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Malyutina S, Zabolotskaia A, Savilov V, Syunyakov T, Kurmyshev M, Kurmysheva E, Lobanova I, Osipova N, Karpenko O, Andriushchenko A. Are subjective language complaints in memory clinic patients informative? NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:795-822. [PMID: 37865966 DOI: 10.1080/13825585.2023.2270209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 10/08/2023] [Indexed: 10/24/2023]
Abstract
To diagnose mild cognitive impairment, it is crucial to understand whether subjective cognitive complaints reflect objective cognitive deficits. This question has mostly been investigated in the memory domain, with mixed results. Our study was one of the first to address it for language. Participants were 55-to-93-year-old memory clinic patients (n = 163). They filled in a questionnaire about subjective language and memory complaints and performed two language tasks (naming-by-definition and sentence comprehension). Greater language complaints were associated with two language measures, thus showing a moderate value in predicting language performance. Greater relative severity of language versus memory complaints was a better predictor, associated with three language performance measures. Surprisingly, greater memory complaints were associated with better naming, probably due to anosognosia in further disease progression or personality-related factors. Our findings highlight the importance of relative complaint severity across domains and, clinically, call for developing self-assessment questionnaires asking specific questions about multiple cognitive functions.
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Affiliation(s)
| | | | - Victor Savilov
- Day Hospital Memory Clinic, Mental Health Clinic No. 1 named after N.A. Alexeev, Moscow, Russia
| | - Timur Syunyakov
- Education Center, Mental Health Clinic No. 1 named after N.A. Alexeev, Moscow, Russia
- Republican Specialized Scientific and Practical Medical Center for Mental Health, Tashkent, Uzbekistan
- International Centre for Education and Research in Neuropsychiatry, Samara State Medical University, Samara, Russia
| | - Marat Kurmyshev
- Mental Health Clinic No. 1 named after N.A. Alexeev, Moscow, Russia
| | - Elena Kurmysheva
- Day Hospital Memory Clinic, Mental Health Clinic No. 1 named after N.A. Alexeev, Moscow, Russia
| | - Irina Lobanova
- Center for Language and Brain, HSE University, Moscow, Russia
| | - Natalia Osipova
- Day Hospital Memory Clinic, Mental Health Clinic No. 1 named after N.A. Alexeev, Moscow, Russia
| | - Olga Karpenko
- Scientific Сollaborations Department, Mental Health Clinic No. 1 named after N.A. Alexeev, Moscow, Russia
| | - Alisa Andriushchenko
- Department of Mental Disorders in Neurodegenerative Diseases of the Brain, Scientific Center of Neuropsychiatry, Mental Health Clinic No. 1 named after N.A. Alexeev, Moscow, Russia
- Department of Mental Health, Faculty of Psychology, Lomonosov Moscow State University, Moscow, Russia
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Weijters RMMM, Almela M, van Boxtel GJM, de Vroege L. Subjective cognitive concerns not related to objective impairment in patients with somatic symptom and related disorders. J Clin Exp Neuropsychol 2024:1-13. [PMID: 39141370 DOI: 10.1080/13803395.2024.2383282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 07/18/2024] [Indexed: 08/15/2024]
Abstract
OBJECTIVES Patients with Somatic Symptom and Related Disorders (SSRD) report subjective cognitive concerns, and research indicates that they show objective cognitive impairment. This study explored the value of subjective concerns flagging objective impairment. Furthermore, we investigated whether coping moderated this relationship, and the role of depressive symptomatology. METHOD In a cross-sectional design, objective impairment was measured with an extensive neuropsychological assessment; subjective concerns with the Cognitive Failure Questionnaire; coping styles with the Coping Inventory of Stressful Situations; and symptoms of depression with the Patient Health Questionnaire- 9. RESULTS The results show that subjective concerns are of limited value in signaling objective impairment in patients with SSRD. Regression analyses performed on data from 225 patients showed that symptoms of depression (β = .32) were the main predictor of subjective concerns, which were unrelated to objective impairment. Coping was not a moderator, but patients with emotion-oriented coping styles had more subjective concerns (β=.40), and conversely, patients with avoidance- and/or task-oriented coping styles had less (respectively, β=-.27 and β=-.24). CONCLUSIONS These results align with the Somatosensory Amplification Theory; patients with SSRD may amplify benign cognitive failures and experience them as intrusive, noxious, and more intense. In patients with SSRD, subjective cognitive concerns are more related to psychological constructs (symptoms of depression and coping styles) than to objective impairment.
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Affiliation(s)
- Robin M M M Weijters
- Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, The Netherlands
| | - Mercedes Almela
- Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands
| | - Geert J M van Boxtel
- Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands
| | - Lars de Vroege
- Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, The Netherlands
- Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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Ly TK, Allen RS, Cundiff JM, DeCaro JA. Investigating the Effects of Discrimination Experiences on Everyday Metamemory Accuracy. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae089. [PMID: 38841817 DOI: 10.1093/geronb/gbae089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Indexed: 06/07/2024] Open
Abstract
OBJECTIVES Lifetime and daily experiences of discrimination contribute to impaired performance on cognitive assessments. However, the underlying mechanism by which discrimination negatively affects cognition is unclear. Recent research investigating stress-induced impairment of metamemory may address the relationship between discrimination experiences and cognitive impairment. METHODS The aim of this study was to determine the relationship of lifetime and daily experiences of discrimination, daily affect balance, baseline objective cognitive performance, and sociodemographic variables (age, race, ethnicity, and sex) with metamemory accuracy across the lifespan (ages 20-75). Impaired metamemory accuracy was defined by the number of subjective cognitive complaints. Diary data from the Midlife in the United States (MIDUS Refresher 1) Daily Diary Project (N = 782) was used for these analyses. RESULTS Results from linear mixed model analyses showed significant within-person effects of daily discrimination, where people who reported more daily discrimination also reported lower metamemory accuracy, and daily affect balance, where people who reported very negative affect also reported lower metamemory accuracy. Additionally, linear mixed model analyses revealed significant between-person effects of race on metamemory accuracy, with individuals from minoritized racial groups generally reporting poorer metamemory accuracy. Daily discrimination experiences also interacted with other variables in predicting day-to-day metamemory accuracy. DISCUSSION These findings add to our understanding of how psychosocial stress in the form of daily discrimination experiences may impair metamemory processes contributing to increased subjective cognitive complaints. Future research should consider the contribution of daily experiences of discrimination across the lifespan to poor cognitive outcomes in later life.
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Affiliation(s)
- Timothy K Ly
- Alabama Research Institute on Aging, The University of Alabama, Tuscaloosa, Alabama, USA
- Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Rebecca S Allen
- Alabama Research Institute on Aging, The University of Alabama, Tuscaloosa, Alabama, USA
- Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Jeanne M Cundiff
- Alabama Research Institute on Aging, The University of Alabama, Tuscaloosa, Alabama, USA
- Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Jason A DeCaro
- Alabama Research Institute on Aging, The University of Alabama, Tuscaloosa, Alabama, USA
- Department of Anthropology, The University of Alabama, Tuscaloosa, Alabama, USA
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Carr DC, Schmidt B, Schubert FT, Sachs-Ericsson N. Prospective exploration of the role of combined internalizing symptoms in self-reported memory among older adults during the COVID-19 pandemic. Aging Ment Health 2024; 28:1011-1019. [PMID: 38285681 DOI: 10.1080/13607863.2023.2297049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 12/12/2023] [Indexed: 01/31/2024]
Abstract
OBJECTIVES A growing literature suggests depression and anxiety increase risk of cognitive decline. However, few studies have examined their combined effects on cognition, among older adults, especially during periods of high stress. METHOD Based on a sample of community dwelling older adults (N = 576), we evaluated the effects of pre-pandemic anxiety and depressive symptoms, obtained in September 2018, to changes in self-reported memory (SRM) assessed 3 months into the COVID-19 pandemic. RESULTS In separate models, we found participants with depression scores at least 1-SD above the mean and participants with anxiety scores at least 2-SD above the mean to report a significant decline in SRM. Moderation analyses revealed those with high depressive symptoms (at or above the mean) showed a decrease in SRM regardless of anxiety. The extent to which high pre-pandemic anxiety symptoms influenced SRM is dependent on whether pre-pandemic depression was at or above the mean. CONCLUSIONS Pre-pandemic depression predicted a decline in SRM regardless of anxiety. Moderation analyses revealed that the extent to which anxiety symptoms influenced SRM was dependent on depression being at or above the mean. Those with high anxiety and depression are at highest risk of experiencing cognitive consequences related to stressful exposures like COVID-19.
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Affiliation(s)
- Dawn C Carr
- Department of Sociology, Florida State University, Tallahassee, FL, USA
| | - Brad Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL, USA
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Rekers S, Heine J, Thöne-Otto AIT, Finke C. Neuropsychiatric symptoms and metamemory across the life span: psychometric properties of the German Multifactorial Memory Questionnaire (MMQ). J Neurol 2024; 271:4551-4565. [PMID: 38717611 PMCID: PMC11233313 DOI: 10.1007/s00415-024-12402-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/18/2024] [Accepted: 04/22/2024] [Indexed: 07/10/2024]
Abstract
OBJECTIVE We assessed the psychometric properties, established normative data for the German Multifactorial Memory Questionnaire (MMQ), and analyzed its association with neuropsychiatric factors across the life span to provide a validated metamemory assessment for a German-speaking population. METHODS The three MMQ scales (memory satisfaction, self-rated ability, and strategy application) were translated into German, considering cultural, linguistic, and conceptual aspects. To validate the MMQ and assess associations with neuropsychiatric factors, the Complainer Profile Identification, Geriatric Depression Scale, Beck Anxiety Inventory, Pittsburgh Sleep Quality Index, and Short-Form-Health Survey were applied in an online study in 336 healthy participants with follow-up after 8 months. RESULTS Psychometric evaluation of the German MMQ showed normal distribution of all scales and good to excellent validity, internal consistency, and retest reliability. We provide percentiles and normative data for z-score conversion. Importantly, even subclinically elevated scores in depressiveness and anxiety were associated with decreased memory satisfaction and self-rated ability. Furthermore, although the influence of age on the German MMQ scales was minimal, effects of neuropsychiatric factors such as sleep quality, anxiety, and depressiveness on MMQ Satisfaction and Ability varied across the life span. CONCLUSIONS Our study provides a validated German translation of the MMQ with normative data and reliability measures, including reliable change scores. We show the impact of neuropsychiatric factors on the MMQ scales across the life span and emphasize the relevance of a multifactorial approach to metamemory as a measure of individualized everyday functionality and the importance of including neuropsychiatric factors into both research and clinical assessments of metamemory.
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Affiliation(s)
- Sophia Rekers
- Department of Neurology, Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.
| | - Josephine Heine
- Department of Neurology, Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Angelika I T Thöne-Otto
- Clinic for Cognitive Neurology, University of Leipzig, Max-Planck-Institute of Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Carsten Finke
- Department of Neurology, Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
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Kurita S, Doi T, Harada K, Morikawa M, Nishijima C, Fujii K, Kakita D, Shimada H. Subjective memory concerns and car collisions: A cross-sectional cohort study among older Japanese drivers. Heliyon 2024; 10:e33080. [PMID: 39021989 PMCID: PMC11253256 DOI: 10.1016/j.heliyon.2024.e33080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Accepted: 06/13/2024] [Indexed: 07/20/2024] Open
Abstract
Background A previous study suggested older drivers with subjective memory concerns (SMC) had increased odds of experiencing car collisions, but whether SMC in different contexts and the number of SMC applicable items change this association is unknown. The aim of this study was to examine the association between SMC and car collisions among older drivers in Japan. Methods This cross-sectional study was conducted using data from a Japanese community-based cohort study. Participants were community-dwelling older adults aged ≥60 years. SMC was assessed using five questions: 1) "Do you feel you have more problems with memory than most?" 2) "Do you have any difficulty with your memory?" 3) "Do you forget where you have left things more than you used to?" 4) "Do you forget the names of close friends or relatives?" and 5) "Do other people find you forgetful?" Participants were asked about their experiences with car collisions during the previous two years. Results A total of 13,137 older drivers (72.1 ± 5.5 years old, and 43.6 % female) were analyzed. Cochran-Armitage trend test showed that as the number of SMC applicable items increased, the percentage of the experiences of car collisions significantly increased (6.8 %-15.8 %, P < 0.001). Logistic regression models showed each SMC question was associated with an increased odds ratio (OR) of car collisions (OR 1.26 to 1.71, all P < 0.001) after adjusting for confounding factors. As the number of SMC applicable items increased, the OR of car collisions significantly increased (OR 1.19 to 2.28, all P < 0.05, P for trend <0.001). Conclusions This cross-sectional study among community-dwelling older drivers in Japan suggested each SMC question and the number of applicable items were associated with car collisions. SMC may be a sign of increased risk of traffic incidents for older drivers.
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Affiliation(s)
- Satoshi Kurita
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
- School of Psychology, Faculty of Science, The University of New South Wales, Sydney, Australia
| | - Takehiko Doi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kenji Harada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Masanori Morikawa
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Chiharu Nishijima
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kazuya Fujii
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Daisuke Kakita
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Medical Sciences, Medical Science Division, Graduate School of Medicine, Science and Technology, Shinshu University, Matsumoto, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
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Alzola P, Carnero C, Bermejo-Pareja F, Sánchez-Benavides G, Peña-Casanova J, Puertas-Martín V, Fernández-Calvo B, Contador I. Neuropsychological Assessment for Early Detection and Diagnosis of Dementia: Current Knowledge and New Insights. J Clin Med 2024; 13:3442. [PMID: 38929971 PMCID: PMC11204334 DOI: 10.3390/jcm13123442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 06/06/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024] Open
Abstract
Dementia remains an underdiagnosed syndrome, and there is a need to improve the early detection of cognitive decline. This narrative review examines the role of neuropsychological assessment in the characterization of cognitive changes associated with dementia syndrome at different states. The first section describes the early indicators of cognitive decline and the major barriers to their identification. Further, the optimal cognitive screening conditions and the most widely accepted tests are described. The second section analyzes the main differences in cognitive performance between Alzheimer's disease and other subtypes of dementia. Finally, the current challenges of neuropsychological assessment in aging/dementia and future approaches are discussed. Essentially, we find that current research is beginning to uncover early cognitive changes that precede dementia, while continuing to improve and refine the differential diagnosis of neurodegenerative disorders that cause dementia. However, neuropsychology faces several barriers, including the cultural diversity of the populations, a limited implementation in public health systems, and the adaptation to technological advances. Nowadays, neuropsychological assessment plays a fundamental role in characterizing cognitive decline in the different stages of dementia, but more efforts are needed to develop harmonized procedures that facilitate its use in different clinical contexts and research protocols.
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Affiliation(s)
- Patricia Alzola
- Department of Basic Psychology, Psychobiology and Methodology of Behavioral Sciences, University of Salamanca, 37005 Salamanca, Spain;
| | - Cristóbal Carnero
- Neurology Department, Granada University Hospital Complex, 18014 Granada, Spain
| | - Félix Bermejo-Pareja
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Institute of Health Carlos III, 28029 Madrid, Spain
- Institute of Research i+12, University Hospital “12 de Octubre”, 28041 Madrid, Spain
| | | | | | | | | | - Israel Contador
- Department of Basic Psychology, Psychobiology and Methodology of Behavioral Sciences, University of Salamanca, 37005 Salamanca, Spain;
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Ly MT, Adler J, Ton Loy AF, Edmonds EC, Bondi MW, Delano-Wood L. Comparing neuropsychological, typical, and ADNI criteria for the diagnosis of mild cognitive impairment in Vietnam-era veterans. J Int Neuropsychol Soc 2024; 30:439-447. [PMID: 38263745 DOI: 10.1017/s135561772301144x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
OBJECTIVE Neuropsychological criteria for mild cognitive impairment (MCI) more accurately predict progression to Alzheimer's disease (AD) and are more strongly associated with AD biomarkers and neuroimaging profiles than ADNI criteria. However, research to date has been conducted in relatively healthy samples with few comorbidities. Given that history of traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) are risk factors for AD and common in Veterans, we compared neuropsychological, typical (Petersen/Winblad), and ADNI criteria for MCI in Vietnam-era Veterans with histories of TBI or PTSD. METHOD 267 Veterans (mean age = 69.8) from the DOD-ADNI study were evaluated for MCI using neuropsychological, typical, and ADNI criteria. Linear regressions adjusting for age and education assessed associations between MCI status and AD biomarker levels (cerebrospinal fluid [CSF] p-tau181, t-tau, and Aβ42) by diagnostic criteria. Logistic regressions adjusting for age and education assessed the effects of TBI severity and PTSD symptom severity simultaneously on MCI classification by each criteria. RESULTS Agreement between criteria was poor. Neuropsychological criteria identified more Veterans with MCI than typical or ADNI criteria, and were associated with higher CSF p-tau181 and t-tau. Typical and ADNI criteria were not associated with CSF biomarkers. PTSD symptom severity predicted MCI diagnosis by neuropsychological and ADNI criteria. History of moderate/severe TBI predicted MCI by typical and ADNI criteria. CONCLUSIONS MCI diagnosis using sensitive neuropsychological criteria is more strongly associated with AD biomarkers than conventional diagnostic methods. MCI diagnostics in Veterans would benefit from incorporation of comprehensive neuropsychological methods and consideration of the impact of PTSD.
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Affiliation(s)
- Monica T Ly
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California San Diego Health, La Jolla, CA, USA
| | - Jennifer Adler
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California San Diego Health, La Jolla, CA, USA
| | - Adan F Ton Loy
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Emily C Edmonds
- Banner Alzheimer's Institute, Tucson, AZ, USA
- Departments of Neurology and Psychology, University of Arizona, Tucson, AZ, USA
| | - Mark W Bondi
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California San Diego Health, La Jolla, CA, USA
| | - Lisa Delano-Wood
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California San Diego Health, La Jolla, CA, USA
- Center for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
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Gerschmann A, Lehrner J. Depressive symptoms-Not a predictor for five-year mortality in patients with subjective cognitive decline, non-amnestic and amnestic mild cognitive impairment. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2024:10.1007/s40211-024-00495-2. [PMID: 38777983 DOI: 10.1007/s40211-024-00495-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 04/06/2024] [Indexed: 05/25/2024]
Abstract
The main aim of the present study is to evaluate the influence of depressive symptoms on mortality in patients with SCD (subjective cognitive decline), naMCI (non-amnestic mild cognitive impairment), and aMCI (amnestic mild cognitive impairment). Additional factors (age, sex, years of school attendance, and neuropsychological performance) were considered to determine the impact on survival probability. A monocentric retrospective data analysis based on adjusted patient protocols (n = 1221) from the observation period 1998-2021, using the Cox Proportional Hazards model, assessed whether depressivity had an explanatory value for survival, considering SCD as the reference level in relation to naMCI and aMCI. Covariates were included blockwise. Cox regression revealed that depressiveness (Beck Depression Inventory, Geriatric Depression Scale) did not make a significant contribution as a risk factor for mortality in all five model blocks, BDI-II with HR 0.997 [0.978; 1.02] and GDS-15 with HR 1.03 [0.98; 1.08]. Increasing age with HR 1.09 [1.07; 1.11] and male sex with HR (inverted) 1.53 [1.17; 2.00] appeared as risk factors for increased mortality across all five model blocks. aMCI (vs. SCD) with HR 1.91 [1.33; 2.76] showed a significant explanatory value only up to the fourth model block. By adding the six dimensions of the Neuropsychological Test Battery Vienna in the fifth model block, the domains attention and perceptual speed with HR 1.34 [1.18; 1.53], and executive functions with HR 1.24 [1.11; 1.39], showed substantial explanatory values for survival. Accordingly, no tendency can be attributed to depressiveness as a risk factor on the probability of survival, whereas the influence of certain cognitive dimensions, especially attention and perceptual speed, and executive functions, can be seen as protective for survival.
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Affiliation(s)
| | - Johann Lehrner
- Department of Neurology, Medical University of Vienna, Währinger Gürtel 18- 20, 1090, Vienna, Austria.
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Liu Y, Su N, Li W, Hong B, Yan F, Wang J, Li X, Chen J, Xiao S, Yue L. Associations between Informant-Reported Cognitive Complaint and Longitudinal Cognitive Decline in Subjective Cognitive Decline A 7-Year Longitudinal Study. Arch Clin Neuropsychol 2024; 39:409-417. [PMID: 38180808 DOI: 10.1093/arclin/acad096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 11/21/2023] [Accepted: 12/07/2023] [Indexed: 01/07/2024] Open
Abstract
OBJECTIVE This study aimed to determine the predictive values of informant-reported memory decline (IMD) among subjective cognitive decline (SCD) older adults from a 7-year community-based cohort study. METHOD Ninety SCD participants were included. Demographic data and neuropsychological test scores at both baseline and 7-year follow-up were collected. Differences between SCD with IMD (+IMD) and SCD without IMD (-IMD) were compared. Logistic regression models were used to determine whether baseline IMD could predict diagnostic outcomes at 7-year follow-up. RESULTS Forty-one percent of SCD adults had IMD. At baseline, the +IMD group showed more depressive symptoms (p = 0.016) than the -IMD group. Furthermore, the Beijing-version Montreal Cognitive Assessment (MoCA), Digit Span Test-Forward, Visual Matching and Reasoning, and Wechsler Adult Intelligence Scale-RC Picture Completion (WAIS-PC) scores in the +IMD group were significantly lower than those in the -IMD group. Fifty-four percent of +IMD participants converted to mild cognitive impairment (MCI) or dementia at follow-up, and 22.6% of the -IMD participants converted to MCI. Follow-up Mini-Mental State Examination, MoCA, and Verbal Fluency Test scores of the +IMD group were significantly lower than those in the -IMD group. The +IMD group was more likely to progress to cognitive impairment at 7-year follow-up (OR = 3.361, p = 0.028). CONCLUSIONS SCD participants with +IMD may have poorer cognition and are more likely to convert to cognitive impairment over time. Our long-term follow-up study confirmed the importance of informants' perceptions of SCD, which can help clinicians identify individuals at risk of cognitive decline.
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Affiliation(s)
- Yuanyuan Liu
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Ning Su
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Bo Hong
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Feng Yan
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Jinghua Wang
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Xia Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Jianhua Chen
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Ling Yue
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
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Smit D, Koerts J, Bangma DF, Fuermaier ABM, Tucha L, Tucha O. Look who is complaining: Psychological factors predicting subjective cognitive complaints in a large community sample of older adults. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:203-217. [PMID: 34882062 DOI: 10.1080/23279095.2021.2007387] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Subjective cognitive complaints (SCCs) are not directly related to objective impairments in cognition. This study examines the role of psychological factors in predicting SCCs in the domains of executive functioning, memory, and attention in older adults. A community sample of 1,219 Dutch adults, aged 40 year or older, completed the BRIEF-A, MSEQ, FEDA, NEO-FFI, DASS-21, and a demographic questionnaire. Participants were randomly divided into exploratory (n = 813) and confirmatory samples (n = 406). In the exploratory sample, we analyzed whether personality factors, symptoms of depression and anxiety, perceived stress, and demographics could predict SCCs in the different cognitive domains. For this purpose, a two-step regression approach with bootstrapping was used. To independently validate the results, these analyses were repeated in the confirmatory sample. Concerning executive functioning, complaints regarding the ability to regulate behavior and emotional responses were predicted by lower agreeableness levels and higher levels of neuroticism and perceived stress. Complaints regarding the ability to actively solve problems in different circumstances were predicted by a lower conscientiousness level, higher agreeableness level, and more depressive symptoms. Attentional complaints were predicted by lower levels of conscientiousness and extraversion, together with a higher level of neuroticism. For memory, no significant predictors were consistently found. Psychological factors are of influence on the subjective experience of cognitive complaints. In particular personality factors, perceived stress, and symptoms of depression, seem to predict SCCs in the domains of executive functioning and attention. Clinicians should take these factors into account in older adults who have SCCs.
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Affiliation(s)
- Diede Smit
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Groningen, the Netherlands
| | - Janneke Koerts
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Groningen, the Netherlands
| | - Dorien F Bangma
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Anselm B M Fuermaier
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Groningen, the Netherlands
| | - Lara Tucha
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock, Germany
- Department of Psychology, Maynooth University, National University of Ireland, Maynooth, Ireland
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Gasquoine PG. Self-reported anterograde memory loss in older persons that is not validated on neuropsychological assessment: Considerations for a dissociative diagnosis. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-6. [PMID: 38615907 DOI: 10.1080/23279095.2024.2341801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
The past decade has witnessed amplified public awareness of age-related dementias. This has resulted in a dramatic rise in the number of older persons referred to memory clinics with a primary complaint of self-reported memory loss without an antecedent neurological event (e.g., stroke) who produce neuropsychological test profiles that lack evidence of such impairment. Since the latter part of the 19th century, a confusing array of changing terminology, criteria, and perceived causation have been ascribed to patients with unverified medical symptoms to implicate psychological causation. Such terms are often misperceived by laypersons as reflecting character flaws or malingering. Of import for clinical neuropsychologists, the 11th edition of the International Classification of Diseases added cognitive to symptoms eligible for a diagnosis of the modern formulation, dissociative neurological symptom disorder. One dissociative option for referrals with self-reported neurocognitive symptoms not validated on neuropsychological testing is functional memory disorder, conceived as a psychological disorder where emotional distress is plausibly related to the perceived memory loss but is of less severity than would warrant a major depressive or anxiety diagnosis. If evidence of psychological distress or behavioral impairment is not present the referral likely reflects the increased public awareness of age-related dementias interacting with the high base rate of self-perceived memory loss in the general population. In such cases, a dissociative diagnosis should be avoided as there is evidence of neither a medical nor a psychological disorder. A summary statement of not dementia or similar is likely sufficient to help the patient.
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Affiliation(s)
- Philip Gerard Gasquoine
- Department of Psychological Science, University of Texas Rio Grande Valley, Edinburg, TX, USA
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13
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Finley JCA, Cladek A, Gonzalez C, Brook M. Perceived cognitive impairment is related to internalizing psychopathology but unrelated to objective cognitive performance among nongeriatric adults presenting for outpatient neuropsychological evaluation. Clin Neuropsychol 2024; 38:644-667. [PMID: 37518890 DOI: 10.1080/13854046.2023.2241190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 07/20/2023] [Indexed: 08/01/2023]
Abstract
Objective: This study investigated the relationship between perceived cognitive impairment, objective cognitive performance, and intrapersonal variables thought to influence ratings of perceived cognitive impairment. Method: Study sample comprised 194 nongeriatric adults who were seen in a general outpatient neuropsychology clinic for a variety of referral questions. The cognition subscale score from the WHO Disability Assessment Schedule served as the measure of perceived cognitive impairment. Objective cognitive performance was indexed via a composite score derived from a comprehensive neuropsychological battery. Internalizing psychopathology was indexed via a composite score derived from anxiety and depression measures. Medical and neuropsychiatric comorbidities were indexed by the number of different ICD diagnostic categories documented in medical records. Demographics included age, sex, race, and years of education. Results: Objective cognitive performance was unrelated to subjective concerns, explaining <1% of the variance in perceived cognitive impairment ratings. Conversely, internalizing psychopathology was significantly predictive, explaining nearly one-third of the variance in perceived cognitive impairment ratings, even after accounting for test performance, demographics, and number of comorbidities. Internalizing psychopathology was also highly associated with a greater discrepancy between scores on perceived and objective cognitive measures among participants with greater cognitive concerns. Clinically significant somatic symptoms uniquely contributed to the explained variance in perceived cognitive impairment (by ∼13%) when analyzed in a model with internalizing symptoms. Conclusions: These findings suggest that perceived cognitive impairment may be more indicative of the extent of internalizing psychopathology and somatic concerns than cognitive ability.
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Affiliation(s)
- John-Christopher A Finley
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Andrea Cladek
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Michael Brook
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Van Patten R, Chan L, Tocco K, Mordecai K, Altalib H, Cotton E, Correia S, Gaston TE, Grayson LP, Martin A, Fry S, Goodman A, Allendorfer JB, Szaflarski J, LaFrance WC. Reduced Subjective Cognitive Concerns With Neurobehavioral Therapy in Functional Seizures and Traumatic Brain Injury. J Neuropsychiatry Clin Neurosci 2024; 36:197-205. [PMID: 38481168 DOI: 10.1176/appi.neuropsych.20230138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Abstract
OBJECTIVE Functional seizures are common among people with traumatic brain injury (TBI). Subjective cognitive concerns refer to a person's own perception of problems with cognitive functioning in everyday life. The authors investigated the presence and correlates of subjective cognitive concerns and the response to neurobehavioral therapy among adults with TBI and functional seizures (TBI+FS group). METHODS In this observational study, participants in the TBI+FS group (N=47) completed a 12-session neurobehavioral therapy protocol for seizures, while participants in the comparison group (TBI without seizures) (N=50) received usual treatment. Subjective cognitive concerns, objective cognition, mental health, and quality of life were assessed before and after treatment. Data collection occurred from 2018 to 2022. RESULTS Baseline subjective cognitive concerns were reported for 37 (79%) participants in the TBI+FS group and 20 (40%) participants in the comparison group. In a multivariable regression model in the TBI+FS group, baseline global mental health (β=-0.97) and obsessive-compulsive symptoms (β=-1.01) were associated with subjective cognitive concerns at baseline. The TBI+FS group had fewer subjective cognitive concerns after treatment (η2=0.09), whereas the TBI comparison group showed a nonsignificant increase in subjective cognitive concerns. CONCLUSIONS Subjective cognitive concerns are common among people with TBI and functional seizures and may be related to general mental health and obsessive-compulsive symptoms. Evidence-based neurobehavioral therapy for functional seizures is a reasonable treatment option to address such concerns in this population, although additional studies in culturally diverse samples are needed. In addition, people with functional seizures would likely benefit from rehabilitation specifically targeted toward cognitive functioning.
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Affiliation(s)
- Ryan Van Patten
- Center for Neurorestoration and Neurotechnology, Veterans Affairs (VA) Providence Health Care System, and Department of Psychiatry and Human Behavior, Brown University, Providence, R.I. (Van Patten, Chan, Tocco, LaFrance); Rhode Island Hospital, Providence (Tocco, LaFrance); VA Maryland Health Care System, Baltimore (Mordecai); VA Connecticut Health Care System and Department of Neurology, Yale University, New Haven (Altalib); Department of Psychiatry and Behavioral Sciences and Department of Neurology, Northwestern University Feinberg School of Medicine, Evanston, Ill. (Cotton); College of Public Health, University of Georgia, Athens (Correia); Department of Neurology, University of Alabama at Birmingham, Birmingham (Gaston, Grayson, Martin, Fry, Goodman, Allendorfer, Szaflarski)
| | - Lawrence Chan
- Center for Neurorestoration and Neurotechnology, Veterans Affairs (VA) Providence Health Care System, and Department of Psychiatry and Human Behavior, Brown University, Providence, R.I. (Van Patten, Chan, Tocco, LaFrance); Rhode Island Hospital, Providence (Tocco, LaFrance); VA Maryland Health Care System, Baltimore (Mordecai); VA Connecticut Health Care System and Department of Neurology, Yale University, New Haven (Altalib); Department of Psychiatry and Behavioral Sciences and Department of Neurology, Northwestern University Feinberg School of Medicine, Evanston, Ill. (Cotton); College of Public Health, University of Georgia, Athens (Correia); Department of Neurology, University of Alabama at Birmingham, Birmingham (Gaston, Grayson, Martin, Fry, Goodman, Allendorfer, Szaflarski)
| | - Krista Tocco
- Center for Neurorestoration and Neurotechnology, Veterans Affairs (VA) Providence Health Care System, and Department of Psychiatry and Human Behavior, Brown University, Providence, R.I. (Van Patten, Chan, Tocco, LaFrance); Rhode Island Hospital, Providence (Tocco, LaFrance); VA Maryland Health Care System, Baltimore (Mordecai); VA Connecticut Health Care System and Department of Neurology, Yale University, New Haven (Altalib); Department of Psychiatry and Behavioral Sciences and Department of Neurology, Northwestern University Feinberg School of Medicine, Evanston, Ill. (Cotton); College of Public Health, University of Georgia, Athens (Correia); Department of Neurology, University of Alabama at Birmingham, Birmingham (Gaston, Grayson, Martin, Fry, Goodman, Allendorfer, Szaflarski)
| | - Kristen Mordecai
- Center for Neurorestoration and Neurotechnology, Veterans Affairs (VA) Providence Health Care System, and Department of Psychiatry and Human Behavior, Brown University, Providence, R.I. (Van Patten, Chan, Tocco, LaFrance); Rhode Island Hospital, Providence (Tocco, LaFrance); VA Maryland Health Care System, Baltimore (Mordecai); VA Connecticut Health Care System and Department of Neurology, Yale University, New Haven (Altalib); Department of Psychiatry and Behavioral Sciences and Department of Neurology, Northwestern University Feinberg School of Medicine, Evanston, Ill. (Cotton); College of Public Health, University of Georgia, Athens (Correia); Department of Neurology, University of Alabama at Birmingham, Birmingham (Gaston, Grayson, Martin, Fry, Goodman, Allendorfer, Szaflarski)
| | - Hamada Altalib
- Center for Neurorestoration and Neurotechnology, Veterans Affairs (VA) Providence Health Care System, and Department of Psychiatry and Human Behavior, Brown University, Providence, R.I. (Van Patten, Chan, Tocco, LaFrance); Rhode Island Hospital, Providence (Tocco, LaFrance); VA Maryland Health Care System, Baltimore (Mordecai); VA Connecticut Health Care System and Department of Neurology, Yale University, New Haven (Altalib); Department of Psychiatry and Behavioral Sciences and Department of Neurology, Northwestern University Feinberg School of Medicine, Evanston, Ill. (Cotton); College of Public Health, University of Georgia, Athens (Correia); Department of Neurology, University of Alabama at Birmingham, Birmingham (Gaston, Grayson, Martin, Fry, Goodman, Allendorfer, Szaflarski)
| | - Erica Cotton
- Center for Neurorestoration and Neurotechnology, Veterans Affairs (VA) Providence Health Care System, and Department of Psychiatry and Human Behavior, Brown University, Providence, R.I. (Van Patten, Chan, Tocco, LaFrance); Rhode Island Hospital, Providence (Tocco, LaFrance); VA Maryland Health Care System, Baltimore (Mordecai); VA Connecticut Health Care System and Department of Neurology, Yale University, New Haven (Altalib); Department of Psychiatry and Behavioral Sciences and Department of Neurology, Northwestern University Feinberg School of Medicine, Evanston, Ill. (Cotton); College of Public Health, University of Georgia, Athens (Correia); Department of Neurology, University of Alabama at Birmingham, Birmingham (Gaston, Grayson, Martin, Fry, Goodman, Allendorfer, Szaflarski)
| | - Stephen Correia
- Center for Neurorestoration and Neurotechnology, Veterans Affairs (VA) Providence Health Care System, and Department of Psychiatry and Human Behavior, Brown University, Providence, R.I. (Van Patten, Chan, Tocco, LaFrance); Rhode Island Hospital, Providence (Tocco, LaFrance); VA Maryland Health Care System, Baltimore (Mordecai); VA Connecticut Health Care System and Department of Neurology, Yale University, New Haven (Altalib); Department of Psychiatry and Behavioral Sciences and Department of Neurology, Northwestern University Feinberg School of Medicine, Evanston, Ill. (Cotton); College of Public Health, University of Georgia, Athens (Correia); Department of Neurology, University of Alabama at Birmingham, Birmingham (Gaston, Grayson, Martin, Fry, Goodman, Allendorfer, Szaflarski)
| | - Tyler E Gaston
- Center for Neurorestoration and Neurotechnology, Veterans Affairs (VA) Providence Health Care System, and Department of Psychiatry and Human Behavior, Brown University, Providence, R.I. (Van Patten, Chan, Tocco, LaFrance); Rhode Island Hospital, Providence (Tocco, LaFrance); VA Maryland Health Care System, Baltimore (Mordecai); VA Connecticut Health Care System and Department of Neurology, Yale University, New Haven (Altalib); Department of Psychiatry and Behavioral Sciences and Department of Neurology, Northwestern University Feinberg School of Medicine, Evanston, Ill. (Cotton); College of Public Health, University of Georgia, Athens (Correia); Department of Neurology, University of Alabama at Birmingham, Birmingham (Gaston, Grayson, Martin, Fry, Goodman, Allendorfer, Szaflarski)
| | - Leslie P Grayson
- Center for Neurorestoration and Neurotechnology, Veterans Affairs (VA) Providence Health Care System, and Department of Psychiatry and Human Behavior, Brown University, Providence, R.I. (Van Patten, Chan, Tocco, LaFrance); Rhode Island Hospital, Providence (Tocco, LaFrance); VA Maryland Health Care System, Baltimore (Mordecai); VA Connecticut Health Care System and Department of Neurology, Yale University, New Haven (Altalib); Department of Psychiatry and Behavioral Sciences and Department of Neurology, Northwestern University Feinberg School of Medicine, Evanston, Ill. (Cotton); College of Public Health, University of Georgia, Athens (Correia); Department of Neurology, University of Alabama at Birmingham, Birmingham (Gaston, Grayson, Martin, Fry, Goodman, Allendorfer, Szaflarski)
| | - Amber Martin
- Center for Neurorestoration and Neurotechnology, Veterans Affairs (VA) Providence Health Care System, and Department of Psychiatry and Human Behavior, Brown University, Providence, R.I. (Van Patten, Chan, Tocco, LaFrance); Rhode Island Hospital, Providence (Tocco, LaFrance); VA Maryland Health Care System, Baltimore (Mordecai); VA Connecticut Health Care System and Department of Neurology, Yale University, New Haven (Altalib); Department of Psychiatry and Behavioral Sciences and Department of Neurology, Northwestern University Feinberg School of Medicine, Evanston, Ill. (Cotton); College of Public Health, University of Georgia, Athens (Correia); Department of Neurology, University of Alabama at Birmingham, Birmingham (Gaston, Grayson, Martin, Fry, Goodman, Allendorfer, Szaflarski)
| | - Samantha Fry
- Center for Neurorestoration and Neurotechnology, Veterans Affairs (VA) Providence Health Care System, and Department of Psychiatry and Human Behavior, Brown University, Providence, R.I. (Van Patten, Chan, Tocco, LaFrance); Rhode Island Hospital, Providence (Tocco, LaFrance); VA Maryland Health Care System, Baltimore (Mordecai); VA Connecticut Health Care System and Department of Neurology, Yale University, New Haven (Altalib); Department of Psychiatry and Behavioral Sciences and Department of Neurology, Northwestern University Feinberg School of Medicine, Evanston, Ill. (Cotton); College of Public Health, University of Georgia, Athens (Correia); Department of Neurology, University of Alabama at Birmingham, Birmingham (Gaston, Grayson, Martin, Fry, Goodman, Allendorfer, Szaflarski)
| | - Adam Goodman
- Center for Neurorestoration and Neurotechnology, Veterans Affairs (VA) Providence Health Care System, and Department of Psychiatry and Human Behavior, Brown University, Providence, R.I. (Van Patten, Chan, Tocco, LaFrance); Rhode Island Hospital, Providence (Tocco, LaFrance); VA Maryland Health Care System, Baltimore (Mordecai); VA Connecticut Health Care System and Department of Neurology, Yale University, New Haven (Altalib); Department of Psychiatry and Behavioral Sciences and Department of Neurology, Northwestern University Feinberg School of Medicine, Evanston, Ill. (Cotton); College of Public Health, University of Georgia, Athens (Correia); Department of Neurology, University of Alabama at Birmingham, Birmingham (Gaston, Grayson, Martin, Fry, Goodman, Allendorfer, Szaflarski)
| | - Jane B Allendorfer
- Center for Neurorestoration and Neurotechnology, Veterans Affairs (VA) Providence Health Care System, and Department of Psychiatry and Human Behavior, Brown University, Providence, R.I. (Van Patten, Chan, Tocco, LaFrance); Rhode Island Hospital, Providence (Tocco, LaFrance); VA Maryland Health Care System, Baltimore (Mordecai); VA Connecticut Health Care System and Department of Neurology, Yale University, New Haven (Altalib); Department of Psychiatry and Behavioral Sciences and Department of Neurology, Northwestern University Feinberg School of Medicine, Evanston, Ill. (Cotton); College of Public Health, University of Georgia, Athens (Correia); Department of Neurology, University of Alabama at Birmingham, Birmingham (Gaston, Grayson, Martin, Fry, Goodman, Allendorfer, Szaflarski)
| | - Jerzy Szaflarski
- Center for Neurorestoration and Neurotechnology, Veterans Affairs (VA) Providence Health Care System, and Department of Psychiatry and Human Behavior, Brown University, Providence, R.I. (Van Patten, Chan, Tocco, LaFrance); Rhode Island Hospital, Providence (Tocco, LaFrance); VA Maryland Health Care System, Baltimore (Mordecai); VA Connecticut Health Care System and Department of Neurology, Yale University, New Haven (Altalib); Department of Psychiatry and Behavioral Sciences and Department of Neurology, Northwestern University Feinberg School of Medicine, Evanston, Ill. (Cotton); College of Public Health, University of Georgia, Athens (Correia); Department of Neurology, University of Alabama at Birmingham, Birmingham (Gaston, Grayson, Martin, Fry, Goodman, Allendorfer, Szaflarski)
| | - W Curt LaFrance
- Center for Neurorestoration and Neurotechnology, Veterans Affairs (VA) Providence Health Care System, and Department of Psychiatry and Human Behavior, Brown University, Providence, R.I. (Van Patten, Chan, Tocco, LaFrance); Rhode Island Hospital, Providence (Tocco, LaFrance); VA Maryland Health Care System, Baltimore (Mordecai); VA Connecticut Health Care System and Department of Neurology, Yale University, New Haven (Altalib); Department of Psychiatry and Behavioral Sciences and Department of Neurology, Northwestern University Feinberg School of Medicine, Evanston, Ill. (Cotton); College of Public Health, University of Georgia, Athens (Correia); Department of Neurology, University of Alabama at Birmingham, Birmingham (Gaston, Grayson, Martin, Fry, Goodman, Allendorfer, Szaflarski)
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15
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Torenvliet C, Groenman AP, Agelink van Rentergem JA, Radhoe TA, Geurts HM. When mind and measurement diverge; the interplay between subjective cognitive complaints (SCCs), objective cognition, age, and depression in autistic adults. Psychiatry Res 2024; 333:115759. [PMID: 38301288 DOI: 10.1016/j.psychres.2024.115759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 02/03/2024]
Abstract
While the increased incidence of dementia and subjective cognitive complaints (SCCs) suggests that autistic adults may face cognitive challenges at older age, the extent to which SCCs predict (future) cognitive functioning remains uncertain. This uncertainty is complicated by associations with variables like depression. The current study aims to unravel the interplay of age, depression, cognitive performance, and SCCs in autism. Using a large cross-sectional cohort of autistic (n=202) and non-autistic adults (n=247), we analyzed associations of SCCs with age, depression, and cognitive performance across three domains (visual memory, verbal memory, and fluency). Results showed a strong significant association between depression and SCCs in both autistic and non-autistic adults. Cognitive performance was not significantly associated with SCCs, except for a (modest) association between visual memory performance and SCCs in autistic adults only. Follow-up regression tree analysis indicated that depression and being autistic were considerably more predictive of SCCs than objective cognitive performance. Age nor sex was significantly associated with SCCs. These findings indicate that self-reported cognitive functioning does not equal cognitive performance, and should be interpreted with care, especially in individuals with high rates of depression. Longitudinal investigations are needed to understand SCCs' role in dementia and cognitive health in autism.
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Affiliation(s)
- Carolien Torenvliet
- Department of Psychology, Dutch Autism & ADHD Research Center, University of Amsterdam, Amsterdam, The Netherlands.
| | - Annabeth P Groenman
- Department of Psychology, Dutch Autism & ADHD Research Center, University of Amsterdam, Amsterdam, The Netherlands; Research Institute of Child Development and Education, University of Amsterdam, The Netherlands; Department of Child and Adolescent Psychiatry Groningen, University of Groningen, University Medical Center Groningen, The Netherlands; Accare Child Study Center, Groningen, The Netherlands
| | | | - Tulsi A Radhoe
- Department of Psychology, Dutch Autism & ADHD Research Center, University of Amsterdam, Amsterdam, The Netherlands; Dr. Leo Kannerhuis, Autism Clinic (Youz/Parnassia Group), Amsterdam, The Netherlands
| | - Hilde M Geurts
- Department of Psychology, Dutch Autism & ADHD Research Center, University of Amsterdam, Amsterdam, The Netherlands; Dr. Leo Kannerhuis, Autism Clinic (Youz/Parnassia Group), Amsterdam, The Netherlands
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16
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Karr JE, Hakun JG, Elbich DB, Pinheiro CN, Schmitt FA, Segerstrom SC. Detecting cognitive decline in high-functioning older adults: The relationship between subjective cognitive concerns, frequency of high neuropsychological test scores, and the frontoparietal control network. J Int Neuropsychol Soc 2024; 30:220-231. [PMID: 37750195 PMCID: PMC10922091 DOI: 10.1017/s1355617723000607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
OBJECTIVE Neuropsychologists have difficulty detecting cognitive decline in high-functioning older adults because greater neurological change must occur before cognitive performances are low enough to indicate decline or impairment. For high-functioning older adults, early neurological changes may correspond with subjective cognitive concerns and an absence of high scores. This study compared high-functioning older adults with and without subjective cognitive concerns, hypothesizing those with cognitive concerns would have fewer high scores on neuropsychological testing and lower frontoparietal network volume, thickness, and connectivity. METHOD Participants had high estimated premorbid functioning (e.g., estimated intelligence ≥75th percentile or college-educated) and were divided based on subjective cognitive concerns. Participants with cognitive concerns (n = 35; 74.0 ± 9.6 years old, 62.9% female, 94.3% White) and without cognitive concerns (n = 33; 71.2 ± 7.1 years old, 75.8% female, 100% White) completed a neuropsychological battery of memory and executive function tests and underwent structural and resting-state magnetic resonance imaging, calculating frontoparietal network volume, thickness, and connectivity. RESULTS Participants with and without cognitive concerns had comparable numbers of low test scores (≤16th percentile), p = .103, d = .40. Participants with cognitive concerns had fewer high scores (≥75th percentile), p = .004, d = .71, and lower mean frontoparietal network volumes (left: p = .004, d = .74; right: p = .011, d = .66) and cortical thickness (left: p = .010, d = .66; right: p = .033, d = .54), but did not differ in network connectivity. CONCLUSIONS Among high-functioning older adults, subjective cognitive decline may correspond with an absence of high scores on neuropsychological testing and underlying changes in the frontoparietal network that would not be detected by a traditional focus on low cognitive test scores.
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Affiliation(s)
| | - Jonathan G. Hakun
- Department of Neurology, College of Medicine, The Pennsylvania State University, Hershey, PA, United States
- Department of Psychology, The Pennsylvania State University, State College, PA, United States
| | - Daniel B. Elbich
- Department of Neurology, College of Medicine, The Pennsylvania State University, Hershey, PA, United States
| | | | - Frederick A. Schmitt
- Department of Psychology, University of Kentucky
- Department of Neurology, College of Medicine, University of Kentucky
- Sanders-Brown Center on Aging, College of Medicine, University of Kentucky
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17
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Thompson K, Lo AHY, McGlashan HL, Ownsworth T, Haslam C, Pegna A, Reutens DC. Measures of Subjective Memory for People with Epilepsy: A Systematic Review of Measurement Properties. Neuropsychol Rev 2024; 34:67-97. [PMID: 36633798 DOI: 10.1007/s11065-022-09568-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 10/21/2022] [Indexed: 01/13/2023]
Abstract
People with epilepsy frequently express concern about the burden of memory problems in their everyday lives. Self-report memory questionnaires may provide valuable insight into individuals' perceptions of their everyday memory performance and changes over time. Yet, despite their potential utility, the measurement properties of self-report memory questionnaires have not been evaluated in epilepsy. This systematic review aimed to provide a critical appraisal of the measurement properties of self-report memory questionnaires for adults with epilepsy. Following protocol registration (PROSPERO CRD42020210967), a systematic search of PubMed, EMBASE, Web of Science, CINAHL, and PsychInfo from database inception until 27 May 2021 was conducted. Eligible studies were published in English-language peer-reviewed journals, recruited adults with epilepsy, and reported on the development or evaluation of the measurement properties of a self-report memory questionnaire. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology was used to evaluate each study of a measurement property, and results were qualitatively synthesised. In total, 80 articles and one test manual were located containing 153 studies of measurement properties pertinent to 23 self-report memory questionnaires. Overall, no scale could be recommended outright for the evaluation of subjective memory symptoms in adults with epilepsy. This was due to the near absence of dedicated content validation studies relevant to this population and shortcomings in the methodology and scientific reporting of available studies of structural validity. Recommendations to support the advancement and psychometric validation of self-report memory questionnaires for people with epilepsy are provided.
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Affiliation(s)
- Kate Thompson
- Centre for Advanced Imaging, the University of Queensland, Brisbane, QLD, Australia.
- Psychology Department, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia.
- School of Psychology, the University of Queensland, Brisbane, QLD, Australia.
| | - Ada H Y Lo
- Psychology Department, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia
- School of Psychology, the University of Queensland, Brisbane, QLD, Australia
| | - Hannah L McGlashan
- School of Psychology, the University of Queensland, Brisbane, QLD, Australia
- Surgical Treatment and Rehabilitation Service, Metro North Hospital and Health Service, Brisbane, QLD, Australia
| | - Tamara Ownsworth
- School of Applied Psychology and The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Catherine Haslam
- School of Psychology, the University of Queensland, Brisbane, QLD, Australia
| | - Alan Pegna
- School of Psychology, the University of Queensland, Brisbane, QLD, Australia
| | - David C Reutens
- Centre for Advanced Imaging, the University of Queensland, Brisbane, QLD, Australia
- Neurology Department, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia
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18
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Juengst SB, Wright B, Vos L, Perna R, Williams M, Dudek E, DeMello A, Taiwo Z, Novelo LL. Emotional, Behavioral, and Cognitive Symptom Associations With Community Participation in Chronic Traumatic Brain Injury. J Head Trauma Rehabil 2024; 39:E83-E94. [PMID: 37582176 PMCID: PMC10864677 DOI: 10.1097/htr.0000000000000887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
OBJECTIVES To determine the association between self-reported emotional and cognitive symptoms and participation outcomes in chronic traumatic brain injury (TBI) and to explore the relative contribution of self-reported versus performance-based cognition to participation outcomes. SETTING Community. PARTICIPANTS Community-dwelling adults ( n = 135) with a lifetime history of mild to severe TBI. DESIGN Secondary analysis of a cross-sectional study on neurobehavioral symptoms in chronic TBI. MAIN MEASURES Behavioral Assessment Screening Tool (BAST) (Negative Affect, Fatigue, Executive Dysfunction, Impulsivity, Substance Abuse subscales) measured self-reported neurobehavioral symptoms; Participation Assessment with Recombined Tools (Productivity, Social Relations, and Out and About) measured self-reported participation outcomes; and Brief Test of Adult Cognition by Telephone (BTACT) measured performance-based cognition (Episodic Memory and Executive Function summary scores) in a subsample ( n = 40). RESULTS The BAST Executive Dysfunction was significantly associated with less frequent participation and had the strongest effect on participation in all participation domains. No other BAST subscales were associated with participation, after adjusting for all subscale scores and age, with the exception of BAST Impulsivity, which was associated with more frequent Social Relationships. Exploratory analysis in the sample including the BTACT revealed that, after accounting for subjective Executive Dysfunction using the BAST, performance-based Executive Function was associated with Productivity and Working Memory was associated with Social Relations, but neither was associated with being Out and About; the BAST Executive Dysfunction remained significant in all models even after including BTACT scores. CONCLUSIONS Self-reported Executive Dysfunction contributed to participation outcomes after mild to severe TBI in community-dwelling adults, whereas self-reported emotional and fatigue symptoms did not. Performance-based cognition measures may capture different variability in participation after injury.
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Affiliation(s)
- Shannon B Juengst
- Author Affiliations: TIRR Memorial Hermann, Houston, Texas (Drs Juengst, Perna, and Taiwo); Departments of Physical Medicine & Rehabilitation (Dr Juengst) and Biostatistics and Data Science (Dr Novelo), The University of Texas Health Science Center at Houston; Department of Physical Medicine & Rehabilitation, University of Texas Southwestern Medical Center, Dallas (Drs Juengst and Wright); Spectrum Health Medical Group, Neurosciences, Grand Rapids, Michigan (Dr Vos); Department of Psychology, University of Houston, Houston, Texas (Dr Williams and Ms Dudek); School of Nursing, The University of Texas Medical Branch, Galveston (Dr DeMello); and Department of Neurology, Section of Neuropsychology, Baylor College of Medicine, Houston, Texas (Dr Taiwo)
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19
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van der Feen FE, de Haan GA, van der Lijn I, Stellingwerf C, Vrijling ACL, Heersema DJ, Meilof JF, Heutink J. The complex relation between visual complaints and decline in visual, visuoperceptual and cognitive functions in people with multiple sclerosis. Neuropsychol Rehabil 2024; 34:220-243. [PMID: 36871257 DOI: 10.1080/09602011.2023.2179075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 02/05/2023] [Indexed: 03/06/2023]
Abstract
People with multiple sclerosis (pwMS) report many different visual complaints, but not all of them are well understood. Decline in visual, visuoperceptual and cognitive functions do occur in pwMS, but it is unclear to what extend those help us understand visual complaints. The purpose of this cross-sectional study was to explore the relation between visual complaints and decline in visual, visuoperceptual and cognitive functions, to optimize care for pwMS. Visual, visuoperceptual and cognitive functions of 68 pwMS with visual complaints and 37 pwMS with no or minimal visual complaints were assessed. The frequency of functional decline was compared between the two groups and correlations were calculated between visual complaints and the assessed functions. Decline in several functions occurred more frequently in pwMS with visual complaints. Visual complaints may be an indication of declined visual or cognitive functioning. However, as most correlations were not significant or weak, we cannot infer that visual complaints are directly related to functions. The relationship may be indirect and more complex. Future research could focus on the overarching cognitive capacity that may contribute to visual complaints. Further research into these and other explanations for visual complaints could help us to provide appropriate care for pwMS.
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Affiliation(s)
- F E van der Feen
- Clinical and Developmental Neuropsychology, University of Groningen, Groningen, Netherlands
- Centre of Expertise for blind and partially sighted people, Royal Dutch Visio, Huizen, Netherlands
| | - G A de Haan
- Clinical and Developmental Neuropsychology, University of Groningen, Groningen, Netherlands
- Centre of Expertise for blind and partially sighted people, Royal Dutch Visio, Huizen, Netherlands
| | - I van der Lijn
- Clinical and Developmental Neuropsychology, University of Groningen, Groningen, Netherlands
- Centre of Expertise for blind and partially sighted people, Royal Dutch Visio, Huizen, Netherlands
| | - C Stellingwerf
- Centre of Expertise for blind and partially sighted people, Royal Dutch Visio, Huizen, Netherlands
| | - A C L Vrijling
- Centre of Expertise for blind and partially sighted people, Royal Dutch Visio, Huizen, Netherlands
| | - D J Heersema
- Department of Neurology, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands
- MS Centrum Noord Nederland, Groningen, Netherlands
| | - J F Meilof
- Department of Neurology, Martini Hospital Groningen, Groningen, Netherlands
- MS Centrum Noord Nederland, Groningen, Netherlands
| | - J Heutink
- Clinical and Developmental Neuropsychology, University of Groningen, Groningen, Netherlands
- Centre of Expertise for blind and partially sighted people, Royal Dutch Visio, Huizen, Netherlands
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20
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Evans SA, Paitel ER, Bhasin R, Nielson KA. Genetic Risk for Alzheimer's Disease Alters Perceived Executive Dysfunction in Cognitively Healthy Middle-Aged and Older Adults. J Alzheimers Dis Rep 2024; 8:267-279. [PMID: 38405345 PMCID: PMC10894609 DOI: 10.3233/adr-230166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 01/17/2024] [Indexed: 02/27/2024] Open
Abstract
Background Subjective cognitive complaints (SCC) may be an early indicator of future cognitive decline. However, findings comparing SCC and objective cognitive performance have varied, particularly in the memory domain. Even less well established is the relationship between subjective and objective complaints in non-amnestic domains, such as in executive functioning, despite evidence indicating very early changes in these domains. Moreover, particularly early changes in both amnestic and non-amnestic domains are apparent in those carrying the Apolipoprotein-E ɛ4 allele, a primary genetic risk for Alzheimer's disease (AD). Objective This study investigated the role of the ɛ4 allele in the consistency between subjective and objective executive functioning in 54 healthy, cognitively intact, middle-aged and older adults. Methods Participants (Mage = 64.07, SD = 9.27, range = 48-84; ɛ4+ = 18) completed the Frontal Systems Behavior Scale (FrSBe) Executive Dysfunction Scale (EXECDYS) to measure subjective executive functioning (SEF) and multiple executive functioning tasks, which were condensed into a single factor. Results After accounting for age, depression, and anxiety, objective executive functioning performance significantly predicted SEF. Importantly, ɛ4 moderated this effect. Specifically, those carrying the ɛ4 allele had significantly less accurate self-awareness of their executive functioning compared to ɛ4 non-carriers. Conclusions Utilizing an approach that integrates self-evaluation of executive functioning with objective neurocognitive assessment may help identify the earliest signs of impending cognitive decline, particularly in those with genetic risk for AD. Such an approach could sensitively determine those most prone to future cognitive decline prior to symptom onset, when interventions could be most effective.
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Affiliation(s)
- Sarah A. Evans
- Department of Psychology, Marquette University, Milwaukee, WI, USA
| | | | - Riya Bhasin
- Department of Psychology, Marquette University, Milwaukee, WI, USA
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21
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Zhang S, Yuan M, He D, Dang W, Zhang W. Long-term follow-up of brain regional changes and the association with cognitive impairment in quarantined COVID-19 survivors. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-023-01741-4. [PMID: 38319396 DOI: 10.1007/s00406-023-01741-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 12/11/2023] [Indexed: 02/07/2024]
Abstract
OBJECTIVE This study aimed to evaluate the neuropsychiatric symptoms of quarantined COVID-19 survivors 15 months after discharge and explore its potential association with structural and functional brain changes and inflammation. METHODS A total of 51 quarantined COVID-19 survivors and 74 healthy controls were included in this study. Cognitive function was assessed using the THINC-integrated tool. Structural brain changes were examined through both surface- and volume-based analyses, and functional changes were assessed using resting-state amplitude low-frequency fluctuation (ALFF). Serum inflammatory markers were measured by a multiplexed flow cytometric assay. RESULTS COVID-19 survivors exhibited subjective cognitive decline compared to healthy controls, despite no significant differences in objective cognitive tasks. Structural analysis revealed significantly increased gray matter volume and cortical surface area in the left transverse temporal gyrus (Heschl's gyrus) in quarantined COVID-19 survivors. This enlargement was negatively correlated with cognitive impairment. The ALFF analysis showed decreased neural activity in multiple brain regions. Elevated levels of serum inflammatory markers were also found in COVID-19 survivors, including MIP-1a, MIP-1b, TNF-a, and IL-8, which correlated with functional abnormalities. CONCLUSIONS Our findings indicate a subjective cognitive decline in quarantined COVID-19 survivors 15 months after discharge, which is associated with brain structural alterations in the left Heschl's gyrus. The observed elevation of inflammatory markers suggests a potential mechanism involving inflammation-induced neurogenesis. These results contribute to our understanding of the possible mechanisms underlying long-term neuropsychiatric consequences of COVID-19 and highlight the need for further research to develop targeted interventions.
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Affiliation(s)
- Simai Zhang
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, No. 37 Guoxue Street, Chengdu, 610041, China
- Med-X Center for Informatics, Sichuan University, Chengdu, 610041, China
| | - Minlan Yuan
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, 610041, China.
| | - Danmei He
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Wen Dang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Wei Zhang
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, No. 37 Guoxue Street, Chengdu, 610041, China.
- Med-X Center for Informatics, Sichuan University, Chengdu, 610041, China.
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, 610041, China.
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22
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Pérez-Blanco L, Felpete-López A, Nieto-Vieites A, Lojo-Seoane C, Campos-Magdaleno M, Fernández-Feijoo F, Juncos-Rabadán O, Pereiro AX. Predicting progression of cognitive decline to dementia using dyadic patterns of subjective reporting: evidence from the CompAS longitudinal study. Front Aging Neurosci 2024; 16:1319743. [PMID: 38371398 PMCID: PMC10870422 DOI: 10.3389/fnagi.2024.1319743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/17/2024] [Indexed: 02/20/2024] Open
Abstract
Objective To analyze the validity of self and informant reports, depressive symptomatology, and some sociodemographic variables to predict the risk of cognitive decline at different follow-up times. Methods A total of 337 participants over 50 years of age included in the CompAS and classified as Cognitively Unimpaired (CU), Subjective Cognitive Decline (SCD) and Mild Cognitive Impairment (MCI) groups were assessed at baseline and three follow-ups. A short version of the QAM was administered to assess the severity of subjective cognitive complaints (SCCs), and the GDS-15 was used to evaluate the depressive symptoms. At each follow-up assessment, participants were reclassified according to the stability, regression or progression of their conditions. Logistic regression analysis was used to predict which CU, SCD and MCI participants would remain stable, regress or progress at a 3rd follow-up by using self- and informant-reported complaints, depressive symptomatology, age and education at baseline and 2nd follow-ups as the predictive variables. Results Overall, self-reported complaints predicted progression between the asymptomatic and presymptomatic stages. As the objective deterioration increased, i.e., when SCD progressed to MCI or dementia, the SCCs reported by informants proved the best predictors of progression. Depressive symptomatology was also a predictor of progression from CU to SCD and from SCD to MCI. Conclusion A late increase in self-reported complaints make valid estimates to predict subjective decline at asymptomatic stages. However, an early increase in complaints reported by informants was more accurate in predicting objective decline from asymptomatic stages. Both, early and late decrease in self-reported complaints successfully predict dementia from prodromic stage. Only late decrease in self-reported complaints predict reversion from prodromic and pre-symptomatic stages.
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Affiliation(s)
- Lucía Pérez-Blanco
- Department of Developmental Psychology, Faculty of Psychology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Applied Cognitive Neuroscience and Psychogerontology Group, Health Research Institute of Santiago (IDIS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Alba Felpete-López
- Department of Developmental Psychology, Faculty of Psychology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Applied Cognitive Neuroscience and Psychogerontology Group, Health Research Institute of Santiago (IDIS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Ana Nieto-Vieites
- Department of Developmental Psychology, Faculty of Psychology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Applied Cognitive Neuroscience and Psychogerontology Group, Health Research Institute of Santiago (IDIS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Cristina Lojo-Seoane
- Department of Developmental Psychology, Faculty of Psychology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Applied Cognitive Neuroscience and Psychogerontology Group, Health Research Institute of Santiago (IDIS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - María Campos-Magdaleno
- Department of Developmental Psychology, Faculty of Psychology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Applied Cognitive Neuroscience and Psychogerontology Group, Health Research Institute of Santiago (IDIS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Fátima Fernández-Feijoo
- Department of Developmental Psychology, Faculty of Psychology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Applied Cognitive Neuroscience and Psychogerontology Group, Health Research Institute of Santiago (IDIS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Onésimo Juncos-Rabadán
- Department of Developmental Psychology, Faculty of Psychology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Applied Cognitive Neuroscience and Psychogerontology Group, Health Research Institute of Santiago (IDIS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Arturo X. Pereiro
- Department of Developmental Psychology, Faculty of Psychology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Applied Cognitive Neuroscience and Psychogerontology Group, Health Research Institute of Santiago (IDIS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
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23
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Scholz MP, Donders J. Cognitive complaints in older adults: relationships between self and informant report, objective test performance, and symptoms of depression. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:263-278. [PMID: 36345862 DOI: 10.1080/13825585.2022.2144617] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 11/01/2022] [Indexed: 11/10/2022]
Abstract
This study explored the relationships between objective measures of cognitive functioning, self and informant reports of cognitive problems in daily life, and depression screening in older adults who had been referred because of reported or suspected cognitive changes. We used archival data from 100, predominantly White (97%), typically educated (M = 13.25 years), older adults (M = 70.38 years) who received an outpatient neuropsychological evaluation. We characterized the cognitive performance using the CVLT-II Total score. We characterized patient and collateral reports using the BRIEF-A MI index, a normed scale of cognitive problems in daily life. We also incorporated a depression screener (PHQ-9) into our analyses. Multiple linear regression analysis revealed that only the informant reported problems in daily life, using the BRIEF-A MI index, was a significant predictor of objective cognitive deficits, as defined by CVLT-II Total scores. Self BRIEF-A MI index scores were not significant predictors of CVLT-II Total performance after we accounted for depression using the patient's PHQ-9 score. Additionally, elevated depression widened the discrepancy between raters, with elevated depression associated with worsening sself-report scores compared to informant-reported scores. As informant-reported problems were the strongest predictor of cognitive deficits, we recommend routine collection of collateral informant reports in the neuropsychological evaluation of older adults referred for cognitive concerns. We also recommend incorporating self-ratings of daily life functioning and screening for depression to contextualize patient complaints and address their concerns, even in the absence of objective cognitive dysfunction.
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Affiliation(s)
- Michael P Scholz
- Psychology Department, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
| | - Jacobus Donders
- Psychology Department, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
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24
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Siciliano M, Tessitore A, Morgante F, Goldman JG, Ricciardi L. Subjective Cognitive Complaints in Parkinson's Disease: A Systematic Review and Meta-Analysis. Mov Disord 2024; 39:17-28. [PMID: 38173220 DOI: 10.1002/mds.29649] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 10/15/2023] [Accepted: 10/17/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Subjective cognitive complaints (SCCs) in Parkinson's disease (PD) are reported frequently, but their prevalence and association with changes on objective testing are not fully known. OBJECTIVE We aimed to determine the prevalence, clinical correlates, and predictive value of SCCs in PD. METHODS We conducted a systematic review and meta-analysis. From 204 abstracts, we selected 31 studies (n = 3441 patients), and from these, identified the prevalence, clinical features, associations with neuropsychiatric symptoms, and predictive values of SCCs in PD. RESULTS The meta-analysis showed an SCC prevalence of 36%. This prevalence, however, was significantly moderated by study heterogeneity regarding female sex, disease severity, levodopa equivalent daily dosage, exclusion from the overall sample of patients with objective cognitive impairment, and measurement instrument. SCC prevalence did not differ between de novo and treated PD patients. SCCs were weakly and negligibly associated with cognitive changes on objective testing in cross-sectional studies. However, in cognitively healthy patients, SCCs had a risk ratio of 2.71 for later cognitive decline over a mean follow-up of 3.16 years. Moreover, SCCs were moderately related to co-occurring symptoms of depression, anxiety, or apathy and were more strongly related to these neuropsychiatric symptoms than objective cognitive functioning. CONCLUSION Our analyses suggest that SCCs in patients with and without objective cognitive impairment are frequent, occurring in more than one third of PD patients. Establishing uniform measurement instruments for identifying PD-related SCCs is critical to understand their implications. Even in cases lacking evidence of objective cognitive impairment and where SCCs might reflect underlying neuropsychiatric symptoms, the possibility of later cognitive deterioration should not be excluded. Therefore, SCCs in PD patients warrant close monitoring for opportunities for targeted and effective interventions. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Mattia Siciliano
- Department of Advanced Medical and Surgical Sciences-MRI Research Center Vanvitelli-FISM, University of Campania "Luigi Vanvitelli", Naples, Italy
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, United Kingdom
| | - Alessandro Tessitore
- Department of Advanced Medical and Surgical Sciences-MRI Research Center Vanvitelli-FISM, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Francesca Morgante
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, United Kingdom
| | | | - Lucia Ricciardi
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, United Kingdom
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25
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Freed SA, Sprague BN, Ross LA. Does the association between objective and subjective memory vary by age among healthy older adults? NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:249-262. [PMID: 36353743 PMCID: PMC10166764 DOI: 10.1080/13825585.2022.2143471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/28/2022] [Indexed: 11/11/2022]
Abstract
Subjective memory is commonly used as an indicator of older adults' objective memory in clinical screening; however, the correspondence between subjective and objective memory across different ages is unclear. The current study examined age-varying associations between subjective and objective memory in a cross-sectional sample of healthy older adults from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study (N = 2,496). Time varying effects modeling (TVEM) models the association between variables as a function of time-varying metrics including age without imposing linear assumptions. TVEM was used to examine relationship magnitude fluctuations between subjective and objective memory across ages 65 to 85. Better subjective memory was weakly associated with better objective memory, even after controlling for gender, depressive symptoms, and education. The association was stable across all ages. There is a stable weak correspondence between subjective and objective memory in older adulthood across age, supporting the use of linear age as an appropriate time metric for examinations of objective and subjective memory among healthy older adults. Future work should examine the correspondence between subjective and objective memory in a larger age range. Longitudinal designs can also provide insights on whether the accuracy of subjective memory ratings change within a person over time.
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Affiliation(s)
- Sara A. Freed
- TransAnalytics, LLC, Quakertown, United States of America
| | - Briana N. Sprague
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, United States of America
| | - Lesley A. Ross
- Department of Psychology and Institute for Engaged Aging, Clemson University, Clemson, United States of America
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Nester CO, Gao Q, Katz MJ, Mogle JA, Wang C, Derby CA, Lipton RB, Saykin AJ, Rabin LA. Does the Cognitive Change Index Predict Future Cognitive and Clinical Decline? Longitudinal Analysis in a Demographically Diverse Cohort. J Alzheimers Dis 2024; 98:319-332. [PMID: 38393900 DOI: 10.3233/jad-230752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
Background The Cognitive Change Index (CCI) is a widely-used measure of self-perceived cognitive ability and change. Unfortunately, it is unclear if the CCI predicts future cognitive and clinical decline. Objective We evaluated baseline CCI to predict transition from normal cognition to cognitive impairment in nondemented older adults and in predementia groups including, subjective cognitive decline, motoric cognitive risk syndrome, and mild cognitive impairment. Different versions of the CCI were assessed to uncover any differential risk sensitivity. We also examined the effect of ethnicity/race on CCI. Methods Einstein Aging Study participants (N = 322, Mage = 77.57±4.96, % female=67.1, Meducation = 15.06±3.54, % non-Hispanic white = 46.3) completed an expanded 40-item CCI version (CCI-40) and neuropsychological evaluation (including Clinical Dementia Rating Scale [CDR], Montreal Cognitive Assessment, and Craft Story) at baseline and annual follow-up (Mfollow - up=3.4 years). CCI-40 includes the original 20 items (CCI-20) and the first 12 memory items (CCI-12). Linear mixed effects models (LME) and generalized LME assessed the association of CCI total scores at baseline with rate of decline in neuropsychological tests and CDR. Results In the overall sample and across predementia groups, the CCI was associated with rate of change in log odds on CDR, with higher CCI at baseline predicting faster increase in the odds of being impaired on CDR. The predictive validity of the CCI broadly held across versions (CCI-12, 20, 40) and ethnic/racial groups (non-Hispanic black and white). Conclusions Self-perception of cognitive change on the CCI is a useful marker of dementia risk in demographically/clinically diverse nondemented samples. All CCI versions successfully predicted decline.
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Affiliation(s)
- Caroline O Nester
- Department of Psychology, The Graduate Center, City University of New York, New York, NY, USA
- Department of Psychology, Queens College, City University of New York, Queens, NY, USA
| | - Qi Gao
- Department of Epidemiology and Public Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Mindy J Katz
- The Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jacqueline A Mogle
- College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC, USA
| | - Cuiling Wang
- Department of Epidemiology and Public Health, Albert Einstein College of Medicine, Bronx, NY, USA
- The Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Carol A Derby
- Department of Epidemiology and Public Health, Albert Einstein College of Medicine, Bronx, NY, USA
- The Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Richard B Lipton
- Department of Epidemiology and Public Health, Albert Einstein College of Medicine, Bronx, NY, USA
- The Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Andrew J Saykin
- Department of Radiology and Imaging Sciences, Indiana Alzheimer's Disease Research Center, IU Center for Neuroimaging, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Laura A Rabin
- Department of Psychology, The Graduate Center, City University of New York, New York, NY, USA
- Department of Psychology, Brooklyn College, City University of New York, Brooklyn, NY, USA
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27
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Nakhla MZ, Bangen KJ, Schiehser DM, Roesch S, Zlatar ZZ. Greater subjective cognitive decline severity is associated with worse memory performance and lower entorhinal cerebral blood flow in healthy older adults. J Int Neuropsychol Soc 2024; 30:1-10. [PMID: 36781410 PMCID: PMC10423746 DOI: 10.1017/s1355617723000115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
OBJECTIVE Subjective cognitive decline (SCD) is a potential early risk marker for Alzheimer's disease (AD), but its utility may vary across individuals. We investigated the relationship of SCD severity with memory function and cerebral blood flow (CBF) in areas of the middle temporal lobe (MTL) in a cognitively normal and overall healthy sample of older adults. Exploratory analyses examined if the association of SCD severity with memory and MTL CBF was different in those with lower and higher cardiovascular disease (CVD) risk status. METHODS Fifty-two community-dwelling older adults underwent magnetic resonance imaging, neuropsychological testing, and were administered the Everyday Cognition Scale (ECog) to measure SCD. Regression models investigated whether ECog scores were associated with memory performance and MTL CBF, followed by similar exploratory regressions stratified by CVD risk status (i.e., lower vs higher stroke risk). RESULTS Higher ECog scores were associated with lower objective memory performance and lower entorhinal cortex CBF after adjusting for demographics and mood. In exploratory stratified analyses, these associations remained significant in the higher stroke risk group only. CONCLUSIONS Our preliminary findings suggest that SCD severity is associated with cognition and brain markers of preclinical AD in otherwise healthy older adults with overall low CVD burden and that this relationship may be stronger for individuals with higher stroke risk, although larger studies with more diverse samples are needed to confirm these findings. Our results shed light on individual characteristics that may increase the utility of SCD as an early risk marker of cognitive decline.
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Affiliation(s)
- Marina Z. Nakhla
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Ct, San Diego, CA
- Department of Psychiatry; University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093
- Research Service, VA San Diego Healthcare System, La Jolla, California, 3350 La Jolla Village Dr., San Diego, CA 92161
| | - Katherine J. Bangen
- Department of Psychiatry; University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093
- Research Service, VA San Diego Healthcare System, La Jolla, California, 3350 La Jolla Village Dr., San Diego, CA 92161
| | - Dawn M. Schiehser
- Department of Psychiatry; University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093
- Research Service, VA San Diego Healthcare System, La Jolla, California, 3350 La Jolla Village Dr., San Diego, CA 92161
| | - Scott Roesch
- Department of Psychology, San Diego State University, 5500 Campanile Dr., San Diego, 92182
| | - Zvinka Z. Zlatar
- Department of Psychiatry; University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093
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Howlett CA, Miles S, Berryman C, Phillipou A, Moseley GL. Conflation between self-report and neurocognitive assessments of cognitive flexibility: a critical review of the Jingle Fallacy. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2023. [DOI: 10.1080/00049530.2023.2174684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- Caitlin A. Howlett
- Innovation, Implementation & Clinical Translation (IIMPACT) in Health, University of South Australia, Kaurna Country, Adelaide, Australia
| | - Stephanie Miles
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| | - Carolyn Berryman
- Innovation, Implementation & Clinical Translation (IIMPACT) in Health, University of South Australia, Kaurna Country, Adelaide, Australia
- Brain Stimulation, Imaging and Cognition Research Group, School of Medicine, The University of Adelaide, Adelaide, Australia
| | - Andrea Phillipou
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
- Department of Mental Health, St Vincent’s Hospital, Melbourne, Australia
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- Department of Mental Health, Austin Health, Melbourne, Australia
| | - G. Lorimer Moseley
- Innovation, Implementation & Clinical Translation (IIMPACT) in Health, University of South Australia, Kaurna Country, Adelaide, Australia
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Paban V, Mheich A, Spieser L, Sacher M. A multidimensional model of memory complaints in older individuals and the associated hub regions. Front Aging Neurosci 2023; 15:1324309. [PMID: 38187362 PMCID: PMC10771290 DOI: 10.3389/fnagi.2023.1324309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 11/27/2023] [Indexed: 01/09/2024] Open
Abstract
Memory complaints are highly prevalent among middle-aged and older adults, and they are frequently reported in individuals experiencing subjective cognitive decline (SCD). SCD has received increasing attention due to its implications for the early detection of dementia. This study aims to advance our comprehension of individuals with SCD by elucidating potential cognitive/psychologic-contributing factors and characterizing cerebral hubs within the brain network. To identify these potential contributing factors, a structural equation modeling approach was employed to investigate the relationships between various factors, such as metacognitive beliefs, personality, anxiety, depression, self-esteem, and resilience, and memory complaints. Our findings revealed that self-esteem and conscientiousness significantly influenced memory complaints. At the cerebral level, analysis of delta and theta electroencephalographic frequency bands recorded during rest was conducted to identify hub regions using a local centrality metric known as betweenness centrality. Notably, our study demonstrated that certain brain regions undergo changes in their hub roles in response to the pathology of SCD. Specifically, the inferior temporal gyrus and the left orbitofrontal area transition into hubs, while the dorsolateral prefrontal cortex and the middle temporal gyrus lose their hub function in the presence of SCD. This rewiring of the neural network may be interpreted as a compensatory response employed by the brain in response to SCD, wherein functional connectivity is maintained or restored by reallocating resources to other regions.
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Affiliation(s)
- Véronique Paban
- Aix-Marseille Université, CNRS, LNC (Laboratoire de Neurosciences Cognitives–UMR 7291), Marseille, France
| | - A. Mheich
- CHUV-Centre Hospitalier Universitaire Vaudois, Service des Troubles du Spectre de l’Autisme et Apparentés, Lausanne University Hospital, Lausanne, Switzerland
| | - L. Spieser
- Aix-Marseille Université, CNRS, LNC (Laboratoire de Neurosciences Cognitives–UMR 7291), Marseille, France
| | - M. Sacher
- University of Toulouse Jean-Jaurès, CNRS, LCLLE (Laboratoire Cognition, Langues, Langage, Ergonomie–UMR 5263), Toulouse, France
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Allen AT, Cole WR, Walton SR, Kerr ZY, Chandran A, Mannix R, Guskiewicz KM, Meehan WP, Echemendia RJ, McCrea MA, Brett BL. Subjective and Performance-Based Cognition and Their Associations with Head Injury History in Older Former National Football League Players. Med Sci Sports Exerc 2023; 55:2170-2179. [PMID: 37443456 PMCID: PMC10787800 DOI: 10.1249/mss.0000000000003256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023]
Abstract
PURPOSE Investigate the association between self-reported subjective and performance-based cognition among older (50-70 years) former professional American football players, as well as the relationship of cognitive measures with concussion history and years of football participation, as a proxy for repetitive head impact exposure. METHODS Among older former National Football League (NFL) players ( N = 172; mean age = 60.69 ± 5.64), associations of subjective (Patient Reported Outcome Measurement Information System Cognitive Function-Short Form) and performance-based cognitive measures (Brief Test of Adult Cognition by Telephone [BTACT] Executive Function and Episodic Memory indices) were assessed via univariable and multivariable regression models, with a priori covariates of depression and race. A similar univariate and multivariable regression approach assessed associations between concussion history and years of football participation with subjective and performance-based cognitive measures. In a sample subset ( n = 114), stability of subjective cognitive rating was assessed via partial correlation. RESULTS Subjective ratings of cognition were significantly associated with performance-based assessment, with moderate effect sizes (episodic memory ηp2 = 0.12; executive function ηp2 = 0.178). These associations were weakened, but remained significant ( P s < 0.05), with the inclusion of covariates. Greater concussion history was associated with lower subjective cognitive function ( ηp2 = 0.114, P < 0.001), but not performance-based cognition. The strength of association between concussion history and subjective cognition was substantially weakened with inclusion of covariates ( ηp2 = 0.057). Years of participation were not associated with measures of subjective or objective cognition ( P s > 0.05). CONCLUSIONS These findings reinforce the importance of comprehensive evaluation reflecting both subjective and objective measures of cognition, as well as the consideration of patient-specific factors, as part of a comprehensive neurobehavioral and health assessment of older former contact sport athletes.
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Affiliation(s)
- Andrew T. Allen
- Department of Neurosurgery, Medical College of Wisconsin, Wauwatosa, WI
| | - Wesley R. Cole
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Samuel R. Walton
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, VA
| | - Zachary Yukio Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Avinash Chandran
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, VA
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Rebekah Mannix
- Division of Emergency Medicine, Boston Children’s Hospital, Boston, MA
- Department of Pediatrics and Emergency Medicine, Harvard Medical School, Boston, MA
| | - Kevin M. Guskiewicz
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - William P. Meehan
- Sports Medicine Division, Boston Children’s Hospital, Boston, MA
- Department of Pediatrics and Orthopedics, Harvard Medical School, Boston, MA
| | - Ruben J. Echemendia
- Psychological and Neurobehavioral Associates, Inc, State College, PA
- University Orthopedics Center Concussion Clinic, State College, PA
| | - Michael A. McCrea
- Department of Neurosurgery, Medical College of Wisconsin, Wauwatosa, WI
- Department of Neurology, Medical College of Wisconsin, Wauwatosa, WI
| | - Benjamin L. Brett
- Department of Neurosurgery, Medical College of Wisconsin, Wauwatosa, WI
- Department of Neurology, Medical College of Wisconsin, Wauwatosa, WI
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Pick S, Millman LM, Sun Y, Short E, Stanton B, Winston JS, Mehta MA, Nicholson TR, Reinders AA, David AS, Edwards MJ, Goldstein LH, Hotopf M, Chalder T. Objective and subjective neurocognitive functioning in functional motor symptoms and functional seizures: preliminary findings. J Clin Exp Neuropsychol 2023; 45:970-987. [PMID: 37724767 PMCID: PMC11057846 DOI: 10.1080/13803395.2023.2245110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 07/30/2023] [Indexed: 09/21/2023]
Abstract
INTRODUCTION This study aimed to provide a preliminary assessment of objective and subjective neurocognitive functioning in individuals with functional motor symptoms (FMS) and/or functional seizures (FS). We tested the hypotheses that the FMS/FS group would display poorer objective attentional and executive functioning, altered social cognition, and reduced metacognitive accuracy. METHOD Individuals with FMS/FS (n = 16) and healthy controls (HCs, n = 17) completed an abbreviated CANTAB battery, and measures of intellectual functioning, subjective cognitive complaints, performance validity, and comorbid symptoms. Subjective performance ratings were obtained to assess local metacognitive accuracy. RESULTS The groups were comparable in age (p = 0.45), sex (p = 0.62), IQ (p = 0.57), and performance validity (p-values = 0.10-0.91). We observed no impairment on any CANTAB test in this FMS/FS sample compared to HCs, although the FMS/FS group displayed shorter reaction times on the Emotional Bias task (anger) (p = 0.01, np2 = 0.20). The groups did not differ in subjective performance ratings (p-values 0.15). Whilst CANTAB attentional set-shifting performance (total trials/errors) correlated with subjective performance ratings in HCs (p-values<0.005, rs = -0.85), these correlations were non-significant in the FMS/FS sample (p-values = 0.10-0.13, rs-values = -0.46-0.50). The FMS/FS group reported more daily cognitive complaints than HCs (p = 0.006, g = 0.92), which were associated with subjective performance ratings on CANTAB sustained attention (p = 0.001, rs = -0.74) and working memory tests (p < 0.001, rs = -0.75), and with depression (p = 0.003, rs = 0.70), and somatoform (p = 0.003, rs = 0.70) and psychological dissociation (p-values<0.005, rs-values = 0.67-0.85). CONCLUSIONS These results suggest a discordance between objective and subjective neurocognitive functioning in this FMS/FS sample, reflecting intact test performance alongside poorer subjective cognitive functioning. Further investigation of neurocognitive functioning in FND subgroups is necessary.
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Affiliation(s)
- Susannah Pick
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK
| | - L.S. Merritt Millman
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK
| | - Yiqing Sun
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK
| | - Eleanor Short
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK
| | - Biba Stanton
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK
| | - Joel S. Winston
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK
| | - Mitul A. Mehta
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK
| | - Timothy R. Nicholson
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK
| | | | | | - Mark J. Edwards
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK
| | - Laura H. Goldstein
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK
| | - Matthew Hotopf
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK
- South London and Maudsley NHS Foundation Trust, UK
| | - Trudie Chalder
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK
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Van Patten R, Bellone JA. The neuropsychology of functional neurological disorders. J Clin Exp Neuropsychol 2023; 45:957-969. [PMID: 38441076 DOI: 10.1080/13803395.2024.2322798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Affiliation(s)
- Ryan Van Patten
- VA Providence Healthcare System, Center for Neurorestoration & Neurotechnology, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School at Brown University, Providence, RI, USA
| | - John A Bellone
- Department of Behavioral Health, Kaiser Permanente, San Bernardino, CA, USA
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Sekendiz Z, Clouston SAP, Morozova O, Carr MA, Fontana A, Mehta N, Ali A, Jiang E, Luft B. ASSESSMENT AND CHARACTERIZATION OF COVID-19 RELATED COGNITIVE DECLINE: RESULTS FROM A NATURAL EXPERIMENT. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.11.06.23298101. [PMID: 37986906 PMCID: PMC10659478 DOI: 10.1101/2023.11.06.23298101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Background Cognitive impairment is the most common and disabling manifestation of post-acute sequelae of SARS-CoV-2. There is an urgent need for the application of more stringent methods for evaluating cognitive outcomes in research studies. Objective To determine whether cognitive decline emerges with the onset of COVID-19 and whether it is more pronounced in patients with Post-Acute Sequelae of SARS-CoV-2 or severe COVID-19. Methods This longitudinal cohort study compared the cognitive performance of 276 patients with COVID-19 to that of 217 controls across four neuroinflammation or vascular disease-sensitive domains of cognition using data collected both before and after the pandemic starting in 2015. Results The mean age of the COVID-19 group was 56.04±6.6 years, while that of the control group was 58.1±7.3 years. Longitudinal models indicated a significant decline in cognitive throughput ((β=-0.168, P=.001) following COVID-19, after adjustment for pre-COVID-19 functioning, demographics, and medical factors. The effect sizes were large; the observed changes in throughput were equivalent to 10.6 years of normal aging and a 59.8% increase in the burden of mild cognitive impairment. Cognitive decline worsened with coronavirus disease 2019 severity and was concentrated in participants reporting post-acute sequelae of SARS-CoV-2. Conclusion COVID-19 was most likely associated with the observed cognitive decline, which was worse among patients with PASC or severe COVID-19. Monitoring patients with post-acute sequelae of SARS-CoV-2 for declines in the domains of processing speed and visual working memory and determining the long-term prognosis of this decline are therefore warranted.
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Affiliation(s)
- Zennur Sekendiz
- Stony Brook University, Department of Medicine-World Trade Center Health Program
| | - Sean A P Clouston
- Stony Brook University, Family, Population and Preventive Medicine, Program in Public Health
| | - Olga Morozova
- The University of Chicago, Department of Public Health Sciences
| | - Melissa A Carr
- Stony Brook University, Department of Medicine-World Trade Center Health Program
| | - Ashley Fontana
- Stony Brook University, Department of Medicine-World Trade Center Health Program
| | - Nikhil Mehta
- Stony Brook University, Department of Medicine-World Trade Center Health Program
| | - Alina Ali
- Stony Brook University, Department of Medicine-World Trade Center Health Program
| | - Eugene Jiang
- Stony Brook University, Department of Medicine-World Trade Center Health Program
| | - Benjamin Luft
- Stony Brook University, Department of Medicine-World Trade Center Health Program
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Ly MT, Merritt VC, Ozturk ED, Clark AL, Hanson KL, Delano-Wood LM, Sorg SF. Subjective memory complaints are associated with decreased cortical thickness in Veterans with histories of mild traumatic brain injury. Clin Neuropsychol 2023; 37:1745-1765. [PMID: 36883430 DOI: 10.1080/13854046.2023.2184720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 02/21/2023] [Indexed: 03/09/2023]
Abstract
Objective: Memory problems are frequently endorsed in Veterans following mild traumatic brain injury (mTBI), but subjective complaints are poorly associated with objective memory performance. Few studies have examined associations between subjective memory complaints and brain morphometry. We investigated whether self-reported memory problems were associated with objective memory performance and cortical thickness in Veterans with a history of mTBI. Methods: 40 Veterans with a history of remote mTBI and 29 Veterans with no history of TBI completed the Prospective-Retrospective Memory Questionnaire (PRMQ), PTSD Checklist (PCL), California Verbal Learning Test-2nd edition (CVLT-II), and 3 T T1 structural magnetic resonance imaging. Cortical thickness was estimated in 14 a priori frontal and temporal regions. Multiple regressions adjusting for age and PCL scores examined associations between PRMQ, CVLT-II scores, and cortical thickness within each Veteran group. Results: Greater subjective memory complaints on the PRMQ were associated with lower cortical thickness in the right middle temporal gyrus (β = 0.64, q = .004), right inferior temporal gyrus (β = 0.56, q = .014), right rostral middle frontal gyrus (β = 0.45, q = .046), and right rostral anterior cingulate gyrus (β = 0.58, q = .014) in the mTBI group but not the control group (q's > .05). These associations remained significant after adjusting for CVLT-II learning. CVLT-II performance was not associated with PRMQ score or cortical thickness in either group. Conclusions: Subjective memory complaints were associated with lower cortical thickness in right frontal and temporal regions, but not with objective memory performance, in Veterans with histories of mTBI. Subjective complaints post-mTBI may indicate underlying brain morphometry independently of objective cognitive testing.
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Affiliation(s)
- Monica T Ly
- Veterans Affairs San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Department of Psychiatry, University of California San Diego Health, CA, USA
| | - Victoria C Merritt
- Veterans Affairs San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Department of Psychiatry, University of California San Diego Health, CA, USA
- Center of Excellence for Stress and Mental Health, VASDHS, San Diego, CA, USA
| | - Erin D Ozturk
- Veterans Affairs San Diego Healthcare System (VASDHS), San Diego, CA, USA
- San Diego Joint Doctoral Program, San Diego State University/University of California San Diego, San Diego, CA, USA
| | - Alexandra L Clark
- Department of Psychology, The University of Texas at Austin, Austin, TX, USA
| | - Karen L Hanson
- Veterans Affairs San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Department of Psychiatry, University of California San Diego Health, CA, USA
| | - Lisa M Delano-Wood
- Veterans Affairs San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Department of Psychiatry, University of California San Diego Health, CA, USA
- Center of Excellence for Stress and Mental Health, VASDHS, San Diego, CA, USA
| | - Scott F Sorg
- Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Boston, MA, USA
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Zhu C, Thomas EH, Li Q, Arunogiri S, Thomas N, Gurvich C. Evaluation of the Everyday Memory Questionnaire-Revised in a menopausal population: understanding the brain fog during menopause. Menopause 2023; 30:1147-1156. [PMID: 37788429 DOI: 10.1097/gme.0000000000002256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
OBJECTIVE Brain fog (ie, memory complaints and concentration difficulties) is frequently reported during the menopausal transition. There is lack of standardized scales available to measure brain fog across the menopausal transition. This study aimed to evaluate the factor structure of the Everyday Memory Questionnaire-Revised (EMQ-R) and to determine the most commonly reported everyday cognitive symptoms in a menopausal population. METHODS Four hundred seventeen eligible women aged from 40 to 60 years (107 premenopausal, 149 perimenopausal, and 161 early postmenopausal) were recruited from the general community and were included in the analyses. Confirmatory factor analysis was conducted to test the model fit of the bifactor structure (ie, 4-item attentional subscale ranged 0-16, 7-item retrieval subscale ranged 0-28) of the 13-item EMQ-R (ranged 0-52) in a menopausal populations. Typical items in the retrieval subscale include "difficulty finding words," the attentional subscale include "difficulty following the thread of a story," and analysis of variance and multivariate analysis of covariance were used to investigate the group differences of individual items and two subscales. RESULTS Confirmatory factor analysis indicated the bifactor structure of the EMQ-R has a good fit in all three groups. A significant difference was identified in the mean retrieval scores (pre: 11.8, peri: 13.6, early post: 11.7) but not in the mean attentional scores (pre: 4.53, peri: 5.01, early post: 4.65). CONCLUSIONS The EMQ-R retrieval subscale may serve as a potential instrument to assess memory retrieval symptoms that contribute to "brain fog" in menopause. Increased memory retrieval complaints reported by the perimenopausal group suggests a transition-related memory retrieval dysfunction during menopausal transition.
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Affiliation(s)
- Chen Zhu
- From the HER Centre Australia, Department of Psychiatry, Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University and The Alfred Hospital, Melbourne, Australia
| | - Elizabeth Hx Thomas
- From the HER Centre Australia, Department of Psychiatry, Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University and The Alfred Hospital, Melbourne, Australia
| | - Qi Li
- From the HER Centre Australia, Department of Psychiatry, Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University and The Alfred Hospital, Melbourne, Australia
| | - Shalini Arunogiri
- Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Turning Point, Melbourne, Australia
| | - Natalie Thomas
- Department of Biochemistry and Pharmacology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Caroline Gurvich
- From the HER Centre Australia, Department of Psychiatry, Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University and The Alfred Hospital, Melbourne, Australia
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Ball HA, Coulthard E, Fish M, Bayer A, Gallacher J, Ben-Shlomo Y. Predictors and prognosis of population-based subjective cognitive decline: longitudinal evidence from the Caerphilly Prospective Study (CaPS). BMJ Open 2023; 13:e073205. [PMID: 37844990 PMCID: PMC10582873 DOI: 10.1136/bmjopen-2023-073205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 09/11/2023] [Indexed: 10/18/2023] Open
Abstract
OBJECTIVES To understand associations between the subjective experience of cognitive decline and objective cognition. This subjective experience is often conceptualised as an early step towards neurodegeneration, but this has not been scrutinised at the population level. An alternative explanation is poor meta-cognition, the extreme of which is seen in functional cognitive disorder (FCD). DESIGN Prospective cohort (Caerphilly Prospective Study). SETTING Population-based, South Wales, UK. PARTICIPANTS This men-only study began in 1979; 1225 men participated at an average age of 73 in 2002-2004, including assessments of simple subjective cognitive decline (sSCD, defined as a subjective report of worsening memory or concentration). Dementia outcomes were followed up to 2012-2014. Data on non-completers was additionally obtained from death certificates and local health records. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome measure was incident dementia over 10 years. Secondary outcome measures included prospective change in objective cognition and cross-sectional cognitive internal inconsistency (the existence of a cognitive ability at some times, and its absence at other times, with no intervening explanatory factors except for focus of attention). RESULTS sSCD was common (30%) and only weakly associated with prior objective cognitive decline (sensitivity 36% (95% CI 30 to 42) and specificity 72% (95% CI 68 to 75)). Independent predictors of sSCD were older age, poor sleep quality and higher trait anxiety. Those with sSCD did not have excess cognitive internal inconsistency, but results suggested a mild attentional deficit. sSCD did not predict objective cognitive change (linear regression coefficient -0.01 (95% CI -0.13 to 0.15)) nor dementia (odds ratio 1.35 (0.61 to 2.99)) 10 years later. CONCLUSIONS sSCD is weakly associated with prior objective cognitive decline and does not predict future cognition. Prior sleep difficulties and anxiety were the most robust predictors of sSCD. sSCD in the absence of objective decline appears to be a highly prevalent example of poor meta-cognition (ie, poor self-awareness of cognitive performance), which could be a driver for later FCD.
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Affiliation(s)
- Harriet A Ball
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Elizabeth Coulthard
- Translational Health Sciences, University of Bristol Medical School, Bristol, UK
| | - Mark Fish
- Royal Devon University Healthcare NHS Foundation Trust, Exeter, Devon, UK
| | - Antony Bayer
- Institute of Primary Care and Public Health, Cardiff University, Cardiff, Wales, UK
| | - John Gallacher
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Yoav Ben-Shlomo
- Population Health Sciences, University of Bristol, Bristol, UK
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Delgado-Alonso C, Díez-Cirarda M, Pagán J, Pérez-Izquierdo C, Oliver-Mas S, Fernández-Romero L, Martínez-Petit Á, Valles-Salgado M, Gil-Moreno MJ, Yus M, Matías-Guiu J, Ayala JL, Matias-Guiu JA. Unraveling brain fog in post-COVID syndrome: Relationship between subjective cognitive complaints and cognitive function, fatigue, and neuropsychiatric symptoms. Eur J Neurol 2023. [PMID: 37797297 DOI: 10.1111/ene.16084] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 09/10/2023] [Accepted: 09/17/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND AND PURPOSE "Brain fog" is a frequent and disabling symptom that can occur after SARS-CoV-2 infection. However, its clinical characteristics and the relationships among brain fog and objective cognitive function, fatigue, and neuropsychiatric symptoms (depression, anxiety) are still unclear. In this study, we aimed to examine the characteristics of brain fog and to understand how fatigue, cognitive performance, and neuropsychiatric symptoms and the mutual relationships among these variables influence subjective cognitive complaints. METHODS A total of 170 patients with cognitive complaints in the context of post-COVID syndrome were evaluated using a comprehensive neuropsychological protocol. The FLEI scale was used to characterize subjective cognitive complaints. Correlation analysis, regression machine-learning algorithms, and mediation analysis were calculated. RESULTS Cognitive complaints were mainly attention and episodic memory symptoms, while executive functions (planning) issues were less often reported. The FLEI scale, a mental ability questionnaire, showed high correlations with a fatigue scale and moderate correlations with the Stroop test, and anxiety and depressive symptoms. Random forest algorithms showed an R2 value of 0.409 for the prediction of FLEI score, with several cognitive tests, fatigue and depression being the best variables used in the prediction. Mediation analysis showed that fatigue was the main mediator between objective and subjective cognition, while the effect of depression was indirect and mediated through fatigue. CONCLUSIONS Brain fog associated with COVID-19 is mainly characterized by attention and episodic memory, and fatigue, which is the main mediator between objective and subjective cognition. Our findings contribute to understanding the pathophysiology of brain fog and emphasize the need to unravel the main mechanisms underlying brain fog, considering several aspects.
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Affiliation(s)
- Cristina Delgado-Alonso
- Department of Neurology, Hospital Clínico San Carlos, Health Research Institute "San Carlos" (IdISCC), Universidad Complutense de Madrid, Madrid, Spain
| | - María Díez-Cirarda
- Department of Neurology, Hospital Clínico San Carlos, Health Research Institute "San Carlos" (IdISCC), Universidad Complutense de Madrid, Madrid, Spain
| | - Josué Pagán
- Department of Electronic Engineering, Universidad Politécnica de Madrid, Madrid, Spain
- Center for Computational Simulation, Universidad Politécnica de Madrid, Madrid, Spain
| | - Carlos Pérez-Izquierdo
- Department of Agricultural and Forestry Engineering, University Center of Plasencia, University of Extremadura, Plasencia, Spain
| | - Silvia Oliver-Mas
- Department of Neurology, Hospital Clínico San Carlos, Health Research Institute "San Carlos" (IdISCC), Universidad Complutense de Madrid, Madrid, Spain
| | - Lucía Fernández-Romero
- Department of Neurology, Hospital Clínico San Carlos, Health Research Institute "San Carlos" (IdISCC), Universidad Complutense de Madrid, Madrid, Spain
| | - Álvaro Martínez-Petit
- Department of Electronic Engineering, Universidad Politécnica de Madrid, Madrid, Spain
- Center for Computational Simulation, Universidad Politécnica de Madrid, Madrid, Spain
| | - María Valles-Salgado
- Department of Neurology, Hospital Clínico San Carlos, Health Research Institute "San Carlos" (IdISCC), Universidad Complutense de Madrid, Madrid, Spain
| | - María José Gil-Moreno
- Department of Neurology, Hospital Clínico San Carlos, Health Research Institute "San Carlos" (IdISCC), Universidad Complutense de Madrid, Madrid, Spain
| | - Miguel Yus
- Department of Radiology, Hospital Clinico San Carlos, Health Research Institute "San Carlos" (IdISCC), Universidad Complutense de Madrid, Madrid, Spain
| | - Jorge Matías-Guiu
- Department of Neurology, Hospital Clínico San Carlos, Health Research Institute "San Carlos" (IdISCC), Universidad Complutense de Madrid, Madrid, Spain
| | - José Luis Ayala
- Department of Automatic Architecture and Automation, Universidad Complutense, Madrid, Spain
| | - Jordi A Matias-Guiu
- Department of Neurology, Hospital Clínico San Carlos, Health Research Institute "San Carlos" (IdISCC), Universidad Complutense de Madrid, Madrid, Spain
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Werrmann M, Schegolevska A, Eid M, Niedeggen M. Uncovering mnestic problems in help-seeking individuals reporting subjective cognitive complaints. Sci Rep 2023; 13:15266. [PMID: 37709826 PMCID: PMC10502030 DOI: 10.1038/s41598-023-42527-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 09/11/2023] [Indexed: 09/16/2023] Open
Abstract
In individuals with subjective cognitive impairments (SCI) the risk for the development of a neurodegenerative disease is assumed to be increased. However, it is not clear which factors contribute to the expression of SCI: Is it related to the cognitive resources already challenged, or is the psycho-affective state of more relevance? Using a novel online assessment combining self-report questionnaires and neuropsychological psychometric tests, significant predictors for the level of complaints were identified in two samples of elderly individuals: Help-seekers (HS, n = 48) consulting a memory clinic and a matched sample of non-help-seekers (nHS, n = 48). Based on the results of the online assessment, the SCI level was found to be significantly determined by the psycho-affective state (depressive mood) in the nHS group, whereas cognitive performance (cued recall) was the main predictor in the HS group. The predictive value of recall performance, however, is more-strongly expressed in memory tests which reduce the impact of compensatory strategies (face-name-association vs. word lists). Our results indicate that the problem-focused behavior of help-seeking individuals is also associated with a higher sensitivity for cognitive deficits-which can be uncovered with an appropriate psychometric test. Considering these factors, the conversion risk in individuals with SCI can probably be determined more reliably.
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Affiliation(s)
- M Werrmann
- Division of Experimental Psychology and Neuropsychology, Department of Educational Science and Psychology, Freie Universität Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany.
| | - A Schegolevska
- Division of Experimental Psychology and Neuropsychology, Department of Educational Science and Psychology, Freie Universität Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany
| | - M Eid
- Division of Methods and Evaluation, Department of Educational Science and Psychology, Freie Universität Berlin, Berlin, Germany
| | - M Niedeggen
- Division of Experimental Psychology and Neuropsychology, Department of Educational Science and Psychology, Freie Universität Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany
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Arola A, Laakso HM, Heinonen H, Pitkänen J, Ahlström M, Lempiäinen J, Paajanen T, Virkkala J, Koikkalainen J, Lötjönen J, Korvenoja A, Melkas S, Jokinen H. Subjective vs informant-reported cognitive complaints have differential clinical significance in covert cerebral small vessel disease. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2023; 5:100182. [PMID: 37745893 PMCID: PMC10514088 DOI: 10.1016/j.cccb.2023.100182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/30/2023] [Accepted: 09/04/2023] [Indexed: 09/26/2023]
Abstract
Objective Subjective cognitive complaints are common in patients with cerebral small vessel disease (cSVD), yet their relationship with informant evaluations, objective cognitive functions and severity of brain changes are poorly understood. We studied the associations of subjective and informant reports with findings from comprehensive neuropsychological assessment and brain MRI. Method In the Helsinki SVD Study, 152 older adults with varying degrees of white matter hyperintensities (WMH) but without stroke or dementia were classified as having normal cognition or mild cognitive impairment (MCI) based on neuropsychological criteria. The measures also included continuous domain scores for memory and executive functions. Cognitive complaints were evaluated with the subjective and informant versions of the Prospective and Retrospective Memory Questionnaire (PRMQ) and Dysexecutive Questionnaire (DEX); functional abilities with the Amsterdam Instrumental Activities of Daily Living Questionnaire (A-IADL); and depressive symptoms with the Geriatric Depression Scale (GDS-15). Results Subjective cognitive complaints correlated significantly with informant reports (r=0.40-0.50, p<0.001). After controlling for demographics, subjective and informant DEX and PRMQ were not related to MCI, memory or executive functions. Instead, subjective DEX and PRMQ significantly associated with GDS-15 and informant DEX and PRMQ with WMH volume and A-IADL. Conclusions Neither subjective nor informant-reported cognitive complaints associated with objective cognitive performance. Informant-evaluations were related to functional impairment and more severe WMH, whereas subjective complaints only associated with mild depressive symptoms. These findings suggest that awareness of cognitive impairment may be limited in early-stage cSVD and highlight the value of informant assessments in the identification of patients with functional impairment.
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Affiliation(s)
- Anne Arola
- Division of Neuropsychology, HUS Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Hanna M. Laakso
- Division of Neuropsychology, HUS Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Heidi Heinonen
- Division of Neuropsychology, HUS Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Johanna Pitkänen
- Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Matti Ahlström
- Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Juha Lempiäinen
- Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Teemu Paajanen
- Work ability and working careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jussi Virkkala
- Department of Neurophysiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Juha Koikkalainen
- Combinostics Ltd, Tampere, Finland
- Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Jyrki Lötjönen
- Combinostics Ltd, Tampere, Finland
- Department of Neuroscience and Biomedical Engineering, School of Science, Aalto University, Espoo, Finland
| | - Antti Korvenoja
- Medical Imaging Center, Radiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Susanna Melkas
- Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Hanna Jokinen
- Division of Neuropsychology, HUS Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Zöllinger I, Bauer A, Blotenberg I, Brettschneider C, Buchholz M, Czock D, Döhring J, Escales C, Fankhaenel T, Frese T, Hoffmann W, Kaduszkiewicz H, König HH, Luppa M, Oey A, Pabst A, Sanftenberg L, Thyrian JR, Weiss J, Wendel F, Wiese B, Riedel-Heller SG, Gensichen J. Associations of Depressive Symptoms with Subjective Cognitive Decline in Elderly People-A Cross-Sectional Analysis from the AgeWell.de-Study. J Clin Med 2023; 12:5205. [PMID: 37629244 PMCID: PMC10455560 DOI: 10.3390/jcm12165205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/30/2023] [Accepted: 08/03/2023] [Indexed: 08/27/2023] Open
Abstract
To develop effective dementia prevention strategies, it is necessary to understand risk factors, associated factors and early signs of dementia. Subjective cognitive decline (SCD) is the earliest form of dementia. The aim of this study is to assess depression as a factor that is significantly associated with SCD. The data of 1030 general practitioner patients from the AgeWell.de-study (60-77 years; CAIDE dementia risk score ≥ 9) were analysed. A descriptive analysis was conducted using validated instruments like the Geriatric depression scale (GDS), Lubben social network scale (LSNS-6) and education classes according to CASMIN (Comparative Analysis of Social Mobility in Industrial Nations). A multivariate regression model with the dependent variable SCD was calculated. Of the 1030 participants, 5.9% had depressive symptoms and 31.3% SCD. The group with depressive symptoms showed significantly higher body-mass-index (p = 0.005), lower education class (p = 0.022), lower LSNS-6 score (p < 0.001), higher sports activity (p < 0.001), and more sleeping problems (p = 0.026). In the regression model a higher GDS-score [Odds ratio (OR): 1.219 (p < 0.001)], more sleeping problems [OR: 1.550 (p = 0.017)] and higher education class [middle/high: OR: 1.474/1.875 (p = 0.037/0.004)] were significantly associated with SCD. This study identified depressive symptoms, sleeping problems, and higher education classes as factors associated with SCD, which can represent an early form of dementia.
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Affiliation(s)
- Isabel Zöllinger
- Institute of General Practice and Family Medicine, University Hospital of LMU Munich, 80336 Munich, Germany; (L.S.); (J.W.); (F.W.); (J.G.)
| | - Alexander Bauer
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany; (A.B.); (T.F.); (T.F.)
| | - Iris Blotenberg
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, 17489 Greifswald, Germany; (I.B.); (M.B.); (W.H.); (J.R.T.)
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (C.B.); (H.-H.K.)
| | - Maresa Buchholz
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, 17489 Greifswald, Germany; (I.B.); (M.B.); (W.H.); (J.R.T.)
| | - David Czock
- Department of Clinical Pharmacology and Pharmacoepidemiology, University Hospital Heidelberg, 69120 Heidelberg, Germany;
| | - Juliane Döhring
- Institute of General Practice, University of Kiel, 24105 Kiel, Germany; (J.D.); (C.E.); (H.K.)
| | - Catharina Escales
- Institute of General Practice, University of Kiel, 24105 Kiel, Germany; (J.D.); (C.E.); (H.K.)
| | - Thomas Fankhaenel
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany; (A.B.); (T.F.); (T.F.)
| | - Thomas Frese
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany; (A.B.); (T.F.); (T.F.)
| | - Wolfgang Hoffmann
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, 17489 Greifswald, Germany; (I.B.); (M.B.); (W.H.); (J.R.T.)
- Institute for Community Medicine, University Medicine Greifswald, 17487 Greifswald, Germany
| | - Hanna Kaduszkiewicz
- Institute of General Practice, University of Kiel, 24105 Kiel, Germany; (J.D.); (C.E.); (H.K.)
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (C.B.); (H.-H.K.)
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, 04103 Leipzig, Germany; (M.L.); (A.P.); (S.G.R.-H.)
| | - Anke Oey
- State Health Department of Lower Saxony, 30449 Hannover, Germany;
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, 04103 Leipzig, Germany; (M.L.); (A.P.); (S.G.R.-H.)
| | - Linda Sanftenberg
- Institute of General Practice and Family Medicine, University Hospital of LMU Munich, 80336 Munich, Germany; (L.S.); (J.W.); (F.W.); (J.G.)
| | - Jochen René Thyrian
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, 17489 Greifswald, Germany; (I.B.); (M.B.); (W.H.); (J.R.T.)
- Institute for Community Medicine, University Medicine Greifswald, 17487 Greifswald, Germany
| | - Julian Weiss
- Institute of General Practice and Family Medicine, University Hospital of LMU Munich, 80336 Munich, Germany; (L.S.); (J.W.); (F.W.); (J.G.)
| | - Flora Wendel
- Institute of General Practice and Family Medicine, University Hospital of LMU Munich, 80336 Munich, Germany; (L.S.); (J.W.); (F.W.); (J.G.)
| | - Birgitt Wiese
- Work Group Medical Statistics and IT-Infrastructure, Institute for General Practice, Hannover Medical School, 30625 Hannover, Germany;
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, 04103 Leipzig, Germany; (M.L.); (A.P.); (S.G.R.-H.)
| | - Jochen Gensichen
- Institute of General Practice and Family Medicine, University Hospital of LMU Munich, 80336 Munich, Germany; (L.S.); (J.W.); (F.W.); (J.G.)
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Tassoni MB, Drabick DAG, Giovannetti T. The frequency of self-reported memory failures is influenced by everyday context across the lifespan: Implications for neuropsychology research and clinical practice. Clin Neuropsychol 2023; 37:1115-1135. [PMID: 36000515 PMCID: PMC9950286 DOI: 10.1080/13854046.2022.2112297] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 08/07/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To investigate the influence of contextual factors on self-reports of cognitive abilities, this study investigated whether the frequency of self-reported memory failures was affected by level of daily busyness (Busyness) and daily routines (Routine) and whether age moderated these relations. The influence of the COVID-19 pandemic on self-reported memory failures also was explored. Method: 902 community-dwelling participants (mean age= 56.98 years; sd= 18.96; range: 22-97 years) completed self-report questionnaires. Multiple linear regressions examined predictors of the frequency of retrospective (RM) and prospective memory (PM) failures and interactions with age. A pilot measure of the Influence of the Pandemic was added in secondary analyses. Results: Frequency of PM failures was significantly predicted by Age, Busyness, and Routine, such that people who were younger and those with busier and less routine activities reported more frequent PM failures. Frequency of RM failures was significantly predicted by Busyness, and the Age × Busyness and Age × Routine interactions. Busyness was associated with more frequent RM failures for people of all ages, but the effect was stronger for younger people. By contrast, more routine daily schedules were associated with fewer RM failures only for older people. PM/RM failures were predicted by the Influence of the Pandemic in exploratory analyses. Conclusions: Self-reports of cognitive abilities are influenced by contextual factors in adults of all ages. Contextual factors, including everyday task demands, daily routines, and acute stressors that disrupt daily activities, should be considered when interpreting self-reports of cognitive abilities in research and clinical practice settings.
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Affiliation(s)
- Molly B Tassoni
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Deborah A G Drabick
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Tania Giovannetti
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
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Azar M, Chapman S, Joyce J, Schultheis M, Zhang Z, Waltrip L, Shagalow S, Zeiger P, Sunderaraman P, Cosentino S. Education as a Moderator of Help Seeking Behavior in Subjective Cognitive Decline. Alzheimer Dis Assoc Disord 2023; 37:184-188. [PMID: 37561937 PMCID: PMC10530107 DOI: 10.1097/wad.0000000000000571] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 06/19/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVE Disparities in Alzheimer disease (AD) and differences in help seeking (HS) across sociodemographic groups warrant public health concern. Research addressing such disparities must shift toward the earliest clinical manifestations of AD to optimize diagnosis, intervention and care planning. Subjective cognitive decline (SCD), a risk state for AD, provides an important context in which to examine sociodemographic-related disparities in HS. PARTICIPANTS AND METHODS One hundred sixty-seven cognitively healthy older adults (M age =73, M education =16) (26.4% Black, Asian, or "Other") completed SCD questionnaire, HS questions, and mood measures (depression and anxiety). Binary logistic adjusted regressions examined: (a) the association between SCD and HS; and (b) the extent to which education moderated the relationship between SCD and HS. SCD [b = 0.06, SE=0.13, P <0.001, odds ratio=1.06, 95% CI (1.03, 1.08)] and education [b=0.32, SE=0.09, P <0.001, odds ratio=1.37, 95% CI (1.15, 1.64)] were independently associated with HS, with significant interaction between education and SCD on HS [b=0.2, SE=0.01, P =0.01, odds ratio=1.02, 95% CI (1.00, 1.03)]. CONCLUSIONS Findings elucidate the importance of tailoring SCD-related psychoeducational resources depending on educational background as a preliminary stepping-stone in encouraging HS among older adults who may be at particular risk for developing dementia.
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Affiliation(s)
- Martina Azar
- Psychology Department, VA Boston Healthcare System, Boston, MA, USA
| | - Silvia Chapman
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, NY, NY, USA
| | - Jillian Joyce
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, NY, NY, USA
| | - Maria Schultheis
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA
| | - Zoe Zhang
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA
| | - Leah Waltrip
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, NY, NY, USA
| | - Shaina Shagalow
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, NY, NY, USA
| | - Peter Zeiger
- Vagelos College of Physicians and Surgeons, Columbia University, NY, NY, USA
| | | | - Stephanie Cosentino
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, NY, NY, USA
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Lee CD, Foster ER. Subjective Memory Complaints Predict Decline in Memory, Instrumental Activities of Daily Living, and Social Participation in Older Adults: A Fixed-Effects Model. Am J Occup Ther 2023; 77:7704205100. [PMID: 37606938 PMCID: PMC10494969 DOI: 10.5014/ajot.2023.050151] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023] Open
Abstract
IMPORTANCE Although subjective memory complaints (SMCs) have been suggested to be associated with future memory impairment, limitations in instrumental activities of daily living (IADLs), and social participation restriction, these associations are still inconclusive. OBJECTIVE To determine whether changes in SMCs over time predict decline in memory, IADLs, and social participation in older adults. DESIGN Longitudinal study. SETTING Community. PARTICIPANTS Sample 1 included 2,493 community-dwelling older adults drawn from the Health and Retirement Study (HRS) data collected between 2004 and 2018. Sample 2 included 1,644 community-dwelling older adults drawn from the HRS data collected between 2008 and 2018. OUTCOMES AND MEASURES Self-reported SMCs, memory function, self-reported IADL performance, and self-reported social participation. RESULTS The mean age of Sample 1 at baseline was 70.16 yr; 1,468 (58.88%) were female. In Sample 1, immediate and delayed memory (all ps < .001) and IADL performance (p < .01) declined over time. Increases in SMCs over time significantly predicted future immediate and delayed memory declines (p < .01 and p < .001, respectively) and future IADL performance decline (p < .001), after controlling for depressive symptoms. The mean age of Sample 2 at baseline was 71.52 yr; 928 (56.45%) were female. In Sample 2, social participation declined over time (all ps < .001). Increases in SMCs over time significantly predicted future social participation decline (p < .05), after controlling for depressive symptoms. CONCLUSIONS AND RELEVANCE Increases in SMCs predict future decline in memory, IADL performance, and social participation after accounting for depressive symptoms. What This Article Adds: SMCs can be used as an early indicator of future memory impairment, IADL limitations, and social participation restrictions in older adults. Furthermore, interventions that minimize SMCs may help older adults achieve successful aging.
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Affiliation(s)
- Chang Dae Lee
- Chang Dae Lee, PhD, OTR/L, is Postdoctoral Researcher, Human Engineering Research Laboratories, Department of Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, and Human Engineering Research Laboratories, Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA;
| | - Erin R Foster
- Erin R. Foster, PhD, OTD, OTR/L, is Associate Professor, Program in Occupational Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO
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Curran E, Palmer VJ, Ellis KA, Chong TWH, Rego T, Cox KL, Anstey KJ, Westphal A, Moorhead R, Southam J, Lai R, You E, Lautenschlager NT. Physical Activity for Cognitive Health: A Model for Intervention Design for People Experiencing Cognitive Concerns and Symptoms of Depression or Anxiety. J Alzheimers Dis 2023:JAD221216. [PMID: 37334591 PMCID: PMC10357152 DOI: 10.3233/jad-221216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
BACKGROUND People experiencing cognitive concerns and symptoms of depression or anxiety are at risk for Alzheimer's disease and dementia. We know physical activity can benefit cognition but understanding how to best support engagement is an ongoing challenge. Evidence-based conceptual models of factors underpinning physical activity engagement in target populations can inform intervention tailoring to address this challenge. OBJECTIVE This study (part of a pragmatic physical activity implementation trial) aimed to develop a specified model of physical activity engagement in people experiencing depressive or anxiety symptoms and cognitive concerns, to enable optimized dementia risk reduction intervention tailoring. METHODS We employed a qualitative design, triangulating data from three sources: semi-structured individual interviews with people experiencing cognitive concerns and mild to moderate depressive or anxiety symptoms; review of published evidence; and the Capability, Opportunity and Motivation system of behavior, an existing behavioral science model. Findings were integrated to develop a contextualized model of mechanisms of action for optimizing engagement. RESULTS Twenty-one participants were interviewed, and 24 relevant papers included. Convergent and complementary themes extended understanding of intervention needs. Findings highlighted emotional regulation, capacities to enact intentions despite barriers, and confidence in existing skills as areas of population-specific need that have not previously been emphasized. The final model provides specificity, directionality, and linked approaches for intervention tailoring. CONCLUSION This study demonstrated that people experiencing cognitive concerns and symptoms of depression or anxiety require different interventions to improve physical activity engagement. The novel model can enable more precise intervention tailoring, and, ultimately, benefits for a key at-risk population.
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Affiliation(s)
- Eleanor Curran
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
- North Western Mental Health, Royal Melbourne Hospital, Parkville, Australia
| | - Victoria J Palmer
- ALIVE National Centre for Mental Health Research Translation, Department of General Practice, Melbourne Medical School, The University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Australia
- Primary Care Mental Health Research Program, Department of General Practice, Melbourne Medical School, The University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Australia
| | - Kathryn A Ellis
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia
| | - Terence W H Chong
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
- North Western Mental Health, Royal Melbourne Hospital, Parkville, Australia
- St Vincent's Hospital Melbourne, St George's Campus, Melbourne, Australia
| | - Thomas Rego
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
- North Western Mental Health, Royal Melbourne Hospital, Parkville, Australia
| | - Kay L Cox
- Medical School, The University of Western Australia, Perth, Australia
| | - Kaarin J Anstey
- University of New South Wales Ageing Futures Institute, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
| | - Alissa Westphal
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
| | - Rebecca Moorhead
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
| | - Jenny Southam
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
| | - Rhoda Lai
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
| | - Emily You
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
| | - Nicola T Lautenschlager
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
- North Western Mental Health, Royal Melbourne Hospital, Parkville, Australia
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Haddad C, Sacre H, Abboche E, Salameh P, Calvet B. The self-assessment scale of cognitive complaints in Schizophrenia: validation of the Arabic version among a sample of lebanese patients. BMC Psychiatry 2023; 23:415. [PMID: 37296387 PMCID: PMC10257267 DOI: 10.1186/s12888-023-04925-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 06/05/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Several subjective scales have been used to measure cognitive complaints in patients with schizophrenia, such as the Self-Assessment Scale of Cognitive Complaints in Schizophrenia (SASCCS), which was designed to be clear, simple, and easy to use. This study aimed to examine the ability of SASCCS as a validated tool to collect and assess subjective cognitive complaints of patients with schizophrenia. METHODS A cross-sectional study among 120 patients with schizophrenia was performed between July 2019 and Mars 2020 at the Psychiatric Hospital of the Cross, Lebanon. The SASCCS was used to assess how patients with schizophrenia perceived their cognitive impairment. RESULTS The internal consistency of the SASCCS scale was 0.911, and the intra-class correlation coefficient was 0.81 (p < 0.001), suggesting a good stability over time. The factor analysis of the SASCCS scale showed a 5-factor solution using the Varimax rotated matrix. The SASCCS total score positively correlated with their own factors. A negative correlation was found between the objective cognitive scale and subjective cognitive complaints, which were positively correlated with clinical symptoms and depression. No significant association was found between insight and subjective cognitive complaints. CONCLUSION The SASCCS scale showed appropriate psychometric properties, with high internal consistency, good construct validity, and adequate concurrent validity, which makes it valuable for the evaluation of subjective cognitive complaints in patients with schizophrenia.
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Affiliation(s)
- Chadia Haddad
- EpiMaCT - Epidémiologie des maladies chroniques en zone tropicale, Institut d'Epidémiologie et de Neurologie Tropicale, Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, OmegaHealth, Limoges, France.
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut, Lebanon.
- School of Medicine, Lebanese American University, Byblos, Lebanon.
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
- School of Health Sciences, Modern University for Business and Science, Beirut, Lebanon.
| | - Hala Sacre
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut, Lebanon
| | - Elie Abboche
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Pascale Salameh
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut, Lebanon
- School of Medicine, Lebanese American University, Byblos, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, Egkomi, Nicosia, 2417, Cyprus
| | - Benjamin Calvet
- EpiMaCT - Epidémiologie des maladies chroniques en zone tropicale, Institut d'Epidémiologie et de Neurologie Tropicale, Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, OmegaHealth, Limoges, France
- Pôle Universitaire de Psychiatrie de l'Adulte et de la Personne Âgée, Centre Hospitalier Esquirol, Limoges, 87000, France
- Unité de Recherche et d'Innovation, Centre Hospitalier Esquirol, Limoges, 87000, France
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Simons R, Ong M, Beach S, Lei MK, Philibert R, Mielke M. Direct and Indirect Effects of Socioeconomic Status and Discrimination on Subjective Cognitive Decline: A Longitudinal Study of African American Women. J Gerontol B Psychol Sci Soc Sci 2023; 78:799-808. [PMID: 36810805 PMCID: PMC10195880 DOI: 10.1093/geronb/gbad029] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVES The present study builds on recent findings suggesting that the stress of institutional and interpersonal racism may contribute to African Americans' elevated risk for dementia. We investigated the extent to which 2 consequences of racism-low socioeconomic status (SES) and discrimination-predict self-reported cognitive decline (SCD) 19 years later. Further, we examined potential mediating pathways that might link SES and discrimination to cognitive decline. Potential mediators included depression, accelerated biological aging, and onset of chronic illnesses. METHODS Hypotheses were tested using a sample of 293 African American women. SCD was assessed using the Everyday Cognition Scale. Structural equation modeling was used to assess the effects of SES and racial discrimination, both measured in 2002, on SCD reported in 2021. Turning to the mediators, midlife depression was assessed in 2002, accelerated aging in 2019, and chronic illness in 2019. Age and prodrome depression were included as covariates. RESULTS There were direct effects of SES and discrimination on SCD. In addition, these 2 stressors showed a significant indirect effect on SCD through depression. Finally, there was evidence for a more complex pathway where SES and discrimination accelerate biological aging, with accelerated aging, in turn leading to chronic illness, which then predicted SCD. DISCUSSION Results of the present study add to a growing literature indicating that living in a racialized society is a central factor in explaining the high risk for dementia among Black Americans. Future research should continue to emphasize the various ways that exposure to racism over the life course effects cognition.
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Affiliation(s)
- Ronald L Simons
- Department of Sociology, University of Georgia,
Athens, Georgia, USA
| | - Mei Ling Ong
- Center for Family Research, University of Georgia,
Athens, Georgia, USA
| | - Steven R H Beach
- Department of Psychology, University of Georgia,
Athens, Georgia, USA
| | - Man-Kit Lei
- Department of Sociology, University of Georgia,
Athens, Georgia, USA
| | - Robert Philibert
- Department of Psychiatry, University of Iowa School of
Medicine, Iowa City, Iowa, USA
| | - Michelle M Mielke
- Department of Epidemiology and Prevention, Wake Forest University, School
of Medicine, Winston-Salem, North Carolina,
USA
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47
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Li C, Hong Y, Yang X, Zeng X, Ocepek-Welikson K, Eimicke JP, Kong J, Sano M, Zhu C, Neugroschl J, Aloysi A, Cai D, Martin J, Loizos M, Sewell M, Akrivos J, Evans K, Sheppard F, Greenberg J, Ardolino A, Teresi JA. The use of subjective cognitive complaints for detecting mild cognitive impairment in older adults across cultural and linguistic groups: A comparison of the Cognitive Function Instrument to the Montreal Cognitive Assessment. Alzheimers Dement 2023; 19:1764-1774. [PMID: 36222321 PMCID: PMC10090224 DOI: 10.1002/alz.12804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/26/2022] [Accepted: 08/11/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION This pilot study aims to explore the psychometric properties of the Cognitive Function Instrument (CFI) as a measure of subjective cognitive complaints (SCC) and its performance in distinguishing mild cognitive impairment (MCI) from normal control (NC) compared to an objective cognitive screen (Montreal Cognitive Assessment [MoCA]). METHODS One hundred ninety-four community-dwelling non-demented older adults with racial/ethnic diversity were included. Unidimensionality and internal consistency of the CFI were examined using factor analysis, Cronbach's alpha, and McDonald's omega. Logistic regression models and receiver operating characteristic (ROC) analysis were used to examine the performance of CFI. RESULTS The CFI demonstrated adequate internal consistency; however, the fit for a unidimensional model was suboptimal. The CFI distinguished MCI from NC alone or in combination with MoCA. ROC analysis showed comparable performance of the CFI and the MoCA. DISCUSSION Our findings support the use of CFI as a brief and easy-to-use screen to detect MCI in culturally/linguistically diverse older adults. HIGHLIGHT What is the key scientific question or problem of central interest of the paper? Subjective cognitive complaints (SCCs) are considered the earliest sign of dementia in older adults. However, it is unclear if SCC are equivalent in different cultures. The Cognitive Function Instrument (CFI) is a 14-item measure of SCC. This study provides pilot data suggesting that CFI is sensitive for detecting mild cognitive impairment in a cohort of older adults with racial/ethnic diversity. Comparing performance, CFI demonstrates comparable sensitivity to the Montreal Cognitive Assessment, an objective cognitive screening test. Overall, SCC may provide a non-invasive, easy-to-use method to flag possible cognitive impairment in both research and clinical settings.
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Affiliation(s)
- Clara Li
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yue Hong
- Salem Hospital, Mass General Brigham, Salem, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Xiao Yang
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Xiaoyi Zeng
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Katja Ocepek-Welikson
- Columbia University Stroud Center, New York State Psychiatric Institute, New York, NY, USA
| | | | - Jian Kong
- Research Division, The Hebrew Home at Riverdale, Riverdale, NY, USA
| | - Mary Sano
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- James J. Peters VA Medical Center, New York, NY, USA
| | - Carolyn Zhu
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- James J. Peters VA Medical Center, New York, NY, USA
| | - Judith Neugroschl
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Amy Aloysi
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Dongming Cai
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- James J. Peters VA Medical Center, New York, NY, USA
| | - Jane Martin
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Maria Loizos
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Margaret Sewell
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jimmy Akrivos
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kirsten Evans
- James J. Peters VA Medical Center, New York, NY, USA
| | - Faye Sheppard
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jonathan Greenberg
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Allison Ardolino
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jeanne A. Teresi
- Columbia University Stroud Center, New York State Psychiatric Institute, New York, NY, USA
- Research Division, The Hebrew Home at Riverdale, Riverdale, NY, USA
- Mount Sinai Pepper Older Americans Independence Center, Department of Geriatrics and Palliative Medicine, Mount Sinai Medical Center, New York, NY, USA
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48
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Heikkinen AL, Paajanen TI, Hublin C, Valtonen T, Krüger J, Tikkanen V, Saari T, Koivisto AM, Hänninen T, Remes AM. The Cognitive Function at Work Questionnaire in memory clinic setting: a validation study. J Clin Exp Neuropsychol 2023; 45:365-376. [PMID: 37561064 DOI: 10.1080/13803395.2023.2239508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 07/14/2023] [Indexed: 08/11/2023]
Abstract
INTRODUCTION As there is a trend toward more people seeking medical help due to cognitive symptoms, validated and targeted questionnaires are increasingly important in the clinical evaluation process. The Cognitive Function at Work Questionnaire (CFWQ) was developed to identify and rate subjective cognitive symptoms of individuals active in working life. However, its psychometric characteristics have not been previously studied in a memory clinic setting. METHOD The factorial structure, internal consistency, test-retest reliability, and convergent validity of the CFWQ were studied in a memory clinic setting (N = 113). We also investigated the instrument's ability to identify cognitive symptoms in a cohort of early-onset dementia (EOD, N = 22), mild cognitive impairment-neurological (MCI-n, N = 18), MCI due to mood, sleep, or other physical health problems (MCI-o, N = 59), and subjective cognitive decline (SCD, N = 14) patients. RESULTS Based on factor analysis, eight cognitive subscales were identified covering main cognitive domains: Memory, Language, Executive Function, Speed of Processing, Cognitive Control, Name Memory, Visuospatial/Praxis and Attention. The internal consistency (α = .93) and the test-retest reliability (ICC = .91) were high. Several correlations (r = .19 - .33, p < .05) were documented between neuropsychological impairment level and CFWQ scores. EOD, MCI-n, MCI-o, and SCD groups did not differ statistically significantly in the levels of cognitive symptoms as measured by the CFWQ Total score. EOD group scored higher (p = .009) than other patient groups on the Visuospatial/Praxis subscale, but the difference between EOD and MCI-o groups turned insignificant after correcting for multiple testing. CONCLUSIONS The results of the study support the validity and reliability characteristics of the CFWQ in a memory clinic setting. The instrument is easy-to-use and has clinical utility in capturing the subjective cognitive symptoms of patients active in working life and who need a referral to a more detailed evaluation.
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Affiliation(s)
- Anna-Leena Heikkinen
- Research Unit of Clinical Medicine, Neurology, University of Oulu, Oulu, Finland
- MRC, Oulu University Hospital, Oulu, Finland
- Neurocenter, Neurology, Oulu University Hospital, Oulu, Finland
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Teemu I Paajanen
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Christer Hublin
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Teppo Valtonen
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Johanna Krüger
- Research Unit of Clinical Medicine, Neurology, University of Oulu, Oulu, Finland
- MRC, Oulu University Hospital, Oulu, Finland
- Neurocenter, Neurology, Oulu University Hospital, Oulu, Finland
| | - Veera Tikkanen
- Research Unit of Clinical Medicine, Neurology, University of Oulu, Oulu, Finland
- MRC, Oulu University Hospital, Oulu, Finland
- Neurocenter, Neurology, Oulu University Hospital, Oulu, Finland
| | - Toni Saari
- Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland
- Unit of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Anne M Koivisto
- Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland
- Unit of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Geriatrics, Helsinki University Hospital, Helsinki, Finland
- Clinical Neurosciences, University of Helsinki, Helsinki, Finland
| | - Tuomo Hänninen
- Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Anne M Remes
- Research Unit of Clinical Medicine, Neurology, University of Oulu, Oulu, Finland
- MRC, Oulu University Hospital, Oulu, Finland
- Neurocenter, Neurology, Oulu University Hospital, Oulu, Finland
- Clinical Neurosciences, University of Helsinki, Helsinki, Finland
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49
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Gunstad J, Disabato D, Shrestha R, Sanborn V, Mistler CB, Copenhaver MM. Latent profile analysis of data from the brief inventory of neurocognitive impairment (BINI) to develop neuro-cognitive profiles among opioid-dependent patients in drug treatment. J Addict Dis 2023; 41:120-127. [PMID: 35615880 PMCID: PMC9699904 DOI: 10.1080/10550887.2022.2080626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Neurocognitive dysfunction is common among individuals with opioid use disorders (OUD) and can impede a range of treatment outcomes. We developed the 57-item Brief Inventory of Neuro-cognitive Impairment (BINI) to help detect and monitor neurocognitive dysfunction in the context of drug treatment settings. To date, no study has examined the possible presence of BINI subgroups among OUD patients, which could enhance our ability to tailor intervention strategies to meet individual treatment needs. The purpose of this study was to conduct a latent profile analysis to identify BINI subgroups that differ in terms of their reported and objective neurocognitive dysfunction. We hypothesized that subgroups would emerge, suggesting the potential benefit of implementing tailored strategies for optimal treatment outcomes. METHODS Latent profile analyses included data from opioid-dependent patients (N = 177) enrolled in a methadone maintenance treatment program between July 2018 and October 2019. RESULTS We found three profiles of self-reported neurocognitive symptoms, including those with 1) minimal concerns 2) moderate concerns, and 3) many concerns across multiple domains. CONCLUSIONS If these results are confirmed, the BINI may be used to rapidly identify persons who require specific accommodation strategies to improve their drug treatment outcomes.
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Affiliation(s)
- John Gunstad
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - David Disabato
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - Roman Shrestha
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Victoria Sanborn
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - Colleen B. Mistler
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
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50
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Bryant AM, Kerr ZY, Walton SR, Barr WB, Guskiewicz KM, McCrea MA, Brett BL. Investigating the association between subjective and objective performance-based cognitive function among former collegiate football players. Clin Neuropsychol 2023; 37:595-616. [PMID: 35670306 PMCID: PMC9726994 DOI: 10.1080/13854046.2022.2083021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 05/22/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Studies have observed variable associations of prior contact sport participation with subjective and objective measures of cognitive function. This study directly investigated the association between subjective self-report and objective performance-based cognition among former collegiate football players, as well as its relationship to self-reported concussion history. METHODS Former collegiate football players (N = 57; mean age = 37.9 years [SD = 1.49]) retired from sport 15-years prior were enrolled. Linear regression models examined associations between subjective cognition (Quality of Life in Neurological Disorders Cognitive Functioning-Short Form), and performance on a neuropsychological battery. Domain specific (executive function) metrics of subjective (Behavior Rating Inventory of Executive Function-Adult) and objective cognition were also exclusively examined. Associations between self-reported concussion history with subjective and objective measures were tested. Potential influential factors (sleep quality and distress) were included as covariates. RESULTS Subjective cognition was not significantly associated with any objective measures of cognitive functioning (p's > .05). Greater self-reported concussion history was inversely associated with subjective cognition (B = -2.49, p = .004), but not objective performance-based cognition (p's > .05). Distress was significantly related to all metrics of subjective cognition (p's < .001) as well as performance on delayed recall and verbal fluency (p's < .05). Sleep quality was only significantly related to timed visuospatial sequencing (p = .033). CONCLUSIONS Reliance on self-reported measures of cognitive functioning alone is insufficient when assessing cognition in former contact sport athletes. Assessment of other factors known to influence subjective cognitive complaints should also be examined in determining the presence of cognitive deficits.
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Affiliation(s)
- Andrew M. Bryant
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Zachary Y. Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Samuel R. Walton
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | | | - Kevin M. Guskiewicz
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Michael A. McCrea
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Benjamin L. Brett
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin
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