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Cognitive Performance (cognitive + performance)
Kinds of Cognitive Performance Selected AbstractsTranscranial Doppler Blood Flow Assessment in Patients With Mild Heart Failure: Correlates With Neuroimaging and Cognitive PerformanceCONGESTIVE HEART FAILURE, Issue 2 2008Raymond L. C. Vogels MD Cardiac output and cerebral perfusion are reduced in patients with advanced stages of heart failure. Our aim was to determine whether cerebral blood flow velocity measured by transcranial Doppler ultrasonography was reduced in outpatients with mild heart failure in comparison to controls and, if so, whether this reduction was related to cognitive performance and abnormalities of the brain diagnosed by magnetic resonance imaging. [source] The Cross-Sectional Relationship Between Body Mass Index, Waist,Hip Ratio, and Cognitive Performance in Postmenopausal Women Enrolled in the Women's Health InitiativeJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2010Diana R. Kerwin MD OBJECTIVES: To determine whether body mass index (BMI) is independently associated with cognitive function in postmenopausal women and the relationship between body fat distribution as estimated by waist-hip ratio (WHR). DESIGN: Cross-sectional data analysis. SETTING: Baseline data from the Women's Health Initiative (WHI) hormone trials. PARTICIPANTS: Eight thousand seven hundred forty-five postmenopausal women aged 65 to 79 free of clinical evidence of dementia who completed the baseline evaluation in the WHI hormone trials. MEASUREMENTS: Participants completed a Modified Mini-Mental State Examination (3MSE), health and lifestyle questionnaires, and standardized measurements of height, weight, body circumference, and blood pressure. Statistical analysis was performed of associations between 3MSE score, BMI, and WHR after controlling for known confounders. RESULTS: With the exception of smoking and exercise, vascular disease risk factors, including hypertension, waist measurement, heart disease, and diabetes mellitus, were significantly associated with 3MSE score and were included as covariables in subsequent analyses. BMI was inversely related to 3MSE score; for every 1-unit increase in BMI, 3MSE score decreased 0.988 points (P<.001) after adjusting for age, education, and vascular disease risk factors. BMI had the most pronounced association with poorer cognitive functioning scores in women with smaller waist measurements. In women with the highest WHR, cognitive scores increased with BMI. CONCLUSION: Higher BMI was associated with poorer cognitive function in women with smaller WHR. Higher WHR, estimating central fat mass, was associated with higher cognitive function in this cross-sectional study. Further research is needed to clarify the mechanism for this association. [source] Health Literacy and Cognitive Performance in Older AdultsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2009Alex D. Federman MD OBJECTIVES: To study the relationship between health literacy and memory and verbal fluency in older adults. DESIGN: Cross-sectional cohort. SETTING: Twenty senior centers and apartment buildings in New York, New York. PARTICIPANTS: Independently living, English- and Spanish-speaking adults aged 60 and older (N=414). MEASUREMENTS: Health literacy was measured using the Short Test of Functional Health Literacy in Adults (S-TOFHLA). The associations between S-TOFHLA scores and immediate and delayed recall (Wechsler Memory Scale II), verbal fluency (Animal Naming), and global cognitive function (Mini-Mental State Examination, MMSE) were modeled using multivariable logistic and linear regression. RESULTS: Health literacy was inadequate in 24.3% of participants. Impairment of immediate recall occurred in 20.4%; delayed recall, 15.0%; verbal fluency, 9.9%; and MMSE, 17.4%. Abnormal cognitive function was strongly associated with inadequate health literacy: immediate recall (adjusted odds ratio (AOR)=3.44, 95% confidence interval (CI)=1.71,6.94, P<.001), delayed recall (AOR=3.48, 95% CI=1.58,7.67, P=.002), and verbal fluency (AOR=3.47, 95% CI=1.44,8.38, P=.006). These associations persisted in subgroups that excluded individuals with normal age-adjusted MMSE scores. CONCLUSION: Memory and verbal fluency are strongly associated with health literacy, independently of education and health status, even in those with subtle cognitive dysfunction. Reducing the cognitive burden of health information might mitigate the detrimental effects of limited health literacy in older adults. Research that examines the effect of materials modified to older adults' cognitive limitations on health literacy and health outcomes is needed. [source] An 8-Year Prospective Study of the Relationship Between Cognitive Performance and Falling in Very Old AdultsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2006Kaarin J. Anstey PhD OBJECTIVES: To determine whether cognitive performance, as distinct from cognitive impairment, predicts falling during an 8-year follow-up in a community-based sample of very old adults and to evaluate how cognitive change is associated with falling. DESIGN: Prospective cohort study including three waves of data collected in 1992, 1994, and 2000. SETTING: Population based, with the baseline sample drawn from the electoral roll. PARTICIPANTS: Inclusion criteria were completion of at least three cognitive tests at baseline and completion of the falls questionnaire at Wave 6 (N=539). MEASUREMENTS: Assessments of health and medical conditions, visual acuity, cognitive function, functional reach, semitandem stand, and grip strength were conducted in 1992 (baseline), 1994, and 2000. Self-report information on falls in the previous 12 months was obtained on each of these occasions. Marginal models using generalized estimating equations were used to assess the association between baseline cognitive performance and falling over 8 years, adjusting for sociodemographic, health, and sensorimotor variables. Random effects models were used to assess the relationship between change in cognitive performance and change in fall rate and fall risk over 8 years. RESULTS: Mini-Mental State Examination and verbal reasoning at baseline predicted rate of falling over an 8-year period. Within individuals, declines in verbal ability, processing speed, and immediate memory were associated with increases in rates of falling and fall risk. CONCLUSION: Cognitive performance is associated with falling over 8 years in very old adults and should be assessed in clinical practice when evaluating short- and long-term fall risk. [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] Mood Symptoms and Cognitive Performance in Women Estrogen Users and Nonusers and MenJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2002Karen J. Miller PhD OBJECTIVES: Previous studies have suggested sex differences in mood and cognition and that estrogen effects may partially explain such differences. In this study, we explore sex differences for a range of mood symptoms and for neuropsychological performance in men and postmenopausal women and assess the potential influence of estrogen on these measures. DESIGN: Cross-sectional study of men and women examining mood, neuropsychological test data, and estrogen replacement therapy (ERT) use. SETTING: Outpatient study at an urban teaching hospital with subjects recruited from the community. PARTICIPANTS: All subjects (N = 96) were between the ages of 57 and 75 and included 31 women using ERT, 16 non-ERT users, and 49 men. Subjects did not have major depression and were nondemented. MEASUREMENT: The three groups were compared according to profile of mood states and neuropsychological performance, and statistical analyses were controlled for socioeconomic status, age, and education level. RESULTS: Female ERT users were less depressed and less angry and performed better on measures of verbal fluency and working memory than the other subject groups. CONCLUSION: Postmenopausal estrogen use is associated with better mood and cognitive performance on tasks of fluency and working memory. These results suggest that estrogen should be examined as a potentially critical variable influencing late-life sex differences in mood and cognition. [source] The Assessment of Cognitive Performance in Children: Considerations for Detecting Nutritional InfluencesNUTRITION REVIEWS, Issue 12 2003Donna Hughes MPsychClin The accurate assessment of cognitive performance in children is critical for detecting the effects of micronutrient deficiency or supplementation on the developing brain and its functions. Relatively little attention has been paid to the selection of culturally appropriate measures that are sensitive enough to detect the subtle cognitive changes that could be expected following nutritional intervention. Normal brain development and the emergence of cognitive abilities throughout infancy and childhood is discussed in this paper, followed by a description of the more pertinent and sensitive neuropsychological tests that can be used to assess cognitive performance and investigate the effects of micronutrient deficiency and supplementation on cognitive development among children in a variety of cultures. [source] Roles of Vitamins E and C on Neurodegenerative Diseases and Cognitive PerformanceNUTRITION REVIEWS, Issue 10 2002Antonio Martin Demographic changes, together with improvements in nutrition, general health, and life expectancy, will greatly change the social and economic structures of most industrialized and developing countries in the next 50 years. Extended life expectancy has increased the number of chronic illnesses and disabilities, including cognitive impairments. Inflammatory processes and vascular dysfunctions appear to play important roles in the pathogenesis of age-associated pathologies including Alzheimer's and Parkinson's disease. A large body of evidence shows that both vitamins E and C are important for the central nervous system and that a decrease in their concentrations causes structural and functional damage to the cells. Several studies reveal a link between diets rich in fruits and vegetables containing generous amounts of vitamins E and C and lower incidence of certain chronic diseases. [source] The Effects of Ginseng, Ephedrine, and Caffeine on Cognitive Performance, Mood and EnergyNUTRITION REVIEWS, Issue 4 2001Harris R. Lieberman Ph.D. A variety of claims regarding the purported energy-enhancing properties of nutritional supplements and food constituents have recently been made. It appears that the supplements most frequently associated with such assertions are ginseng, ephedrine, and caffeine. Claims of increased energy are difficult to evaluate objectively because their meaning is not usually defined or specified. Often it is not clear whether the claims refer to physical or mental energy or both. Furthermore, an agreed upon scientific definition of either physical or mental energy enhancement does not exist. In spite of obvious differences in what the term physical energy, as opposed to mental energy implies, there is no clear scientific consensus on whether there is a difference between the two types of energy. Because the substances in question have been anecdotally associated with improvements in both physical and mental performance, their effects on both functions will be discussed, but with an emphasis placed on cognitive function and mood. Of the three substances discussed, caffeine's effects on cognitive and physical function, mood, and energy are best understood. It is clear that this food/drug enhances these functions when administered in moderate doses. Ephedrine may also enhance certain physical and mental functions related to "energy," but the evidence that ginseng has such properties is exceedingly weak. [source] Neuroimaging Determinants of Cognitive Performances in Stroke Associated With Small Vessel DiseaseJOURNAL OF NEUROIMAGING, Issue 2 2005V. Mok MD ABSTRACT Background and Purpose. Controversies still exist as to the neuroimaging determinants of cognitive impairment in cerebral small vessel disease (SVD). The authors studied the neuroimaging correlates of cognitive performances among patients with stroke associated with SVD. Methods. The authors per formed cerebral computed tomography, magnetic resonance imaging, and diffusion-weighted imaging among 74 consecu tive patients admitted to the acute stroke unit because of stroke associated with SVD. They examined the association between cognitive performances and the following neuroimaging features: volume of white matter changes (WMC), multiplicity of lacunae, location of lacunae, total cerebral atrophy, and frontal and medial temporal lobe atrophy. Results. Apart from age and education, univariate linear regression analyses revealed that WMC volume, presence of thalamic lacunae, cerebral atrophy, and left frontal lobe atrophy predicted performance on the Mini-Mental State Examination while WMC volume, presence of thalamic infarcts, cerebral atrophy, and frontal lobe atrophy of both sides predicted performance on the Mattis Dementia Rat ing Scale-Initiation/Preservation subscale. In the multivariate analyses, education (R2= 0.22, P < .001), left frontal lobe atrophy (R2= 0.10, P= .004), and presence of thalamic lacunae (R2= 0.04, P= .049) were found to predict performance on the Mini-Mental State Examination while age (R2= 0.23, P < .001) and presence of thalamic lacunae (R2= 0.08, P= .011) were found to predict performance on the Mattis Dementia Rating Scale-Initiation/Preservation. Conclusions. Among patients with stroke associated with SVD, thalamic lacunae and frontal lobe atrophy are key determinants of cognitive performances. [source] Severe falciparum malaria and acquired childhood language disorderDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 1 2006Julie A Carter BSc (Hons) MSc PhD Language disorders have been reported after severe falciparum malaria but the deficits have not been described in detail. We assessed language outcome in three groups of children aged 6 to 9 years (n=487): those previously admitted to Kilifi District Hospital, Kenya, with cerebral malaria (CM; n=152; mean age 7y 4 mo [SD 1y 1mo]; 77 males, 75 females); or those with malaria and complicated seizures (M/S; n=156; mean age 7y 4mo [SD 1y 2mo]; 72 males, 84 females); and those unexposed to either condition (n=179; mean age 7y 6mo [SD 1y 1mo]; 93 males, 86 females). Median age at hospital admission was 28 months (interquartile range [IQR] 19 to 44 mo) among children with a history of CM and 23 months (IQR 12 to 35mo) among children with a history of M/S. A battery of eight assessments covering the major facets of speech and language was used to measure language performance. Cognitive performance, neurological/motor skills, behaviour, hearing, and vision were also measured. Eighteen (11.8%) of the CM group, 14 (9%) of the M/S group, and four (2.2%) of the unexposed group were found to have a language impairment. CM (odds ratio 3.68,95% confidence interval 1.09 to 12.4, p=0.04) was associated with significantly increased odds of an impairment-level score relative to the unexposed group. The results suggest that falciparum malaria is one of the most common causes of acquired language disorders in the tropics. [source] Cognitive performance of male adolescents is lower than controls across psychiatric disorders: a population-based studyACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2004M. Weiser Objective:, Psychiatric patients, as well as humans or experimental animals with brain lesions, often concurrently manifest behavioral deviations and subtle cognitive impairments. This study tested the hypothesis that as a group, adolescents suffering from psychiatric disorders score worse on cognitive tests compared with controls. Method:, As part of the assessment for eligibility to serve in the military, the entire, unselected population of 16,17-year old male Israelis undergo cognitive testing and screening for psychopathology by the Draft Board. We retrieved the cognitive test scores of 19 075 adolescents who were assigned any psychiatric diagnosis, and compared them with the scores of 243 507 adolescents without psychiatric diagnoses. Results:, Mean test scores of cases were significantly poorer then controls for all diagnostic groups, except for eating disorders. Effect sizes ranged from 0.3 to 1.6. Conclusion:, As group, adolescent males with psychiatric disorders manifest at least subtle impairments in cognitive functioning. [source] Cognitive performance following endarterectomy in asymptomatic severe carotid stenosisEUROPEAN JOURNAL OF NEUROLOGY, Issue 5 2003J. Aharon-Peretz Cognition and the effects of carotid endarterectomy (CEA) were evaluated in 22 non-demented subjects with vascular risk factors (VRF) and asymptomatic severe carotid artery stenosis (ASCAS), 14 volunteers with VRF but without stenosis, and 24 healthy controls (HC) without VRF. Non-demented subjects with VRF, with or without carotid stenosis scored inferior to HC. It is concluded that carotid stenosis is not a primary cause of cognitive deterioration and CEA does not improve cognition in patients with ASCAS. [source] Acute cognitive effects of standardised Ginkgo biloba extract complexed with phosphatidylserineHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 4 2007D. O. Kennedy Abstract Recent data suggest that the complexation of standardised Ginkgo biloba extract (GBE) with soy-derived phospholipids enhances the bio-availablity of GBE's active components. The current study therefore aimed to assess the comparative cognitive and mood effects of a low dose of GBE and products complexing the same extract with either phosphatidylserine or phosphatidylcholine. The study utilised a placebo-controlled, multi-dose, double-blind, balanced-crossover design. Twenty-eight healthy young participants received 120,mg GBE, 120,mg GBE complexed with phosphatidylserine (VirtivaÔ), 120,mg GBE complexed with phosphatidylcholine and a matching placebo, on separate days 7 days apart. Cognitive performance was assessed using the Cognitive Drug Research (CDR) computerised test battery and Serial Subtraction tasks immediately prior to dosing and at 1, 2.5, 4 and 6,h thereafter. The primary outcome measures were the four aspects of cognitive performance, which have previously been derived by factor analysis of CDR subtests. Levels of terpenoids (bilobalide, ginkgolide A and ginkgolide B) were concomitantly assessed in plasma samples taken pre-dose and at 3 and 6.5,h post-dose. In keeping with previous research utilising the same methodology, 120,mg of GBE was not associated with markedly improved performance on the primary outcomes. However, administration of GBE complexed with phosphatidylserine resulted both in improved secondary memory performance and significantly increased speed of memory task performance across all of the post-dose testing sessions. Enhancement following GBE complexed with phosphatidylcholine was restricted to a modest improvement in secondary memory performance which was restricted to one post-dose time point. All three treatments were associated with improved calmness. There were no significant differences in post-dose levels of terpenoids between the Ginkgo containing treatments, although this latter finding may be attributable to methodological factors. Complexation with phosphatidylserine appears to potentiate the cognitive effects associated with a low dose of GBE. Further research is required to identify whether this effect is due to the complexation of the extracts, their mere combination, or the separate psychopharmacological actions of the two extracts. Copyright © 2007 John Wiley & Sons, Ltd. [source] Anemia and cognitive performance in hospitalized older patients: results from the GIFA studyINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 6 2006Valentina Zamboni Abstract Background Anemia represents a major risk factor for adverse health-related events in older persons. The aim of this study was to evaluate the association between hemoglobin levels/anemia and cognitive function in hospitalized older persons. Method Data are from the Gruppo Italiano di Farmacovigilanza nell'Anziano (GIFA) study. Hemoglobin levels (in g/dL) were measured upon admission to hospital; anemia was defined according to the WHO criteria. Cognitive performance was assessed by the Abbreviated Mental Test (AMT) on admission; an AMT score <7 defined cognitive impairment. Logistic regressions and analyses of covariance were performed to evaluate the relationship between cognitive status and hemoglobin levels/anemia. Results Mean age of the sample (n,=,13,301) was 72.0 years. Participants with cognitive impairment presented a higher prevalence of anemia (47%) compared to those without cognitive impairment (35%, p,<,0.001). Adjusted logistic regressions showed that hemoglobin levels/anemia were significantly associated with cognitive impairment (OR,=,0.96, 95%CI,=,0.94,0.99, p,=,0.004, and OR,=,1.32, 95%CI,=,1.18,1.48, p,<,0.001, respectively). Patients with anemia and cognitive impairment at the hospital admission presented a higher number of impaired Activities of Daily Living compared to those with only one or none of the studied conditions (p for trend,<,0.001). Conclusion Low hemoglobin levels and anemia are independently associated with cognitive performance in older persons admitted to acute care units. Copyright © 2006 John Wiley & Sons, Ltd. [source] Donepezil for the symptomatic treatment of patients with mild to moderate Alzheimer's disease: a meta-analysis of individual patient data from randomised controlled trialsINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 7 2004Anne Whitehead Abstract Background The objective was to evaluate the efficacy and tolerability of donepezil (5 and 10,mg/day) compared with placebo in alleviating manifestations of mild to moderate Alzheimer's disease (AD). Method A systematic review of individual patient data from Phase II and III double-blind, randomised, placebo-controlled studies of up to 24 weeks and completed by 20 December 1999. The main outcome measures were the ADAS-cog, the CIBIC-plus, and reports of adverse events. Results A total of 2376 patients from ten trials were randomised to either donepezil 5,mg/day (n,=,821), 10,mg/day (n,=,662) or placebo (n,=,893). Cognitive performance was better in patients receiving donepezil than in patients receiving placebo. At 12 weeks the differences in ADAS-cog scores were 5,mg/day,placebo: ,,,2.1 [95% confidence interval (CI), ,,,2.6 to ,,,1.6; p,<,0.001], 10,mg/day,placebo: ,,,2.5 (,,,3.1 to ,,,2.0; p,<,0.001). The corresponding results at 24 weeks were ,,,2.0 (,,,2.7 to ,,,1.3; p,<,0.001) and ,,,3.1 (,,,3.9 to ,,,2.4; p,<,0.001). The difference between the 5 and 10,mg/day doses was significant at 24 weeks (p,=,0.005). The odds ratios (OR) of improvement on the CIBIC-plus at 12 weeks were: 5,mg/day,placebo 1.8 (1.5 to 2.1; p,<,0.001), 10,mg/day,placebo 1.9 (1.5 to 2.4; p,<,0.001). The corresponding values at 24 weeks were 1.9 (1.5 to 2.4; p,=,0.001) and 2.1 (1.6 to 2.8; p,<,0.001). Donepezil was well tolerated; adverse events were cholinergic in nature and generally of mild severity and brief in duration. Conclusion Donepezil (5 and 10,mg/day) provides meaningful benefits in alleviating deficits in cognitive and clinician-rated global function in AD patients relative to placebo. Increased improvements in cognition were indicated for the higher dose. Copyright © 2004 John Wiley & Sons, Ltd. [source] An 8-Year Prospective Study of the Relationship Between Cognitive Performance and Falling in Very Old AdultsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2006Kaarin J. Anstey PhD OBJECTIVES: To determine whether cognitive performance, as distinct from cognitive impairment, predicts falling during an 8-year follow-up in a community-based sample of very old adults and to evaluate how cognitive change is associated with falling. DESIGN: Prospective cohort study including three waves of data collected in 1992, 1994, and 2000. SETTING: Population based, with the baseline sample drawn from the electoral roll. PARTICIPANTS: Inclusion criteria were completion of at least three cognitive tests at baseline and completion of the falls questionnaire at Wave 6 (N=539). MEASUREMENTS: Assessments of health and medical conditions, visual acuity, cognitive function, functional reach, semitandem stand, and grip strength were conducted in 1992 (baseline), 1994, and 2000. Self-report information on falls in the previous 12 months was obtained on each of these occasions. Marginal models using generalized estimating equations were used to assess the association between baseline cognitive performance and falling over 8 years, adjusting for sociodemographic, health, and sensorimotor variables. Random effects models were used to assess the relationship between change in cognitive performance and change in fall rate and fall risk over 8 years. RESULTS: Mini-Mental State Examination and verbal reasoning at baseline predicted rate of falling over an 8-year period. Within individuals, declines in verbal ability, processing speed, and immediate memory were associated with increases in rates of falling and fall risk. CONCLUSION: Cognitive performance is associated with falling over 8 years in very old adults and should be assessed in clinical practice when evaluating short- and long-term fall risk. [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] Can High-Risk Older Drivers Be Identified Through Performance-Based Measures in a Department of Motor Vehicles Setting?JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2006Karlene K. Ball PhD OBJECTIVES: To evaluate the relationship between performance-based risk factors and subsequent at-fault motor vehicle collision (MVC) involvement in a cohort of older drivers. DESIGN: Prospective cohort study. SETTING: Motor Vehicle Administration (MVA) field sites in Maryland. PARTICIPANTS: Of the 4,173 older drivers invited to participate in the study, 2,114 individuals aged 55 to 96 agreed to do so. These analyses focus on 1,910 individuals recruited through MVA field sites. MEASUREMENTS: Gross Impairment Screening Battery, which included Rapid Pace Walk, Head/Neck Rotation, Foot Tap, Arm Reach, Cued Recall, Symbol Scan, Visual Closure subtest of the Motor Free Visual Perception Test (MVPT), Delayed Recall, and Trail Making Test with an Abbreviated Part A and standard Part B; Useful Field of View (UFOV®) subtest 2; a Mobility Questionnaire; and MVC occurrence. RESULTS: In drivers aged 55 and older with intact vision (20/70 far visual acuity and 140° visual field), age, sex, history of falls, and poorer cognitive performance, as measured using Trails B, MVPT, and UFOV subtest 2, were predictive of future at-fault MVC involvement. After adjusting for annual mileage, participants aged 78 and older were 2.11 as more likely to be involved in an at-fault MVC, those who made four or more errors on the MVPT were 2.10 times as likely to crash, those who took 147 seconds or longer to complete Trails B were 2.01 times as likely to crash, and those who took 353 ms or longer on subtest 2 of the UFOV were 2.02 times as likely to incur an at-fault MVC. Older adults, men, and individuals with a history of falls were more likely to be involved in subsequent at-fault MVCs. CONCLUSION: Performance-based cognitive measures are predictive of future at-fault MVCs in older adults. Cognitive performance, in particular, is a salient predictor of subsequent crash involvement in older adults. High-risk older drivers can be identified through brief, performance-based measures administered in a MVA setting. [source] Ketamine attenuates post-operative cognitive dysfunction after cardiac surgeryACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 7 2009J. A. HUDETZ Background: Post-operative cognitive dysfunction (POCD) commonly occurs after cardiac surgery. Ketamine exerts neuroprotective effects after cerebral ischemia by anti-excitotoxic and anti-inflammatory mechanisms. We hypothesized that ketamine attenuates POCD in patients undergoing cardiac surgery concomitant with an anti-inflammatory effect. Methods: Patients randomly received placebo (0.9% saline; n=26) or an i.v. bolus of ketamine (0.5 mg/kg; n=26) during anesthetic induction. Anesthesia was maintained with isoflurane and fentanyl. A nonsurgical group (n=26) was also included as control. Recent verbal and nonverbal memory and executive functions were assessed before and 1 week after surgery or a 1-week waiting period for the nonsurgical controls. Serum C-reactive protein (CRP) concentrations were determined before surgery and on the first post-operative day. Results: Baseline neurocognitive and depression scores were similar in the placebo, ketamine, and nonsurgical control groups. Cognitive performance after surgery decreased by at least 2 SDs (z -score of 1.96) in 21 patients in the placebo group and only in seven patients in the ketamine group compared with the nonsurgical controls (P<0.001, Fisher's exact test). Cognitive performance was also significantly different between the placebo- and the ketamine-treated groups based on all z -scores (P<0.001, Mann,Whitney U -test). Pre-operative CRP concentrations were similar (P<0.33, Mann,Whitney U -test) in the placebo- and ketamine-treated groups. The post-operative CRP concentration was significantly (P<0.01, Mann,Whitney U -test) lower in the ketamine-treated than in the placebo-treated group. Conclusions: Ketamine attenuates POCD 1 week after cardiac surgery and this effect may be related to the anti-inflammatory action of the drug. [source] Exposure, health complaints and cognitive performance among employees of an MRI scanners manufacturing departmentJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 2 2006Frank de Vocht MSc Abstract Purpose To assess sensory effects and other health complaints that are reported by system testers working near magnetic resonance imaging (MRI) magnets, realizing that it is believed that exposure up to 8 T is safe for humans. Materials and Methods Levels of exposure to static magnetic fields (SMFs), movement speed during exposure, health complaints, and cognitive performance among employees in an MRI-manufacturing department and at a reference department have been analyzed. Mercury concentrations in urine samples were determined to analyze whether they depend on exposure to SMFs. Results Average exposure of system testers was 25.9 mT/8 hours at a 1.0-T system and 40.4 mT/8 hours at a 1.5-T system. Vertigo, metallic taste, and concentration problems were more reported among workers of MRI-fabrication than in the reference department. Cognitive performance was tested outside the SMF, and no significant changes were detected. Conclusion This study suggests that any effects on cognitive functions are acute and transient and disappear rapidly after exposure has ended. All complaints, except for headaches, were more frequently reported by "fast movers" than by "slow movers," and depended on field strength and duration of exposure. Mercury-levels in urine were not affected. J. Magn. Reson. Imaging 2006. © 2005 Wiley-Liss, Inc. [source] Qualitative similarities in cognitive impairment associated with 24 h of sustained wakefulness and a blood alcohol concentration of 0.05%JOURNAL OF SLEEP RESEARCH, Issue 4 2003Marina G. Falleti Summary Previous studies that have quantified fatigue-related cognitive impairment as blood alcohol concentration (BAC) equivalents have been limited by two issues: the effect of practice on tests of cognition and, more importantly, the statistic used to quantify change in cognitive performance. The current study addressed these issues by adopting an ABACA design, which allowed for the adequate control of practice effects, and by using effect size metrics, which enabled direct comparisons to be made in performance impairments as a result of fatigue (i.e. sustained wakefulness of 24 h) and alcohol (i.e. BAC of 0.05%). Cognitive performance under the fatigue and alcohol conditions required the use of the CogStateTM battery. It was demonstrated that fatigue caused greater impairment than alcohol on the speed of continuous attention and memory and learning, and on the accuracy of complex matching. Alcohol was more detrimental than fatigue only on the accuracy of memory and learning. Performances on the remaining tasks were the same for both the fatigue and alcohol conditions. These differences and similarities in performance impairment are discussed emphasizing the deleterious cognitive effects of relatively short periods of sustained wakefulness. [source] The functional status and perceived quality of life in long-term survivors of out-of-hospital cardiac arrestACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 2 2007H. Harve Background:, Limited data exist on how long-term survivors after pre-hospital cardiac arrest lead their lives. This study assessed functional status and perceived quality of life in patients surviving for 15 years after successful resuscitation from witnessed out-of-hospital cardiac arrest as a result of ventricular fibrillation. Methods:, A 15-year follow-up study of 59 1-year survivors after successful pre-hospital resuscitation who were thoroughly evaluated at 3 and 12 months after out-of-hospital cardiac arrest. Eleven patients were still alive 15 years later. Ten of them were reached and underwent a comprehensive neuropsychological and neurological examination. Cognitive performance was evaluated and compared with individual results 15 years earlier and with an age-matched control group. The cause and time of death of the non-survivors were established. Results:, All 10 evaluated long-term survivors lived at home and were independent in their activities of daily living. Their mean age was 72 years. In nine patients there was no change in the present neurological status compared with the status at 1 year after resuscitation, and in one patient it had improved. Five patients were cognitively intact. In four patients mild cognitive problems had emerged or slightly progressed. All but one were satisfied with their perceived quality of life. By the time of examination, the mean survival time for the 1-year survivors was 7 years, and the mean age at the time of death was 70 years. Conclusion:, Once good outcome after cardiac arrest is achieved, it can be maintained for more than 10 years. [source] Rhythms of Mental PerformanceMIND, BRAIN, AND EDUCATION, Issue 1 2008Pablo Valdez ABSTRACT, Cognitive performance is affected by an individual's characteristics and the environment, as well as by the nature of the task and the amount of practice at it. Mental performance tests range in complexity and include subjective estimates of mood, simple objective tests (reaction time), and measures of complex performance that require decisions to be made and priorities set. Mental performance tasks show 2 components, a circadian rhythm and the effects of time awake. The circadian rhythm is in phase with the rhythm of core temperature and there is evidence for a causal link. Increasing time awake results in performance deterioration and is attributed to fatigue. The relative contribution of these 2 components depends upon the task under consideration; simple tasks generally show smaller effects due to increasing time awake. These contributions have been assessed by constant routines and forced desynchronization protocols and have formed the basis of several mathematical models that attempt to predict performance in a variety of field conditions. Mental performance is negatively affected by sleep loss; although short naps are beneficial, sleep inertia limits their value immediately after waking. The processes involved in cognition include attention (tonic and phasic alertness, and selective and sustained attention), working memory (phonological, used for speech, reading, and writing; and visuospatial, used for spatial processing, drawing, and mathematics), and executive function (initiative, decision making, and problem solving). These processes are illuminated by analysis of the regions of the brain involved, the presence of circadian rhythmicity, and the effects of sleep loss. The results from such laboratory- and field-based observations are relevant to the issue of learning in schoolchildren and lead to suggestions for improving their performance. [source] Anxiolytic effects of a combination of Melissa ofcinalis and Valeriana ofcinalis during laboratory induced stressPHYTOTHERAPY RESEARCH, Issue 2 2006David O. Kennedy Abstract Objective: Melissa ofcinalis (lemon balm) and Valeriana ofcinalis (valerian) have been used both traditionally and contemporaneously as mild sedatives, anxiolytics and hypnotics. Recent research has suggested that both may attenuate laboratory induced stress. As the two herbs are most often sold in combination with each other the current study assessed the anxiolytic properties of such a combination during laboratory-induced stress. Methods: In this double-blind, placebo-controlled, randomized, balanced cross-over experiment, 24 healthy volunteers received three separate single doses (600 mg, 1200 mg, 1800 mg) of a standardized product containing M. ofcinalis and V. ofcinalis extracts, plus a placebo, on separate days separated by a 7 day wash out period. Modulation of mood and anxiety were assessed during pre-dose and 1 h, 3 h and 6 h post-dose completions of a 20 min version of the Dened Intensity Stressor Simulation (DISS) battery. Cognitive performance on the four concurrent tasks of the battery was also assessed. Results: The results showed that the 600 mg dose of the combination ameliorated the negative effects of the DISS on ratings of anxiety. However, the highest dose (1800 mg) showed an increase in anxiety that was less marked but which reached signicance during one testing session. In addition, all three doses led to decrements in performance on the Stroop task module within the battery, and the two lower doses led to decrements on the overall score generated on the DISS battery. Conclusions: These results suggest that a combination of Melissa ofcinalis and Valeriana ofcinalis possesses anxiolytic properties that deserve further investigation. Copyright © 2006 John Wiley & Sons, Ltd. [source] Effects of recurrence on the cognitive performance of patients with bipolar I disorder: implications for relapse prevention and treatment adherenceBIPOLAR DISORDERS, Issue 5 2010Carlos López-Jaramillo López-Jaramillo C, Lopera-Vásquez J, Gallo A, Ospina-Duque J, Bell V, Torrent C, Martínez-Arán A, Vieta E. Effects of recurrence on the cognitive performance of patients with bipolar I disorder: implications for relapse prevention and treatment adherence. Bipolar Disord 2010: 12: 557,567. © 2010 The Authors. Journal compilation © 2010 John Wiley & Sons A/S. Objective:, To determine if the repeated occurrence of manic episodes in bipolar I disorder (BD-I) patients is associated with reduced cognitive performance, which could in turn imply a worsening in the disorder's evolution. Method:, Cognitive performance in euthymic patients was assessed using attention, memory, and executive function tests on 24 BD-I patients who had experienced only 1 manic episode, on 27 BD-I patients with 2 manic episodes, on 47 BD-I patients with 3 or more manic episodes, and on 66 healthy control subjects. Results:, In BD-I patients, number of manic episodes was positively associated with poorer performance on neurocognitive tests, an association that was not accounted for by depression, disease chronicity, onset, or medication. Significant differences in attention and executive function were found between patients and controls and in those patients who had had just 1 manic episode compared to those who had 3 or more. Conclusion:, The number of manic episodes predicted poor cognitive performance, suggesting that the recurrence of mania may have a long-term neuropsychological impact. Prospective follow-up studies need to be completed to explore this effect further as better treatment adherence may have a protective effect on neurocognitive function. [source] Cognitive impairment and white matter damage in hypertension: a pilot studyACTA NEUROLOGICA SCANDINAVICA, Issue 4 2009K. Hannesdottir Objectives,,, Hypertension has been associated with impaired cognition. Diffusion tensor imaging (DTI) and magnetic resonance spectroscopy were applied to assess white matter abnormalities in treated vs untreated hypertension and if these correlated with neuropsychological performance. Methods,,, Subjects were 40 patients with medically treated hypertension (mean age 69.3 years), 10 patients with untreated hypertension (mean age 57.6 years) and 30 normotensive controls (mean age 68.2 years). Hypertension was defined as a previous diagnosis and taking hypertensive medication, or a resting blood pressure of >140/90 mmHg on the day of assessment. Results,,, Patients with treated hypertension performed worse on immediate (P = 0.037) as well as delayed memory tasks (P = 0.024) compared with normotensive controls. Cognitive performance was worse in untreated compared with treated hypertension on executive functions (P = 0.041) and psychomotor speed (P = 0.003). There was no significant correlation between cognition and any of the imaging parameters in treated hypertension. However, in untreated hypertension the results revealed a positive correlation between an executive functioning and attention composite score and DTI mean diffusivity values (P = 0.016) and between psychomotor speed and spectroscopy NAA/tCr levels (P = 0.015). Conclusions,,, These results suggest there is cognitive impairment in hypertension. Treated hypertension was associated with deficits in memory while untreated hypertension revealed a more ,subcortical' pattern of cognitive impairment. [source] Homocysteine, white matter hyperintensities, and cognition in healthy elderly peopleANNALS OF NEUROLOGY, Issue 2 2003Carole Dufouil PhD Hyperhomocysteinemia is associated with an increased risk of vascular disease, and recent results suggest that it also could increase the risk of dementia. We examined the relationship between homocysteine and cognitive decline in 1,241 subjects aged 61 to 73 years, followed up over 4 years. Plasma homocysteine levels were determined in all participants as well as cardiovascular risk factors, apolipoprotein E genotype, plasma levels of folate, and vitamin B12. Cognitive performances were assessed repeatedly by using Mini-Mental State Examination, Trail Making Test, Digit Symbol Substitution Test, and Finger Tapping Test. At 2-year follow-up, 841 subjects underwent cerebral magnetic resonance imaging, and white matter hyperintensities were rated visually. Analyses were adjusted for all cardiovascular risk factors. Cross-sectional analyses showed that higher concentrations of homocysteine were significantly related to poorer performances at all neuropsychological tests. Longitudinal analyses confirmed this finding. The odds of cognitive decline was 2.8-fold (p < 0.05) higher in subjects with homocysteine levels above 15,mol/L compared with those with homocysteine levels below 10,mol/L. In participants who underwent magnetic resonance imaging, the relationship between homocysteine and cognition was unchanged after taking into account white matter hyperintensities suggesting that white matter hyperintensities do not mediate the association between homocysteine and cognition. Ann Neurol 2003;53:000,000 [source] Transcranial Doppler Blood Flow Assessment in Patients With Mild Heart Failure: Correlates With Neuroimaging and Cognitive PerformanceCONGESTIVE HEART FAILURE, Issue 2 2008Raymond L. C. Vogels MD Cardiac output and cerebral perfusion are reduced in patients with advanced stages of heart failure. Our aim was to determine whether cerebral blood flow velocity measured by transcranial Doppler ultrasonography was reduced in outpatients with mild heart failure in comparison to controls and, if so, whether this reduction was related to cognitive performance and abnormalities of the brain diagnosed by magnetic resonance imaging. [source] Activation of the basal forebrain by the orexin/hypocretin neuronesACTA PHYSIOLOGICA, Issue 3 2010E. Arrigoni Abstract The orexin neurones play an essential role in driving arousal and in maintaining normal wakefulness. Lack of orexin neurotransmission produces a chronic state of hypoarousal characterized by excessive sleepiness, frequent transitions between wake and sleep, and episodes of cataplexy. A growing body of research now suggests that the basal forebrain (BF) may be a key site through which the orexin-producing neurones promote arousal. Here we review anatomical, pharmacological and electrophysiological studies on how the orexin neurones may promote arousal by exciting cortically projecting neurones of the BF. Orexin fibres synapse on BF cholinergic neurones and orexin-A is released in the BF during waking. Local application of orexins excites BF cholinergic neurones, induces cortical release of acetylcholine and promotes wakefulness. The orexin neurones also contain and probably co-release the inhibitory neuropeptide dynorphin. We found that orexin-A and dynorphin have specific effects on different classes of BF neurones that project to the cortex. Cholinergic neurones were directly excited by orexin-A, but did not respond to dynorphin. Non-cholinergic BF neurones that project to the cortex seem to comprise at least two populations with some directly excited by orexin-A that may represent wake-active, GABAergic neurones, whereas others did not respond to orexin-A but were inhibited by dynorphin and may be sleep-active, GABAergic neurones. This evidence suggests that the BF is a key site through which orexins activate the cortex and promote behavioural arousal. In addition, orexins and dynorphin may act synergistically in the BF to promote arousal and improve cognitive performance. [source] | ||||||||||||||||||||||||||||||||||