrected Harrell's c-statistic was 0.71(95% CI: 0.68-0.75. Fourteen percent of subjects with low risk scores (0-2 points, n = 124 converted to probable Alzheimer's disease over 3 years, compared to 51% of those with moderate risk scores (3-8 points, n = 223 and 91% of those with high risk scores (9-16 points, n = 35.An index using factors that can be obtained in most clinical settings can predict progression from amnestic mild cognitive impairment to probable Alzheimer's disease and may help clinicians differentiate between mild cognitive impairment patients at low vs. high risk of progression.

  8. Cognitive impairment and risk factor prevalence in a population over 60 in Argentina

    Science.gov (United States)

    Arizaga, Raul L; Gogorza, Roxana E; Allegri, Ricardo F; Baumann, Patricia D; Morales, María C; Harris, Paula; Pallo, Vicente; Cegarra, María M

    2014-01-01

    Epidemiological data on dementia and cognitive impairment are scarce in South America. In Argentina, no dementia/cognitive impairment population-based epidemiological studies are available. The Ceibo Study is a population-based epidemiological study of dementia and cognitive impairment in individuals over 60 to be conducted. The present paper reports the results of the pilot phase (survey of cognitive impairment) conducted in Cañuelas (province of Buenos Aires). Methods In a door-to-door survey, trained high school students evaluated 1453 individuals aged 60 years and over in one day using a demographic data and risk factors questionnaire, the Mini-Mental State Examination (MMSE) and the 15-item Geriatric Depression Scale (GDS). Results Mean age of the individuals was 70.9 (±7.5) years, 61.4% were women, mean schooling was 5.5 (±3.5) years. Mean MMSE score was 24.5 (±4.7) and mean GDS 3.1 (±2.7). Risk factors of higher prevalence in the population under study were: hypertension (40.6%), smoking (35.1%), alcohol consumption (32.8%), high cholesterol (16.1%), diabetes (12.5%), cranial trauma with loss of consciousness (12.5%), 7 points or more on the GDS (11.7%). Prevalence of cognitive impairment for the whole sample was 23%, and 16.9% in subjects aged 60-69, 23.3% in 70-79 and 42.5% in subjects aged 80 or over . A significant correlation of cognitive impairment with age, functional illiteracy, cranial trauma, high blood pressure, inactivity and depression was found. Conclusion In this pilot study, the prevalence of cognitive impairment was comparable with previous international studies. PMID:29213927

  9. 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

  10. 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.

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

    International Nuclear Information System (INIS)

    Li Xinling; Zhu Xiangyang; Huang Huaiyu; Jin Yan

    2011-01-01

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

  12. 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...

  13. The Characterization of Biological Rhythms in Mild Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    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.

  14. 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.

  15. 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

  16. 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.

  17. 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

  18. 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

  19. 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.

  20. Insulin resistance in human subjects having impaired glucose regulation

    International Nuclear Information System (INIS)

    Khan, S.H.; Khan, F.A.; Ijaz, A.

    2007-01-01

    To determine insulin resistance in human subjects having impaired glucose regulation (IGR) by Homeostasis Model Assessment for Insulin Resistance (HOMA-IR). A total of 100 subjects with impaired glucose regulation were selected for evaluation of metabolic syndrome as per the criteria of National Cholesterol Education Program, Adult Treatment Panel III (NCEP, ATP III), along with 47 healthy age and gender-matched controls. Physical examination to determine blood pressure and waist circumference was carried out and so was sampling for plasma glucose, serum triglycerides, HDL-cholesterol and insulin. Insulin resistance was calculated by the HOMA-IR. Finally, subjects with and without metabolic syndrome were compared with controls (n=47), using one-way ANOVA for studying insulin resistance between groups, with Tukey's post-hoc comparison. The frequency of finding metabolic syndrome in cases of IGR remained 47%. The insulin resistance demonstrated stepwise worsening from control population (mean=1.54, 95 % CI: 1.77 - 2.37) to subjects suffering from only IGR (mean=2.07, 95 % CI: 1.77- 2.37) to metabolic syndrome (mean=2.67, 95 %, CI: 2.34 - 3.00) (p < 0.001). Patients with impaired glucose regulation may have significant insulin resistance. It is, thus, recommended that a vigorous search be made to measure insulin resistance in all cases diagnosed to have impaired glucose regulation. (author)

  1. Clinical usefulness of the clock drawing test applying rasch analysis in predicting of cognitive impairment.

    Science.gov (United States)

    Yoo, Doo Han; Lee, Jae Shin

    2016-07-01

    [Purpose] This study examined the clinical usefulness of the clock drawing test applying Rasch analysis for predicting the level of cognitive impairment. [Subjects and Methods] A total of 187 stroke patients with cognitive impairment were enrolled in this study. The 187 patients were evaluated by the clock drawing test developed through Rasch analysis along with the mini-mental state examination of cognitive evaluation tool. An analysis of the variance was performed to examine the significance of the mini-mental state examination and the clock drawing test according to the general characteristics of the subjects. Receiver operating characteristic analysis was performed to determine the cutoff point for cognitive impairment and to calculate the sensitivity and specificity values. [Results] The results of comparison of the clock drawing test with the mini-mental state showed significant differences in according to gender, age, education, and affected side. A total CDT of 10.5, which was selected as the cutoff point to identify cognitive impairement, showed a sensitivity, specificity, Youden index, positive predictive, and negative predicive values of 86.4%, 91.5%, 0.8, 95%, and 88.2%. [Conclusion] The clock drawing test is believed to be useful in assessments and interventions based on its excellent ability to identify cognitive disorders.

  2. 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.

  3. Dual Task Gait Performance in Frail Individuals with and without Mild Cognitive Impairment.

    Science.gov (United States)

    Martínez-Ramírez, Alicia; Martinikorena, Ion; Lecumberri, Pablo; Gómez, Marisol; Millor, Nora; Casas-Herrero, Alvaro; Zambom-Ferraresi, Fabrício; Izquierdo, Mikel

    2016-01-01

    Several studies have stated that frailty is associated with cognitive impairment. Based on various studies, cognition impairment has been considered as a component of frailty. Other authors have shown that physical frailty is associated with low cognitive performance. Dual task gait tests are used as a strong predictor of falls in either dementia or frailty. Consequently, it is important to investigate dual task walking tests in elderly populations including control robust oldest old, frail oldest old with mild cognitive impairment (MCI) and frail oldest old without MCI. Dual task walking tests were carried out to examine the association between frailty and cognitive impairment in a population with advanced age. Forty-one elderly men and women participated in this study. The subjects from control, frail with MCI and frail without MCI groups, completed the 5-meter walk test at their own gait velocity. Arithmetic and verbal dual task walking performance was also assessed. Kinematic data were acquired from a unique tri-axial inertial sensor. The spatiotemporal and frequency parameters related to gait disorders did not show any significant differences between frail with and without MCI groups. The evaluation of these parameters extracted from the acceleration signals led us to conclude that these results expand the knowledge regarding the common conditions in frailty and MCI and may highlight the idea that the impairment in walking performance does not depend of frailty and cognitive status. © 2016 S. Karger AG, Basel.

  4. Plasma antioxidants and brain glucose metabolism in elderly subjects with cognitive complaints

    Energy Technology Data Exchange (ETDEWEB)

    Picco, Agnese; Ferrara, Michela; Arnaldi, Dario; Brugnolo, Andrea; Nobili, Flavio [University of Genoa and IRCCS San Martino-IST, Clinical Neurology, Department of Neuroscience (DINOGMI), Largo P. Daneo, 3, 16132, Genoa (Italy); Polidori, M.C. [University of Cologne, Institute of Geriatrics, Cologne (Germany); Cecchetti, Roberta; Baglioni, Mauro; Bastiani, Patrizia; Mecocci, Patrizia [University of Perugia, Institute of Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, Perugia (Italy); Morbelli, Silvia; Bossert, Irene [University of Genoa and IRCCS San Martino-IST, Nuclear Medicine, Department of Health Science (DISSAL), Genoa (Italy); Fiorucci, Giuliana; Dottorini, Massimo Eugenio [Nuclear Medicine, S. M. della Misericordia Hospital, Perugia (Italy)

    2014-04-15

    The role of oxidative stress is increasingly recognized in cognitive disorders of the elderly, notably Alzheimer's disease (AD). In these subjects brain{sup 18}F-FDG PET is regarded as a reliable biomarker of neurodegeneration. We hypothesized that oxidative stress could play a role in impairing brain glucose utilization in elderly subjects with increasing severity of cognitive disturbance. The study group comprised 85 subjects with cognitive disturbance of increasing degrees of severity including 23 subjects with subjective cognitive impairment (SCI), 28 patients with mild cognitive impairment and 34 patients with mild AD. In all subjects brain FDG PET was performed and plasma activities of extracellular superoxide dismutase (eSOD), catalase and glutathione peroxidase were measured. Voxel-based analysis (SPM8) was used to compare FDG PET between groups and to evaluate correlations between plasma antioxidants and glucose metabolism in the whole group of subjects, correcting for age and Mini-Mental State Examination score. Brain glucose metabolism progressively decreased in the bilateral posterior temporoparietal and cingulate cortices across the three groups, from SCI to mild AD. eSOD activity was positively correlated with glucose metabolism in a large area of the left temporal lobe including the superior, middle and inferior temporal gyri and the fusiform gyrus. These results suggest a role of oxidative stress in the impairment of glucose utilization in the left temporal lobe structures in elderly patients with cognitive abnormalities, including AD and conditions predisposing to AD. Further studies exploring the oxidative stress-energy metabolism axis are considered worthwhile in larger groups of these patients in order to identify pivotal pathophysiological mechanisms and innovative therapeutic opportunities. (orig.)

  5. 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

  6. 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

  7. 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.

  8. 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.

  9. 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

  10. 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.

  11. Predictors of the discrepancy between objective and subjective cognition in bipolar disorder

    DEFF Research Database (Denmark)

    Miskowiak, K. W.; Petersen, Jeff Zarp; Ott, C. V.

    2016-01-01

    OBJECTIVE: The poor relationship between subjective and objective cognitive impairment in bipolar disorder (BD) is well-established. However, beyond simple correlation, this has not been explored further using a methodology that quantifies the degree and direction of the discrepancy. This study...... aimed to develop such a methodology to explore clinical characteristics predictive of subjective-objective discrepancy in a large BD patient cohort. METHODS: Data from 109 remitted BD patients and 110 healthy controls were pooled from previous studies, including neuropsychological test scores, self......-reported cognitive difficulties, and ratings of mood, stress, socio-occupational capacity, and quality of life. Cognitive symptom 'sensitivity' scores were calculated using a novel methodology, with positive scores reflecting disproportionately more subjective complaints than objective impairment and negative values...

  12. Mnemonics usage and cognitive decline in age-associated memory impairment.

    Science.gov (United States)

    Small, G W; La Rue, A; Komo, S; Kaplan, A; Mandelkern, M A

    1997-03-01

    To determine predictors of cognitive deterioration, the authors performed baseline and 1- to 5-year follow-up (mean +/- SD = 2.5 +/- 1.2 years) neuropsychological assessments on 36 persons (mean age +/- SD = 62.1 +/- 8.0; range = 50 to 81 years) with age-associated memory impairment. Subjects were recruited from a larger group of volunteers, had minimal medical comorbidity, and 25 of them had a family history of Alzheimer's disease. Baseline age and a subjective memory measure indicating reported frequency of mnemonics usage were significant decline predictors. Subjects reporting more frequent mnemonics use at baseline were more likely to show objective cognitive decline at follow-up. Baseline full-scale IQ, educational level, and family history of Alzheimer's disease failed to predict decline. These findings suggest that although age is the strongest decline predictor in some people with age-associated memory impairment, self-perception of memory function may also predict subsequent cognitive loss.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

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

    Directory of Open Access Journals (Sweden)

    Márcio Luiz Figueredo Balthazar

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

  18. Perspective taking abilities in amnestic mild cognitive impairment and Alzheimer's disease

    Czech Academy of Sciences Publication Activity Database

    Marková, H.; Laczó, J.; Andel, R.; Hort, J.; Vlček, Kamil

    2015-01-01

    Roč. 281, Mar 15 (2015), s. 229-238 ISSN 0166-4328 R&D Projects: GA MZd(CZ) NT13386 Institutional support: RVO:67985823 Keywords : Alzheimer's disease * mild cognitive impairment * spatial transformation * standardized road-map test of direction sense * perspective taking task * sexual differences Subject RIV: FH - Neurology Impact factor: 3.002, year: 2015

  19. Probing the molecular mechanism behind the cognitive impairment induced by THC

    Czech Academy of Sciences Publication Activity Database

    Botta, J.; Cordomi, A.; Bondar, Alexey; Lazar, Josef; Pardo, L.; McCormick, P. J.

    2017-01-01

    Roč. 121, č. 2 (2017), s. 11-12 ISSN 1742-7835 Institutional support: RVO:67179843 Keywords : THC * molecular mechanism * cognitive impairment Subject RIV: FR - Pharmacology ; Medidal Chemistry OBOR OECD: Toxicology Impact factor: 3.176, year: 2016

  20. Famous Landmark Identification in Amnestic Mild Cognitive Impairment and Alzheimer's Disease

    Czech Academy of Sciences Publication Activity Database

    Sheardová, K.; Laczó, J.; Vyhnálek, M.; Andel, R.; Mokrišová, I.; Vlček, Kamil; Amlerová, J.; Hort, J.

    2014-01-01

    Roč. 9, č. 8 (2014), e105623 E-ISSN 1932-6203 Institutional support: RVO:67985823 Keywords : visual perception * Alzheimer’s disease * brain changes * mild cognitive impairment * medial temporal lobe Subject RIV: FH - Neurology Impact factor: 3.234, year: 2014

  1. Is mild cognitive impairment a precursor of Alzheimer´s disease? Short review.

    Czech Academy of Sciences Publication Activity Database

    Janoutová, J.; Šerý, Omar; Hosák, L.; Janout, V.

    2015-01-01

    Roč. 23, č. 4 (2015), s. 365-367 ISSN 1210-7778 Institutional support: RVO:67985904 Keywords : mild cognitive impairment * Alzheimer´s dementia * terminology Subject RIV: FH - Neurology OBOR OECD: Neurosciences (including psychophysiology Impact factor: 0.525, year: 2015

  2. Prevalence and prognosis of Alzheimer's disease at the mild cognitive impairment stage

    NARCIS (Netherlands)

    Vos, S.J.B.; Verhey, F.; Frolich, L.; Kornhuber, J.; Wiltfang, J.; Maier, W.; Peters, O.; Ruther, E.; Nobili, F.; Morbelli, S.; Frisoni, G. B.; Drzezga, A.; Didic, M.; van Berckel, B.N.M.; Simmons, A.; Soininen, H.; Kloszewska, I.; Mecocci, P.; Tsolaki, M.; Vellas, B.; Lovestone, S.; Muscio, C.; Herukka, S.K.; Salmon, E.; Bastin, C.; Wallin, A.; Nordlund, A.; de Mendonca, A.; Silva, D.; Santana, I.; Lemos, R.; Engelborghs, S.; Van der Mussele, S.; Freund-Levi, Y.; Wallin, A.K.; Hampel, H.; van der Flier, W.M.; Scheltens, P.; Visser, P.J.

    2015-01-01

    Three sets of research criteria are available for diagnosis of Alzheimer's disease in subjects with mild cognitive impairment: the International Working Group-1, International Working Group-2, and National Institute of Aging-Alzheimer Association criteria. We compared the prevalence and prognosis of

  3. 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

  4. 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.

  5. Sleep Quality and 1-Year Incident Cognitive Impairment in Community-Dwelling Older Adults

    Science.gov (United States)

    Potvin, Olivier; Lorrain, Dominique; Forget, Hélène; Dubé, Micheline; Grenier, Sébastien; Préville, Michel; Hudon, Carol

    2012-01-01

    Study Objectives: To examine in cognitively intact older men and women the associations between subjective sleep quality and 1-yr incident cognitive impairment. Design: Prospective cohort study. Setting: General community. Participants: 1,664 cognitively intact individuals age 65 to 96 years. Measurements and Results: Sleep quality at baseline was measured using the Pittsburgh Sleep Quality Index (PSQI). Cognitive functioning was assessed at baseline and 12 months later using the Mini-Mental State Examination (MMSE). Incident general cognitive impairment was defined according to a follow-up MMSE score below the 15th percentile according to normative data and of at least 2 points below baseline. General cognitive impairments were also separated into amnestic and nonamnestic subtypes according to MMSE delayed recall performance. Associations between sleep quality indicators at baseline and incident cognitive impairment were assessed by odds ratio (OR) adjusted for age, education, baseline MMSE score, psychotropic drug use, anxiety, depressive episodes, cardiovascular conditions, and chronic diseases. Results revealed that global PSQI score was significantly linked with incident cognitive impairment (OR 1.17, 95% confidence interval (CI) 1.05-1.30) in men, but not in women. In women, sleep disturbance score (OR 2.62, 95% CI 1.41-4.86) and long sleep duration (≥ 9 hr; OR 3.70, 95% CI 1.49-9.17) were associated with nonamnestic and amnestic incident cognitive impairment, respectively. In men, short sleep duration (≤ 5 hr; OR 4.95, 95% CI 1.72-14.27) and habitual sleep efficiency score (OR 1.94, 95% CI 1.42-2.66) were associated with amnestic and general incident cognitive impairment, respectively. Conclusions: Sleep quality in older adults should receive particular attention by clinicians because poor sleep quality can be an early sign of cognitive decline. Citation: Potvin O; Lorrain D; Forget H; Dubé M; Grenier S; Préville M; Hudon C. Sleep quality and 1-year

  6. 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

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

    Science.gov (United States)

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

    2015-06-01

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

  8. 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

  9. Pathology and pathogenesis of vascular cognitive impairment – A critical update

    Directory of Open Access Journals (Sweden)

    Kurt A. Jellinger

    2013-04-01

    Full Text Available Vascular cognitive impairment describes a continuum of cognitive diorders ranging from mild cognitive impairment to dementia, in which vascular brain injury involving regions important for memory, cognition and behaviour plays an important role. Classification, prevalence, and pathophysiology are a matter of current research. Clinical diagnostic criteria show moderate sensitivity (ca 50% and variable specificity (range 64-98%. In Western clinical series, VaD is suggested in 8-10% of cognitively impaired elderly subjects. Its prevalence in autopsy series varies from 0.03 to 58%. In contrast to Alzheimer disease (AD and mixed dementia showing significant age-related increase, the prevalence of VaD significantly decreases after age 80 years. Cognitive decline is commonly associated with widespread small ischemic vascular lesions involving subcortical brain areas. The lesions affect neuronal networks involved in cognition, memory, and behavior.Cerebrovascular lesions (CVLs often coexist wth Alzheimer-type lesions and other pathologies. The lesion pattern of "pure" VaD differs from that in mixed dementia (AD + CVLs, which suggests different pathogenesis of both phenotypes. Minor CVLs appear not essential for cognitive impairment in full-blown AD, while both mild AD-type pathology and small vessel disease may interact synergistically in promoting and progressing dementia. However, both AD-related and vascular brain pathologies have been reported.Despite recent suggestions for staging and grading CVLs in specific brain areas, no validated neuropathological criteria are currently available for VaD and mixed dementia. Further clinico-pathological studies and harmonization of neuropathological procedures are needed to validate the diagostic criteria for VaD and mixed dementia in order to clarify the impact of CVLs and other coexistent pathologies on cognitive impairment as a basis for further successful therapeutic options.

  10. Is there a difference in subjective experience of cognitive function in patients with unipolar disorder versus bipolar disorder?

    DEFF Research Database (Denmark)

    Miskowiak, Kamilla; Vinberg, Maj; Christensen, Ellen Magrethe

    2012-01-01

    at their initial consultation at the clinic. Results: Patients experienced mild to moderate cognitive impairment despite being in partial or full remission, but there were no differences in subjective difficulties between BD and UD. Subjective cognitive dysfunction was predicted by depression severity, anxiety......Background: Cognitive dysfunction in unipolar disorder (UD) and bipolar disorder (BD) may persist into remission and affect psychosocial function. Executive and memory deficits during remission may be more pronounced in BD than UD. However, patients' subjective experience of cognitive difficulties...... is poorly understood, and it is unclear whether BD and UD patients experience different cognitive difficulties. Aims: To investigate whether there are differences in the quality and magnitude of subjective cognitive difficulties between UD and BD, and which factors influence the subjective cognitive...

  11. 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.

  12. Quality of Life and Its Factors in Korean Elderly With Mild Cognitive Impairment.

    Science.gov (United States)

    Kang, Younhee; Lee, Eliza

    2017-06-01

    Based on the secondary data analysis, this study aimed to identify quality of life and factors that affect quality of life among Korean elderly with mild cognitive impairment. Demographic characteristics, physical factors, and psychosocial factors as well as quality of life of the elderly with mild cognitive impairment were comprehensively measured. The research subjects consisted of 348 home-resident elderly and their quality of life scores were relatively high at 29.86. Their quality of life varied according to education and gender, and instrumental activities of daily living (actual, latent), somatic symptoms, sleep quality, depression, and social support affected their quality of life. Depression and social support were predictors of quality of life. The most powerful predictor was depression (β = -.583, p quality of life among elderly with mild cognitive impairment, nursing interventions to alleviate depression and to enhance social support from family, friends, and relevant neighbors are needed.

  13. Factors affecting impairment of blood rheology in obese subjects.

    Science.gov (United States)

    Hitsumoto, Takashi

    2012-11-01

    Impairment of blood rheology has been reported to be associated with cardiovascular diseases. Recently, visible micro channel methods [micro channel array flow analyzer (MC-FAN)] have been developed to clinically evaluate blood rheology. The aim of this cross-sectional study is to clarify the factors important for impairment of blood rheology in obese subjects using MC-FAN. One hundred and fifty-nine obese subjects and 100 non-obese subjects with no history of cardiovascular diseases were enrolled. Blood passage time (BPT) was measured using MC-FAN and relationships between BPT and various clinical parameters were examined. BPT was significantly higher in obese subjects than in non-obese subjects (obesity vs. non-obesity: 62.8 ± 17.9s vs. 54.1 ± 14.6s, prheology, which is evaluated by MC-FAN, than the degree of adiposity in obese subjects. Copyright © 2012 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  14. Ventricular and Periventricular Anomalies in the Aging and Cognitively Impaired Brain

    Directory of Open Access Journals (Sweden)

    Krysti L. Todd

    2018-01-01

    Full Text Available Ventriculomegaly (expansion of the brain’s fluid-filled ventricles, a condition commonly found in the aging brain, results in areas of gliosis where the ependymal cells are replaced with dense astrocytic patches. Loss of ependymal cells would compromise trans-ependymal bulk flow mechanisms required for clearance of proteins and metabolites from the brain parenchyma. However, little is known about the interplay between age-related ventricle expansion, the decline in ependymal integrity, altered periventricular fluid homeostasis, abnormal protein accumulation and cognitive impairment. In collaboration with the Baltimore Longitudinal Study of Aging (BLSA and Alzheimer’s Disease Neuroimaging Initiative (ADNI, we analyzed longitudinal structural magnetic resonance imaging (MRI and subject-matched fluid-attenuated inversion recovery (FLAIR MRI and periventricular biospecimens to map spatiotemporally the progression of ventricle expansion and associated periventricular edema and loss of transependymal exchange functions in healthy aging individuals and those with varying degrees of cognitive impairment. We found that the trajectory of ventricle expansion and periventricular edema progression correlated with degree of cognitive impairment in both speed and severity, and confirmed that areas of expansion showed ventricle surface gliosis accompanied by edema and periventricular accumulation of protein aggregates, suggesting impaired clearance mechanisms in these regions. These findings reveal pathophysiological outcomes associated with normal brain aging and cognitive impairment, and indicate that a multifactorial analysis is best suited to predict and monitor cognitive decline.

  15. Walking Stroop carpet: an innovative dual-task concept for detecting cognitive impairment.

    Science.gov (United States)

    Perrochon, A; Kemoun, G; Watelain, E; Berthoz, A

    2013-01-01

    Several studies have reported the potential value of the dual-task concept during locomotion in clinical evaluation because cognitive decline is strongly associated with gait abnormalities. However, current dual-task tests appear to be insufficient for early diagnosis of cognitive impairment. Forty-nine subjects (young, old, with or without mild cognitive impairment) underwent cognitive evaluation (Mini-Mental State Examination, Frontal Assessment Battery, five-word test, Stroop, clock-drawing) and single-task locomotor evaluation on an electronic walkway. They were then dual-task-tested on the Walking Stroop carpet, which is an adaptation of the Stroop color-word task for locomotion. A cluster analysis, followed by an analysis of variance, was performed to assess gait parameters. Cluster analysis of gait parameters on the Walking Stroop carpet revealed an interaction between cognitive and functional abilities because it made it possible to distinguish dysexecutive cognitive fragility or decline with a sensitivity of 89% and a specificity of 94%. Locomotor abilities differed according to the group and dual-task conditions. Healthy subjects performed less well on dual-tasking under reading conditions than when they were asked to distinguish colors, whereas dysexecutive subjects had worse motor performances when they were required to dual task. The Walking Stroop carpet is a dual-task test that enables early detection of cognitive fragility that has not been revealed by traditional neuropsychological tests or single-task walking analysis.

  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. Preclinical dementia: an Italian multicentre study on amnestic mild cognitive impairment.

    Science.gov (United States)

    Perri, R; Serra, L; Carlesimo, G A; Caltagirone, C

    2007-01-01

    Different rates and cognitive predictors of conversion to dementia have been reported in subjects with different kinds of mild cognitive impairment (MCI). A prospective, 24-month follow-up study, involving 269 subjects who strictly fulfilled criteria for the amnestic MCI. Conversion rate to dementia was 21.4% per year. Seventy-nine out of the 83 individuals who developed dementia were affected by probable Alzheimer's disease (AD). Among others, at the 24-month follow-up 24.1% were still affected by amnestic MCI, 13.3% had changed their neuropsychological profile of impairment and 17.2% were cognitively normalised. Compared to subjects who did not convert to AD, those who did convert showed poorer immediate and delayed recall and recognition of verbal and visual material at baseline as well as reduced executive abilities. A combination of age, Clinical Dementia Rating boxes and scores on delayed recall and recognition of verbal and visual material accurately identified 86% of the subjects who developed AD. Elderly subjects affected by an isolated memory disorder have a high probability of developing AD. The ability of verbal and visual measures to predict incipient dementia of memory impairment may be increased by the simultaneous assessment of individual features, such as age or rate of functional impairment. Copyright 2007 S. Karger AG, Basel.

  18. 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.

  19. 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.

  20. 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.

  1. 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

  2. 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.

  3. 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 ...

  4. [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.

  5. [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

  6. To rise and to fall: functional connectivity in cognitively normal and cognitively impaired patients with Parkinson's disease.

    Science.gov (United States)

    Gorges, Martin; Müller, Hans-Peter; Lulé, Dorothée; Pinkhardt, Elmar H; Ludolph, Albert C; Kassubek, Jan

    2015-04-01

    Cognitive decline is a burdensome extra-motor symptom associated with Parkinson's disease (PD). This study aimed at investigating intrinsic functional connectivity (iFC) of the brain in cognitively unimpaired (PD-CU) and impaired PD patients (PD-CI) compared with age-matched healthy controls. "Resting-state" functional magnetic resonance imaging was acquired in 53 subjects, that is, 14 PD-CU patients, 17 PD-CI patients, and 22 control subjects. Cognition and cognitive status for patient classification were assessed using detailed neuropsychological testing. In PD-CU patients versus controls, we demonstrated significantly increased iFC (hyperconnectivity) presenting as network expansions in cortical, limbic, and basal ganglia-thalamic areas. Significantly, decreased iFC in PD-CI patients compared with control subjects was observed, predominantly between major nodes of the default mode network. In conclusion, the increased iFC might be the initial manifestation of altered brain function preceding cognitive deficits. Hyperconnectivity could be an adaptive (compensatory) mechanism by recruiting additional resources to maintain normal cognitive performance. As PD-related pathology progresses, functional disruptions within the default mode networks seem to be considerably associated with cognitive decline. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. 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

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-07-01

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

  10. 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.

  11. 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.

  12. 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

  13. 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

  14. 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)....

  15. Prevalence of Cognitive Impairment and Depression among a Population Aged over 60 Years in the Metropolitan Area of Guadalajara, Mexico

    Directory of Open Access Journals (Sweden)

    Genaro G. Ortiz

    2012-01-01

    Full Text Available Background. Cognitive impairment is an important clinical issue among elderly patients with depression and has a more complex etiology because of the variable rate of neurodegenerative changes associated with depression. The aim of the present work was to examine the prevalence of cognitive impairment and depression in a representative sample of adults aged ≥60 years. Methods. The presented work was a cross-sectional study on the prevalence of cognitive impairment and depression. Door-to-door interview technique was assigned in condition with multistage probability random sampling to obtain subjects that represent a population of the Guadalajara metropolitan area (GMA, Mexico. Cognitive function and depression were assessed by applying standardized Mini-Mental State Examination of Folstein (MMSE and the Geriatric Depression Scale (GDS, respectively. Results. Prevalence of cognitive impairment was 13.8% (14.5% women, 12.6% men; no significant differences by gender and retired or pensioner were found. Prevalence of depression was 29.1% (33.6% women, 21.1% men; no significant differences by retired or pensioner were found. Cognitive impairment was associated with depression (OR  =  3.26, CI 95%, 2.31–4.60. Prevalence of cognitive impairment and depression is associated with: being woman, only in depression being older than 75 years being married, and a low level of education. Conclusion. Cognitive impairment and depression are highly correlated in adults aged ≥60.

  16. Prevalence of Cognitive Impairment and Depression among a Population Aged over 60 Years in the Metropolitan Area of Guadalajara, Mexico

    Science.gov (United States)

    Ortiz, Genaro G.; Arias-Merino, Elva D.; Flores-Saiffe, María E.; Velázquez-Brizuela, Irma E.; Macías-Islas, Miguel A.; Pacheco-Moisés, Fermín P.

    2012-01-01

    Background. Cognitive impairment is an important clinical issue among elderly patients with depression and has a more complex etiology because of the variable rate of neurodegenerative changes associated with depression. The aim of the present work was to examine the prevalence of cognitive impairment and depression in a representative sample of adults aged ≥60 years. Methods. The presented work was a cross-sectional study on the prevalence of cognitive impairment and depression. Door-to-door interview technique was assigned in condition with multistage probability random sampling to obtain subjects that represent a population of the Guadalajara metropolitan area (GMA), Mexico. Cognitive function and depression were assessed by applying standardized Mini-Mental State Examination of Folstein (MMSE) and the Geriatric Depression Scale (GDS), respectively. Results. Prevalence of cognitive impairment was 13.8% (14.5% women, 12.6% men); no significant differences by gender and retired or pensioner were found. Prevalence of depression was 29.1% (33.6% women, 21.1% men); no significant differences by retired or pensioner were found. Cognitive impairment was associated with depression (OR  =  3.26, CI 95%, 2.31–4.60). Prevalence of cognitive impairment and depression is associated with: being woman, only in depression being older than 75 years being married, and a low level of education. Conclusion. Cognitive impairment and depression are highly correlated in adults aged ≥60. PMID:23243421

  17. 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.

  18. The Effects of Integrated Attention Training for Older Chinese Adults With Subjective Cognitive Complaints.

    Science.gov (United States)

    Cheng, Calvin Pak-Wing; Chiu-Wa Lam, Linda; Cheng, Sheung-Tak

    2016-12-01

    Early intervention to reduce cognitive decline and preserve functioning is a compelling public health issue. Because impaired attention occurs early in the process of cognitive impairment, focusing training strategies upon attention may be a potential intervention to prevent further cognitive decline. We sought to test the effects on cognitive performance and daily functioning of a new cognitive training program that focuses on attention. This single-blind randomized controlled trial lasted 6 months and included two phases. Assessments were conducted at baseline, at 3 months, and at 6 months. The study was performed in four community older adult centers. Ninety-three participants with subjective cognitive impairment without dementia were included. Forty-seven participants were randomized to the Integrated Attention Training Program (IATP), and 46 were randomized to the control group. The two arms of the study included the IATP (intervention group) and a health-related education program (active control group). No significant interactions were identified between group and time for the Clinical Dementia Rating-Sum of Boxes and other secondary outcomes, except for the Digit Forward Score ( p stimulation in a group format. Further studies are needed to determine the role of attention in cognitive training.

  19. Impaired financial capacity in late life depression is associated with cognitive performance on measures of executive functioning and attention.

    Science.gov (United States)

    Mackin, R Scott; Areán, Patricia A

    2009-09-01

    Few studies have evaluated the prevalence of impairments of financial capacity among individuals with psychiatric disorders. Late life depression (LLD) is a common psychiatric disorder associated with significant disability and cognitive impairment. The purpose of this investigation was to determine the prevalence and cognitive correlates of impairments of financial capacity among individuals with LLD. Participants included 65 LLD individuals and 32 comparison subjects. Assessments included measures of financial capacity, cognitive functioning, and depression symptom severity. Individuals with LLD exhibited a significantly higher rate of impaired financial capacity (22%) than the comparison group (6%). Results of a multiple regression analysis indicated that performance on measures of executive functioning and attention, but not depression severity, were most strongly associated with financial capacity performance in LLD. Our results suggest impairments of financial capacity in LLD are largely explained by cognitive functioning in these domains.

  20. Neuropsychological Impairment in Detoxified Alcohol-Dependent Subjects with Preserved Psychosocial Functioning

    Directory of Open Access Journals (Sweden)

    Catherine Martelli

    2017-09-01

    Full Text Available BackgroundChronic alcoholism and its related cognitive impairments are associated with increased social, relational, and professional deficits which have a variable overall impact on social integration. These impairments are known to have varying severities and have rarely been studied among healthy alcohol-dependent subjects with preserved psychosocial functioning. Thus, the objective of this study is to describe neuropsychological performance in this particular population.MethodTwenty-nine socially adjusted alcohol-dependent men, hospitalized for a first or second withdrawal and abstinent for 3 weeks minimum, were compared to 29 healthy non-alcoholic controls. All subjects underwent clinical and psychiatric examination, neuropsychological tests of memory (M, working memory (WM, and executive functions (EF. Comparisons were performed using Student’s t-tests or Mann–Whitney U tests.ResultsNo group differences were found on the Self-Reported Social Adjustment Scale (SAS-SR or in the Mini-Mental State Examination. Compared to controls, patients had greater episodic, spatial, and WM deficits as well as slightly altered executive functions. In contrast, their executive functions (spontaneous flexibility, criteria generation, rule maintenance, and inhibitory control were relatively preserved.ConclusionOur sample of socially and professionally integrated alcoholic patients shows fewer cognitive deficits than described in previous studies. Our results suggest that early on, alcohol-dependent subjects develop compensatory adaptation processes to preserve social function and adaptation. Minor cognitive impairments should be screened early in the disease to integrate cognitive interventions into the health-care plan to thus eventually prevent further socio-professional marginalization.

  1. Tea Consumption and Cognitive Impairment: A Cross-Sectional Study among Chinese Elderly

    Science.gov (United States)

    Shen, Wei; Xiao, Yuanyuan; Ying, Xuhua; Li, Songtao; Zhai, Yujia; Shang, Xiaopeng; Li, Fudong; Wang, Xiyi; He, Fan; Lin, Junfen

    2015-01-01

    Background Laboratorial and epidemiological researches suggested that tea exhibited potential neuroprotective effect which may prevent cognitive impairment, but there were few data among the elderly aged 60 years and above in China. Objective The objective was to explore the relationship between characteristics of tea consumption and cognitive impairment. Design We analyzed the baseline data from Zhejiang Major Public Health Surveillance Program (ZPHS) which was conducted in 2014. Totally 9,375 residents aged 60 years and above were recruited in this study. Face-to-face interview based on a self-developed questionnaire was performed for each participant. Detailed tea consumption habits were included in the questionnaire. Cognitive impairment screening was performed by using Mini-Mental State Examination (MMSE). Education-specific cut-off points for Chinese were applied to determine the status of cognitive impairment. Logistic regression analysis was used to calculate odds ratios (ORs) of cognitive impairment associated with tea consumption. Results The means (SD) of MMSE scores for the subjects who did not consume tea and consumed tea consumption (of all types) and prevalence of cognitive impairment. Volume of tea consumption was significantly associated with cognitive impairment: compared with non-consumption participants, those who consumed tea presented a positive correlation with cognitive function after controlling for potential confounders (OR = 0.52, 95% CI: 0.28, 0.95), while green tea showed no significant difference (OR = 1.04, 95% CI: 0.72, 1.51). Participants who consumed weak tea, moderate tea or strong tea more often were observed a better cognitive status when compared with those who did not have tea, with an OR of 0.51 (95% CI: 0.28, 0.92), 0.32 (95% CI: 0.19, 0.56) and 0.42 (95% CI: 0.22, 0.78) after adjusting for the potential confounders. But there was no statistically significant difference between any two of these ORs. Conclusion Black tea

  2. 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...

  3. 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.

  4. Validation of reaction time as a measure of cognitive function and quality of life in healthy subjects and patients

    DEFF Research Database (Denmark)

    Jakobsen, Lene Holm; Sorensen, Janice Marie; Rask, Ingeborg Krarup

    2011-01-01

    Malnutrition is a common problem in hospitalized patients and is related to decreased cognitive function and impaired quality of life (QoL). We investigated the validity of reaction time as a simple bedside tool for measuring cognitive function in healthy subjects and patients, and additionally...

  5. 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.

  6. 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...

  7. 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

  8. 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.

  9. 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 ...

  10. 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…

  11. 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…

  12. 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 ...

  13. 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...

  14. 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.

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  16. 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

  17. 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 ...

  18. 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 ...

  19. 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…

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Uemura K

    2013-01-01

    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.Keywords: exercise, mobility, rehabilitation, Timed Up and Go test

  2. 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.

  3. 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

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

    Science.gov (United States)

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

    2017-01-01

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

  5. Impaired cognitive plasticity and goal-directed control in adolescent obsessive-compulsive disorder.

    Science.gov (United States)

    Gottwald, Julia; de Wit, Sanne; Apergis-Schoute, Annemieke M; Morein-Zamir, Sharon; Kaser, Muzaffer; Cormack, Francesca; Sule, Akeem; Limmer, Winifred; Morris, Anna Conway; Robbins, Trevor W; Sahakian, Barbara J

    2018-01-22

    Youths with obsessive-compulsive disorder (OCD) experience severe distress and impaired functioning at school and at home. Critical cognitive domains for daily functioning and academic success are learning, memory, cognitive flexibility and goal-directed behavioural control. Performance in these important domains among teenagers with OCD was therefore investigated in this study. A total of 36 youths with OCD and 36 healthy comparison subjects completed two memory tasks: Pattern Recognition Memory (PRM) and Paired Associates Learning (PAL); as well as the Intra-Extra Dimensional Set Shift (IED) task to quantitatively gauge learning as well as cognitive flexibility. A subset of 30 participants of each group also completed a Differential-Outcome Effect (DOE) task followed by a Slips-of-Action Task, designed to assess the balance of goal-directed and habitual behavioural control. Adolescent OCD patients showed a significant learning and memory impairment. Compared with healthy comparison subjects, they made more errors on PRM and PAL and in the first stages of IED involving discrimination and reversal learning. Patients were also slower to learn about contingencies in the DOE task and were less sensitive to outcome devaluation, suggesting an impairment in goal-directed control. This study advances the characterization of juvenile OCD. Patients demonstrated impairments in all learning and memory tasks. We also provide the first experimental evidence of impaired goal-directed control and lack of cognitive plasticity early in the development of OCD. The extent to which the impairments in these cognitive domains impact academic performance and symptom development warrants further investigation.

  6. Tolerability of ambulatory blood pressure monitoring (ABPM) in cognitively impaired elderly.

    Science.gov (United States)

    Nesti, Nicola; Pieraccioli, Mariachiara; Mossello, Enrico; Sgrilli, Federica; Bulgaresi, Matteo; Crescioli, Elena; Biagini, Francesco; Caleri, Veronica; Tonon, Elisabetta; Cantini, Claudia; Biagini, Carlo A; Marchionni, Niccolò; Ungar, Andrea

    2014-12-01

    Recent guidelines have widened clinical indications for out-of-office blood pressure measurement, including home blood pressure monitoring and ambulatory blood pressure monitoring (ABPM), suggesting the latter as recommended method in cognitively impaired patients. There is, however, a widespread belief that ABPM could be poorly tolerated in dementia, often leading to withdraw from its use in these patients. To assess the actual tolerability of ABPM in a group of cognitively impaired elderly, affected by dementia or mild cognitive impairment (MCI). We evaluated 176 patients aged 65 + years, recruited in two different memory clinics, with a Mini Mental State Examination (MMSE) between 10 and 27. Behavioral and psychological symptoms were assessed with Neuropsychiatric Inventory (NPI). A patient was considered tolerant if able to keep the device on continuously for 24 h. The minimum number of correct measurements required was 70% of the predicted total number. 16% of patients wore the device for less than 24 h. Dividing the study population in tertiles of MMSE performance, 29% failed to tolerate the device in the lowest, 12% in the middle and 7% in the highest tertile (p ABPM proved a generally well-tolerated technique even in cognitively impaired elderly. Only a minority of subjects with poorer cognitive performances and greater behavioral symptoms did not tolerate the monitoring. Among most patients who failed to achieve the minimum number of measurements needed, the number of valid measurements was very close to the minimum required.

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

    Directory of Open Access Journals (Sweden)

    Leyla Baysal Kıraç

    2014-01-01

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

  8. Cognitive impairments in patients with intractable temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Mahgol Tavakoli

    2011-01-01

    Conclusions: These findings indicated that WMS-III and WAIS-R can differentiate patients with refractory temporal lobe epilepsy from normal subjects. However, the obtained cognitive profile could not differentiate between the right and the left TLE.

  9. 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.

  10. 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...

  11. Clinical relevance of specific cognitive complaints in determining Mild Cognitive Impairment from Cognitively Normal States in a study of Healthy Elderly Controls

    Directory of Open Access Journals (Sweden)

    Marina Avila Villanueva

    2016-10-01

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

  12. 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.

  13. Impaired social cognition processes in Asperger syndrome and anorexia nervosa. In search for endophenotypes of social cognition.

    Science.gov (United States)

    Kasperek-Zimowska, Beata Joanna; Zimowski, Janusz Grzegorz; Biernacka, Katarzyna; Kucharska-Pietura, Katarzyna; Rybakowski, Filip

    2016-01-01

    A growing number of publications indicates presence of significant deficits in social cognition in patients with anorexia nervosa (AN). These deficits appear to be comparable in qualitative and quantitative dimension with impairment of the same functions among people with Asperger syndrome (AS). The aim of this study is to identify subject areas in the field of impairment of social cognition processes among people with Asperger syndrome and anorexia nervosa taking into consideration the potential contribution of genetic pathways of oxytocin and vasopressin in the pathogenesis of these diseases. In the first part of the paper a systematic analysis of studies aimed at the evaluation of the processes of social cognition among patients with AN and AS has been carried out. The results of a significant number of studies confirm the presence of deficits in social cognition in AN and AS. In addition, among patients with AN and AS there exists a similar structure and distribution of the brain functions in regions responsible for social cognition. The second part of the paper describes the role of the oxytocin-vasopressin system (OT-AVP) in the processes of social cognition in AN and AS. Its genetic basis and the possible importance of single nucleotide polymorphisms within the genes: OXT, AVP, CD38, OXTR, AVPR1A and LNPEP have also been presented.

  14. 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.

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Nilton Custodio

    2014-08-01

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

  17. 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…

  18. 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.

  19. 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.

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    ZHOU Yu-ying

    2013-04-01

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

  2. 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.

  3. 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.

  4. Cognitively impaired elderly exhibit insulin resistance and no memory improvement with infused insulin.

    Science.gov (United States)

    Morris, Jill K; Vidoni, Eric D; Mahnken, Jonathan D; Montgomery, Robert N; Johnson, David K; Thyfault, John P; Burns, Jeffrey M

    2016-03-01

    Insulin resistance is a risk factor for Alzheimer's disease (AD), although its role in AD etiology is unclear. We assessed insulin resistance using fasting and insulin-stimulated measures in 51 elderly subjects with no dementia (ND; n = 37) and with cognitive impairment (CI; n = 14). CI subjects exhibited either mild CI or AD. Fasting insulin resistance was measured using the homeostatic model assessment of insulin resistance (HOMA-IR). Insulin-stimulated glucose disposal was assessed using the hyperinsulinemic-euglycemic clamp to calculate glucose disposal rate into lean mass, the primary site of insulin-stimulated glucose disposal. Because insulin crosses the blood-brain barrier, we also assessed whether insulin infusion would improve verbal episodic memory compared to baseline. Different but equivalent versions of cognitive tests were administered in counterbalanced order in the basal and insulin-stimulated state. Groups did not differ in age or body mass index. Cognitively impaired subjects exhibited greater insulin resistance as measured at fasting (HOMA-IR; ND: 1.09 [1.1] vs. CI: 2.01 [2.3], p = 0.028) and during the hyperinsulinemic clamp (glucose disposal rate into lean mass; ND: 9.9 (4.5) vs. AD 7.2 (3.2), p = 0.040). Cognitively impaired subjects also exhibited higher fasting insulin compared to ND subjects, (CI: 8.7 [7.8] vs. ND: 4.2 [3.8] μU/mL; p = 0.023) and higher fasting amylin (CI: 24.1 [39.1] vs. 8.37 [14.2]; p = 0.050) with no difference in fasting glucose. Insulin infusion elicited a detrimental effect on one test of verbal episodic memory (Free and Cued Selective Reminding Test) in both groups (p insulin resistance was observed in cognitively impaired subjects compared to ND controls, insulin infusion did not improve memory. Furthermore, a significant correlation between HOMA-IR and glucose disposal rate was present only in ND (p = 0.0002) but not in cognitively impaired (p = 0.884) subjects, indicating potentially important

  5. 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

  6. Objective Cognitive Impairment and Progression to Dementia in Women: The Prospective Epidemiological Risk Factor Study

    DEFF Research Database (Denmark)

    Neergaard, Jesper; Dragsbæk, K.; Christiansen, C.

    2017-01-01

    cognitive impairment (OCI), who were most likely to progress to dementia and to identify the risk factors associated with progression. Design: Prospective cohort study. Setting: Population-based. Participants: 5,380 elderly women from Denmark. Measurements: The Short Blessed Test and a category fluency test...... with animal naming, was used to assess cognitive function, and to classify them into different groups of OCI. Results: OCI was identified in 852 subjects at baseline. The risk of dementia was elevated for OCI subjects as compared to subjects with normal cognition (HR 1.46[1.19-1.79]). The courses of OCI were...... predictor of conversion to dementia, additionally several modifiable risk factors were associated with progression....

  7. 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.

  8. Association between cortical thickness and CSF biomarkers in mild cognitive impairment and Alzheimer’s disease

    DEFF Research Database (Denmark)

    Mohades, Sara; Dubois, Jonathan; Parent, Maxime

    regional cortical thinning (CT) measured by Magnetic Resonance Imaging (MRI) and brain amyloidosis (measured by CSF Ab 1-42 concentrations), or tau hyperphosphorylation (tau 181; p-tau) in Alzheimer’s Disease (AD) and Mild Cognitive Impairment (MCI) patients. We test the hypothesis that the association...... between cortical thinning, amyloidosis or tau hyperphosphorylation depends on cortical regions and clinical stages of AD. Methods: T1-weighed MRIs and associated CSF markers from individuals with mild cognitive impairment (MCI; 16), Alzheimer Disease (AD; n¼7) and age-matched cognitively normal subjects...... analyses in the MCI group showed a positive correlation between CT and Ab 1-42 measures predominantly in the temporo-parietal regions, namely the precuneus (peak r¼0.67; p

  9. Sleep-Wake Patterns and Cognition of Older Adults with Amnestic Mild Cognitive Impairment (aMCI): A Comparison with Cognitively Healthy Adults and Moderate Alzheimer's Disease Patients.

    Science.gov (United States)

    Wams, Emma J; Wilcock, Gordon K; Foster, Russell G; Wulff, Katharina

    2017-01-01

    Age-related cognitive impairment and the prevalence of neurodegenerative disease contribute to decreasing quality of life in affected individuals and their families as well as demand considerable societal responsibility. Sleep supports overall brain activity and contributes to both physical and mental health. As a result, sleep is an attractive target for exploring ways to promote health in accelerated cognitive aging. The aims of this study were to characterise cognitive performance and sleepwake behaviour in older adults with different degrees of cognitive impairment. Cognitive ability in a variety of domains of amnestic mild cognitive impairment (aMCI) individuals, moderate AD patients and cognitively healthy adults was assessed with the Mini-Mental-State- Examination and five computerised tests (CANTABeclipse™). It was imperative to exclude mixed diagnosis, comorbidities (psychiatric, neurological, sleep disorders), anti-dementia medication, institutionalised subjects, and to study participants within their home to minimise confounders. Sleep profiles were assessed with the Jupiter Sleep Questionnaire and Pittsburgh Sleep Quality Index completed by participants and carers. Participants' sleep-wake activity was monitored for three weeks using a wrist-worn actigraph and a semi-standardised diary. Groups were compared according to their diagnostic category and then pooled to correlate sleep data with cognitive performance. Mild cognitive impairment in aMCI individuals was reflected in domains of verbal and visuospatial memory but not attentional capacity or episodic memory. All self-reported and objective measures of sleep quality and sleep quantity of the aMCIs were within the normal range and comparable to those of cognitively healthy controls. Moderate AD patients scored significantly lower on all cognitive tests and had lower rest-activity amplitudes and distinctively longer nightly sleep periods that were not associated with sleep disorders, sleep

  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. [Cognitive impairment, nutritional status and clinical profile in chronic obstructive pulmonary disease].

    Science.gov (United States)

    López Torres, Isabel; Torres-Sánchez, Irene; Martín Salvador, Adelina; Ortiz Rubio, Araceli; Rodríguez Alzueta, Elisabeth; Valenza, Marie Carmen

    2014-11-01

    Chronic obstructive pulmonary disease (COPD) is a progressive disease with a prevalence that increases with the aging of the subject. It presents a high prevalence of comorbidities, such as cognitive decline, which is gaining great clinical relevance in recent years. Factors such as pulmonary function, hypoxemia, hypercapnia or exacerbations contribute to the decline of cognitive functions. The nutritional status has been added to these factors as contributing to cognitive function decline when presenting in COPD. To evidence the relationship between cognitive decline, nutritional status and the clinical profile of patients admitted because of an acute exacerbation of COPD (AECOPD). 110 subjects hospitalized because of COPD, divided in two groups according to their nutritional status and assessment of cognitive decline at admittance, nutritional status and clinical profile. Significant differences between groups concerning nutritional status in anthropometric variables (sex and IMC), functional ability (Barthel index and Daily Life Activities Scale), quality of life (Euroqol- 5D y SGRQ), sleep quality (Pittsburgh), mood (HAD) and cognitive decline (MoCa attention, MoCa abstraction). (pCognitive function is affected in COPD patients with an altered nutritional status when compared to those with a normal nutritional status. The nutritional decline is a factor contributing to the impairment of cognitive functions in this kind of patients, particularly a decline in attention and abstraction ability. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  12. The impact of human-computer interaction-based comprehensive training on the cognitive functions of cognitive impairment elderly individuals in a nursing home.

    Science.gov (United States)

    Zhuang, Jun-Peng; Fang, Rong; Feng, Xia; Xu, Xu-Hua; Liu, Li-Hua; Bai, Qing-Ke; Tang, Hui-Dong; Zhao, Zhen-Guo; Chen, Sheng-Di

    2013-01-01

    Given the increasing prevalence of dementia, any intervention that can effectively slow the deterioration of cognitive function is of great importance. This study investigated the efficacy of a human-computer interaction-based comprehensive cognitive training program in cognitively impaired elderly individuals living in a nursing home. All subjects, who were aged ≥70 years and had cognitive impairment, were randomly allocated to an intervention group (n = 19) or a control group (n = 14). The intervention group received human-computer interaction-based comprehensive cognitive training for 24 weeks. Neuropsychological examinations were conducted before and after this period. The intervention group was subdivided into two groups according to the scores of global cortical atrophy (GCA) to evaluate the impact of training effectiveness on GCA. After 24 weeks, neither group showed a significant change compared with baseline cognitive examinations. However, there was a tendency for greater improvement in memory, language, and visuospatial abilities for the intervention group as compared with controls. Patients with mild cognitive impairment showed improvements in language and visuospatial capacity, while patients with dementia showed improvements in attention/orientation, memory, language, and fluency. However, none of these findings were statistically significant. The results for the intervention subgroups showed that visuospatial ability improvement was significantly greater among those with a global cortical atrophy score of ≤15 (p Human-computer interaction-based comprehensive training may improve cognitive functions among cognitively impaired elderly individuals. The training effect was most prominent among those with milder cerebral atrophy.

  13. 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.

  14. 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.

  15. 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.

  16. [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.

  17. Chronic cerebral hypoperfusion independently exacerbates cognitive impairment within the pathopoiesis of Parkinson's disease via microvascular pathologys.

    Science.gov (United States)

    Tang, Hongmei; Gao, Yuyuan; Zhang, Qingxi; Nie, Kun; Zhu, Ruiming; Gao, Liang; Feng, Shujun; Wang, Limin; Zhao, Jiehao; Huang, Zhiheng; Zhang, Yuhu; Wang, Lijuan

    2017-08-30

    To date, the role of microvascular pathology and chronic cerebral hypoperfusion (CHH) in the development of mild cognitive impairment in Parkinson's disease (PD-MCI) is unclear. Here, we investigated how the combined injury through interaction of CHH and 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) toxicity act as an exacerbating element to damagae cognitive fuction in a mouse model. In the present study, C57BL/6 mice underwent MPTP injection. Subjects were classified into a PD with normal cognitive performance (PDCN) group or a PD-MCI group using the Morris Water Maze test. Further, CHH was induced by stenosis of the bilateral common carotid arteries (BCCAs). Consequently, the animals were divided into 7 groups: they are control, sham, BCCAs, PDCN, PD-MCI, PDCN+BCCAs and PD-MCI+BCCAs. The Morris Water Maze test, open field test, histological investigation and western blotting were performed to analyze cerebral microvascular impairment in each group. The results showed that CHH and MPTP injection caused spatial memory and behavioral impairment, accompanied by microvascular impairment and down-regulation of ZO-1 and Occludin at the protein level compared to the control group. The above injuries were synergistically exacerbated in the PDCN+BCCAs group and the PD-MCI+BCCAs group, which paralleled the elevated expression of p-MAPK and p-Akt. In short, our data demonstrate that CHH and MPTP caused cognitive and microvascular impairment separately. Moreover, CHH may exacerbate cognitive impairment in a mouse model of PD. The study provides a new opportunity for understanding the pathogenesis of PD-MCI. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. 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.

  19. 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.

  20. 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

  1. 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...

  2. Operationalizing the Diagnostic Criteria for Mild Cognitive Impairment: The Salience of Objective Measures in Predicting Incident Dementia.

    Science.gov (United States)

    Brodaty, Henry; Aerts, Liesbeth; Crawford, John D; Heffernan, Megan; Kochan, Nicole A; Reppermund, Simone; Kang, Kristan; Maston, Kate; Draper, Brian; Trollor, Julian N; Sachdev, Perminder S

    2017-05-01

    Mild cognitive impairment (MCI) is considered an intermediate stage between normal aging and dementia. It is diagnosed in the presence of subjective cognitive decline and objective cognitive impairment without significant functional impairment, although there are no standard operationalizations for each of these criteria. The objective of this study is to determine which operationalization of the MCI criteria is most accurate at predicting dementia. Six-year longitudinal study, part of the Sydney Memory and Ageing Study. Community-based. 873 community-dwelling dementia-free adults between 70 and 90 years of age. Persons from a non-English speaking background were excluded. Seven different operationalizations for subjective cognitive decline and eight measures of objective cognitive impairment (resulting in 56 different MCI operational algorithms) were applied. The accuracy of each algorithm to predict progression to dementia over 6 years was examined for 618 individuals. Baseline MCI prevalence varied between 0.4% and 30.2% and dementia conversion between 15.9% and 61.9% across different algorithms. The predictive accuracy for progression to dementia was poor. The highest accuracy was achieved based on objective cognitive impairment alone. Inclusion of subjective cognitive decline or mild functional impairment did not improve dementia prediction accuracy. Not MCI, but objective cognitive impairment alone, is the best predictor for progression to dementia in a community sample. Nevertheless, clinical assessment procedures need to be refined to improve the identification of pre-dementia individuals. Copyright © 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  3. 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.

  4. 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...

  5. Evidence of Objective Memory Impairments in Deployed Gulf War Veterans With Subjective Memory Complaints.

    Science.gov (United States)

    Chao, Linda L

    2017-05-01

    deployed GW veterans with subjective memory complaints have objective memory impairments. In light of the evidence linking subjective memory complaint to increased risk for dementia in the elderly, these findings suggest that aging GW veterans with subjective memory complaints should be closely monitored for further cognitive decline. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

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

    Science.gov (United States)

    Yancar Demir, Esra; Özcan, Tuba

    2015-09-01

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

  7. 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

  8. 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...

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

    Science.gov (United States)

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

    2016-03-01

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

  10. Neural correlates of spatial navigation changes in mild cognitive impairment and Alzheimer's disease

    Czech Academy of Sciences Publication Activity Database

    Vlček, Kamil; Laczó, J.

    2014-01-01

    Roč. 8, Mar 17 (2014), s. 89 ISSN 1662-5153 R&D Projects: GA MZd(CZ) NT13386 Grant - others:GA MŠk(CZ) ED1.100/02/0123 Institutional support: RVO:67985823 Keywords : spatial navigation * Alzheimer’s disease * spatial disorientation * brain changes * mild cognitive impairment Subject RIV: FH - Neurology Impact factor: 3.270, year: 2014

  11. 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.

  12. 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...

  13. 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.

  14. 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.

  15. Nutritional status and cognitive function in frail elderly subjects

    OpenAIRE

    Faxén Irving, Gerd

    2004-01-01

    Longevity, frailty and chronic disease are often associated with protein energy-malnutrition (PEM). Subjects with dementia are at particular risk for PEM. The overall aims of this thesis were to evaluate relationships between nutrition, cognition and functional capacity and to assess interventional means of developing the nutritional care of elderly. In study I and 11, the nutritional status and the cognitive function were examined in 28 and 80 service flat (SF) residents. F...

  16. 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.

  17. Early detection of Alzheimer disease: ¹¹C-PiB PET in twins discordant for cognitive impairment.

    Science.gov (United States)

    Scheinin, N M; Aalto, S; Kaprio, J; Koskenvuo, M; Räihä, I; Rokka, J; Hinkka-Yli-Salomäki, S; Rinne, J O

    2011-08-02

    The aim of this study was to investigate whether cognitively preserved monozygotic or dizygotic cotwins of persons with Alzheimer disease (AD) exhibit increased brain amyloid accumulation. We performed a cross-sectional carbon-11 labeled 2-(4'-methylaminophenyl)-6-hydroxybenzothiazole ((11)C)-Pittsburgh compound B (PiB) PET study on 9 monozygotic and 8 dizygotic twin pairs discordant for cognitive impairment as well as on 9 healthy elderly control subjects. (11)C-PiB uptake was analyzed with Statistical Parametric Mapping and with region of interest analysis with the region-to-cerebellum ratio as a measure of tracer uptake. Cognitively preserved monozygotic cotwins of cognitively impaired probands had increased cortical (11)C-PiB uptake (117%-121% of control mean) in their temporal and parietal cortices and the posterior cingulate. Cognitively preserved dizygotic subjects did not differ from the controls. Further, the cognitively preserved monozygotic subjects showed similar (11)C-PiB uptake patterns as their cognitively impaired cotwins. The cognitively impaired subjects (monozygotic and dizygotic individuals combined) showed typical Alzheimer-like patterns of (11)C-PiB uptake. Genetic factors appear to influence the development of Alzheimer-like β-amyloid plaque pathology. The dissociation between cognitive impairment and brain β-amyloidosis in monozygotic twins implies that there may be important environmental/acquired factors that modulate the relationship between brain amyloidosis and neurodegeneration. AD may be detectable in high-risk individuals in its presymptomatic stage with (11)C-PiB PET, but clinical follow-up will be needed to confirm this.

  18. Could cognitive vulnerability identify high-risk subjects for schizophrenia?

    Science.gov (United States)

    Sarfati, Yves; Hardy-Baylé, Marie-Christine

    2002-12-08

    This review puts into questions the possible role of cognitive vulnerability markers in prediction and prevention of schizophrenia. Until recently, none of the identified cognitive anomalies has been proved to be definitive. However, as new promising candidates are emerging (DS-CPT, CPT-IP, P suppression, Saccadic Eye Movements), the predictive value of these trait-type anomalies may be criticized regarding four issues, which are discussed: technical, metrological, theoretical, and clinical. As things stand, the existence of a cognitive vulnerability marker, which testify to a permanent pathological trait, does not constitute a sufficient factor to identify and treat subjects who are at risk for schizophrenia. Copyright 2002 Wiley-Liss, Inc.

  19. The influence of cognitive impairment on driving performance in multiple sclerosis.

    Science.gov (United States)

    Schultheis, M T; Garay, E; DeLuca, J

    2001-04-24

    To examine the influence of impaired cognitive processing on measures of driving skills in persons with MS. Twenty-eight subjects with documented MS were divided into two groups-with [MS(+), n = 13] and without [MS(-), n = 15] cognitive impairment-based on neuropsychological performance. Healthy control (HC) subjects (n = 17) matched on age and driving experience were also studied. Driving-related skills were compared between the groups based on performance on two computerized driving tests: the Useful Field of Vision (UFOV) and the Neurocognitive Driving Test (NDT). The MS(+) group performed significantly worse than both the MS(-) and HC groups in the latency to perform several driving-specific functions on the NDT, but no overall group differences were observed in actual errors on the NDT. On the UFOV, when compared to MS(-) and HC subjects, the MS(+) group demonstrated poorer performance on two of the three subtests. Additionally, a significantly higher percentage of MS(+) individuals were rated within the high risk (probability of crash involvement) category, relative to the MS(-) and HC groups. Cognitive impairment can negatively affect driving-related skills in persons with MS and should be considered in the determination of driving ability.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. Omega-3 fatty acids related to cognitive impairment in patients with schizophrenia

    Directory of Open Access Journals (Sweden)

    Kazumi Satogami

    2017-09-01

    Full Text Available Cognitive impairment is strongly associated with functional outcome in patients with schizophrenia but its pathophysiology remains largely unclear. Involvement of omega-3 fatty acids in the cognitive function of healthy individuals and patients with neuropsychiatric disease has received increasing attention. The aim of this study was to examine the relationship between omega-3 fatty acids with cognitive function, social function, and psychiatric symptoms in patients with schizophrenia. The subjects included 30 patients with schizophrenia or schizoaffective disorder. Psychiatric symptoms, cognitive function, and social function were assessed using the Positive and Negative Syndrome Scale, the Brief Assessment of Cognition in Schizophrenia (BACS, and the Social Functioning Scale (SFS, respectively. Blood serum omega-3 fatty acids were assessed using gas chromatography. The BACS composite score was significantly correlated with blood eicosapentaenoic acid (EPA and docosahexaenoic acid (DHA levels. In addition, a daily dose of antipsychotic medication was negatively and significantly correlated with the blood DHA level and with the BACS composite score. Step-wise multiple regression analyses demonstrated that the SFS score was significantly associated with the BACS composite score. Our results indicate that reduced blood omega-3 fatty acids are associated with cognitive impairment, which then impacts social functioning outcomes in schizophrenia.

  6. 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

  7. Does depression, apathy, or cognitive impairment reduce the benefit of inpatient rehabilitation facilities for elderly hip fracture patients?

    Science.gov (United States)

    Lenze, Eric J.; Skidmore, Elizabeth R.; Dew, Mary Amanda; Butters, Meryl A.; Rogers, Joan C.; Begley, Amy; Reynolds, Charles F.; Munin, Michael C.

    2007-01-01

    Objective Depression, apathy (amotivation), and cognitive impairment are common comorbidities in hip fracture patients, which may adversely affect functional outcome of rehabilitation. We examined whether post-fracture measures of mood, motivation, or cognition are associated with rehabilitation outcome (defined as functional improvement) in inpatient rehabilitation facilities (IRFs), as compared to skilled nursing facilities (SNFs). Methods This prospective study examined elderly patients who received surgical fixation for hip fracture and then received post-acute rehabilitation at an IRF or a SNF. Subjects were characterized at baseline for depression using the Hamilton Rating Scale for Depression, apathy/amotivation using the Apathy Evaluation Scale, and mild-moderate cognitive impairment using the Mini-Mental Status Examination. Functional recovery was measured over 12-week follow-up using the Functional Independence Measure. Results 58 subjects were discharged from acute care to an IRF and 39 to a SNF. Patients with depression, apathy, or cognitive impairment who received rehabilitation at an IRF had significantly better functional outcomes than similarly-impaired patients at SNFs, and similar outcomes as nondepressed, motivated, and cognitively intact elderly at IRFs. Conclusion These findings suggest that depression, amotivation, or mild-moderate cognitive impairment after hip fracture do not reduce the benefit of post-acute rehabilitation in an IRF. PMID:17336663

  8. Impairment in visual cognition in patients with Parkinson disease

    International Nuclear Information System (INIS)

    Hirayama, Kazumi; Ishioka, Toshiyuki

    2007-01-01

    Neural pathway for visual information processing involves retina, lateral geniculate body, primary visual cortex, and higher visual cortical areas, all of which have been reported to be disordered either functionally or pathologically in Parkinson disease (PD). As elementary visual disorders, there have been studies that reported reduced contrast sensitivity for middle to high spatial frequencies and impaired blue color perception. Most of those studies suggested retina as the damaged cite that is responsible for the impairments, whereas some studies pointed to the possible cortical involvement. Impairments of higher visual functions also have been reported. In the dorsal stream, impairments of object localization, depth perception, and mental rotation have been reported. In the ventral stream, object perception and visual integration of objects have been found to be impaired. A meta-analysis study, however, concluded that although there may be impairments in higher order functions like attention and problem solving capacity there is no firm evidence for the impairments of higher visual functions. Neuroimaging studies have found a relationship between reduced metabolism centered in the parietal lobe and impaired performance in higher visual functions. Impaired identification of overlapping figures has been reported in dementia with Lewy bodies a disease that is akin to PD. Capacity to discriminate textured areas has been found to be damaged in PD. We conducted a fluorodeoxyglucose-positron emission tomography (FDG-PET) study to explore the relationship between brain metabolism and perception of overlapping figures, perception of shapes defined by texture differences and perception of subjective contours in PD. It revealed that there is a correlation between reduced activation in lateral occipital complex and impaired performance for these tasks, suggesting some compromised ventral rout functions. (author)

  9. Impact of mild cognitive impairment on health-related quality of life in Parkinson's disease.

    Science.gov (United States)

    Reginold, William; Duff-Canning, Sarah; Meaney, Christopher; Armstrong, Melissa J; Fox, Susan; Rothberg, Brandon; Zadikoff, Cindy; Kennedy, Nancy; Gill, David; Eslinger, Paul; Marshall, Fred; Mapstone, Mark; Chou, Kelvin L; Persad, Carol; Litvan, Irene; Mast, Benjamin; Tang-Wai, David; Lang, Anthony E; Marras, Connie

    2013-01-01

    To assess the impact of mild cognitive impairment (MCI) or cognitive decline on health-related quality of life (HR-QOL) in Parkinson's disease (PD). HR-QOL measured by the Parkinson Disease Quality of Life Questionnaire (PDQ-39), MCI according to Movement Disorder Society Task Force criteria and cognitive decline from premorbid baseline were assessed in non-demented PD patients at 6 movement disorder clinics. Among 137 patients, after adjusting for education, gender, disease duration, and Movement Disorder Society Unified Parkinson's Disease Rating Scale total score, MCI was associated with worse scores within the PDQ-39 dimension of communication (p = 0.008). Subjects were divided into tertiles of cognitive decline from premorbid level. Scores in the dimension of stigma were worst in the second tertile of cognitive decline (p = 0.03). MCI was associated with worse social support scores in the second tertile of cognitive decline (p = 0.008). MCI and cognitive decline from premorbid baseline are associated with reduced HR-QOL in communication, stigma, and social support domains. The cognitive decline from premorbid baseline modifies the association between MCI and HR-QOL in PD and knowing both will allow a better appreciation of difficulties patients face in daily life. Copyright © 2013 S. Karger AG, Basel.

  10. 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...

  11. Mechanisms of cognitive impairment in cerebral small vessel disease: multimodal MRI results from the St George's cognition and neuroimaging in stroke (SCANS study.

    Directory of Open Access Journals (Sweden)

    Andrew J Lawrence

    Full Text Available Cerebral small vessel disease (SVD is a common cause of vascular cognitive impairment. A number of disease features can be assessed on MRI including lacunar infarcts, T2 lesion volume, brain atrophy, and cerebral microbleeds. In addition, diffusion tensor imaging (DTI is sensitive to disruption of white matter ultrastructure, and recently it has been suggested that additional information on the pattern of damage may be obtained from axial diffusivity, a proposed marker of axonal damage, and radial diffusivity, an indicator of demyelination. We determined the contribution of these whole brain MRI markers to cognitive impairment in SVD. Consecutive patients with lacunar stroke and confluent leukoaraiosis were recruited into the ongoing SCANS study of cognitive impairment in SVD (n = 115, and underwent neuropsychological assessment and multimodal MRI. SVD subjects displayed poor performance on tests of executive function and processing speed. In the SVD group brain volume was lower, white matter hyperintensity volume higher and all diffusion characteristics differed significantly from control subjects (n = 50. On multi-predictor analysis independent predictors of executive function in SVD were lacunar infarct count and diffusivity of normal appearing white matter on DTI. Independent predictors of processing speed were lacunar infarct count and brain atrophy. Radial diffusivity was a stronger DTI predictor than axial diffusivity, suggesting ischaemic demyelination, seen neuropathologically in SVD, may be an important predictor of cognitive impairment in SVD. Our study provides information on the mechanism of cognitive impairment in SVD.

  12. Cognitive stimulation in cognitively impaired individuals and cognitively healthy individuals with a family history of dementia: short-term results from the "Allena-Mente" randomized controlled trial.

    Science.gov (United States)

    Polito, Letizia; Abbondanza, Simona; Vaccaro, Roberta; Valle, Eleonora; Davin, Annalisa; Degrate, Alessandro; Villani, Simona; Guaita, Antonio

    2015-06-01

    We evaluated the short-term efficacy of a protocol of cognitive stimulation (CS), compared with a sham intervention, on cognitive performance in cognitively healthy individuals with a family history of dementia (NDFAM) and in non-demented individuals with cognitive impairment (CI). We performed a randomized controlled trial of CS in NDFAM and CI. CS consisted in 10 twice weekly meetings of CS focused on a specific cognitive area. CS was compared with a sham intervention (CT) using Mini-mental state examination (MMSE), Montreal Cognitive Assessment (MoCA), and the Corsi test. All study participants were typed for the presence of apolipoprotein E (APOE)-Ɛ4. Cognitively healthy NDFAM showed a higher net cognitive gain after CS, as reflected in their MoCA score, and a borderline significant net increase in visuospatial memory (Corsi test) compared with those receiving the CT. APOE-Ɛ4 carriers showed a less significant improvement on the Corsi test with respect to APOE-Ɛ4 non-carriers. In the CI sample, the MoCA and Corsi test results did not differ between the cognitively stimulated subjects and the controls. No changes in MMSE scores were found in either sample of subjects. These findings suggest that CS as structured in this study is an effective treatment in cognitively healthy individuals, whereas it is less effective in individuals with CI. Moreover, evaluation of APOE-Ɛ4 status provided evidence of a substantial genetic contribution to the efficacy of CS on visuospatial memory as measured using the Corsi test. Copyright © 2014 John Wiley & Sons, Ltd.

  13. Prevalence and predictors of “subjective cognitive complaints” in the Sydney Memory and Ageing Study.

    Science.gov (United States)

    Slavin, Melissa J; Brodaty, Henry; Kochan, Nicole A; Crawford, John D; Trollor, Julian N; Draper, Brian; Sachdev, Perminder S

    2010-08-01

    To document the prevalence of self- and informant report of cognitive problems, usually referred to as "subjective cognitive complaints" (SCCs), in a community-dwelling sample of older adults and to examine the relationship between SCCs and objective impairment, mood, and personality measures. Eight hundred twenty-seven nondemented community-dwelling adults aged 70-90 years. Participants were asked 24 SCC questions, including the Memory Complaint Questionnaire (MAC-Q), and completed neuropsychological testing in the domains of memory, language, executive function, visuospatial skills, and psychomotor speed. The Geriatric Depression Scale, Goldberg Anxiety Scale, and Neuroticism, Openness, and Conscientiousness from the NEO-Five Factor Inventory were used as measures of participants' psychological status. Informants completed 19 SCC questions, including a modified short Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Overall, 95.5% of participants or their informants endorsed at least one SCC. Although participants were more likely to endorse a memory complaint, informants seemed more accurate in endorsing a complaint when cognitive impairment was objectively present. SCC correlated with participants' scores on measures of depression, anxiety, neuroticism, and inversely with measures of openness and conscientiousness. Age, education, and sex had little impact on these effects. Regression analysis showed that psychological factors explained the number of complaints more than cognitive performance. The usefulness of SCCs as a criterion for mild cognitive impairment is questioned because of their high prevalence and their relationship to psychological factors. This may be helpful for clinicians to bear in mind when presented with patients with cognitive complaints.

  14. Clock drawing test in screening for Alzheimer's dementia and mild cognitive impairment in clinical practice.

    Science.gov (United States)

    Vyhnálek, Martin; Rubínová, Eva; Marková, Hana; Nikolai, Tomáš; Laczó, Jan; Andel, Ross; Hort, Jakub

    2017-09-01

    The clock drawing test (CDT) is a commonly used brief cognitive measure. We evaluated diagnostic accuracy of subjective ratings of CDT by physicians (with/without specialty in cognitive neurology) and neuropsychologists in discriminating amnestic mild cognitive impairment (aMCI), Alzheimer's dementia (AD) and cognitively healthy older adults. We further compared the diagnostic accuracy of subjective categorical ratings with complex scoring of CDT. Three cognitive neurologists, three neuropsychologists and six neurology residents without experience in cognitive neurology blinded to the diagnosis rated 187 CDTs (50 mild AD, 49 aMCI and 88 cognitively healthy older adults) using a "yes" (abnormal) versus "suspected" versus "no" (normal) classification. The rating suspected was combined with yes or no to obtain two sets of sensitivity estimates. We also used a 17-point CDT rating system. When using the categorical rating, neuropsychologists had highest sensitivity (89%) in differentiating patients with mild AD (yes/suspected versus no), followed by neurologic residents (80%) and cognitive neurologists (79%). When differentiating patients with aMCI (yes/suspected versus no), the sensitivity was 84% for neuropsychologists, 64% for cognitive neurologists and 62% for residents. The sensitivity using the complex scoring system was 92% in patients with mild AD and 69% in patients with aMCI. A categorical rating of CDT shows high sensitivity for mild AD even in non-experienced raters. Neuropsychologists outperformed physicians in differentiating patients with aMCI from cognitively healthy older adults (specificity), which was counterbalanced by the lower specificity of their ratings. The diagnostic accuracy was not substantially improved by using complex scoring system. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  15. Cognitive reserve modulates attention processes in healthy elderly and amnestic mild cognitive impairment: An event-related potential study.

    Science.gov (United States)

    Gu, Lihua; Chen, Jiu; Gao, Lijuan; Shu, Hao; Wang, Zan; Liu, Duan; Yan, Yanna; Li, Shijiang; Zhang, Zhijun

    2018-01-01

    The study aimed to investigate and compare the effect of cognitive reserve (CR) on brain activation in healthy controls (HC) and amnestic mild cognitive impairment (aMCI) patients during 0-back and 1-back tasks measured by event-related potential (ERP). The study recorded 85 subjects (39 aMCI patients and 46 their matched controls) with a 64-channel electroencephalogram (EEG). Subjects performed 0- and 1-back tasks. Compared to HC, aMCI patients showed reduced accuracy, delayed mean correct response time (RT) and decreased P300 amplitude at central-parietal and parietal electrodes. A mediation analysis indicated that higher CR reduced neural inefficiency, which might be associated with better task performance in HC. However, no correlation was detected between CR and neural inefficiency in aMCI patients, whereas higher CR was still related to enhanced accuracy and prolonged RT in aMCI patients. The present study reported that higher CR could contribute to better task performance via down-regulating neural inefficiency in HC. In addition, higher CR might modulate attention processes in aMCI via a way distinct from that in HC, and eventually result in better task performance. The study provided evidence for that improving CR might lower cognitive impairment of healthy elderly and aMCI patients. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  16. 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.

  17. 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...

  18. 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.

  19. 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...

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

    Directory of Open Access Journals (Sweden)

    Felipe Kenji Sudo

    2013-07-01

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

  1. Subjective memory complaints in elders: depression, anxiety, or cognitive decline?

    Science.gov (United States)

    Balash, Y; Mordechovich, M; Shabtai, H; Giladi, N; Gurevich, T; Korczyn, A D

    2013-05-01

    To study the association of subjective memory complaints (SMC) with affective state and cognitive performance in elders. We studied community dwelling elderly persons with normal physical examination. Participants completed questionnaires regarding memory difficulties and lifestyle habits, the Geriatric Depression Scale (GDS) and the Spielberger State-Trait Anxiety Inventory (STAI). Depending on their answers to the question about their memory condition, participants were divided into complainers and non-complainers and to five groups according to their MMSE scores. These data have been compared to objective cognitive performance according to Mindstreams - a computerized neuropsychological battery. A logistic regression was performed to evaluate odds ratios (OR) and 95% confidence intervals (CI) for those factors, which were associated with SMС (dependent variable). Of 636 consecutive subjects (61% females), 507 participants (79.7%) had SMС. Presence of SMC was inversely correlated with MMSE scores, (r = -0.108; P for trend = 0.007). GDS and STAI scores were higher among subjects with SMC (OR = 1.23: CI 95%: 1.1-1.36 and OR = 1.03: CI 95%: 1.01-1.07, respectively). SMC did not correlate with objective cognitive performance measured by Mindstreams. Subjective memory complaints are associated with sub-syndromal depression and anxiety in healthy cognitively normal elders. © 2012 John Wiley & Sons A/S.

  2. Alzheimer's disease cerebrospinal fluid biomarker in cognitively normal subjects

    NARCIS (Netherlands)

    Toledo, J.B.; Zetterberg, H.; van Harten, A.C.; Glodzik, L.; Martinez-Lage, P.; Bocchio-Chiavetto, L.; Rami, L.; Hansson, O.; Sperling, R.; Engelborghs, S.; Osorio, R.S.; Vanderstichele, H.; Vandijck, M.; Hampel, H.; Teipl, S.; Moghekar, A.; Albert, M.; Hu, W.T.; Argiles, J.A.M.; Gorostidi, A.; Teunissen, C.E.; de Deyn, P.P.; Hyman, B.T.; Molinuevo, J.L.; Frisoni, G. B.; Linazasoro, G.; de Leon, M.J.; van der Flier, W.M.; Scheltens, P.; Blennow, K.; Shaw, L.M.; Trojanowski, J.Q.

    2015-01-01

    In a large multicentre sample of cognitively normal subjects, as a function of age, gender and APOE genotype, we studied the frequency of abnormal cerebrospinal fluid levels of Alzheimer's disease biomarkers including: total tau, phosphorylated tau and amyloid-β1-42. Fifteen cohorts from

  3. 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.

  4. 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

  5. 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

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

    Directory of Open Access Journals (Sweden)

    Ma Shwe Zin Nyunt

    2017-12-01

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

  7. Movements Execution in Amnestic Mild Cognitive Impairment and Alzheimer’s Disease

    Directory of Open Access Journals (Sweden)

    Rosolino Camarda

    2007-01-01

    Full Text Available We evaluated the relationship between motor and neuropsychological deficits in subjects affected by amnestic Mild Cognitive Impairment (aMCI and early Alzheimer’s Disease (AD. Kinematics of goal-directed movement of aMCI and AD subjects were compared to those of age-matched control subjects. AD showed a slowing down of motor performance compared to aMCI and controls. No relationships were found between motor and cognitive performances in both AD and aMCI. Our results suggest that the different motor behaviour between AD and aMCI cannot be related to memory deficits, probably reflecting the initial degeneration of parietal-frontal circuits for movement planning. The onset of motor dysfunction in early AD could represent the transition from aMCI to AD.

  8. 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.

  9. 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</