Home About us Contact
|
Home About us Contact | ||
|
|
||
Cognitive Tests (cognitive + test)
Terms modified by Cognitive Tests Selected AbstractsCut-off scores in MMSE: a moving target?EUROPEAN JOURNAL OF NEUROLOGY, Issue 5 2010J. Morgado Background:, Cognitive tests are known to be influenced by language, culture and education. In addition, there may be an impact of ,epoch' in cognition, because there is secular increase in scores of IQ tests in children. If we assume this is a long lasting process, then it should persist later in life. Methods:, To test this hypothesis, we compared the performance of two cohorts of individuals (,50 years of age), evaluated 20 years apart using the Mini-Mental State Examination (MMSE). Results:, Study population included 135 participants in 1988 and 411 in 2008. MMSE scores were higher in 2008 than in 1988 for literacy x age-matched subgroups, the difference being significant for participants with lower literacy. Score variance was explained by literacy (, = 0.479, t = 14.598, P = 0.00), epoch (, = 0.34, t = 10.33, P = 0.00) and age (, = ,0.142, t = ,4.184, P = 0.00). Conclusion:, The present results are in accordance with a lifelong secular improvement in cognitive performance. The operational cut-off values may change with time, which may have clinical impact in the diagnosis of disorders like mild cognitive impairment or dementia. [source] Prefrontal cognition in schizophrenia and bipolar illness in relation to Val66Met polymorphism of the brain-derived neurotrophic factor genePSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 1 2006JANUSZ K. RYBAKOWSKI md Abstract, The measures of prefrontal cognition have been used as endophenotype in molecular-genetic studies. Brain-derived neurotrophic factor (BDNF) has been implicated in cognitive functions and in the pathogenesis of major psychoses. This study investigates the relationship between Val66Met polymorphisms of the BDNF gene and prefrontal cognitive function in 129 patients with schizophrenia and 111 patients with bipolar mood disorder. Cognitive tests included the Wisconsin Card Sorting Test (WCST), with such domains as number of perseverative errors, non-perseverative errors, completed corrected categories, conceptual level responses, and set to the first category, and the N-back test, where mean reaction time and percent of correct reactions were measured. Genotyping for Val66Met BDNF polymorphism was done by polymerase chain reaction method. In schizophrenia, no relationship between Val66Met polymorphism of the BDNF gene and the results of the WCST was observed. Patients with Val/Val genotype had a higher percentage of correct reactions in the N-back test than those with the remaining genotypes. Bipolar patients with Val/Val genotype obtained significantly better results on three of five domains of the WCST. No relationship between BDNF polymorphism and the results of the N-back test was found in this group. A limitation to the results could be variable psychopathological state and medication during cognitive testing and lack of Hardy,Weinberg equilibrium in schizophrenia group. Val66Met polymorphism of the BDNF gene may be associated with cognitive performance on the WCST in bipolar mood disorder but not in schizophrenia. An association of this polymorphism with performance on the N-back test in schizophrenia and not in bipolar illness may suggest that in schizophrenia, the BDNF system may be connected with early phases of information processing. [source] THE ROLE OF NONCOGNITIVE SKILLS IN EXPLAINING COGNITIVE TEST SCORESECONOMIC INQUIRY, Issue 1 2008LEX BORGHANS This article examines whether noncognitive skills,measured both by personality traits and by economic preference parameters,influence cognitive tests' performance. The basic idea is that noncognitive skills might affect the effort people put into a test to obtain good results. We experimentally varied the rewards for questions in a cognitive test to measure to what extent people are sensitive to financial incentives. To distinguish increased mental effort from extra time investments, we also varied the questions' time constraints. Subjects with favorable personality traits such as high performance motivation and an internal locus of control perform relatively well in the absence of rewards, consistent with a model in which trying as hard as you can is the best strategy. In contrast, favorable economic preference parameters (low discount rate, low risk aversion) are associated with increases in time investments when incentives are introduced, consistent with a rational economic model in which people only invest when there are monetary returns. The main conclusion is that individual behavior at cognitive tests depends on noncognitive skills. (JEL J20, J24) [source] Brief screening tool for mild cognitive impairment in older Japanese: Validation of the Japanese version of the Montreal Cognitive AssessmentGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 3 2010Yoshinori Fujiwara Aim: The Montreal Cognitive Assessment (MoCA), developed by Dr Nasreddine (Nasreddine et al. 2005), is a brief cognitive screening tool for detecting older people with mild cognitive impairment (MCI). We examined the reliability and validity of the Japanese version of the MoCA (MoCA-J) in older Japanese subjects. Methods: Subjects were recruited from the outpatient memory clinic of Tokyo Metropolitan Geriatric Hospital or community-based medical health check-ups in 2008. The MoCA-J, the Mini-Mental State Examination (MMSE), the revised version of Hasegawa's Dementia Scale (HDS-R), Clinical Dementia Rating (CDR) scale, and routine neuropsychological batteries were conducted on 96 older subjects. Mild Alzheimer's disease (AD) was found in 30 subjects and MCI in 30, with 36 normal controls. Results: The Cronbach's alpha of MoCA-J as an index of internal consistency was 0.74. The test,retest reliability of MoCA, using intraclass correlation coefficient between the scores at baseline survey and follow-up survey 8 weeks later was 0.88 (P < 0.001). MoCA-J score was highly correlated with MMSE (r = 0.83, P < 0.001), HDS-R (r = 0.79, P < 0.001) and CDR (r = ,0.79, P < 0.001) scores. The areas under receiver,operator curves (AUC) for predicting MCI and AD groups by the MoCA-J were 0.95 (95% confidence interval [CI] = 0.90,1.00) and 0.99 (95% CI = 0.00,1.00), respectively. The corresponding values for MMSE and HDS-R were 0.85 (95% CI = 0.75,0.95) and 0.97 (95% CI = 0.00,1.00), and 0.86 (95% CI = 0.76,0.95) and 0.97 (95% CI = 0.00,1.00), respectively. Using a cut-off point of 25/26, the MoCA-J demonstrated a sensitivity of 93.0% and a specificity of 87.0% in screening MCI. Conclusion: The MoCA-J could be a useful cognitive test for screening MCI, and could be recommended in a primary clinical setting and for geriatric health screening in the community. Geriatr Gerontol Int 2010; 10: 225,232. [source] Reliving lifelong episodic autobiographical memories via the hippocampus: A correlative resting PET study in healthy middle-aged subjectsHIPPOCAMPUS, Issue 5 2008Pascale Piolino Abstract We aimed at identifying the cerebral structures whose synaptic function subserves the recollection of lifetime's episodic autobiographical memory (AM) via autonoetic consciousness. Twelve healthy middle-aged subjects (mean age: 59 years ± 2.5) underwent a specially designed cognitive test to assess the ability to relive richly detailed episodic autobiographical memories from five time periods using the Remember/Know procedure. We computed an index of episodicity (number of Remember responses justified by the recall of specific events and details) and an index of retrieval spontaneity, and additionally an index of semanticized memories (number of Know responses). The regional cerebral blood flow (rCBF) was measured in the resting state, with H2O15 as part of an activation PET study. The indexes were correlated with blood flow using volumes of interest in frontotemporal regions, including hippocampus and voxel-wise analyses in SPM. With both analyses, significant correlations were mainly found between the index of episodicity and rCBF in the medial temporal lobe, including hippocampus, across the five time periods (unlike the index of semanticized memories) and between the spontaneity index and rCBF in the prefrontal areas. These results highlight, in healthy subjects, the distinct role of these two structures in AM retrieval and support the view that the hippocampus is needed for reexperiencing detailed episodic memories no matter how old they are. © 2008 Wiley-Liss, Inc. [source] Moderate wine consumption is associated with better cognitive test results: a 7 year follow up of 5033 subjects in the Tromsø StudyACTA NEUROLOGICA SCANDINAVICA, Issue 2010K. A. Arntzen Arntzen KA, Schirmer H, Wilsgaard T, Mathiesen EB. Moderate wine consumption is associated with better cognitive test results: a 7 year follow up of 5033 subjects in the Tromsø Study. Acta Neurol Scand: 2010: 122 (Suppl. 190): 23,29. © 2010 John Wiley & Sons A/S. Background,,, The impact of moderate alcohol consumption on cognitive function and dementia is unclear. We examined the relationship between consumption of different alcoholic beverages and cognitive function in a large population-based study. Methods,,, Subjects were 5033 stroke-free men and women who participated in a longitudinal population-based study in Tromsø, Norway. Alcohol consumption and other cardiovascular risk factors were measured at baseline and cognitive function was assessed after 7 years follow up with verbal memory test, digit,symbol coding test and tapping test. Results,,, Moderate wine consumption was independently associated with better performance on all cognitive tests in both men and women. There was no consistent association between consumption of beer and spirits and cognitive test results. Alcohol abstention was associated with lower cognitive performance in women. Conclusions,,, Light-to-moderate wine consumption was associated with better performance on cognitive tests after 7 years follow up. [source] Is late-onset schizophrenia a subtype of schizophrenia?ACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2010I. V. Vahia Vahia IV, Palmer BW, Depp C, Fellows I, Golshan S, Kraemer HC, Jeste DV. Is late-onset schizophrenia a subtype of schizophrenia? Objective:, To determine whether late-onset schizophrenia (LOS, onset after age 40) should be considered a distinct subtype of schizophrenia. Method:, Participants included 359 normal comparison subjects (NCs) and 854 schizophrenia out-patients age >40 (110 LOS, 744 early-onset schizophrenia or EOS). Assessments included standardized measures of psychopathology, neurocognition, and functioning. Results:, Early-onset schizophrenia and LOS groups differed from NCs on all measures of psychopathology and functioning, and most cognitive tests. Early-onset schizophrenia and LOS groups had similar education, severity of depressive, negative, and deficit symptoms, crystallized knowledge, and auditory working memory, but LOS patients included more women and married individuals, had less severe positive symptoms and general psychopathology, and better processing speed, abstraction, verbal memory, and everyday functioning, and were on lower antipsychotic doses. Most EOS,LOS differences remained significant after adjusting for age, gender, severity of negative or deficit symptoms, and duration of illness. Conclusion:, Late-onset schizophrenia should be considered a subtype of schizophrenia. [source] Immediate effects of methylphenidate on cognitive attention skills of children with attention-deficit-hyperactivity disorderDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 6 2005Jane Hood MSc This study investigated the immediate effects of stimulant medication (methylphenidate) on cognitive attention processes in children with attention-deficit-hyperactivity disorder (ADHD). Thirteen males and two females (mean age 9y 5mo, SD 18.3mo) with a diagnosis of ADHD and who were to be prescribed methylphenidate were assessed twice on one day with the Test of Everyday Attention for Children, a neuropsychological battery designed to tap different aspects of cognitive attention. Between assessments, the children were administered methylphenidate (10mg). Each child had at least average intelligence (IQ 80 or over, as measured by the Wechsler Intelligence Scale for Children - III UK) and was on no other medication. A group of 16 children, who were matched for age, sex, and intelligence, also performed the cognitive tests twice on the same day to control for practice effects of testing. At the first assessment, children with ADHD demonstrated significant impairments in several aspects of cognitive attention in comparison with the control group, particularly sustained attention. After administration of methylphenidate for the children with ADHD, they showed significant improvements in their performance on measures of cognitive attention compared to controls. The immediate effects of methylphenidate and the significance of measuring cognitive aspects of attention as well as behavioural measures are discussed. [source] Ophthalmological, cognitive, electrophysiological and MRI assessment of visual processing in preterm children without major neuromotor impairmentDEVELOPMENTAL SCIENCE, Issue 5 2010Michelle O'Reilly Many studies report chronic deficits in visual processing in children born preterm. We investigated whether functional abnormalities in visual processing exist in children born preterm but without major neuromotor impairment (i.e. cerebral palsy). Twelve such children (< 33 weeks gestation or birthweight < 1000 g) without major neuromotor impairment and 12 born full-term controls were assessed at 8,12 years of age by means of ophthalmological assessment (visual acuity, colour vision, stereopsis, stereoacuity, visual fields, ocular motility, motor fusion), cognitive tests of visual-motor, visual-perceptual and visual-spatial skills and pattern-reversal visual evoked potentials (PR-VEPs). All participants also underwent magnetic resonance imaging (MRI) of the brain and neuromotor assessments. No significant differences were found between the groups on the ophthalmological, visual cognitive, neurological, neuromotor or MRI measures. The P100 component of the PR-VEP showed a significantly shorter latency in the preterm compared with the full-term participants. Whilst this P100 finding suggests that subtle abnormalities may exist at the neurophysiological level, we conclude that visual dysfunction is not systematically associated with preterm birth in the context of normal neurological status. [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] THE ROLE OF NONCOGNITIVE SKILLS IN EXPLAINING COGNITIVE TEST SCORESECONOMIC INQUIRY, Issue 1 2008LEX BORGHANS This article examines whether noncognitive skills,measured both by personality traits and by economic preference parameters,influence cognitive tests' performance. The basic idea is that noncognitive skills might affect the effort people put into a test to obtain good results. We experimentally varied the rewards for questions in a cognitive test to measure to what extent people are sensitive to financial incentives. To distinguish increased mental effort from extra time investments, we also varied the questions' time constraints. Subjects with favorable personality traits such as high performance motivation and an internal locus of control perform relatively well in the absence of rewards, consistent with a model in which trying as hard as you can is the best strategy. In contrast, favorable economic preference parameters (low discount rate, low risk aversion) are associated with increases in time investments when incentives are introduced, consistent with a rational economic model in which people only invest when there are monetary returns. The main conclusion is that individual behavior at cognitive tests depends on noncognitive skills. (JEL J20, J24) [source] Anatomy of executive deficit following ruptured anterior communicating artery aneurysmEUROPEAN JOURNAL OF NEUROLOGY, Issue 5 2009O. Martinaud Background and purpose:, To evaluate behavioral and cognitive deficits following anterior communicating artery aneurysm rupture and determine critical lesion locations. Methods:, We investigated 74 patients with standardized cognitive tests and behavioral inventory. Two examiners rated MRI signal abnormalities in 51 predetermined regions of interest. Classification tree analysis was used to select regions associated with each cognitive deficit. Results:, Eleven patients presented behavioral executive deficits and 10 had cognitive executive deficit. Their presence depended on left hemisphere lesions only: (i) ventral striatum lesion was associated with behavioral executive deficit (P = 0.04), reduction of activities (P = 0.01), and hyperactivity (P = 0.02); (ii) superior frontal gyrus lesion, with cognitive executive deficit (P = 0.01), action initiation deficit (P = 0.02), and rule deduction deficit (P = 0.02); (iii) anterior half of centrum semiovale lesion, with Stroop inhibition deficit (P = 0.02); (iv) medial superior and middle frontal gyri lesions, with task coordination deficit (P = 0.01); and (v) middle frontal gyrus lesion, with words generation deficit (P = 0.02). Conclusion:, This study supports that (i) cognitive executive deficits depend mostly on lateral prefrontal lesions, (ii) with locations varying according to executive process, and (iii) behavioral executive deficits are mainly due to left ventral striatum lesion in post-aneurysmal damage. [source] Replication study of candidate genes for cognitive abilities: the Lothian Birth Cohort 1936GENES, BRAIN AND BEHAVIOR, Issue 2 2009L. M. Houlihan As the proportion of older people in societies has increased, research into the determinants of cognitive ageing has risen in importance. Genetic influences account for over 50% of the variance in adult cognitive abilities. Previous studies on cognition and illnesses with cognitive impairments have identified single nucleotide polymorphisms (SNPs) within candidate genes that might influence cognition or age-related cognitive change. This study investigated 10 candidate genes in over 1000 Scots: the Lothian Birth Cohort 1936 (LBC1936). These participants were tested on general cognitive ability (Scottish Mental Survey 1947) at age 11. At mean age 70, they completed the same general cognitive ability test and a battery of diverse cognitive tests. Nineteen SNPs in 10 genes previously associated with cognition, Alzheimer's disease or autism were genotyped in 1063 individuals. The genes include BDNF, COMT, DISC1, KL, NCSTN, PPP1R1B, PRNP, SHANK3, SORL1 and WRN. Linear regression analysis investigated the additive effect of each SNP on the cognitive variables, covarying for gender and age. Childhood cognitive ability was also included as a covariate to identify associations specifically with cognitive ageing. Certain SNPs reached the conventional significance threshold for association with cognitive traits or cognitive ageing in LBC1936 (P < 0.05). No SNPs reached the Bonferroni-level of significance (all P > 0.0015). Of the 10 genes, we discuss that COMT, KL, PRNP, PPP1R1B, SORL1 and WRN especially merit further attention for association with cognitive ability and/or age-related cognitive change. All results are also presented so that they are valuable for future meta-analyses of candidate genes for cognition. [source] Predictors and correlates of edentulism in the healthy old people in Edinburgh (HOPE) studyGERODONTOLOGY, Issue 4 2008John M. Starr Objectives:, To determine the extent to which correlates of edentulism are explained by an association between tooth loss and cognitive ability. Methods:, Participants in the Healthy Old People in Edinburgh (HOPE) study aged 70 or more at baseline were assessed and health, cognitive, socio-economic and socio-environmental data collected on four consecutive occasions. It was noted whether the participant had any retained teeth and if not, the age when the last tooth was lost. Prior determinants of edentulism were investigated with binary logistic regression models. At the 9-year follow-up, associations with edentulism were examined using general linear models with edentulism as an independent factor. Results:, 201 participants were adequately tested, of whom 104 (51.7%) were edentulous. A logistic regression model that considered age, sex, education, social class, deprivation index of residence, objective distance from dentist, participant's estimate of distance from dentist and NART-estimated IQ (NARTIQ) found age (p = 0.032), occupational class (p = 0.019) and NARTIQ (p = 0.027) as significant predictors of edentulism. Cox's proportional hazards modelling found only NARTIQ (p = 0.050) to be correlated. Being edentulous was associated with poorer respiratory function but not hand grip strength (p = 0.23). Edentulous participants had lower self esteem scores (p = 0.020) and poorer dietary assessment scores (p = 0.028). Being edentulous was also associated with significantly lower mean scores on all cognitive testing, although these associations became non-significant after adjustment for NARTIQ and age. Conclusions:, In healthy older people, edentulism is associated with relative impairment of cognitive ability, although this association is explained by the fact that lower original intelligence predisposes to edentulism and poorer performance on cognitive tests in old age. Once original intelligence is adjusted for, tooth loss is not related to cognitive ability. Tooth loss is, however, associated with poorer status across a wide range of health measures: physical health, nutrition, disability and self-esteem. Establishing the degree to which these health outcomes are causally related to edentulism could usefully be factored into cost,benefit analyses of programmes designed to prevent tooth loss. [source] Dementia and the Over-75 Check: the role of the primary care nurseHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 1 2000Heather Trickey BSc MSc (Med) Abstract Primary care nurses are very likely to provide a substantial part of the routine care for patients with dementia. In order to examine the knowledge and attitudes of the primary care nurses who undertake the Over-75 Check, towards assessing and managing patients with symptoms of dementia, and to assess their level of support for a clinical practice guideline, a postal questionnaire survey was undertaken of primary care nurses responsible for the Over-75 Check in 209 general practices in Gloucester, Avon and Somerset. The questionnaire ascertained some demographic information about the nurses, their training and the practice routine for the Over-75 Check. It also included a case vignette describing a typical presentation of dementia at an Over-75 Check. A 65% response rate was achieved. Only one-fifth of respondents ever used formal validated cognitive tests as part of the Over-75 Check. In response to the vignette, nearly 10% took no action at all and a further 25% simply referred the patient on. Amongst the remainder there was considerable variation regarding the tasks considered to be within their remit. The respondents strongly supported the introduction of guidelines. Given the variation in professional responsibilities between practices, it is proposed that a clinical practice guideline covering diagnosis, assessment and management of dementia should address the practice as a whole rather than be targeted to specific professionals. The guideline should prompt professionals carrying out an Over-75 Check to recognize symptoms of dementia and raise awareness of the range of tasks which need to be undertaken in confirming diagnosis, assessing needs and managing patients. Results from this study suggest that improved training and increased autonomy for primary care nurses would improve access to services for these patients and their carers. [source] The safety and tolerability of duloxetine in depressed elderly patients with and without medical comorbidityINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 8 2007T. N. Wise Summary Aim and methods:, The impact of medical comorbidity on the efficacy and tolerability of duloxetine in elderly patients with major depressive disorder (MDD) was investigated in this study. Data were obtained from a multicentre, randomised, double-blind, placebo-controlled study in 311 patients with MDD aged 65,89. The primary outcome measure was a prespecified composite cognitive score based on four cognitive tests: (i) Verbal Learning and Recall Test; (ii) Symbol Digit Substitution Test; (iii) 2-Digit Cancellation Test and (iv) Letter-Number Sequencing Test. Secondary measures included the Geriatric Depression Scale (GDS), 17-Item Hamilton Depression Scale (HAMD17), Clinical Global Impression-Severity (CGI-S) Scale, Visual Analogue Scale (VAS) for pain and 36-Item Short Form Health Survey (SF-36). Tolerability measures included adverse events reported as the reason for discontinuation and treatment-emergent adverse events (TEAEs). The consistency of the effect of duloxetine vs. placebo comparing patients with and without medical comorbidity (vascular disease, diabetes, arthritis or any of these) was investigated. Results:, Overall, duloxetine 60 mg/day demonstrated significantly greater improvement compared with placebo for the composite cognitive score, GDS and HAMD17 total scores, CGI-Severity, HAMD17 response and remission rates, and some of the SF-36 and VAS measures. There were few significant treatment-by-comorbidity subgroup interactions for these efficacy variables, or for adverse events reported as the reason for discontinuation and common TEAEs. Conclusions:, The present analyses suggested that the efficacy of duloxetine on cognition and depression in elderly patients, and its tolerability, were not largely affected by the comorbidity status. These results further support the use of duloxetine in elderly patients with MDD. [source] Nocturnal sleep duration and cognitive impairment in a population-based study of older adultsINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 1 2010Adrian Loerbroks Abstract Objective We aimed to investigate the association between nocturnal sleep duration, changes in nocturnal sleep duration and cognitive impairment in older adults. Methods 4010 participants of a population-based cohort study provided information on nocturnal sleep duration at baseline (1991,1995) and at follow-up (2002/2003). 792 follow-up participants aged 70+ by 2006 participated in telephone-based cognitive assessments. Several cognitive tests were used including the telephone interview for cognitive status (TICS). Cognitive impairment was defined as <31 points on the TICS (13.0%) and as below this percentile on the other tests. Based on individual tests, a verbal memory score and a total score were constructed. Multivariable prevalence ratios (PRs) of cognitive impairment and 95% confidence intervals (95%CIs) were computed using Poisson regression. Analyses were restricted to those free of depression in 2002/2003 (n,=,695). Results Sleeping ,6 or 8,h per night (versus 7,h) were unrelated to cognitive impairment. Sleeping ,9,h was positively, although imprecisely, associated with impairment of verbal memory (PR,=,1.7, 95%CI,=,1.0, 3.0), and less pronounced with the other cognitive measures. An increase in sleep duration from 7,8,h in 1992,1995 to ,9,h 8.5 years later (versus sleeping 7,8,h at both time points) was associated with an increased prevalence of cognitive impairment according to the TICS (PR,=,2.1, 95%,=,1.0, 4.5) and the verbal memory score (PR,=,2.0, 95%CI,=,1.0, 3.8). Conclusions Increases in sleep duration are associated with cognitive impairment. A biological explanation for this association is currently lacking. Increases in sleep duration could be a marker of cognitive deficits. Copyright © 2009 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] Validation analysis of informant's ratings of cognitive function in African Americans and NigeriansINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 7 2006Jianzhao Shen Abstract Objectives To examine informant validity using the Community Screening Interview for Dementia (CSI ,D') both cross-sectionally and longitudinally in two very different cultures and to explore the effects of informants and study participants' characteristics on the validity of informants' reports. Methods Elderly African Americans age 65 years and older residing in Indianapolis, USA and elderly Yoruba Nigerians age 65 years and older residing in Ibadan, Nigeria were assessed on cognitive functioning using the CSI ,D' at baseline (1992,1993) and five-year follow-up (1997,1998). At baseline, the informant validity in both samples was evaluated against participants' cognitive tests using Pearson correlation and regular regression models. At follow-up, informants ratings on cognitive decline were assessed against participants' cognitive decline scores from baseline to follow-up using biserial correlation and logistic regressions. Results At baseline, informants' reports on cognitive functioning significantly correlated with cognitive scores in both samples (Indianapolis:r,=,,0.43, p,<,0.001; Ibadan:r,=,,0.47, p,<,0.001). The participant,informant relationships significantly affected the informants' reports in the two samples with different patterns (p,=,0.005 for Indianapolis and p,<,0.001 for Ibadan) at a given level of cognitive functioning. African Americans spouses reported more cognitive problems, while siblings reported more problems for the Yoruba Nigerians. At follow-up, informants' ratings on cognitive decline significantly correlated with the cognitive decline scores (Indianapolis r,=,0.38, p,<,0.001; Ibadan r,=,0.32, p,<,0.001). The characteristics of study participants and informants had little impact on the informants' ratings on cognitive decline. Conclusions Informant reports are valid in assessing the cognitive functioning of study participants both cross-sectionally and longitudinally in two very different cultures, languages and environments. Copyright © 2006 John Wiley & Sons, Ltd. [source] Cognitive correlates of brain MRI subcortical signal hyperintensities in non-demented elderlyINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 1 2006Gad A. Marshall Abstract Objective To investigate the relationship between magnetic resonance imaging (MRI) subcortical gray and capsular (SGCH) and white matter hyperintensities (WMH) and cognitive functions in non-demented community dwelling elderly. Methods The severity of SGCH and WMH on proton density and T2 MR images in 16 subjects was scored using the semi-quantitative rating scale of Scheltens et al. (1993). A limited series of cognitive tests selected a priori were then correlated with severity of SGCH and WMH. Results Analysis demonstrated that severity of SGCH was inversely related to performance on the Digit Span (R,=,,0.64, p,<,0.01) and the Stroop Color Word Tests (R,=,,0.64, p,<,0.01). Severity of WMH was related to worsening performance on the Trail Making Test (R,=,0.67, p,<,0.005). Conclusions These findings indicate that severity of WMH is negatively related to more pure executive cognitive functions, specifically set shifting, while severity of SGCH is inversely related to more basic functions of attention and working memory. Copyright © 2005 John Wiley & Sons, Ltd. [source] Apathy and cognitive performance in older adults with depressionINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 6 2003Denise Feil Abstract Objectives Recent studies have linked apathy to frontal lobe dysfunction in persons with dementia, but few studies have explored this relationship in older, depressed persons without dementia. We examined the association between apathy and cognitive function in a group of older persons with major depression using standardized neuropsychological tests. We hypothesized that presence of apathy in depression is associated with poorer frontal executive performance. Methods We analyzed data from 89 older adults with major depression. We defined apathy using four items from the Hamilton Psychiatric Rating Scale for Depression which reflect the clinical state of apathy, including ,diminished work/interest,' ,psychomotor retardation,' ,anergy' and ,lack of insight.' Results Apathy most strongly correlated with two verbal executive measures (Stroop C and FAS), a nonverbal executive measure (Wisconsin Card Sorting Test,Other Responses), and a measure of information processing speed (Stroop B). Apathy was not associated with age, sex, education, medical illness burden, Mini-Mental State Examination score and Full Scale IQ score. Stepwise regression analyses of significant cognitive tests showed that apathy alone or apathy plus depression severity, age, or education accounted for a significant amount of the variance. Conclusions The results of this study provide support for an apathy syndrome associated with poorer executive function in older adults with major depression. Copyright © 2003 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] Clinical Utility of Office-Based Cognitive Predictors of Fitness to Drive in Persons with Dementia: A Systematic ReviewJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 12 2006Frank J. Molnar MDCM OBJECTIVES: To perform a systematic review of evidence available regarding in-office cognitive tests that differentiate safe from unsafe drivers with dementia. DESIGN: A comprehensive literature search of multiple databases including Medline, CINAHL, PsychInfo, AARP Ageline, and Sociofile from 1984 to 2005 was performed. This was supplemented by a search of Current Contents and a review of the bibliographies of all relevant articles. SETTING: English prospective cohort, retrospective cohort, and case-control studies that used accepted diagnostic criteria for dementia or Alzheimer's disease and that employed one of the primary outcomes of crash, simulator assessment, or on-road assessment were included. PARTICIPANTS: Two reviewers. MEASUREMENTS: The reviewers independently assessed study design, main outcome of interest, cognitive tests, and population details and assigned a Newcastle-Ottawa quality assessment rating. RESULTS: Sixteen articles met the inclusion criteria. Tests recommended by guidelines (e.g., the American Medical Association (AMA) and Canadian Medical Association guidelines) for the assessment of fitness to drive did not demonstrate robustly positive findings (e.g., Mini-Mental State Examination, Trails B) or were not evaluated in any of the included studies (e.g., Clock Drawing). Fifteen studies did not report any cutoff scores. CONCLUSION: Without validated cutoff scores, it is impossible to employ tests in a standardized fashion in front-line clinical settings. This study identified a research gap that will prevent the development of evidence-based guidelines. Recommendations to address this gap are that driving researchers routinely perform cutoff score analyses and that stakeholder organizations (e.g., AMA, American Geriatrics Society) sponsor consensus fora to review driving research methodologies. [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] Cognitive Screening Using a Tape Recorder: A Pilot StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2003Peter W. Schofield MD OBJECTIVES: To determine whether a tape recorder can be used to administer cognitive tests efficiently and yield valid results. DESIGN: Convenience sample. Administration of cognitive test materials by tape recorder and conventional technique. SETTING: Outpatient clinic. PARTICIPANTS: Subjects from memory disorder clinic, hostel accommodation, and community. MEASUREMENTS: Responses to Hopkins Verbal Learning Test,revised, verbal fluency items from the controlled oral word association test, 10-item naming task, a construction task, and speed writing task. RESULTS: Performances on the tape- and clinician-administered battery of tests were highly correlated. Memory impairment was accurately detected using the tape battery. Data from 30 minutes of testing via tape were obtained at the cost to the clinician of 2 to 3 minutes of scoring time. CONCLUSION: Tape-administration of cognitive test material warrants further study as an efficient means of cognitive screening. [source] Predicting Cognitive Impairment in High-Functioning Community-Dwelling Older Persons: MacArthur Studies of Successful AgingJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 6 2002Joshua Chodosh MD, MSHS OBJECTIVES: To examine whether simple cognitive tests, when applied to cognitively intact older persons, are useful predictors of cognitive impairment 7 years later. DESIGN: Cohort study. SETTING: Durham, North Carolina; East Boston, Massachusetts; and New Haven, Connecticut, areas that are part of the National Institute on Aging Established Populations for Epidemiological Studies of the Elderly. PARTICIPANTS: Participants, aged 70 to 79, from three community-based studies, who were in the top third of this age group, based on physical and cognitive functional status. MEASUREMENTS: New onset of cognitive impairment as defined by a score of less than 7 on the Short Portable Mental Status Questionnaire (SPMSQ) in 1995. RESULTS: At 7 years, 21.8% (149 of 684 subjects) scored lower than 7 on the SPMSQ. Using multivariate logistic regression, three baseline (1988) cognitive tests predicted impairment in 1995. These included two simple tests of delayed recall,the ability to remember up to six items from a short story and up to 18 words from recall of Boston Naming Test items. For each story item missed, the adjusted odds ratio (AOR) for cognitive impairment was 1.44 (95% confidence interval (CI) = 1.16,1.78, P < .001). For each missed item from the word list, the AOR was 1.20 (95% CI = 1.09,1.31, P < .001). The Delayed Recognition Span, which assesses nonverbal memory, also predicted cognitive impairment, albeit less strongly (odds ratio = 1.06 per each missed answer, 95% CI = 1.003,1.13, P = .04). CONCLUSIONS: This study identifies measures of delayed recall and recognition as significant early predictors of subsequent cognitive decline in high-functioning older persons. Future efforts to identify those at greatest risk of cognitive impairment may benefit by including these measures. [source] Reduced N -acetylaspartate is consistent with axonal dysfunction in cerebral small vessel diseaseNMR IN BIOMEDICINE, Issue 3 2009Arani Nitkunan Abstract Background: Cerebral small vessel disease (SVD) is an important cause of cognitive impairment, but the pathophysiological mechanisms remain unclear. We used 1H MRS to investigate brain metabolic differences between patients with SVD and controls and correlated this with cognition. Methods: 35 patients with SVD (lacunar stroke and radiological evidence of confluent leukoaraiosis) and 35 controls underwent multi-voxel spectroscopic imaging of white matter to obtain absolute metabolite concentrations of N -acetylaspartate (NAA), total creatines, total cholines, myo -inositol, and lactate. A range of cognitive tests was performed on patients with SVD, and composite scores were calculated. Results: Scans of sufficient quality for data analysis were available in 29 cases and 35 controls. NAA was significantly reduced in patients compared with controls (lower by 7.27%, P,=,0.004). However, when lesion load within each individual voxel (mean 22% in SVD vs 5% in controls, P,<,0.001) was added as a covariate, these differences were no longer significant, suggesting that the metabolite differences arose primarily from differences in lesioned tissue. In patients with SVD, there was no correlation between cognitive scores and any brain metabolite. No lactate, an indicator of anaerobic metabolism, was detected. Conclusions: The most consistent change in SVD is a reduction in NAA, a marker of neuronal integrity. The lack of correlation with cognition does not support the use of MRS as a surrogate disease marker. Copyright © 2008 John Wiley & Sons, Ltd. [source] Cognitive and emotional outcome after pediatric liver transplantationPEDIATRIC TRANSPLANTATION, Issue 5 2003Petra Adebäck Abstract: The aim of the study was to evaluate the cognitive and emotional development after pediatric liver transplantation. A total of 21 patients, aged 4,16.9 yr (median 9.6 yr) were tested 1,9 yr (median 4.2 yr) after the transplantation. The pretransplant diagnoses included biliary atresia (eight patients), various metabolic diseases (n = 6), acute liver failure (n = 3), and miscellaneous (n = 4). The cognitive functions were tested with Wechsler preschool and primary scale of intelligence (WPPSI)-R or Wechsler intelligence scale for children (WISC)-III according to age. The Piers,Harris self-concept scale and the evaluation of human figure drawings according to Koppitz were used to detect emotional problems. All tests in all patients were performed by the same psychologist. A significantly lower result on cognitive tests was seen when compared with the expected normal values (p < 0.01). The number of patients with results within or under the lower normal range was higher than expected. Although the mean value of the Piers,Harris self-concept scale was normal, there was a large spread within the group. Indicators of emotional problems were found in the human figure drawings of 50% of the patients. To some extent, low cognitive scores coincided with low scores on self-concept scale and indicators of emotional difficulties. We conclude that the high degree of cognitive and emotional problems after liver transplantation is an important argument for routine psychologic follow-up and support in these patients. [source] Research on aging using brain imaging and cognitive tests over 6 years in 145 healthy elderly subjectsPSYCHOGERIATRICS, Issue 4 2008Hirohide KADA Abstract Background:, Changes over a period of 10 years in the cognitive function, head magnetic resonance imaging findings, and daily life of approximately 300 healthy elderly subjects were determined. As part of the larger 10-year study, changes are reported herein over a period of 6 years for 145 individuals. Methods:, One hundred and forty-five healthy elderly subjects were divided into two groups: (i) those who were 69 years of age or younger at the start of the study (Group A); and (ii) those who were 70 years of age or older (Group B). Results:, Changes over time in Benton's visual retention test (BVRT) and enhanced cued recall (ECR), both of which rely mainly on subjects memorizing figures, were seen in Group B. With the coding test, the results from the second phase (initial test) showed differences according to initial age; in addition, the differences became greater with aging. It appears that work speed is reduced with increasing age. Conclusion:, The results of the BVRT and ECR suggest that enlargement of the Sylvian fissure and atrophy of the temporal lobe are indicators of deterioration of memory. [source] Clinical profiles of autopsy-confirmed dementia with Lewy bodies at institutionalization: Comparison with Alzheimer's diseasePSYCHOGERIATRICS, Issue 3 2007Hiroshige FUJISHIRO Abstract Background:, It has been reported that Alzheimer's disease (AD) patients with Lewy pathology have a shorter time from a given baseline to institutionalization than those with AD alone. Taking the clinical distinction between dementia with Lewy bodies (DLB) and AD into consideration, the previous findings may indicate the possibility that the clinical characteristics of DLB patients have an influence on early institutionalization. This study was carried out to clarify whether there are any differences in the symptoms that required institutionalization between patients with DLB and those with AD. Methods:, Hospital records and standardized data forms completed at admission to a residential care facility were reviewed to assess the profiles in all cases with autopsy-confirmed diagnoses for correct differential diagnosis. We examined functional, cognitive and symptomatic conditions at admission to a residential care facility of 18 DLB and 35 AD patients whose diagnoses were confirmed by autopsy. The examinations were conducted using the Gottfries-Bråne-Steen (GBS) scale and cognitive tests, and the results were compared between the two groups of patients. Results:, Hallucinations, impaired wakefulness, disturbance of ADL and emotional disturbance, common clinical features compatible with DLB, were more frequently observed in DLB patients than in AD patients (P < 0.05). Moreover, DLB patients had higher scores on cognitive tests than did AD patients at admission to a residential care facility (P < 0.05). Conclusion:, The distinctive clinical features at admission to a residential care facility may indicate that the reasons for the necessity of institutionalization are different between DLB and AD, and that the interventions specific to DLB patients and their families would be necessary to prevent or postpone institutionalization. [source] | ||||||||||||||||||||||||||||||||||