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Cognitive Domains (cognitive + domain)
Kinds of Cognitive Domains Selected AbstractsBrain,behavior correlation in children depends on the neurocognitive networkHUMAN BRAIN MAPPING, Issue 2 2004James R. Booth We examined brain,behavior correlations in 12 children (age range 9.3 to 11.7 years) during a selective attention task that required the visual search of a conjunction of features and during a response inhibition task that required the inhibition of a pre-potent response during "no-go" blocks. We found that the association between performance in these tasks and brain activation as measured by functional magnetic resonance imaging (fMRI) depended on the neurocognitive network. Specifically, better performance during the no-go task was associated with greater activation in the response inhibition network including the prefrontal cortex and basal ganglia. In contrast, better performance during the visual search task was associated with less activation in the selective attention network including superior parietal lobule and lateral premotor cortex. These results show that the relation of performance to the magnitude of neural activation is complex and may display differential relationships based on the cognitive domain, anatomical region, and perhaps also developmental stage. Hum Brain Mapping 23:99,108, 2004. © 2004 Wiley-Liss, Inc. [source] Assessing mild cognitive impairment among older African AmericansINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 7 2010Alyssa A. Gamaldo Abstract Objectives To examine the frequency of Mild Cognitive Impairment (MCI) in African American older adults. The study also plans to explore the specific cognitive domains of impairment as well as whether there are differences in demographics, health, and cognitive performance between MCI and normal participants. Design Cross-sectional. Setting Independent-living sample of urban dwelling elders in Baltimore, Maryland. Participants The sample consisted of 554 subjects ranging in age from 50 to 95 (Mean,=,68.79,±,9.60). Measurements Socio-demographics and health were assessed. Several cognitive measures were administered to assess inductive reasoning, declarative memory, perceptual speed, working memory, executive functioning, language and global cognitive functioning. Results Approximately 22% of participants were considered MCI (i.e. 18% non-amnestic vs. 4% amnestic). A majority of the non-amnestic MCI participants had impairment in one cognitive domain, particularly language and executive function. Individuals classified as non-amnestic MCI were significantly older and had more years of education than normal individuals. The MCI groups were not significantly different than cognitively normal individuals on health factors. Individuals classified as MCI performed significantly worse on global cognitive measures as well as across specific cognitive domains than cognitively normal individuals. Conclusion This study demonstrates that impairment in a non-memory domain may be an early indicator of cognitive impairment, particularly among African Americans. Copyright © 2010 John Wiley & Sons, Ltd. [source] Cognitive dysfunction and health-related quality of life after a cardiac arrest and therapeutic hypothermiaACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 6 2010J. TORGERSEN Background: Evidence-based treatment protocols including therapeutic hypothermia have increased hospital survival to over 50% in unconscious out-of-hospital cardiac arrest survivors. In this study we estimated the incidence of cognitive dysfunctions in a group of cardiac arrest survivors with a high functional outcome treated with therapeutic hypothermia. Secondarily, we assessed the cardiac arrest group's level of cognitive performance in each tested cognitive domain and investigated the relationship between cognitive function and age, time since cardiac arrest and health-related quality of life (HRQOL). Methods: We included 26 patients 13,28 months after a cardiac arrest. All patients were scored using the Cerebral Performance Category scale (CPC) and Mini-Mental State Examination (MMSE). Twenty-five of the patients were tested for cognitive function using the Cambridge Neuropsychological Test Automated Battery (CANTAB). These patients were tested using four cognitive tests: Motor Screening Test, Delayed Matching to Sample, Stockings of Cambridge and Paired Associate Learning from CANTAB. All patients filled in the Short Form-36 for the assessment of HRQOL. Results: Thirteen of 25 (52%) patients were classified as having a cognitive dysfunction. Compared with the reference population, there was no difference in the performance in motor function and delayed memory but there were significant differences in executive function and episodic memory. We found no associations between cognitive function and age, time since cardiac arrest or HRQOL. Conclusion: Half of the patients had a cognitive dysfunction with reduced performance on executive function and episodic memory, indicating frontal and temporal lobe affection, respectively. Reduced performance did not affect HRQOL. [source] The cognitive effects of adjuvant chemotherapy in early stage breast cancer: a prospective study,PSYCHO-ONCOLOGY, Issue 2 2008Angela Stewart Abstract Purpose: The primary purpose of this study was to evaluate the cognitive effects of adjuvant chemotherapy in post-menopausal breast cancer patients. Patients and methods: Breast cancer patients scheduled to receive adjuvant chemotherapy (n = 61) completed comprehensive cognitive testing before and after treatment. A control group of women receiving adjuvant hormonal therapy (n = 51) was tested at comparable intervals. Results: Mean scores for both patient groups were within the normal range relative to published norms on all cognitive tests at both time points, and generally inclined or stayed the same from baseline to retest in both groups. However, in an analysis of individual change scores, the chemotherapy patients were 3.3 times more likely than the hormonal patients to show reliable cognitive decline (31 and 12%, respectively). Chemotherapy subjects showing decline were less educated and had higher baseline depression scores than their counterparts who did not decline. Working memory was the cognitive domain most vulnerable to the effects of chemotherapy. Conclusion: These data support previous findings of a subtle negative influence of chemotherapy on cognitive function in a subgroup of breast cancer patients. The results are discussed in terms of the importance of study design. Copyright © 2007 John Wiley & Sons, Ltd. [source] Residual cognitive impairments in remitted depressed patients,DEPRESSION AND ANXIETY, Issue 6 2008Wendelien Merens M.A. Abstract Depressive disorders are associated with various cognitive impairments. Studies on whether or not these impairments persist into the euthymic phase have shown conflicting results, due to differences in test versions and in study samples. In this paper, we aimed to compare the cognitive performance of remitted depressed patients with that of age- and gender-matched healthy volunteers across a wide range of cognitive domains. In two studies, we found few differences on neutral as well as emotional information processing tests. The findings indicate that remitted depressed patients who use antidepressant medication still show an increased recognition of facial expression of fear compared to healthy controls. Patients also performed worse on a test of recognition of abstract visual information from long-term memory. No other residual cognitive impairments were found. These results indicate that most of the cognitive impairments associated with depression resolve with recovery through medication, even when recovery is incomplete. Considering the finding that remitted depressed patients have higher levels of cognitive reactivity, future studies may investigate the possibility that these cognitive impairments have not resolved but have become latent, and may therefore easily be triggered by small changes in mood state. Depression and Anxiety 0:1,10, 2007. © 2007 Wiley-Liss, Inc. [source] Applying the choice/no-choice methodology: the case of children's strategy use in spellingDEVELOPMENTAL SCIENCE, Issue 1 2002Patrick Lemaire The present study illustrates the usefulness of the choice/no-choice method to investigate age-related changes in children's strategies. This method enables independent assessments of strategy use and execution. It is applied in children's spelling strategies. Third- and fifth-grade children were asked to write down words using a dictionary or not (choice condition). Then, they were successively required to spell words using each strategy (no-choice condition). Performance showed that (a) strategy choices and accuracy differed in younger and older children, (b) strategy effectiveness was the strongest predictor of children's strategy use, and (c) having the choice resulted in higher level of spelling accuracy (especially in older children) than having no choice. We discuss the implications of these results on how the choice/no-choice method can be useful for understanding and investigating children's strategy choices in spelling and other cognitive domains. [source] Critical evaluation of cognitive dysfunctions as endophenotypes of schizophreniaACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2004S. Kéri Objective:, Cognitive dysfunctions are potential endophenotypes of schizophrenia. The aim of this study was to investigate whether recent evidence indeed suggests that cognitive dysfunctions are potent indicators of specific genetic traits that represent susceptibility for schizophrenia. Method:, Studies including large, well-defined samples and controlled cognitive assessment have been reviewed. Results:, Evidence suggests that schizophrenia patients and their unaffected biological relatives are impaired in several cognitive domains, including working memory, executive functions, sustained attention, verbal episodic memory, processing of visual and auditory stimuli, and smooth pursuit eye movements. However, these impairments are present only in a limited proportion of subjects, showing low specificity and sensitivity and high variability. Linkage with specific genes is weak. Conclusion:, Although some results are promising, at present cognitive dysfunctions cannot be considered as highly sensitive and specific endophenotypes of schizophrenia. [source] A review of the clinical pharmacology of methamphetamineADDICTION, Issue 7 2009Christopher C. Cruickshank ABSTRACT Aims To examine the literature regarding clinical pharmacokinetics, direct effects and adverse clinical outcomes associated with methamphetamine use. Methods Relevant literature was identified through a PubMed search. Additional literature was obtained from relevant books and monographs. Findings and conclusions The mean elimination half-life for methamphetamine is approximately 10 hours, with considerable inter-individual variability in pharmacokinetics. Direct effects at low-to-moderate methamphetamine doses (5,30 mg) include arousal, positive mood, cardiac stimulation and acute improvement in cognitive domains such as attention and psychomotor coordination. At higher doses used typically by illicit users (,50 mg), methamphetamine can produce psychosis. Its hypertensive effect can produce a number of acute and chronic cardiovascular complications. Repeated use may induce neurotoxicity, associated with prolonged psychiatric symptoms, cognitive impairment and an increased risk of developing Parkinson's disease. Abrupt cessation of repeated methamphetamine use leads to a withdrawal syndrome consisting of depressed mood, anxiety and sleep disturbance. Acute withdrawal lasts typically for 7,10 days, and residual symptoms associated with neurotoxicity may persist for several months. [source] Auditory orienting and inhibition of return in mild traumatic brain injury: A FMRI studyHUMAN BRAIN MAPPING, Issue 12 2009Andrew R. Mayer Abstract The semiacute phase of mild traumatic brain injury (mTBI) is associated with deficits in the cognitive domains of attention, memory, and executive function, which previous work suggests may be related to a specific deficit in disengaging attentional focus. However, to date, there have only been a few studies that have employed dynamic imaging techniques to investigate the potential neurological basis of these cognitive deficits during the semiacute stage of injury. Therefore, event-related functional magnetic resonance imaging was used to investigate the neurological correlates of attentional dysfunction in a clinically homogeneous sample of 16 patients with mTBI during the semiacute phase of injury (<3 weeks). Behaviorally, patients with mTBI exhibited deficits in disengaging and reorienting auditory attention following invalid cues as well as a failure to inhibit attentional allocation to a cued spatial location compared to a group of matched controls. Accordingly, patients with mTBI also exhibited hypoactivation within thalamus, striatum, midbrain nuclei, and cerebellum across all trials as well as hypoactivation in the right posterior parietal cortex, presupplementary motor area, bilateral frontal eye fields, and right ventrolateral prefrontal cortex during attentional disengagement. Finally, the hemodynamic response within several regions of the attentional network predicted response times better for controls than for patients with mTBI. These objective neurological findings represent a potential biomarker for the behavioral deficits in spatial attention that characterize the initial recovery phase of mTBI. Hum Brain Mapp, 2009. © 2009 Wiley-Liss, Inc. [source] Neurocognition and its influencing factors in the treatment of schizophrenia,effects of aripiprazole, olanzapine, quetiapine and risperidoneHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 2 2010M. Riedel Abstract Background To examine influencing variables of neurocognition in patients with schizophrenia and to predict cognition during antipsychotic treatment. Methods Data were obtained from patients with an acute episode of schizophrenia participating in two double-blind and one open label trial comparing the effects of different atypical antipsychotics on cognition. In total, 129 patients were enrolled in this analysis. Cognitive function was assessed at admission, week 4 and 8. Efficacy and tolerability were assessed weekly using the Positive and Negative Syndrome Scale (PANSS) and the Simpson Angus Sale (SAS). Patients were treated with aripirazole, olanzapine, quetiapine and risperidone. Regression analysis including mixed effect models was performed. Results A significant improvement in all cognitive domains was observed from baseline to week 8. Regarding the antipsychotic treatment applied quetiapine seemed to achieve the most favourable cognitive improvement. Negative and depressive symptoms, the patient's age and the concomitant and antipsychotic treatment applied were observed to significantly influence and predict neurocognition. Conclusion The results may indicate that schizophrenia is a static disorder with trait and state dependent cognitive components especially in the memory domains. The influence of negative and depressive symptoms should be considered in daily clinical routine. Copyright © 2010 John Wiley & Sons, Ltd. [source] Acute cognitive effects of donepezil in young, healthy volunteersHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 6 2009Ana LC Zaninotto Abstract Objective The acute nootropic potential of donepezil in young healthy volunteers has not been adequately investigated mainly because in previous studies: (1) effects were assessed before peak-plasma concentration (Tmax) was reached; (2) only a few cognitive processes were assessed. Here we investigated a myriad of cognitive effects of augmentation of acetylcholine using an acute dose of donepezil in healthy adults at theoretical Tmax. Methods This was a double-blind, placebo controlled, parallel group design study of cognitive effects of acute oral donepezil (5,mg). Subjects were tested twice after donepezil ingestion: 90,min (time that coincides with previous testing in the literature) and 210,min. (theoretical Tmax). The test battery included tasks that tap cognitive domains that are sensitive to acetylcholine manipulations. Results At both testing times donepezil improved long-term recall of prose, objects recall, recall of spatial locations, and integration of objects with their locations, some effects having been related to self-reported mood enhancement. However, improvement of performance in the central executive measure (backward digit span) occurred only at Tmax. Conclusion Positive cognitive effects of acute donepezil can be observed in various cognitive domains including mood, but its full nootropic potential is more clearly found close to theoretical peak-plasma concentration. Copyright © 2009 John Wiley & Sons, Ltd. [source] The neuropsychology of ecstasy (MDMA) use: a quantitative reviewHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 7 2007Konstantine K. Zakzanis Abstract A growing number of empirical studies have found varying neuropsychological impairments associated with use of 3,4-methylenedioxymethamphetamine (MDMA) use. We set out to determine to what extent neuropsychological abilities are impaired in MDMA users. To do so, meta-analytical methods were used to determine the magnitude of neuropsychological impairment in MDMA users across pre-specified cognitive domains. We found that cognitive impairment secondary to recreational drug use may result in what might be described as small-to-medium effects across all cognitive domains with learning and memory being most impaired. We also found that total lifetime ingestion of MDMA appears to be negatively associated with performance on tasks ranging from attention and concentration to learning and memory. Implications and limitations of these findings are discussed. Copyright © 2007 John Wiley & Sons, Ltd. [source] Assessing mild cognitive impairment among older African AmericansINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 7 2010Alyssa A. Gamaldo Abstract Objectives To examine the frequency of Mild Cognitive Impairment (MCI) in African American older adults. The study also plans to explore the specific cognitive domains of impairment as well as whether there are differences in demographics, health, and cognitive performance between MCI and normal participants. Design Cross-sectional. Setting Independent-living sample of urban dwelling elders in Baltimore, Maryland. Participants The sample consisted of 554 subjects ranging in age from 50 to 95 (Mean,=,68.79,±,9.60). Measurements Socio-demographics and health were assessed. Several cognitive measures were administered to assess inductive reasoning, declarative memory, perceptual speed, working memory, executive functioning, language and global cognitive functioning. Results Approximately 22% of participants were considered MCI (i.e. 18% non-amnestic vs. 4% amnestic). A majority of the non-amnestic MCI participants had impairment in one cognitive domain, particularly language and executive function. Individuals classified as non-amnestic MCI were significantly older and had more years of education than normal individuals. The MCI groups were not significantly different than cognitively normal individuals on health factors. Individuals classified as MCI performed significantly worse on global cognitive measures as well as across specific cognitive domains than cognitively normal individuals. Conclusion This study demonstrates that impairment in a non-memory domain may be an early indicator of cognitive impairment, particularly among African Americans. Copyright © 2010 John Wiley & Sons, Ltd. [source] The MMSE orientation for time domain is a strong predictor of subsequent cognitive decline in the elderlyINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 12 2009Elizabeth Guerrero-Berroa Abstract Background The mini-mental state exam (MMSE) has been used to address questions such as determination of appropriate cutoff scores for differentiation of individuals with intact cognitive function from patients with dementia and rate of cognitive decline. However, little is known about the relationship of performance in specific cognitive domains to subsequent overall decline. Objective To examine the specific and/or combined contribution of four MMSE domains (orientation for time, orientation for place, delayed recall, and attention) to prediction of overall cognitive decline on the MMSE. Methods Linear mixed models were applied to 505 elderly nursing home residents (mean age,=,85,,>,12 years education,=,27%; 79% F, mean follow-up,=,3.20 years) to examine the relationship between baseline scores of these domains and total MMSE scores over time. Results Orientation for time was the only domain significantly associated with MMSE decline over time. Combination of poor delayed recall with either attention or orientation for place was associated with significantly increased decline on the MMSE. Conclusions The MMSE orientation for time predicts overall decline on MMSE scores over time. A good functioning domain added to good functioning delayed recall was associated with slower rate of decline. Copyright © 2009 John Wiley & Sons, Ltd. [source] Screening for mild cognitive impairment: a systematic reviewINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 9 2009Jane A. Lonie Abstract Objective Patients with mild cognitive impairment account for a significant number of referrals to old age psychiatry services and specialist memory clinics. The cognitive evaluation of such patients is commonly restricted to brief dementia screens, with no consideration to their suitability for assessing MCI. Here, we review the utility of such cognitive screens for MCI and provide an overview of validated instruments. Methods We identified papers published after Petersen and colleagues 1999 MCI criteria (Petersen et al., 1999) and examining face-to-face cognitive screening for MCI from publication databases using combinations of the search terms ,mild cognitive impairment' and ,cognitive screening'. We also combined the former search with the names of 39 screening tests recently identified in a relevant review (Cullen et al., 2007). Results Fifteen cognitive screening instruments were identified, 11 cover a restricted range of cognitive domains. High sensitivity and specificity for MCI relative to healthy controls were reported for two comprehensive and two noncomprehensive screening instruments, adequate test-retest and inter-rater reliability for only one of these. With the exception of three studies, sample sizes were universally small (i.e. n,,,100), and prognostic values were reported for only two of the identified 15 screening measures. Sensitivities of the full domain measures were universally high, but information about their specificity against psychiatric and non-progressive neurological conditions and predictive validity is lacking. Conclusion Several cognitive screening instruments afford the clinician the ability to detect MCI, early AD, and in some cases non-AD dementia, but they cannot currently be used to make reliable inferences about the course and eventual outcome of MCI. Copyright © 2009 John Wiley & Sons, Ltd. [source] Effects of memantine on cognition in patients with moderate to severe Alzheimer's disease: post-hoc analyses of ADAS-cog and SIB total and single-item scores from six randomized, double-blind, placebo-controlled studiesINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 5 2009Patrizia Mecocci Abstract Objectives The post-hoc analyses reported here evaluate the specific effects of memantine treatment on ADAS-cog single-items or SIB subscales for patients with moderate to severe AD. Methods Data from six multicentre, randomised, placebo-controlled, parallel-group, double-blind, 6-month studies were used as the basis for these post-hoc analyses. All patients with a Mini-Mental State Examination (MMSE) score of less than 20 were included. Analyses of patients with moderate AD (MMSE: 10,19), evaluated with the Alzheimer's disease Assessment Scale (ADAS-cog) and analyses of patients with moderate to severe AD (MMSE: 3,14), evaluated using the Severe Impairment Battery (SIB), were performed separately. Results The mean change from baseline showed a significant benefit of memantine treatment on both the ADAS-cog (p,<,0.01) and the SIB (p,<,0.001) total score at study end. The ADAS-cog single-item analyses showed significant benefits of memantine treatment, compared to placebo, for mean change from baseline for commands (p,<,0.001), ideational praxis (p,<,0.05), orientation (p,<,0.01), comprehension (p,<,0.05), and remembering test instructions (p,<,0.05) for observed cases (OC). The SIB subscale analyses showed significant benefits of memantine, compared to placebo, for mean change from baseline for language (p,<,0.05), memory (p,<,0.05), orientation (p,<,0.01), praxis (p,<,0.001), and visuospatial ability (p,<,0.01) for OC. Conclusion Memantine shows significant benefits on overall cognitive abilities as well as on specific key cognitive domains for patients with moderate to severe AD. Copyright © 2009 John Wiley & Sons, Ltd. [source] Randomized double-blind placebo-controlled donepezil augmentation in antidepressant-treated elderly patients with depression and cognitive impairment: a pilot studyINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 7 2008Gregory H. Pelton Abstract Objective To assess combined antidepressant and cognitive enhancer treatment in elderly patients presenting with depression plus cognitive impairment. Methods Twenty-three elderly (>50 years old) depressed, cognitively impaired (DEP-CI) patients participated in a pilot study. We evaluated whether, after 8 weeks of open antidepressant treatment, donepezil HCl (Aricept) would afford added cognitive benefit compared to placebo in a randomized 12-week trial. A subsample continued in an 8-month extension phase of open treatment with donepezil. Neuropsychological testing (NPT) was performed and antidepressant response monitored at baseline and the 8, 20, and 52-week time points. Results At 8-weeks, the antidepressant response rate was 61% (14/23). Improvement in SRT immediate recall (SRT-IR; e.g. episodic verbal memory) was observed in responders compared to non-responders. During the 12-week, placebo-controlled, donepezil add-on trial, patients on donepezil showed further improvement in SRT-IR versus patients on placebo. In the open extension phase, patients who continued open donepezil treatment (n,=,6) maintained improvement in memory and tended to show an advantage over patients who never received donepezil and were evaluated at the 52-week time point (n,=,6). There were no observed significant donepezil effects on non-memory cognitive domains. Conclusion These preliminary findings suggest that addition of a cholinesterase inhibitor (AChEI) following antidepressant medication treatment in elderly Dep-CI patients may improve cognition, and support the need for a confirmatory, larger randomized placebo-controlled trial. Copyright © 2007 John Wiley & Sons, Ltd. [source] The significance of dyslexia screening for the assessment of dementia in older peopleINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 7 2008Claudia Metzler-Baddeley Abstract Dyslexia and Dementia are disorders that share cognitive impairments in attention, language, and working memory. It is therefore possible that the presence of dyslexia may influence the assessment of the severity of dementia and potentially lead to the development of atypical forms of dementia. The present study investigated the prevalence of problems suggestive of dyslexia with a brief self-report questionnaire in a sample of 195 older adults referred to a Memory Clinic for dementia assessment. Ten percent reported problems suggestive of dyslexia consistent with the estimated prevalence in the general population. This group performed significantly lower in a number of attention and language related tests but not in other cognitive domains. These results highlight the importance of dyslexia screening for the assessment of dementia, not least because the choice of treatment is guided by the outcome of the assessment of the severity and the type of dementia. Copyright © 2007 John Wiley & Sons, Ltd. [source] Chronic Kidney Disease and Cognitive Function in Older Adults: Findings from the Chronic Renal Insufficiency Cohort Cognitive StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2010Kristine Yaffe MD OBJECTIVES: To investigate cognitive impairment in older, ethnically diverse individuals with a broad range of kidney function, to evaluate a spectrum of cognitive domains, and to determine whether the relationship between chronic kidney disease (CKD) and cognitive function is independent of demographic and clinical factors. DESIGN: Cross-sectional. SETTING: Chronic Renal Insufficiency Cohort Study. PARTICIPANTS: Eight hundred twenty-five adults aged 55 and older with CKD. MEASUREMENTS: Estimated glomerular filtration rate (eGFR, mL/min per 1.73 m2) was estimated using the four-variable Modification of Diet in Renal Disease equation. Cognitive scores on six cognitive tests were compared across eGFR strata using linear regression; multivariable logistic regression was used to examine level of CKD and clinically significant cognitive impairment (score ,1 standard deviations from the mean). RESULTS: Mean age of the participants was 64.9, 50.4% were male, and 44.5% were black. After multivariable adjustment, participants with lower eGFR had lower cognitive scores on most cognitive domains (P<.05). In addition, participants with advanced CKD (eGFR<30) were more likely to have clinically significant cognitive impairment on global cognition (adjusted odds ratio (AOR) 2.0, 95% CI=1.1,3.9), naming (AOR=1.9, 95% CI=1.0,3.3), attention (AOR=2.4, 95% CI=1.3,4.5), executive function (AOR=2.5, 95% CI=1.9,4.4), and delayed memory (AOR=1.5, 95% CI=0.9,2.6) but not on category fluency (AOR=1.1, 95% CI=0.6,2.0) than those with mild to moderate CKD (eGFR 45,59). CONCLUSION: In older adults with CKD, lower level of kidney function was associated with lower cognitive function on most domains. These results suggest that older patients with advanced CKD should be screened for cognitive impairment. [source] Serum Calcium and Cognitive Function in Old AgeJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2007Miranda T. Schram PhD OBJECTIVES: To determine whether serum calcium is associated with cognitive function in elderly individuals in the general population. DESIGN: Prospective follow-up study of two independent, population-based cohorts. SETTING: The Rotterdam Study (median follow-up 11 years) and the Leiden 85-plus Study (median follow-up 5 years). PARTICIPANTS: Three thousand nine hundred ninety-four individuals, mean age 71, from the Rotterdam Study and 560 individuals, all aged 85, from the Leiden 85-plus Study. MEASUREMENTS: Global cognitive function was assessed in both cohorts using the Mini-Mental State Examination; attention, psychomotor speed, and memory function were assessed in the Leiden 85-plus Study only. Linear regression and linear mixed models were used for statistical analyses. RESULTS: In the Rotterdam Study, high serum calcium was associated with worse global cognitive function at baseline (P<.05) and a faster rate of decline in cognitive function during follow-up (P=.005) in individuals aged 75 and older but not in younger individuals. In the Leiden 85-plus Study, high serum calcium was associated with worse global cognitive function from age 85 through 90 (P<.001). This observation also held for the specific cognitive domains tested (all P<.01). These results did not change when individuals with serum calcium levels greater than normal (>2.55 mmol/L) were excluded from the analyses. CONCLUSION: In the general population, high serum calcium levels are associated with faster decline in cognitive function over the age of 75. [source] Mild Cognitive Impairment Subtypes and Vascular Dementia in Community-Dwelling Elderly People: A 3-Year Follow-Up StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 4 2006Mariella Zanetti MD OBJECTIVES: To investigate whether mild cognitive impairment (MCI) with multiple impaired cognitive domains (mcd-MCI) is a prodromal manifestation of vascular dementia (VaD). DESIGN: Prospective cohort study. SETTING: Geriatric unit of the Ospedale Maggiore Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy. PARTICIPANTS: Four hundred community-dwelling subjects aged 65 and older who came freely to the geriatric unit as part of a comprehensive geriatric assessment program were evaluated for memory impairment or other cognitive disorders. Subjects with MCI were kept under observation for 3 years. MEASUREMENTS: Subjects with MCI were studied by applying a standardized clinical evaluation and a conducting a computed tomography brain scan. Cognitive performance was assessed using the Mini-Mental State Examination, the Clock Drawing Test, and a comprehensive battery of neuropsychological tests. Cardiovascular comorbidity was assessed on the basis of medical history and using electrocardiography, echocardiography, and carotid color Doppler ultrasound. RESULTS: MCI was found in 65 of the 400 community-dwelling subjects; 31 were classified with amnestic MCI (a-MCI) and 34 with mcd-MCI. A dysexecutive syndrome characterized people with mcd-MCI, who had significantly more vascular comorbidity and signs of vascular disease on brain imaging as well as a higher prevalence of extra pyramidal features, mood disorders, and behavioral symptoms than people with a-MCI. Twenty of the 65 subjects with MCI (31%) progressed to dementia within 3 years of follow-up: 11 subjects with Alzheimer's disease (AD) and nine with VaD. All patients who evolved to AD had been classified with a-MCI at baseline, whereas all patients who evolved to subcortical VaD had been classified with mcd-MCI at baseline. CONCLUSION: All subjects who converted to subcortical VaD had been classified with mcd-MCI, suggesting that mcd-MCI might be an early stage of subcortical VaD. [source] Functional and Cognitive Consequences of Silent Stroke Discovered Using Brain Magnetic Resonance Imaging in an Elderly PopulationJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 7 2004Wolf-Peter Schmidt MD Objectives: To evaluate the prevalence of silent stroke and its associated consequences on physical, cognitive, and emotional functioning in an elderly population. Design: Population-based cross-sectional survey. Setting: The Memory and Morbidity in Augsburg Elderly project in the Augsburg region of southern Germany. Participants: Two hundred sixty-seven community-dwelling persons aged 65 to 83. Measurements: The presence of silent stroke was determined using magnetic resonance imaging brain scan and a single question asking for physician-diagnosed stroke in each participant. The health effect of silent stroke was assessed using rating scales for self-perceived health status (36-item short-form health survey), activities of daily living (ADLs) and instrumental ADLs, cognitive function, and depression (Center for Epidemiologic Studies Depression scale). Results: Just fewer than 13% (12.7%) of participants were affected by silent stroke. Silent stroke was associated with a history of hypertension, heart surgery, and elevated C-reactive protein. Individuals with silent stroke showed impairments on the Mini-Mental State Examination test and in the cognitive domains of memory, procedural speed, and motor performance. Conclusion: The presence of silent stroke has a considerable effect on cognitive performance in those affected. Determining the presence of silent stroke using brain imaging may contribute to identifying individuals at risk for developing gradual neurological deficits. [source] Hormone Use and Cognitive Performance in Women of Advanced AgeJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2004J. Galen buckwalter PhD Objectives: To explore the association between hormone replacement therapy (HRT) and cognitive performance in a group of elderly women (,75) using a battery of well-standardized neuropsychological instruments. Design: Equivalent samples from existing cohort. Setting: Healthcare provider organization. Participants: All women enrolled were participants in an ongoing study of the association between HRT and the prevalence and incidence of dementia. Prescription records were used to establish HRT status. Fifty-eight users and 47 nonusers of HRT participated in this substudy. Measurements: Given previous reports that HRT has a positive effect on verbal memory, the California Verbal Learning Test and the Logical Memory Test were used as primary outcomes. A range of validated tests that assess other cognitive domains was also included. Results: There were no significant differences between users and nonusers of HRT on any cognitive measures. Conclusion: Given equivalent groups of users and nonusers of HRT no support was found for the hypothesis that use of HRT improves cognitive performance in older women. [source] Testosterone Supplementation Therapy for Older Men: Potential Benefits and RisksJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2003David A. Gruenewald MD Serum testosterone levels decline gradually and progressively with aging in men. Many manifestations associated with aging in men, including muscle atrophy and weakness, osteoporosis, reduced sexual functioning, and increased fat mass, are similar to changes associated with testosterone deficiency in young men. These similarities suggest that testosterone supplementation may prevent or reverse the effects of aging. A MEDLINE search was performed to identify studies of testosterone supplementation therapy in older men. A structured, qualitative review was performed of placebo-controlled trials that included men aged 60 and older and evaluated one or more physical, cognitive, affective, functional, or quality-of-life outcomes. Studies focusing on patients with severe systemic diseases and hormone deficiencies related to specific diseases were excluded. In healthy older men with low-normal to mildly decreased testosterone levels, testosterone supplementation increased lean body mass and decreased fat mass. Upper and lower body strength, functional performance, sexual functioning, and mood were improved or unchanged with testosterone replacement. Variable effects on cognitive function were reported, with improvements in some cognitive domains (e.g., spatial, working, and verbal memory). Testosterone supplementation improved exercise-induced coronary ischemia in men with coronary heart disease, whereas angina pectoris was improved or unchanged. In a few studies, men with low testosterone levels were more likely to experience improvements in lumbar bone mineral density, self-perceived functional status, libido, erectile function, and exercise-induced coronary ischemia with testosterone replacement than men with less marked testosterone deficiency. No major unfavorable effects on lipids were reported, but hematocrit and prostate specific antigen levels often increased. Based on these results, testosterone supplementation cannot be recommended at this time for older men with normal or low-normal testosterone levels and no clinical manifestations of hypogonadism. However, testosterone replacement may be warranted in older men with markedly decreased testosterone levels, regardless of symptoms, and in men with mildly decreased testosterone levels and symptoms or signs suggesting hypogonadism. The long-term safety and efficacy of testosterone supplementation remain uncertain. Establishment of evidence-based indications will depend on further demonstrations of favorable clinical outcomes and symptomatic, functional, and quality-of-life benefits in carefully performed, long-term, randomized, placebo-controlled clinical trials. J Am Geriatr Soc 51:101,115, 2003. [source] Attention and Vigilance in Children with Down SyndromeJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 6 2008Kim L. Trezise Background, Down syndrome (DS) has been the focus of much cognitive and developmental research; however, there is a gap in knowledge regarding sustained attention, particularly across different sensory domains. This research examined the hypothesis that children with DS would demonstrate superior visual rather than auditory performance on a sustained attention task and that this modality difference would not be seen in children with non-specific intellectual disability (NSID). Materials and Methods, Eleven children with DS and 16 children with NSID were compared on two versions of the sustained attention to response test (SART), varying only in presentation modality (visual or auditory). Errors of commission (failure to withhold response to target) and errors of omission (failure to respond to non-target distractors) were recorded. Results, Significant group differences were found in the visual modality and mental age was also found to effect error rates in the visual condition. No effect of group or mental age was observed in the auditory SART. Conclusions, Results suggest that, for individuals with DS, presentation of education material in a visual medium may facilitate sustained attention and thus learning. Further research using tools such as the SART to explore modality differences in sustained attention and additional cognitive domains is recommended. [source] Proteomic identification of nitrated brain proteins in early Alzheimer's disease inferior parietal lobuleJOURNAL OF CELLULAR AND MOLECULAR MEDICINE, Issue 8b 2009Tanea T. Reed Abstract Alzheimer's disease (AD) is a neurodegenerative disorder characterized by progressive decline in multiple cognitive domains. Its pathological hallmarks include senile plaques and neurofibrillary tangles. Mild cognitive impairment (MCI) is the earliest detectable stage of AD with limited symptomology and no dementia. The yearly conversion rate of patients from MCI to AD is 10,15%, although conversion back to normal is possible in a small percentage. Early diagnosis of AD is important in an attempt to intervene or slow the advancement of the disease. Early AD (EAD) is a stage following MCI and characterized by full-blown dementia; however, information involving EAD is limited. Oxidative stress is well-established in MCI and AD, including protein oxidation. Protein nitration also is an important oxidative modification observed in MCI and AD, and proteomic analysis from our laboratory identified nitrated proteins in both MCI and AD. Therefore, in the current study, a proteomics approach was used to identify nitrated brain proteins in the inferior parietal lobule from four subjects with EAD. Eight proteins were found to be significantly nitrated in EAD: peroxiredoxin 2, triose phosphate isomerase, glutamate dehydrogenase, neuropolypeptide h3, phosphoglycerate mutase1, H+, transporting ATPase, ,-enolase and fructose-1,6-bisphosphate aldolase. Many of these proteins are also nitrated in MCI and late-stage AD, making this study the first to our knowledge to link nitrated proteins in all stages of AD. These results are discussed in terms of potential involvement in the progression of this dementing disorder. [source] A systematic review of peer teaching and learning in clinical educationJOURNAL OF CLINICAL NURSING, Issue 6 2008Jacinta Secomb Aims and objectives., The purpose of this review is to provide a framework for peer teaching and learning in the clinical education of undergraduate health science students in clinical practice settings and make clear the positive and negative aspects of this teaching and learning strategy. Background., The practice of using peers incidentally or purposefully in the clinical education of apprentice or undergraduate health science students is a well-established tradition and commonly practiced, but lacks definition in its implementation. Method., The author conducted a search of health science and educational electronic databases using the terms peer, clinical education and undergraduate. The set limitations were publications after 1980 (2005 inclusive), English language and research papers. Selection of studies occurred: based on participant, intervention, research method and learning outcomes, following a rigorous critical and quality appraisal with a purposefully developed tool. The results have been both tabled and collated in a narrative summary. Results., Twelve articles met the inclusion criteria, representing five countries and four health science disciplines. This review reported mostly positive outcomes on the effectiveness of peer teaching and learning; it can increase student's confidence in clinical practice and improve learning in the psychomotor and cognitive domains. Negative aspects were also identified; these include poor student learning if personalities or learning styles are not compatible and students spending less individualized time with the clinical instructor. Conclusions., Peer teaching and learning is an effective educational intervention for health science students on clinical placements. Preclinical education of students congruent with the academic timetable increases student educational outcomes from peer teaching and learning. Strategies are required prior to clinical placement to accommodate incompatible students or poor student learning. Relevance to clinical practice., The findings from this systematic review, although not statistically significant, do have pragmatic implications for clinical practice. It can increase clinical placement opportunities for undergraduate health students, assist clinical staff with workload pressures and increase clinician time with clients, while further developing students' knowledge, skills and attitudes. [source] Neuropsychological components of intellectual disability: the contributions of immediate, working, and associative memoryJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 5 2010Jamie O. Edgin Abstract Background Efficient memory functions are important to the development of cognitive and functional skills, allowing individuals to manipulate and store information. Theories of memory have suggested the presence of domain-specific (i.e. verbal and spatial) and general processing mechanisms across memory domains, including memory functions dependent on the prefrontal cortex (PFC) and the hippocampus. Comparison of individuals who have syndromes associated with striking contrasts in skills on verbal and spatial tasks [e.g. Down syndrome (DS) and Williams syndrome (WS)] allows us to test whether or not these dissociations may extend across cognitive domains, including PFC and hippocampal memory processes. Methods The profile of memory function, including immediate memory (IM), working memory (WM) and associative memory (AM), was examined in a sample of adolescents and young adults with DS (n = 27) or WS (n = 28), from which closely CA- and IQ-matched samples of individuals with DS (n = 18) or WS (n = 18) were generated. Relations between memory functions and IQ and adaptive behaviour were also assessed in the larger sample. Results Comparisons of the two matched groups indicated significant differences in verbal IM (DS < WS), spatial IM (DS > WS) and spatial and verbal AM (DS > WS), but no between-syndrome differences in WM. For individuals with DS, verbal IM was the most related to variation in IQ, and spatial AM related to adaptive behaviour. The pattern was clearly different for individuals with WS. Verbal and spatial AM were the most related to variation in IQ, and verbal WM related to adaptive behaviour. Conclusions These results suggest that individuals with these two syndromes have very different patterns of relative strengths and weaknesses on memory measures, which do not fully mirror verbal and spatial dissociations. Furthermore, different patterns of memory dysfunction relate to outcome in individuals with each syndrome. [source] Progressive Cerebral Disease in Lymphomatoid Granulomatosis Causes Anterograde Amnesia and Neuropsychiatric DisorderJOURNAL OF NEUROIMAGING, Issue 2 2006Dominic A. Carone PhD ABSTRACT The authors report neuropsychological (NP) and serial quantitative magnetic resonance imaging (MRI) findings of a 29-year-old woman with lymphomatoid granulomatosis (LG). Disease course was characterized by acute psychosis, tremor, fever, seizures, and progressive cognitive impairment. At the time of symptom onset, brain MRI revealed mild lesion volume and normal parenchymal volume. This was followed by dramatic progression of brain lesions and atrophy over 2 years, at which point the patient expired. Atrophy was most prominent in the mesial temporal lobes. NP testing revealed marked amnesia and mild impairments in other cognitive domains. To our knowledge, this is the first recorded case of LG in which bilateral temporal lobe atrophy is evident and accompanied by anterograde amnesia. We speculate that temporal lobe atrophy was influenced by the established susceptibility of this region in various neurological diseases. [source] The Effects of Fetal Alcohol Syndrome on Response Execution and Inhibition: An Event-Related Potential StudyALCOHOLISM, Issue 11 2009Matthew J. Burden Background:, Both executive function deficits and slower processing speed are characteristic of children with fetal alcohol exposure, but the temporal dynamics of neural activity underlying cognitive processing deficits in fetal alcohol spectrum disorder have rarely been studied. To this end, event-related potentials (ERPs) were used to examine the nature of alcohol-related effects on response inhibition by identifying differences in neural activation during task performance. Methods:, We recorded ERPs during a Go/No-go response inhibition task in 2 groups of children in Cape Town, South Africa (M age = 11.7 years; range = 10 to 13),one diagnosed with fetal alcohol syndrome (FAS) or partial FAS (FAS/PFAS; n = 7); the other, a control group whose mothers abstained or drank only minimally during pregnancy (n = 6). Children were instructed to press a "Go" response button to all letter stimuli presented except for the letter "X," the "No-go" stimulus, which occurred relatively infrequently. Results:, Task performance accuracy and reaction time did not differ between groups, but differences emerged for 3 ERP components,P2, N2, and P3. The FAS/PFAS group showed a slower latency to peak P2, suggesting less efficient processing of visual information at a relatively early stage (,200 ms after stimulus onset). Moreover, controls showed a larger P2 amplitude to Go versus No-go, indicating an early discrimination between conditions that was not seen in the FAS/PFAS group. Consistent with previous literature on tasks related to cognitive control, the control group showed a well-defined, larger N2 to No-go versus Go, which was not evident in the FAS/PFAS group. Both groups showed the expected larger P3 amplitude to No-go versus Go, but this condition difference persisted in a late slow wave for the FAS/PFAS group, suggesting increased cognitive effort. Conclusions:, The timing and amplitude differences in the ERP measures suggest that slower, less efficient processing characterizes the FAS/PFAS group during initial stimulus identification. Moreover, the exposed children showed less sharply defined components throughout the stimulus and response evaluation processes involved in successful response inhibition. Although both groups were able to inhibit their responses equally well, the level of neural activation in the children with FAS/PFAS was greater, suggesting more cognitive effort. The specific deficits in response inhibition processing at discrete stages of neural activation may have implications for understanding the nature of alcohol-related deficits in other cognitive domains as well. [source] | |||||||||||||||||||||||||||||||