1
|
Liao YY, Chen IH, Hsu WC, Tseng HY, Wang RY. Effect of exergaming versus combined exercise on cognitive function and brain activation in frail older adults: A randomised controlled trial. Ann Phys Rehabil Med 2021; 64:101492. [PMID: 33454398 DOI: 10.1016/j.rehab.2021.101492] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 12/08/2020] [Accepted: 12/17/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cognitive impairment is prevalent among frail older adults. Traditional exercise and exergaming positively affect cognition in healthy older people. However, few studies have investigated the effects of exergaming on cognition and brain activation in frail older adults. OBJECTIVE This study compared the effect of Kinect based exergaming (EXER) and combined physical exercise (CPE) training on cognitive function and brain activation in frail older adults in Taiwan. We hypothesised that EXER would be superior to CPE in this population. METHODS We randomised 46 community-dwelling frail older adults to the EXER or CPE group for 36 sessions (three 60-min training sessions per week) over 12 weeks. Outcome measures for cognitive function included global cognition measured by the Montreal Cognitive Assessment, executive function measured by the Executive Interview 25, verbal memory measured by the Chinese version of the California Verbal Learning Test, attention measured by the Stroop Colour and Word Test and Trail Making Test (part B), and working memory measured by spatial n-back tests. Prefrontal cortex activation during the global cognition test was documented with functional near-infrared spectroscopy (fNIRS). RESULTS Both groups improved significantly in global cognition (P<0.05), executive function (P<0.05), and attention (P<0.05) after the 12-week intervention. The group×time interaction indicated that EXER training significantly enhanced global cognition more than CPE training (F(1,44)=5.277, P=0.026). Moreover, only the EXER group showed significant improvements in verbal (P<0.05) and working (P<0.05) memory after the intervention. The fNIRS hemodynamics data revealed decreased activation in prefrontal cortices of both groups (P<0.05) during the post-training cognitive assessment, thereby suggesting greater neural efficiency; however, we found no significant group difference. CONCLUSION In frail older adults, exergaming and CPE could improve cognitive function, most likely by increasing neural efficiency. Moreover, exergaming may be superior to CPE, particularly in improving global cognition.
Collapse
Affiliation(s)
- Ying-Yi Liao
- Department of gerontological health care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - I-Hsuan Chen
- Department of physical therapy, Fooyin University, Kaohsiung, Taiwan
| | - Wei-Chun Hsu
- Graduate Institute of biomedical engineering, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Han-Yun Tseng
- Department of gerontological health care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Ray-Yau Wang
- Department of physical therapy and assistive technology, National Yang-Ming University, Taipei, Taiwan.
| |
Collapse
|
2
|
Orkin Simon N, Jansari A, Gilboa Y. Hebrew version of the Jansari assessment of Executive Functions for Children (JEF-C ©): Translation, adaptation and validation. Neuropsychol Rehabil 2020; 32:287-305. [PMID: 33028156 DOI: 10.1080/09602011.2020.1821718] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The Jansari assessment of Executive Functions for Children (JEF-C©) is a non-immersive computerized assessment of executive functions (EFs). This study aimed to create a cross-culturally adapted Hebrew version, JEF-C(H)© and to assess reliability and validity in the Israeli context. Forty typically developing Israeli children and adolescents, aged 11-18 years, were assessed with JEF-C(H)©. In addition, participants and their parents filled in the Behaviour Rating Inventory of Executive Function (BRIEF). JEF-C(H)© was found to be feasible in Israeli children and adolescents. The internal consistency was acceptable (Cronbach's alpha = 0.79). Most of the JEF-C(H)© subtests and the Average score showed significant positive moderate to high correlations with age, ranging from 0.40 to 0.78 demonstrating construct validity. Multiple significant correlations were also found between the JEF-C(H)© Average score and the BRIEF indices as well as total score in the Parent and Self-report questionnaires. These preliminary findings support the reliability and validity of this version. Current findings demonstrate the potential clinical utility of JEF-C(H)© as an ecologically valid tool for Israeli children and adolescents in the assessment of EFs.
Collapse
Affiliation(s)
| | - Ashok Jansari
- Department of Psychology, Goldsmiths, University of London, London, UK
| | - Yafit Gilboa
- School of Occupational Therapy, The Hebrew University of Jerusalem, Jerusalem, Israel
| |
Collapse
|
3
|
Riva G, Mancuso V, Cavedoni S, Stramba-Badiale C. Virtual reality in neurorehabilitation: a review of its effects on multiple cognitive domains. Expert Rev Med Devices 2020; 17:1035-1061. [PMID: 32962433 DOI: 10.1080/17434440.2020.1825939] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Neurological diseases frequently cause adult-onset disability and have increased the demand for rehabilitative interventions. Neurorehabilitation has been progressively relying on computer-assisted programs and, more recently, on virtual reality (VR). Current reviews explore VR-based neurorehabilitation for assessing and treating the most common neurological pathologies. However, none of them explored specifically the impact of VR on multiple cognitive domains. AREAS COVERED The present work is a review of 6 years of literature (2015-2020) on VR in neurorehabilitation with the purpose of analyzing its effects on memory, attention, executive functions, language, and visuospatial ability. EXPERT OPINION Our review suggests that VR-based neurorehabilitation showed encouraging results for executive functions and visuospatial abilities particularly for both acute and neurodegenerative conditions. Conversely, memory, and attention outcomes are conflicting, and language did not show significant improvements following VR-based rehabilitation. Within five years, it is plausible that VR-based intervention would be provided in standalone and mobile-based platforms that won't need a PC to work, with reduced latency and improved user interaction.
Collapse
Affiliation(s)
- Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano , Milan, Italy.,Department of Psychology, Catholic University of the Sacred Heart , Milan, Italy
| | - Valentina Mancuso
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano , Milan, Italy
| | - Silvia Cavedoni
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano , Milan, Italy
| | - Chiara Stramba-Badiale
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano , Milan, Italy
| |
Collapse
|
4
|
Liao YY, Tseng HY, Lin YJ, Wang CJ, Hsu WC. Using virtual reality-based training to improve cognitive function, instrumental activities of daily living and neural efficiency in older adults with mild cognitive impairment. Eur J Phys Rehabil Med 2020; 56:47-57. [DOI: 10.23736/s1973-9087.19.05899-4] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|
5
|
Pickens S, Boss L, Ahn H, Jefferson F. Identifying Cognitive Impairment in Hospitalized Older Adults to Prevent Readmission: Two Case Studies. Clin Gerontol 2018; 41:101-107. [PMID: 28686529 DOI: 10.1080/07317115.2017.1333971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To describe two patient outcomes post-discharge from an acute hospital admission. Both patients underwent cognitive testing during hospitalization. METHODS A battery of cognitive tests was administered to two hospitalized older adult patients. Both patients were evaluated in their homes within 72 hours of discharge and again at 14- and 30-days by a nurse practitioner. RESULTS One of the patients was readmitted within 30 days of hospital discharge due to complications from an amputation. This patient did not perform well on cognitive measures which may have been related to his pain levels and/or his medication regimen. CONCLUSIONS Not all readmissions are avoidable; however, if readmissions are related to cognitive impairment, implementing strategies tailored to this population may reduce readmission rates. CLINICAL IMPLICATIONS Risk factors for readmission should be identified so the discharge team can develop a tailored plan of care. Including both the patient and an informal caregiver may reduce the chance of a hospital readmission in older adults with cognitive impairment regardless of the etiology.
Collapse
Affiliation(s)
- Sabrina Pickens
- a The University of Texas Health Science Center at Houston School of Nursing , Houston , Texas , USA
| | - Lisa Boss
- a The University of Texas Health Science Center at Houston School of Nursing , Houston , Texas , USA.,b Memorial Herman Northeast Hospital , Humble , Texas , USA
| | - Hyochol Ahn
- a The University of Texas Health Science Center at Houston School of Nursing , Houston , Texas , USA
| | | |
Collapse
|
6
|
Gilboa Y, Jansari A, Kerrouche B, Uçak E, Tiberghien A, Benkhaled O, Aligon D, Mariller A, Verdier V, Mintegui A, Abada G, Canizares C, Goldstein A, Chevignard M. Assessment of executive functions in children and adolescents with acquired brain injury (ABI) using a novel complex multi-tasking computerised task: The Jansari assessment of Executive Functions for Children (JEF-C ©). Neuropsychol Rehabil 2017; 29:1359-1382. [PMID: 29283024 DOI: 10.1080/09602011.2017.1411819] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objectives: The Jansari assessment of Executive Functions for Children (JEF-C©) is a new non-immersive computerised assessment of executive functions. The objectives of the study were to test the feasibility and validity of JEF-C© in children and adolescents with acquired brain injury (ABI). Methods: Twenty-nine patients with ABI aged 10-18 years and 30 age-and gender-matched controls were tested. Participants performed JEF-C©, Wechsler Abbreviated Scale of Intelligence (WASI) and the Behavioural Assessment of the Dysexecutive Syndrome for Children (BADS-C), while parents completed the Behaviour Rating Inventory of Executive Function (BRIEF) questionnaire. Results: The JEF-C© task proved feasible in patients with ABI. The internal consistency was medium (Cronbach's alpha = 0.62 and significant intercorrelations between individual JEF-C© constructs). Patients performed significantly worse than controls on most of the JEF-C© subscales and total score, with 41.4% of participants with ABI classified as having severe executive dysfunction. No significant correlations were found between JEF-C© total score, the BRIEF indices, and the BADS-C. Significant correlations were found between JEF-C© and demographic characteristics of the sample and intellectual ability, but not with severity/medical variables. Conclusion: JEF-C© is a playful complex task that appears to be a sensitive and ecologically valid assessment tool, especially for relatively high-functioning individuals.
Collapse
Affiliation(s)
- Yafit Gilboa
- School of Occupational Therapy, Faculty of Medicine, Hadassah and the Hebrew University of Jerusalem , Jerusalem , Israel
| | - Ashok Jansari
- Department of Psychology, Goldsmiths, University of London , London , UK
| | - Bernadette Kerrouche
- Outreach Team for Children And Adolescents with Acquired Brain Injury, Saint Maurice Hospitals , Saint Maurice , France
| | - Emel Uçak
- Outreach Team for Children And Adolescents with Acquired Brain Injury, Saint Maurice Hospitals , Saint Maurice , France
| | - Anne Tiberghien
- Outreach Team for Children And Adolescents with Acquired Brain Injury, Saint Maurice Hospitals , Saint Maurice , France
| | - Ouarda Benkhaled
- Outreach Team for Children And Adolescents with Acquired Brain Injury, Saint Maurice Hospitals , Saint Maurice , France
| | - Delphine Aligon
- Outreach Team for Children And Adolescents with Acquired Brain Injury, Saint Maurice Hospitals , Saint Maurice , France
| | - Aude Mariller
- Rehabilitation Department for Children with Acquired Neurological Injury, Saint Maurice Hospitals , Saint Maurice , France
| | - Valentine Verdier
- Outreach Team for Children And Adolescents with Acquired Brain Injury, Saint Maurice Hospitals , Saint Maurice , France
| | - Amaia Mintegui
- Rehabilitation Department for Children with Acquired Neurological Injury, Saint Maurice Hospitals , Saint Maurice , France
| | - Geneviève Abada
- Rehabilitation Department for Children with Acquired Neurological Injury, Saint Maurice Hospitals , Saint Maurice , France
| | - Céline Canizares
- Outreach Team for Children And Adolescents with Acquired Brain Injury, Saint Maurice Hospitals , Saint Maurice , France
| | - Andrew Goldstein
- School of Journalism, Stony Brook University , Stony Brook , New York , USA
| | - Mathilde Chevignard
- Outreach Team for Children And Adolescents with Acquired Brain Injury, Saint Maurice Hospitals , Saint Maurice , France.,Rehabilitation Department for Children with Acquired Neurological Injury, Saint Maurice Hospitals , Saint Maurice , France.,Sorbonne Universités, UPMC Univ Paris 06 , UMR 7371, UMR_S 1146, LIB, F-75005, Paris , France.,GRC n°18, Handicap Cognitif et Réadaptation (HanCRe); UPMC Paris 6 , Paris , France
| |
Collapse
|
7
|
Moreira HS, Costa AS, Castro SL, Lima CF, Vicente SG. Assessing Executive Dysfunction in Neurodegenerative Disorders: A Critical Review of Brief Neuropsychological Tools. Front Aging Neurosci 2017; 9:369. [PMID: 29170636 PMCID: PMC5684643 DOI: 10.3389/fnagi.2017.00369] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 10/26/2017] [Indexed: 02/05/2023] Open
Abstract
Executive function (EF) has been defined as a multifaceted construct that involves a variety of high-level cognitive abilities such as planning, working memory, mental flexibility, and inhibition. Being able to identify deficits in EF is important for the diagnosis and monitoring of several neurodegenerative disorders, and thus their assessment is a topic of much debate. In particular, there has been a growing interest in the development of neuropsychological screening tools that can potentially provide a reliable quick measure of EF. In this review, we critically discuss the four screening tools of EF currently available in the literature: Executive Interview-25 (EXIT 25), Frontal Assessment Battery (FAB), INECO Frontal Screening (IFS), and FRONTIER Executive Screen (FES). We first describe their features, and then evaluate their psychometric properties, the existing evidence on their neural correlates, and the empirical work that has been conducted in clinical populations. We conclude that the four screening tools generally present appropriate psychometric properties, and are sensitive to impairments in EF in several neurodegenerative conditions. However, more research will be needed mostly with respect to normative data and neural correlates, and to determine the extent to which these tools add specific information to the one provided by global cognition screening tests. More research directly comparing the available tools with each other will also be important to establish in which conditions each of them can be most useful.
Collapse
Affiliation(s)
- Helena S Moreira
- Faculty of Psychology and Education Sciences, Centre for Psychology, University of Porto, Porto, Portugal
| | - Ana S Costa
- Neurology Department, Hospital de Braga, Braga, Portugal
| | - São L Castro
- Faculty of Psychology and Education Sciences, Centre for Psychology, University of Porto, Porto, Portugal
| | - César F Lima
- Faculty of Psychology and Education Sciences, Centre for Psychology, University of Porto, Porto, Portugal.,Institute of Cognitive Neuroscience, University College London, London, United Kingdom.,Instituto Universitário de Lisboa (ISCTE-IUL), Lisbon, Portugal
| | - Selene G Vicente
- Faculty of Psychology and Education Sciences, Centre for Psychology, University of Porto, Porto, Portugal
| |
Collapse
|
8
|
Leslie FVC, Foxe D, Daveson N, Flannagan E, Hodges JR, Piguet O. FRONTIER Executive Screen: a brief executive battery to differentiate frontotemporal dementia and Alzheimer's disease. J Neurol Neurosurg Psychiatry 2016; 87:831-5. [PMID: 26420887 DOI: 10.1136/jnnp-2015-311917] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 09/13/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND AND OBJECTIVE Executive dysfunctions are a key clinical feature of behavioural-variant frontotemporal dementia (bvFTD). Such deficits are also found in Alzheimer's disease (AD), making the differentiation between these two diseases difficult at times, particularly in the absence of extensive cognitive assessments. To address this issue, we developed the FRONTIER Executive Screen (FES), which combines three abbreviated measures of verbal fluency, inhibitory control and working memory. METHODS We administered the FES to 28 patients with dementia (14 bvFTD, 14 AD) matched for disease severity and 33 age-matched and education-matched healthy controls. We also administered traditional tests of executive function to establish the concurrent validity of the FES. RESULTS Both patient groups obtained lower FES scores (total and subscores) compared to controls. Correct classification into patient or control groups was reached in over 90% of study participants based on the FES total score. Only two patients with bvFTD obtained FES scores within 2 SDs of the control group. Receiver operating characteristic analyses on the patient groups showed that a cut-off FES total score of 7/15 achieved 71% sensitivity and 73% specificity for a diagnosis of bvFTD. In addition, the FES showed high correlations with traditional measures of executive function. CONCLUSIONS The FES is a brief (5-10 min) bedside screening measure which is simple to administer and score, and demonstrates good discriminative validity to differentiate bvFTD from AD. It is a useful addendum to general cognitive screening measures and can help with the differential diagnosis of dementia.
Collapse
Affiliation(s)
- F V C Leslie
- Neuroscience Research Australia, Sydney, New South Wales, Australia School of Medical Science, University of New South Wales, Sydney, New South Wales, Australia ARC Centre of Excellence in Cognition and its Disorders, University of New South Wales, Sydney, New South Wales, Australia
| | - D Foxe
- Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - N Daveson
- Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - E Flannagan
- Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - J R Hodges
- Neuroscience Research Australia, Sydney, New South Wales, Australia School of Medical Science, University of New South Wales, Sydney, New South Wales, Australia ARC Centre of Excellence in Cognition and its Disorders, University of New South Wales, Sydney, New South Wales, Australia
| | - O Piguet
- Neuroscience Research Australia, Sydney, New South Wales, Australia School of Medical Science, University of New South Wales, Sydney, New South Wales, Australia ARC Centre of Excellence in Cognition and its Disorders, University of New South Wales, Sydney, New South Wales, Australia
| |
Collapse
|
9
|
Merideth FL, Quinn DK. "Walking the Walk": Decisional Capacity Deficits After Right Hemisphere Subdural Hematoma. PSYCHOSOMATICS 2015; 57:102-6. [PMID: 26481960 DOI: 10.1016/j.psym.2015.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 06/26/2015] [Accepted: 07/06/2015] [Indexed: 11/18/2022]
Affiliation(s)
| | - Davin K Quinn
- Department of Psychiatry, University of New Mexico, Albuquerque, New Mexico.
| |
Collapse
|
10
|
Rej S, Begley A, Gildengers A, Dew MA, Reynolds CF, Butters MA. Psychosocial Risk Factors for Cognitive Decline in Late-Life Depression: Findings from the MTLD-III Study. Can Geriatr J 2015; 18:43-50. [PMID: 26180559 PMCID: PMC4487735 DOI: 10.5770/cgj.18.134] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Cognitive impairment and depression frequently co-occur in late life. There remains a need to better characterize psychosocial risk factors of cognitive decline in older adults with depression. We hypothesized that certain psychosocial factors would be associated with higher risk of cognitive decline in individuals with late-life depression. Methods 130 individuals aged ≥ 65 years who had achieved remission from a major depressive episode were randomized to donepezil or placebo and then closely followed for two years. Using Cox proportional hazard models, we examined the association between baseline median household income, education level, race, marital status, and social support and cognitive decline over the follow-up. Results Lower interpersonal support (OR = 0.86 [0.74–0.99], p = .04) and lower baseline global neuropsychological score (OR = 0.56 [0.36–0.87], p = .001) predicted shorter time to conversion to MCI or dementia in univariate models. These exposures did not remain significant in multivariate analyses. Neither socioeconomic status nor other psychosocial factors independently predicted cognitive diagnostic conversion (p > .05). Conclusions We did not find reliable associations between cognitive outcome and any of the psychosocial factors examined. Future large-scale, epidemiological studies, ideally using well-validated subjective measures, should better characterize psychosocial risk factors for cognitive decline in late-life depression.
Collapse
Affiliation(s)
- Soham Rej
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Amy Begley
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Ariel Gildengers
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Mary Amanda Dew
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Charles F Reynolds
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Meryl A Butters
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| |
Collapse
|
11
|
Affiliation(s)
- Sophia Wang
- Department of Psychiatry and Behavior Sciences, Duke University Medical Center, Durham, North Carolina 27710; ,
- Durham Veterans Affairs Medical Center, Durham, North Carolina 27705
| | - Dan G. Blazer
- Department of Psychiatry and Behavior Sciences, Duke University Medical Center, Durham, North Carolina 27710; ,
- Center for the Study of Aging, Duke University Medical Center, Durham, North Carolina 27710
| |
Collapse
|
12
|
Morimoto SS, Kanellopoulos D, Manning KJ, Alexopoulos GS. Diagnosis and treatment of depression and cognitive impairment in late life. Ann N Y Acad Sci 2015; 1345:36-46. [PMID: 25655026 DOI: 10.1111/nyas.12669] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Cognitive impairment in late-life depression is prevalent, disabling, and heterogeneous. Although mild cognitive impairment in depression does not usually progress to dementia, accurate assessment of cognition is vital to prognosis and treatment planning. For example, executive dysfunction often accompanies late-life depression, influences performance across cognitive domains, and is associated with poor antidepressant treatment outcomes. Here, we review how assessment can capture dysfunction across cognitive domains and discuss cognitive trajectories frequently observed in late-life depression in the context of the neurobiology of this disorder. We also review the efficacy of a sample of interventions tailored to specific cognitive profiles.
Collapse
Affiliation(s)
- Sarah Shizuko Morimoto
- Institute of Geriatric Psychiatry, Weill Cornell Medical College, White Plains, New York
| | - Dora Kanellopoulos
- Institute of Geriatric Psychiatry, Weill Cornell Medical College, White Plains, New York
| | - Kevin J Manning
- Department of Psychiatry, University of Connecticut Health Center, Farmington, Connecticut
| | - George S Alexopoulos
- Institute of Geriatric Psychiatry, Weill Cornell Medical College, White Plains, New York
| |
Collapse
|