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DesRuisseaux LA, Guevara JE, Duff K. Examining the Stability and Predictive Utility of Across- and Within-Domain Intra-Individual Variability in Mild Cognitive Impairment. Arch Clin Neuropsychol 2024:acae054. [PMID: 39003237 DOI: 10.1093/arclin/acae054] [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: 10/30/2023] [Revised: 06/13/2024] [Accepted: 07/01/2024] [Indexed: 07/15/2024] Open
Abstract
OBJECTIVE Dispersion is a form of intra-individual variability across neuropsychological tests that has been shown to predict cognitive decline. However, few studies have investigated the stability and predictive utility of both across- and within-domain dispersion. The current study aims to fill these gaps in the literature by examining multiple indices of dispersion in a longitudinal clinical sample of individuals diagnosed with mild cognitive impairment (MCI) at baseline. METHOD Two hundred thirty-eight MCI patients from a cognitive disorders clinic underwent testing at baseline and after approximately 1.5 years. Linear regression was used to examine whether baseline across- and within-domain dispersion predicted cognitive decline in individuals whose diagnostic classification progressed to dementia (i.e., MCI-Decline) and those who retained an MCI diagnosis at follow-up (i.e., MCI-Stable). Cognitive decline was operationalized dichotomously using group status and continuously using standardized regression-based (SRB) z-scores. RESULTS Dispersion variables at baseline and follow-up were positively correlated in both groups, with the exception of within-domain executive functioning and language dispersion in the MCI-Decline group. None of the dispersion variables predicted diagnostic conversion to MCI. Using SRB z-scores, greater across-domain dispersion predicted greater overall cognitive decline at follow-up, but this was not the case for within-domain variables with the exception of visuospatial skills. CONCLUSIONS Results suggest that across- and within-domain dispersion are relatively stable across time, and that across-domain dispersion is predictive of subtle cognitive decline in patients with MCI. However, these results also highlight that findings may differ based on the tests included in dispersion calculations.
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Affiliation(s)
| | - Jasmin E Guevara
- Department of Psychology, University of Utah, Salt Lake City, UT 84112, USA
| | - Kevin Duff
- Department of Neurology, Layton Aging and Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Neurology, Center for Alzheimer's Care, Imaging, and Research, University of Utah, Salt Lake City, UT 84111, USA
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2
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Peterson RK, King TZ. A systematic review of pediatric neuropsychological outcomes with proton versus photon radiation therapy: A call for equity in access to treatment. J Int Neuropsychol Soc 2023; 29:798-811. [PMID: 36323679 DOI: 10.1017/s1355617722000819] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE There is increasing interest in the utilization of proton beam radiation therapy (PRT) to treat pediatric brain tumors based upon presumed advantages over traditional photon radiation therapy (XRT). PRT provides more conformal radiation to the tumor with reduced dose to healthy brain parenchyma. Less radiation exposure to brain tissue beyond the tumor is thought to reduce neuropsychological sequelae. This systematic review aimed to provide an overview of published studies comparing neuropsychological outcomes between PRT and XRT. METHOD PubMed, PsychINFO, Embase, Web of Science, Scopus, and Cochrane were systematically searched for peer-reviewed published studies that compared neuropsychological outcomes between PRT and XRT in pediatric brain tumor patients. RESULTS Eight studies were included. Six of the studies utilized retrospective neuropsychological data; the majority were longitudinal studies (n = 5). XRT was found to result in lower neuropsychological functioning across time. PRT was associated with generally stable neuropsychological functioning across time, with the exception of working memory and processing speed, which showed variable outcomes across studies. However, studies inconsistently included or considered medical and sociodemographic differences between treatment groups, which may have impacted neuropsychological outcomes. CONCLUSIONS Despite methodological limitations, including limited baseline neuropsychological evaluations, temporal variability between radiation treatment and first evaluation or initial and follow-up evaluations, and heterogenous samples, there is emerging evidence of sociodemographic inequities in access to PRT. With more institutions dedicating funding towards PRT, there may be the opportunity to objectively evaluate the neuropsychological benefits of patients matched on medical and sociodemographic variables.
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Affiliation(s)
- Rachel K Peterson
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Science, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Tricia Z King
- Department of Psychology, Georgia State University, Atlanta, USA
- Neuroscience Institute, Georgia State University, Atlanta, USA
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3
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Henriques-Calado J. Personality traits and disorders in Alzheimer's disease. Brain Behav 2023; 13:e2938. [PMID: 36919197 PMCID: PMC10097140 DOI: 10.1002/brb3.2938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND The relationships between axis II personality disorders and the normative personality traits were explored in the context of current and pre-morbid personality assessment in Alzheimer's disease (AD). METHODS The study was conducted with four groups who were administered the NEO-FFI and the PDQ-4+, in the form of individual interview sessions. Current personality measure: consisting of 44 female participants (AD group) and, the control group, consisting of 80 female participants from the population at large. Pre-morbid personality measure: AD group informants (n = 40); control group informants (n = 42). RESULTS The results are in line with the literature review and provide new research data. By factorial discriminant analysis, the current and pre-morbid personality variables that differentiate AD from control groups are identified. The personality traits variables are the best discriminators such as low agreeableness, low openness to experience, and high neuroticism, suggesting that the maladaptive personality functioning can be described extending the range of psychopathology to a dimensional approach. CONCLUSIONS The study of personality variables seems to suggest, in their inclusion, the possibility to increase sensitivity toward an assessment in AD.
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Affiliation(s)
- Joana Henriques-Calado
- Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, Lisboa, Portugal.,CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, Lisboa, Portugal
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4
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DesRuisseaux LA, Suchy Y, Franchow EI. Intra-individual variability identifies individuals vulnerable to contextually induced executive lapses. Clin Neuropsychol 2023; 37:322-349. [PMID: 35392764 DOI: 10.1080/13854046.2022.2055651] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Contextual stressors, such as engagement in burdensome emotion regulation known as expressive suppression (ES), can result in transient but clinically meaningful decrement in performance on measures of executive functioning (EF). The goal of the present investigation was to examine whether intra-individual variability (IIV-I), which has been identified as an indicator of cognitive weakness, could serve as a marker of vulnerability to EF decrements due to both naturally-occurring and experimentally-manipulated ES. In Study 1, 180 cognitively healthy older adults completed the Push-Turn-Taptap (PTT) task to assess IIV-I, four Delis-Kaplan Executive Function System (D-KEFS) subtests to assess EF, and the Burden of State Emotion Regulation Questionnaire (B-SERQ) to assess naturally-occurring ES. In Study 2, a subset (n = 81) of participants underwent experimental manipulation to induce ES, followed by second administration of the D-KEFS to examine ES-induced decrements in EF. In Study 1, hierarchical linear regression yielded a significant interaction between ES and IIV-I as predictors of EF performance, demonstrating that high ES was associated with low EF only among individuals with high IIV-I. In Study 2, repeated measures ANOVA demonstrated an interaction between time (pre- vs. post- manipulation), group (ES vs. control), and IIV-I (high vs. low), such that only individuals who exhibited high IIV-I were negatively impacted by the ES manipulation. IIV-I moderates the association between ES and EF, such that only individuals with high IIV-I exhibit vulnerability to the impact of ES. Thus, IIV-I may act as a marker of vulnerability to temporary EF depletion.
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Affiliation(s)
| | - Yana Suchy
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Emilie I Franchow
- Department of Psychology, University of Utah, Salt Lake City, UT, USA.,Advocate Aurora Healthcare, Milwaukee, WI, USA
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5
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Sullivan EV, Thompson WK, Brumback T, Prouty D, Tapert SF, Brown SA, De Bellis MD, Nooner KB, Baker FC, Colrain IM, Clark DB, Nagel BJ, Pohl KM, Pfefferbaum A. Prior test experience confounds longitudinal tracking of adolescent cognitive and motor development. BMC Med Res Methodol 2022; 22:177. [PMID: 35751025 PMCID: PMC9233356 DOI: 10.1186/s12874-022-01606-9] [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: 10/26/2021] [Accepted: 04/14/2022] [Indexed: 11/23/2022] Open
Abstract
Background Accurate measurement of trajectories in longitudinal studies, considered the gold standard method for tracking functional growth during adolescence, decline in aging, and change after head injury, is subject to confounding by testing experience. Methods We measured change in cognitive and motor abilities over four test sessions (baseline and three annual assessments) in 154 male and 165 female participants (baseline age 12–21 years) from the National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA) study. At each of the four test sessions, these participants were given a test battery using computerized administration and traditional pencil and paper tests that yielded accuracy and speed measures for multiple component cognitive (Abstraction, Attention, Emotion, Episodic memory, Working memory, and General Ability) and motor (Ataxia and Speed) functions. The analysis aim was to dissociate neurodevelopment from testing experience by using an adaptation of the twice-minus-once tested method, which calculated the difference between longitudinal change (comprising developmental plus practice effects) and practice-free initial cross-sectional performance for each consecutive pairs of test sessions. Accordingly, the first set of analyses quantified the effects of learning (i.e., prior test experience) on accuracy and after speed domain scores. Then developmental effects were determined for each domain for accuracy and speed having removed the measured learning effects. Results The greatest gains in performance occurred between the first and second sessions, especially in younger participants, regardless of sex, but practice gains continued to accrue thereafter for several functions. For all 8 accuracy composite scores, the developmental effect after accounting for learning was significant across age and was adequately described by linear fits. The learning-adjusted developmental effects for speed were adequately described by linear fits for Abstraction, Emotion, Episodic Memory, General Ability, and Motor scores, although a nonlinear fit was better for Attention, Working Memory, and Average Speed scores. Conclusion Thus, what appeared as accelerated cognitive and motor development was, in most cases, attributable to learning. Recognition of the substantial influence of prior testing experience is critical for accurate characterization of normal development and for developing norms for clinical neuropsychological investigations of conditions affecting the brain.
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Affiliation(s)
- Edith V Sullivan
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine (MC5723), 401 Quarry Road, Stanford, CA, 94305-5723, USA.
| | - Wesley K Thompson
- Division of Biostatistics and Dept of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Ty Brumback
- Department of Psychological Sciences, Northern Kentucky University, Highland Heights, KY, USA
| | - Devin Prouty
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Susan F Tapert
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Sandra A Brown
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Michael D De Bellis
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Kate B Nooner
- Department of Psychology, University of North Carolina Wilmington, Wilmington, NC, USA
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Ian M Colrain
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Duncan B Clark
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Bonnie J Nagel
- Departments of Psychiatry and Behavioral Neuroscience, Oregon Health & Sciences University, Portland, OR, USA
| | - Kilian M Pohl
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine (MC5723), 401 Quarry Road, Stanford, CA, 94305-5723, USA.,Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Adolf Pfefferbaum
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine (MC5723), 401 Quarry Road, Stanford, CA, 94305-5723, USA.,Center for Health Sciences, SRI International, Menlo Park, CA, USA
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6
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Tsang RSM, Gallacher JE, Bauermeister S. The long arm of childhood socioeconomic deprivation on mid- to later-life cognitive trajectories: A cross-cohort analysis. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12322. [PMID: 35664888 PMCID: PMC9159813 DOI: 10.1002/dad2.12322] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 03/28/2022] [Accepted: 04/19/2022] [Indexed: 11/10/2022]
Abstract
Introduction Earlier studies of the effects of childhood socioeconomic status (SES) on later-life cognitive function consistently report a social gradient in later-life cognitive function. Evidence for their effects on cognitive decline is, however, less clear. Methods The sample consists of 5324 participants in the Whitehall II study, 8572 in the Health and Retirement Study (HRS), and 1413 in the Kame Project, who completed self-report questionnaires on their early life experiences and underwent repeated cognitive assessments. We characterized cognitive trajectories using latent class mixed models, and explored associations between childhood SES and latent class membership using logistic regressions. Results We identified distinct trajectories classes for all cognitive measures examined. Childhood socioeconomic deprivation was associated with an increased likelihood of being in a lower trajectory class. Discussion Our findings support the notions that cognitive aging is a heterogeneous process and early life circumstances may have lasting effects on cognition across the life-course.
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Affiliation(s)
- Ruby S M Tsang
- Department of Psychiatry University of Oxford Warneford Hospital Oxford UK
| | - John E Gallacher
- Department of Psychiatry University of Oxford Warneford Hospital Oxford UK
| | - Sarah Bauermeister
- Department of Psychiatry University of Oxford Warneford Hospital Oxford UK
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7
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Lingo VanGilder J, Lopez-Lennon C, Paul SS, Dibble LE, Duff K, Schaefer SY. Relating Global Cognition With Upper-Extremity Motor Skill Retention in Individuals With Mild-to-Moderate Parkinson's Disease. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:754118. [PMID: 36188810 PMCID: PMC9397847 DOI: 10.3389/fresc.2021.754118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/27/2021] [Indexed: 11/18/2022]
Abstract
Background and Purpose: Cognition has been linked to rehabilitation outcomes in stroke populations, but this remains unexplored in individuals with Parkinson's disease (PD). The purpose of this secondary data analysis from a recent clinical trial (NCT02600858) was to determine if global cognition was related to skill performance after motor training in individuals with PD. Methods: Twenty-three participants with idiopathic PD completed 3 days of training on an upper-extremity task. For the purposes of the original clinical trial, participants trained either "on" or "off" their dopamine replacement medication. Baseline, training, and 48-h retention data have been previously published. Global cognition was evaluated using the Montreal Cognitive Assessment (MoCA). Linear regression examined whether MoCA score predicted longer-term retention at nine-day follow-up; baseline motor task performance, age, PD severity, depressive symptoms, and group (medication "on"/"off") were included as covariates. Baseline and follow-up motor task performance were assessed for all participants while "on" their medication. Results: MoCA score was positively related to follow-up motor task performance, such that individuals with better cognition were faster than those with poorer cognition. Baseline task performance, age, PD severity, depressive symptoms, and medication status were unrelated to follow-up performance. Discussion and Conclusions: Results of this secondary analysis align with previous work that suggest cognitive impairment may interfere with motor learning in PD and support the premise that cognitive training prior to or concurrent with motor training may enhance rehabilitative outcomes for individuals with PD. Findings also suggest that assessing cognition in individuals with PD could provide prognostic information about their responsiveness to motor rehabilitation.
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Affiliation(s)
- Jennapher Lingo VanGilder
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, United States
| | - Cielita Lopez-Lennon
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, United States
| | - Serene S. Paul
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, United States
- Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Leland E. Dibble
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, United States
| | - Kevin Duff
- Center for Alzheimer's Care, Imaging and Research, University of Utah Health Sciences Center, Salt Lake City, UT, United States
- Department of Neurology, University of Utah Hospital, Salt Lake City, UT, United States
| | - Sydney Y. Schaefer
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, United States
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, United States
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8
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A Path Analytic Model Exploration of Determinants of Happiness of Older Adults in Abu Dhabi. AGEING INTERNATIONAL 2021. [DOI: 10.1007/s12126-021-09463-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AbstractThe objective of the study was to identify the factors associated with the subjective well-being of older adults in Abu Dhabi when happiness is taken as the dependent variable. In the present research, a framework based on theoretical models was developed in which older adult’s happiness was seen in a synergistic relationship and was associated with many other variables related to various domains in the social system. The sample consisted of 1,004 older adults aged 60 and above, who participated in the First Abu Dhabi General Social Survey administered in 2018. Many subjective well-being variables were considered. Path analysis was used to develop a model that incorporated the five following variables directly affecting the happiness of older adults: housing satisfaction, satisfaction with family life, satisfaction with friendships, life satisfaction, satisfaction with surrounding environment, and some psychological feelings. The study highlighted all direct and indirect associations. Further analysis of variance revealed the associations of gender, marital status, and education attainment. Implications of the study were highlighted along with future research directions.
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9
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Hooyman A, Talboom JS, DeBoth MD, Ryan L, Huentelman M, Schaefer SY. Remote, Unsupervised Functional Motor Task Evaluation in Older Adults across the United States Using the MindCrowd Electronic Cohort. Dev Neuropsychol 2021; 46:435-446. [PMID: 34612107 PMCID: PMC8671381 DOI: 10.1080/87565641.2021.1979005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/01/2021] [Accepted: 09/04/2021] [Indexed: 10/20/2022]
Abstract
COVID-19 has impacted the ability to evaluate motor function in older adults, as motor assessments typically require face-to-face interaction. One hundred seventy-seven older adults nationwide completed an unsupervised functional upper-extremity assessment at home. Data were compared to data from an independent sample of community-dwelling older adults (N = 250) assessed in lab. The effect of age on performance was similar between the in-lab and at-home groups. Practice effects were also similar. Assessing upper-extremity motor function remotely is feasible and reliable in community-dwelling older adults. This test offers a practical solution for telehealth practice and other research involving remote or geographically isolated individuals.
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Affiliation(s)
- Andrew Hooyman
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, USA
- The Arizona Alzheimer’s Consortium, Phoenix, AZ, USA
| | - Joshua S. Talboom
- The Arizona Alzheimer’s Consortium, Phoenix, AZ, USA
- Neurogenomics Division, The Translational Genomics Research Institute (TGen), Phoenix, AZ, USA
| | - Matthew D. DeBoth
- The Arizona Alzheimer’s Consortium, Phoenix, AZ, USA
- Neurogenomics Division, The Translational Genomics Research Institute (TGen), Phoenix, AZ, USA
| | - Lee Ryan
- The Arizona Alzheimer’s Consortium, Phoenix, AZ, USA
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Matt Huentelman
- The Arizona Alzheimer’s Consortium, Phoenix, AZ, USA
- Neurogenomics Division, The Translational Genomics Research Institute (TGen), Phoenix, AZ, USA
| | - Sydney Y. Schaefer
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, USA
- The Arizona Alzheimer’s Consortium, Phoenix, AZ, USA
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10
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Weitzner DS, Calamia M, Parsons TD. Test-retest reliability and practice effects of the virtual environment grocery store (VEGS). J Clin Exp Neuropsychol 2021; 43:547-557. [PMID: 34376099 DOI: 10.1080/13803395.2021.1960277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The use of virtual reality (VR) technology has been suggested as a method to increase ecological validity in neuropsychological assessments. Although validity has been a focus in VR research, little attention has been paid to other psychometric properties such as test-retest reliability and practice effects. Practice effects are common on traditional neuropsychological tests and can be impacted by novelty. Because VR is not widely used it was expected that participants would demonstrate higher practice effects on VR as compared to paper-and-pencil testing. METHOD To compare test-retest reliability and practice effects in VR and traditional paper-and-pencil testing, the Virtual Environment Grocery Store (VEGS) and California Verbal Learning Test - Second Edition (CVLT-II) were used in healthy adults (n = 44). Participants received follow-up testing approximately 2 weeks after the initial visit. RESULTS Significant practice effects of similar magnitude were seen on memory scores (i.e., total learning, long-delay free recall, and long-delay cued recall) on the VEGS and the CVLT-II. The VEGS and CVLT-II memory scores also demonstrated strong test-retest reliability (r's > .71). Lastly, total learning scores (d = .32) and long-delay cued recall (d = .70) scores were significantly higher on the CVLT-II compared to the VEGS (p's < .01). CONCLUSIONS Results suggested similar test-retest reliability and practice effects of the VEGS and CVLT-II, although the VEGS has the benefit of being an immersive technology that simulates an everyday activity. The study replicated past findings that the VEGS is more difficult than the CVLT-II which may be a useful property for clinical assessment.
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Affiliation(s)
- Daniel S Weitzner
- Psychology Department, Louisiana State University, Baton Rouge, LA, USA
| | - Matthew Calamia
- Psychology Department, Louisiana State University, Baton Rouge, LA, USA
| | - Thomas D Parsons
- Computations Neuropsychology & Simulation, University of North Texas, Denton, TX, USA.,College of Information, University of North Texas, Denton, TX, USA.,iCenter for Affective Neurotechnologies (Ican), University of North Texas, Denton, TX, USA
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11
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White N, Kouwenhoven M, Machado L. Short-Term Retest Performance in Young versus Older Adults: Consideration of Integrated Speed-Accuracy Measures. Exp Aging Res 2021; 48:68-85. [PMID: 33993852 DOI: 10.1080/0361073x.2021.1919475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objectives: The current research addressed gaps in the literature regarding short-term computerized cognitive retest performance in young and older adults using two integrated speed-accuracy metrics. The aims were: (a) to advance the aging literature on short-term retest performance using a computerized cognitive battery and a retest schedule that included both within- and between-day time points, and (b) to assess the test-retest reliability of two integrated speed-accuracy metrics, inverse efficiency scores (IES) and balanced integration scores (BIS).Method: Twenty young (18-23 years) and thirty older (65-71 years) men completed a battery measuring a range of cognitive functions, six times over three testing days, each 1 week apart.Results: Compared to young adults, older adults exhibited steeper within- and between-day performance gains in IES and BIS, which may reflect a combination of lower initial cognitive ability and familiarity, indicating that older adults may require more familiarization on computerized tests. Relative to unadjusted reaction times, IES reliability appeared comparable in older adults, but slightly lower among young adults. The reliability of BIS was lower than unadjusted reaction times and IES in both age groups.Discussion: Our findings provide guidance for researchers wanting to combine speed and accuracy into a single performance metric in repeated testing contexts.
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Affiliation(s)
- Naomi White
- Department of Psychology, University of Otago, Dunedin, New Zealand.,Brain Research New Zealand, Auckland, New Zealand
| | | | - Liana Machado
- Department of Psychology, University of Otago, Dunedin, New Zealand.,Brain Research New Zealand, Auckland, New Zealand
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12
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Hammers DB, Suhrie KR, Dixon A, Porter S, Duff K. Validation of one-week reliable change methods in cognitively intact community-dwelling older adults. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2021; 28:472-492. [PMID: 32613913 PMCID: PMC7775875 DOI: 10.1080/13825585.2020.1787942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 06/23/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Reliable change methods can assist the determination of whether observed changes in performance are meaningful. The current study sought to validate previously published standardized regression-based (SRB) equations for commonly administered cognitive tests using a cognitively intact sample of older adults, and extend findings by including relevant demographic and test-related variables known to predict cognitive performance. Method: This study applied previously published SRB prediction equations to 107 cognitively intact older adults assessed twice over one week. Prediction equations were also updated by pooling the current validation sample with 93 cognitively intact participants from original development sample to create a combined development sample. Results: Significant improvements were seen between observed baseline and follow-up scores on most measures. However, few differences were seen between observed follow-up scores and those predicted from these SRB algorithms, and the level of practice effects observed based on these equations were consistent with expectations. When SRBs were re-calculated from this combined development sample, predicted follow-up scores were mostly comparable with these equations, but standard errors of the estimate were consistently smaller. Conclusions: These results help support the validity of of these SRB equations to predict cognitive performance on these measures when repeated administration is necessary over short intervals. Findings also highlight the utility of expanding SRB models when predicting follow-up performance serially to provide more accurate assessment of reliable change at the level of the individual. As short-term practice effects are shown to predict cognitive performance annually, they possess the potential to inform clinical decision-making about individuals along the Alzheimer's continuum.
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Affiliation(s)
- Dustin B. Hammers
- Center for Alzheimer’s Care, Imaging, and Research, Department of Neurology, University of Utah
- Center on Aging, University of Utah
| | - Kayla R. Suhrie
- Center for Alzheimer’s Care, Imaging, and Research, Department of Neurology, University of Utah
| | - Ava Dixon
- Center for Alzheimer’s Care, Imaging, and Research, Department of Neurology, University of Utah
| | - Sariah Porter
- Center for Alzheimer’s Care, Imaging, and Research, Department of Neurology, University of Utah
| | - Kevin Duff
- Center for Alzheimer’s Care, Imaging, and Research, Department of Neurology, University of Utah
- Center on Aging, University of Utah
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13
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Hammers DB, Suhrie KR, Dixon A, Porter S, Duff K. Reliable change in cognition over 1 week in community-dwelling older adults: a validation and extension study. Arch Clin Neuropsychol 2021; 36:347-358. [PMID: 32026948 PMCID: PMC8245079 DOI: 10.1093/arclin/acz076] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 11/15/2019] [Accepted: 11/18/2019] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE Reliable change methods can aid neuropsychologists in understanding if performance differences over time represent clinically meaningful change or reflect benefit from practice. The current study sought to externally validate the previously published standardized regression-based (SRB) prediction equations developed by Duff for commonly administered cognitive measures. METHOD This study applied Duff's SRB prediction equations to an independent sample of community-dwelling participants with amnestic mild cognitive impairment (MCI) assessed twice over a 1-week period. A comparison of MCI subgroups (e.g., single v. multi domain) on the amount of change observed over 1 week was also examined. RESULTS Using pairwise t-tests, large and statistically significant improvements were observed on most measures across 1 week. However, the observed follow-up scores were consistently below expectation compared with predictions based on Duff's SRB algorithms. In individual analyses, a greater percentage of MCI participants showed smaller-than-expected practice effects based on normal distributions. In secondary analyses, smaller-than-expected practice effects were observed in participants with worse baseline memory impairment and a greater number of impaired cognitive domains, particularly for measures of executive functioning/speeded processing. CONCLUSIONS These findings help to further support the validity of Duff's 1-week SRB prediction equations in MCI samples and extend previous research by showing incrementally smaller-than-expected benefit from practice for increasingly impaired amnestic MCI subtypes.
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Affiliation(s)
- Dustin B Hammers
- Department of Neurology, Center for Alzheimer’s Care, Imaging, and Research, University of Utah
- Center on Aging, University of Utah
| | - Kayla R Suhrie
- Department of Neurology, Center for Alzheimer’s Care, Imaging, and Research, University of Utah
| | - Ava Dixon
- Department of Neurology, Center for Alzheimer’s Care, Imaging, and Research, University of Utah
| | - Sariah Porter
- Department of Neurology, Center for Alzheimer’s Care, Imaging, and Research, University of Utah
| | - Kevin Duff
- Department of Neurology, Center for Alzheimer’s Care, Imaging, and Research, University of Utah
- Center on Aging, University of Utah
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Hammers DB, Suhrie KR, Porter SM, Dixon AM, Duff K. Validation of one-year reliable change in the RBANS for community-dwelling older adults with amnestic mild cognitive impairment. Clin Neuropsychol 2020; 36:1304-1327. [PMID: 32819188 PMCID: PMC7909751 DOI: 10.1080/13854046.2020.1807058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The current study sought to externally validate previously published standardized regression-based (SRB) equations for the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Indexes administered twice over a one-year period. Method: Hammers and colleagues' SRB prediction equations were applied to two independent samples of community-dwelling older adults with amnestic Mild Cognitive Impairment (MCI), including those recruited from the community (n = 64) and those recruited from a memory disorders clinic (n = 58). Results: While Observed Baseline and Observed Follow-up performances were generally comparable for both MCI samples over one year, both samples possessed significantly lower Observed One-Year Follow-up scores than were predicted based on Hammers and colleagues' development sample across many RBANS Indexes. Relatedly, both amnestic MCI samples possessed a greater percentage of participants either "declining" or failing to exhibit a long-term practice effect over one year relative to expectation across most Indexes. Further, the clinic-recruited amnestic MCI sample displayed worse baseline performances, smaller long-term practice effects, and greater proportions of individual participants exhibiting a decline across one year relative to the community amnestic MCI sample. Conclusions: These findings validate Hammers and colleagues' SRB prediction equations by (1) indicating their ability to identify clinically meaningful change across RBANS Indexes in independent samples, and (2) discriminating rates of cognitive change among cognitively nuanced samples.
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Affiliation(s)
- Dustin B Hammers
- Center for Alzheimer's Care, Imaging, and Research, Department of Neurology, University of Utah, Salt Lake City, UT, USA.,Center on Aging, University of Utah, Salt Lake City, UT, USA
| | - Kayla R Suhrie
- Center for Alzheimer's Care, Imaging, and Research, Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - Sariah M Porter
- Center for Alzheimer's Care, Imaging, and Research, Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - Ava M Dixon
- Center for Alzheimer's Care, Imaging, and Research, Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - Kevin Duff
- Center for Alzheimer's Care, Imaging, and Research, Department of Neurology, University of Utah, Salt Lake City, UT, USA.,Center on Aging, University of Utah, Salt Lake City, UT, USA
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Jutten RJ, Grandoit E, Foldi NS, Sikkes SAM, Jones RN, Choi S, Lamar ML, Louden DKN, Rich J, Tommet D, Crane PK, Rabin LA. Lower practice effects as a marker of cognitive performance and dementia risk: A literature review. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2020; 12:e12055. [PMID: 32671181 PMCID: PMC7346865 DOI: 10.1002/dad2.12055] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/27/2020] [Accepted: 05/27/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Practice effects (PEs) are improvements in performance after repeated exposure to test materials, and typically viewed as a source of bias in repeated cognitive assessments. We aimed to determine whether characterizing PEs could also provide a useful marker of early cognitive decline. METHODS We conducted a systematic review of the literature, searching PsycInfo (Ebsco) and PubMed databases for articles studying PEs in aging and dementia populations. Articles published between 1920 and 2019 were included. RESULT We identified 259 articles, of which 27 studied PEs as markers of cognitive performance. These studies consistently showed that smaller, less-robust PEs were associated with current diagnostic status and/or future cognitive decline. In addition, lower PEs were associated with Alzheimer's disease risk factors and neurodegeneration biomarkers. CONCLUSION PEs provide a potentially useful marker of cognitive decline, and could prove valuable as part of a cost-effective strategy to select individuals who are at-risk for dementia for future interventions.
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Affiliation(s)
- Roos J. Jutten
- Alzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam UMCVrije UniversiteitAmsterdamthe Netherlands
| | | | - Nancy S. Foldi
- Queens College and The Graduate Center of The City University of New YorkQueensNew YorkUSA
| | - Sietske A. M. Sikkes
- Alzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam UMCVrije UniversiteitAmsterdamthe Netherlands
| | - Richard N. Jones
- Warren Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Seo‐Eun Choi
- School of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Melissa L. Lamar
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
| | | | - Joanne Rich
- University Libraries, University of WashingtonSeattleWashingtonUSA
| | - Douglas Tommet
- Warren Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Paul K. Crane
- School of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Laura A. Rabin
- Brooklyn College and The Graduate Center of The City University of New YorkBrooklynNew YorkUSA
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Mulligan BP, Segalowitz SJ, Hofer SM, Smart CM. A multi-timescale, multi-method perspective on older adult neurocognitive adaptability. Clin Neuropsychol 2020; 34:643-677. [DOI: 10.1080/13854046.2020.1723706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Bryce P. Mulligan
- Department of Psychology, The Ottawa Hospital, Ottawa, Ontario, Canada
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
- Institute on Aging & Lifelong Health, University of Victoria, Victoria, British Columbia, Canada
| | - Sidney J. Segalowitz
- Psychology Department, Brock University, St. Catharines, Ontario, Canada
- The Jack and Nora Walker Centre for Lifespan Development Research, Brock University, St. Catharines, Ontario, Canada
| | - Scott M. Hofer
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
- Institute on Aging & Lifelong Health, University of Victoria, Victoria, British Columbia, Canada
| | - Colette M. Smart
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
- Institute on Aging & Lifelong Health, University of Victoria, Victoria, British Columbia, Canada
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Suchy Y, Ziemnik RE, Niermeyer MA, Brothers SL. Executive functioning interacts with complexity of daily life in predicting daily medication management among older adults. Clin Neuropsychol 2019; 34:797-825. [DOI: 10.1080/13854046.2019.1694702] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Yana Suchy
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
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18
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Zoccola D, Shuttleworth-Edwards AB, Radloff SE. Signs of cognitive dysfunction in adult players of club level rugby. SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2019. [DOI: 10.1177/0081246319826816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The objective of this study was to investigate players of club level Rugby Union (hereafter rugby) over one rugby season, for signs of residual cognitive dysfunction due to repeated concussive events incurred during long-term participation in the sport. Adult male players of club level rugby, without a diagnosis of a concussion during the season ( n = 20), were compared with non-contact club level sports participants ( n = 22) of equivalent sex, age, education, and estimated IQ at pre-, mid-, and post-season intervals. Measures included the ImPACT Verbal Memory, Visual Memory, Visual Motor Speed and Reaction Time composites, and the Purdue Pegboard test. Statistical group comparisons revealed consistently poorer performance for rugby players compared with controls for ImPACT Visual Motor Speed and Reaction Time composites at all test intervals, and for the Purdue Pegboard tasks at the first two test intervals. Repeat measures comparisons across the three test intervals demonstrated differential learning patterns between groups on ImPACT Visual Memory, ImPACT Reaction Time, and Purdue Both tasks, suggestive of cognitive vulnerability in the rugby group. Overall, the results reveal deleterious cognitive performance in adult club level rugby players relative to equivalent non-contact sports controls. The finding serves to endorse indications from other studies that demonstrate persistent brain injury effects in association with long-term participation in a contact sport. Recommendations for further research and management of concussion in rugby players are discussed.
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Affiliation(s)
- Diana Zoccola
- Department of Psychology, Rhodes University, South Africa
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Deleterious Impact of Expressive Suppression on Test Performance Persists at One-Year Follow-Up in Community-Dwelling Older Adults. J Int Neuropsychol Soc 2019; 25:29-38. [PMID: 30362445 DOI: 10.1017/s1355617718000838] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Expressive suppression (ES) is an emotion-regulation strategy that is associated with poorer performance on subsequently administered tests of executive functioning (EF). It is not known, however, how far into the future ES interferes with EF. This study examined whether (a) ES negatively affects performance on EF tests repeated 1 year after the initial administration (presumably through interference with learning, leading to a reduced practice effect), and (b) whether such an effect, if seen, is unique to EF or whether it also affects lower-order cognitive processes needed for EF test performance. METHODS Sixty-six non-demented community-dwelling older adults were randomly assigned to either an ES group or control group. Executive and non-executive tests were administered before and immediately following the exposure to an emotionally evocative video, and then again at 1-year follow-up. Groups were compared at 1-year follow-up on tests of EF and lower-order processes, to examine whether the previously demonstrated impact of ES on EF is evident only immediately following the experimental manipulation (Franchow & Suchy, 2017), or also at 1-year follow-up. RESULTS The results showed that participants who engaged in ES continued to exhibit poorer performance on EF tests 1 year later. This effect was not present for performance on tests of lower-order processes. CONCLUSIONS These results suggest that the use of ES before an EF task can interfere with the ability to benefit from exposure to that task, thereby negatively affecting future performance. (JINS, 2019, 25, 29-38).
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Cysique LA, Casaletto KB, Heaton RK. Reliably Measuring Cognitive Change in the Era of Chronic HIV Infection and Chronic HIV-Associated Neurocognitive Disorders. Curr Top Behav Neurosci 2019; 50:271-298. [PMID: 31559600 DOI: 10.1007/7854_2019_116] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
HIV infection has become a chronic disease managed across the life span. In this context, the cognitive health of HIV infection needs to have methods for monitoring over time, in order to better anticipate HIV-associated neurocognitive disorder (HAND) trajectories in relation to biomarkers, and predict prognosis and especially the risk of dementia as People Living with HIV (PLHIV) age. In this chapter, we critically review several statistical frameworks to quantify cognitive change. We then provide a critical review of naturalistic longitudinal studies and selected randomized clinical trials assessing neurocognitive change as a primary outcome in PLHIV, conducted since the advent of the combined antiretroviral therapy era (censored January 2019). Doing so, we distinguish between PLHIV who were treated early and did not experience AIDS (CDC 1993), versus treated late, after experiencing AIDS and more severe immune compromise. Highlighting strengths and limitations of these studies, we emphasize that issues of reliability pertaining to the use of neuropsychological tests need careful consideration for the robust quantification of cognitive change, including measurement error, practice effect, inter-individual variability, baseline level of functioning, demographic effects, timeframe between testing intervals, normative longitudinal data, and operationalization of clinically meaningful neurocognitive change. In addition, issues pertaining to longitudinal analyses including type, amount and pattern of missing data and/or participant attrition, regression toward the mean, and survivor bias need to be properly addressed. We conclude by proposing future research directions with emphasis on research translation to clinical participants.
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Affiliation(s)
- Lucette A Cysique
- Faculty of Medicine, Neuroscience Research Australia, School of Medical Sciences, The University of New South Wales, Sydney, Sydney, NSW, Australia.
| | - Kaitlin B Casaletto
- Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Robert K Heaton
- Department of Psychiatry, UCSD School of Medicine, La Jolla, CA, USA
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Schaefer SY, Saba A, Baird JF, Kolar MB, Duff K, Stewart JC. Within-Session Practice Effects in the Jebsen Hand Function Test (JHFT). Am J Occup Ther 2018; 72:7206345010p1-7206345010p5. [PMID: 30760402 DOI: 10.5014/ajot.2018.024745] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The Jebsen Hand Function Test (JHFT) is a standardized assessment that has been used as a clinical outcome measure. To appropriately interpret the effects of an intervention on hand function (as measured by the JHFT), the extent to which this instrument shows significant practice effects must be quantified. The purpose of this study was to determine whether the JHFT is susceptible to within-session practice effects. The results showed that the dominant and nondominant hands significantly improved on the JHFT and many of its subtests over six consecutive trials. Although practice effects might complicate the interpretation of change due to intervention, we briefly relate our findings to emerging neuropsychological evidence that practice effects may indicate a person's motor learning potential or treatment responsiveness.
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Affiliation(s)
- Sydney Y Schaefer
- Sydney Y. Schaefer, PhD, is Assistant Professor, School of Biological and Health Systems Engineering, Arizona State University, Tempe, and Adjunct Assistant Professor, Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City;
| | - Ashley Saba
- Ashley Saba, DPT, was Doctoral Candidate, Physical Therapy Program, Department of Exercise Science, University of South Carolina, Columbia, at the time of the study
| | - Jessica F Baird
- Jessica F. Baird, PhD, is Postdoctoral Fellow, Physical Therapy Program, Department of Exercise Science, University of South Carolina, Columbia, and Department of Physical Therapy, University of Alabama, Birmingham. She collaborated on this research while she was at the University of South Carolina, Columbia
| | - Melissa B Kolar
- Melissa B. Kolar, PhD, was Doctoral Candidate, Physical Therapy Program, Department of Exercise Science, University of South Carolina, Columbia, at the time of the study
| | - Kevin Duff
- Kevin Duff, PhD, is Professor, Department of Neurology and Center for Alzheimer's Care, Imaging, and Research, University of Utah, Salt Lake City
| | - Jill C Stewart
- Jill C. Stewart, PhD, PT, is Assistant Professor, Physical Therapy Program, Department of Exercise Science, University of South Carolina, Columbia
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Duff K, Anderson JS, Mallik AK, Suhrie KR, Atkinson TJ, Dalley BCA, Morimoto SS, Hoffman JM. Short-term repeat cognitive testing and its relationship to hippocampal volumes in older adults. J Clin Neurosci 2018; 57:121-125. [PMID: 30143414 DOI: 10.1016/j.jocn.2018.08.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 08/13/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND Practice effects are improvements in cognitive test scores due to repeated exposure to testing materials. If practice effects provide information about Alzheimer's disease pathology, then they could be useful for clinical trials enrichment. The current study sought to add to the limited literature on short-term practice effects on cognitive tests and their relationship to neuroimaging biomarkers. METHODS Twenty-five, non-demented older adults (8 cognitively intact, 17 with mild cognitive impairment) received magnetic resonance imaging and two testing sessions across one week to determine practice effects on seven neuropsychological test scores. A series of correlations examined if hippocampal volume was associated with baseline, one-week, or practice effects scores on these tests. Next, a series of stepwise multiple regression models examined which of the three test scores best predicted hippocampal volumes RESULTS: In the correlation analysis, baseline scores on 5 of the 7 tests were significantly associated with hippocampal volumes, one week scores were significantly related for 7 of the 7 tests, and practice effects scores were significantly correlated for 4 of the 7 tests. In the stepwise regression models, 5 of the 7 tests indicated that one-week scores best predicted hippocampal volumes. For the other models, baseline score and practice effects score each best predicted hippocampal volume. CONCLUSIONS These results add to the growing body of evidence suggesting that diminished practice effects on short-term repeat testing is related to neuroimaging biomarkers of Alzheimer's disease and may serve as a screening tool for clinical practice and to enrich samples for research trials.
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Affiliation(s)
- Kevin Duff
- Center for Alzheimer's Care, Imaging and Research, Department of Neurology, University of Utah, United States.
| | | | - Atul K Mallik
- Department of Radiology, University of Utah, United States
| | - Kayla R Suhrie
- Center for Alzheimer's Care, Imaging and Research, Department of Neurology, University of Utah, United States
| | - Taylor J Atkinson
- Center for Alzheimer's Care, Imaging and Research, Department of Neurology, University of Utah, United States
| | - Bonnie C A Dalley
- Center for Alzheimer's Care, Imaging and Research, Department of Neurology, University of Utah, United States
| | | | - John M Hoffman
- Department of Radiology, University of Utah, United States; Huntsman Cancer Institute, University of Utah, United States
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Suchy Y, Franchow EI, Niermeyer MA, Ziemnik RE, Williams PG, Pennington NN. Exaggerated reaction to novelty as a predictor of incipient cognitive decline among community-dwelling older adults. J Clin Exp Neuropsychol 2018; 40:987-999. [PMID: 30112978 DOI: 10.1080/13803395.2018.1457627] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE The ability to detect covert markers of incipient cognitive decline among older adults before cognitive decline becomes overtly evident on traditional cognitive tests represents an important topic of research. Exaggerated reactions to novelty, reflected in novelty-induced increases in action planning latencies ("novelty effect"; NE) and low openness to experience (openness), have been previously associated with incipient cognitive decline among older adults who appeared cognitively normal at baseline. The purposes of the present study were to extend prior research on the utility of these markers by examining whether (a) NE and openness each predict cognitive change uniquely, and (b) whether these indices predict cognitive change above and beyond measures of memory, executive functions, processing speed/efficiency, premorbid IQ, and depressive symptoms. METHOD Sixty-one cognitively normal community-dwelling older adults were administered a battery of tests assessing the relevant constructs at baseline and one-year follow up. Changes in cognitive status were assessed using the Demetia Rating Scale, 2nd Edition, NE was assessed using the Push-Turn-Taptap task (an electronic motor sequence learning task), and openness using the NEO Personality Inventory-Revised. The Test of Premorbid Functioning, and subtests from Repeatable Battery for the Assessment of Neuropsychological Status, Delis-Kaplan Executive Function System, and Wechsler Adult Intelligence Scale, 4th Edition, were used for additional assessment of baseline cognition. Depressive symptoms were assessed using the Geriatric Depression Scale. RESULTS Results confirmed our hypothesis that both NE and openness contribute to prediction of cognitive change beyond baseline cognition and depressive symptoms, but none of the covariates (i.e., depression, executive functions, processing efficiency, or memory) themselves contributed to the model. NE and openness each contributed unique variance and were independent of each other. CONCLUSIONS Openness and NE have the potential to provide evidence-based methods for estimating risk of future cognitive change in persons with currently normal standardized test scores.
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Affiliation(s)
- Yana Suchy
- a Department of Psychology , University of Utah , Salt Lake City , UT , USA
| | - Emilie I Franchow
- a Department of Psychology , University of Utah , Salt Lake City , UT , USA.,b Behavioral Healthcare Line , New Mexico Veterans Affairs Health Care System , Albuquerque , NM , USA
| | | | - Rosemary E Ziemnik
- a Department of Psychology , University of Utah , Salt Lake City , UT , USA
| | - Paula G Williams
- a Department of Psychology , University of Utah , Salt Lake City , UT , USA
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Niermeyer MA, Ziemnik RE, Franchow EI, Barron CA, Suchy Y. Greater naturally occurring expressive suppression is associated with poorer executive functioning and motor-sequence learning among older adults. J Clin Exp Neuropsychol 2018; 41:118-132. [PMID: 30102116 DOI: 10.1080/13803395.2018.1502257] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Objectives: Unusually high engagement in expressive suppression (i.e., purposeful regulation of overt affect) has been associated with poorer performance on executive functioning (EF) and motor-sequence learning tasks. As such, expressive suppression represents one possible source of fluctuations in executive test performance. However, the relationship between expressive suppression and EF and motor performance has not yet been examined in older adults, who are more prone to EF and motor fluctuations than are younger adults. The purpose of this study was to test whether greater self-reported, naturally occurring expressive suppression is related to poorer EF performance and motor-sequence learning in older adults. Method: One hundred and ten community-dwelling older adults completed a self-report measure of expressive suppression, a battery of EF tests, and a computer-based measure of motor-sequence learning. Results: As expected, higher self-reported burden of expressive suppression in the 24 hours prior to testing was related to poorer performance on EF tests and on multiple aspects of motor-sequence learning (action planning latencies and sequencing errors) even after accounting for age, depressive symptoms, and component processes (e.g., processing speed). Conclusions: The current results suggest that naturally occurring expressive suppression depletes EF, which builds on previous findings from experimental studies that show that expressive suppression leads to reduced EF performance. Furthermore, this effect can be captured using self-report methods. These findings highlight expressive suppression as one source of intraindividual fluctuations in executive and motor functioning, which likely place older adults at risk for both functional and motor lapses (e.g., medication mistakes, falls).
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Affiliation(s)
| | - Rosemary E Ziemnik
- a Department of Psychology , University of Utah , Salt Lake City , UT , USA
| | - Emilie I Franchow
- b Behavioral Healthcare Line , New Mexico Veterans Affairs Health Care System , Albuquerque , NM , USA
| | - Casey A Barron
- a Department of Psychology , University of Utah , Salt Lake City , UT , USA
| | - Yana Suchy
- a Department of Psychology , University of Utah , Salt Lake City , UT , USA
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Oh SJ, Seo S, Lee JH, Song MJ, Shin MS. Effects of smartphone-based memory training for older adults with subjective memory complaints: a randomized controlled trial. Aging Ment Health 2018; 22:526-534. [PMID: 28071929 DOI: 10.1080/13607863.2016.1274373] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES We explored whether newly developed application (Smartphone-based brain Anti-aging and memory Reinforcement Training, SMART) improved memory performance in older adults with subjective memory complaints (SMC). METHOD A total of 53 adults (range: 50-68 years; 52.8% female) were randomized into either one of two intervention groups [SMART (n = 18) vs. Fit Brains® (n = 19)] or a wait-list group (n = 16). Participants in the intervention groups underwent 15-20 minutes of training per day, five days per week for 8 weeks. We used objective cognitive measures to evaluate changes with respect to four domains: attention, memory, working memory (WM), and response inhibition. In addition, we included self-report questionnaires to assess levels of SMC, depression, and anxiety. RESULTS Total WM quotient [t(17) = 6.27, p < .001] as well as auditory-verbal WM score [t(17) = 4.45, p < .001] increased significantly in the SMART group but not in the control groups. Self-reports of memory contentment, however, increased in the Fit Brains® group only [t(18) = 2.12, p < .05). CONCLUSION Use of an 8-week smartphone-based memory training program may improve WM function in older adults. However, objective improvement in performance does not necessarily lead to decreased SMC.
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Affiliation(s)
- Seo Jin Oh
- a Department of Clinical Medical Sciences , Seoul National University College of Medicine , Seoul , Korea
| | - Sungmin Seo
- b Department of Neuropsychiatry , Seoul National University Hospital , Seoul , Korea
| | - Ji Hyun Lee
- c Division of Child & Adolescent Psychiatry, Department of Neuropsychiatry , Seoul National University Hospital , Seoul , Korea
| | - Myeong Ju Song
- b Department of Neuropsychiatry , Seoul National University Hospital , Seoul , Korea
| | - Min-Sup Shin
- b Department of Neuropsychiatry , Seoul National University Hospital , Seoul , Korea.,c Division of Child & Adolescent Psychiatry, Department of Neuropsychiatry , Seoul National University Hospital , Seoul , Korea.,d Department of Psychiatry and Behavioral Science , Seoul National University College of Medicine , Seoul , Korea
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26
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Lingo VanGilder J, Hengge CR, Duff K, Schaefer SY. Visuospatial function predicts one-week motor skill retention in cognitively intact older adults. Neurosci Lett 2017; 664:139-143. [PMID: 29154858 DOI: 10.1016/j.neulet.2017.11.032] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 11/08/2017] [Accepted: 11/13/2017] [Indexed: 10/18/2022]
Abstract
Motor learning declines with aging, such that older adults retain less motor skill after practice compared to younger adults. However, it remains unclear if these motor learning declines are related to normal cognitive changes associated with aging. The purpose of this study was to examine which cognitive domains would best predict the amount of retention on a motor task one week after training in cognitively intact older adults. Twenty-one adults ages 65-84 years old were assessed with Repeatable Battery for the Assessment of Neuropsychological Status, which assesses five cognitive domains (immediate and delayed memory, visuospatial/constructional, language, and attention). Participants also completed one training session of a functional upper extremity task, and were re-tested one week later. Stepwise regression indicated that the visuospatial domain was the only significant predictor of how much skill participants retained over one week, with a visual perception subtest explaining the most variance. Results from this study support previous work reporting that older adults' capacity for motor learning can be probed with visuospatial tests. These tests may capture the structural or functional health of neural networks critical for skill learning within the aging brain, and provide valuable clinical insight about an individual's unique rehabilitation potential.
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Affiliation(s)
- Jennapher Lingo VanGilder
- School of Biological and Health Systems Engineering, 501 E. Tyler Mall, ECG 334A, Arizona State University, Tempe, AZ 85287, USA
| | - Caitlin R Hengge
- University of Utah Hospital, 50 N. Medical Dr., Salt Lake City, UT, 84112, USA
| | - Kevin Duff
- Center for Alzheimer's Care, Imaging and Research, University of Utah Health Sciences Center, 650 Komas Dr. 106A, Salt Lake City UT 84108-1225, USA; Department of Neurology, University of Utah, 175 N. Medical Dr. E., Salt Lake City, UT 84132, USA
| | - Sydney Y Schaefer
- School of Biological and Health Systems Engineering, 501 E. Tyler Mall, ECG 334A, Arizona State University, Tempe, AZ 85287, USA.
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Schaefer SY, Duff K. Within-session and one-week practice effects on a motor task in amnestic mild cognitive impairment. J Clin Exp Neuropsychol 2017; 39:473-484. [PMID: 27690745 PMCID: PMC5453647 DOI: 10.1080/13803395.2016.1236905] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Practice effects on neuropsychological tests, which are improvements in test scores due to repeated exposure to testing materials, are robust in healthy elders, but muted in older adults with cognitive disorders. Conversely, few studies have investigated practice effects on motor tasks involving procedural memory, particularly across test-retest periods exceeding 24 hours. The current study examined one-week practice effects on a novel upper extremity motor task in 54 older adults with amnestic mild cognitive impairment. Results indicate that these individuals with primary memory deficits did improve on this motor task within a brief training session as well as across one week. These practice effects were unrelated to demographic characteristics or global cognition. One-week practice effects were, however, negatively related to delayed memory function, with larger practice effects being associated with poorer delayed memory and potentially better visuospatial ability. The presence of longer term practice effects on a procedural motor task not only has implications for how longitudinal assessments with similar measures involving implicit memory might be interpreted, but may also inform future rehabilitative strategies for patients with more severe declarative memory deficits.
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Affiliation(s)
- Sydney Y. Schaefer
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ
- Center on Aging, University of Utah, Salt Lake City, UT, USA
| | - Kevin Duff
- Center on Aging, University of Utah, Salt Lake City, UT, USA
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
- Center for Alzheimer’s Care, Imaging and Research, University of Utah, Salt Lake City, UT, USA
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Libert Y, Borghgraef C, Beguin Y, Delvaux N, Devos M, Doyen C, Dubruille S, Etienne AM, Liénard A, Merckaert I, Reynaert C, Slachmuylder JL, Straetmans N, Van Den Neste E, Bron D, Razavi D. Cognitive compensatory processes of older, clinically fit patients with hematologic malignancies undergoing chemotherapy: A longitudinal cohort study. Psychooncology 2017; 26:2086-2093. [PMID: 28316129 DOI: 10.1002/pon.4424] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 03/06/2017] [Accepted: 03/15/2017] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Despite the well-known negative impacts of cancer and anticancer therapies on cognitive performance, little is known about the cognitive compensatory processes of older patients with cancer. This study was designed to investigate the cognitive compensatory processes of older, clinically fit patients with hematologic malignancies undergoing chemotherapy. METHODS We assessed 89 consecutive patients (age ≥ 65 y) without severe cognitive impairment and 89 age-, sex-, and education level-matched healthy controls. Cognitive compensatory processes were investigated by (1) comparing cognitive performance of patients and healthy controls in novel (first exposure to cognitive tasks) and non-novel (second exposure to the same cognitive tasks) contexts, and (2) assessing psychological factors that may facilitate or inhibit cognitive performance, such as motivation, psychological distress, and perceived cognitive performance. We assessed cognitive performance with the Trail-Making, Digit Span and FCSR-IR tests, psychological distress with the Hospital Anxiety and Depression Scale, and perceived cognitive performance with the FACT-Cog questionnaire. RESULTS In novel and non-novel contexts, average cognitive performances of healthy controls were higher than those of patients and were associated with motivation. Cognitive performance of patients was not associated with investigated psychological factors in the novel context but was associated with motivation and psychological distress in the non-novel context. CONCLUSIONS Older, clinically fit patients with hematologic malignancies undergoing chemotherapy demonstrated lower cognitive compensatory processes compared to healthy controls. Reducing distress and increasing motivation may improve cognitive compensatory processes of patients in non-novel contexts.
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Affiliation(s)
- Yves Libert
- Université Libre de Bruxelles, Brussels, Belgium
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Abstract
OBJECTIVES Accurate detection of executive dysfunction in neuropsychological assessments is complicated by the fact that executive functioning (EF) is vulnerable to temporary disruption (i.e., lapses), with more frequent lapses in older adulthood. Effortful regulation of affect (i.e., expressive suppression) is a well-known source of executive lapses in younger adults, but the generalizability of this depleting effect to older adults is unknown. The purpose of this study was to (1) determine whether EF is subject to depletion via expressive suppression and (2) to examine whether this effect is unique to EF, or whether it also applies to lower-order component processes in older adults. METHODS Ninety-seven non-demented, community-dwelling older adults were randomly assigned to either an expressive suppression group or control group. We compared performance of the groups on a battery of tests measuring EF and component processes both before and after exposure to emotionally evocative stimuli. RESULTS Consistent with the hypothesized depletion effect, suppressing participants showed an attenuated practice effect on post-manipulation EF relative to controls, while performance on lower-order component processes was unaffected by suppression. CONCLUSIONS These results suggest that depletion contributes to executive lapses in older adulthood. (JINS, 2017, 23, 341-351).
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Niermeyer MA, Suchy Y, Ziemnik RE. Motor sequencing in older adulthood: relationships with executive functioning and effects of complexity. Clin Neuropsychol 2016; 31:598-618. [DOI: 10.1080/13854046.2016.1257071] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - Yana Suchy
- Department of Psychology, The University of Utah, Salt Lake City, UT, USA
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Motter JN, Devanand DP, Doraiswamy PM, Sneed JR. Clinical Trials to Gain FDA Approval for Computerized Cognitive Training: What Is the Ideal Control Condition? Front Aging Neurosci 2016; 8:249. [PMID: 27853432 PMCID: PMC5089995 DOI: 10.3389/fnagi.2016.00249] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 10/12/2016] [Indexed: 11/26/2022] Open
Affiliation(s)
- Jeffrey N Motter
- The Graduate Center, City University of New YorkNew York, NY, USA; Queens College, City University of New YorkNew York, NY, USA
| | - Davangere P Devanand
- Division of Geriatric Psychiatry, Columbia University and the New York State Psychiatric Institute New York, NY, USA
| | - P Murali Doraiswamy
- Duke Medicine and Duke Institute for Brain Sciences, Duke University Durham, NC, USA
| | - Joel R Sneed
- The Graduate Center, City University of New YorkNew York, NY, USA; Queens College, City University of New YorkNew York, NY, USA; Division of Geriatric Psychiatry, Columbia University and the New York State Psychiatric InstituteNew York, NY, USA
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Duff K, Atkinson TJ, Suhrie KR, Dalley BCA, Schaefer SY, Hammers DB. Short-term practice effects in mild cognitive impairment: Evaluating different methods of change. J Clin Exp Neuropsychol 2016; 39:396-407. [PMID: 27646966 DOI: 10.1080/13803395.2016.1230596] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Practice effects are improvements on cognitive tests as a result of repeated exposure to testing material. However, variability exists in the literature about whether patients with amnestic mild cognitive impairment (MCI) display practice effects, which may be partially due to the methods used to calculate these changes on repeated tests. The purpose of the current study was to examine multiple methods of assessing short-term practice effects in 58 older adults with MCI. The cognitive battery, which included tests of memory (Hopkins Verbal Learning Test-Revised and Brief Visuospatial Memory Test-Revised) and processing speed (Symbol Digit Modalities Test and Trail Making Test Parts A and B), was administered twice across one week. Dependent t tests showed statistically significant improvement on memory scores (ps < .01, ds = 0.8-1.3), but not on processing speed scores. Despite this, the sample showed no clinically meaningful improvement on any cognitive scores using three different reliable change indices. Regression-based change scores did identify relatively large groups of participants who showed smaller than expected practice effects, which may indicate that this method is more sensitive in identifying individuals who may portend a declining trajectory. Practice effects remain a complex construct, worthy of continued investigation in diverse clinical conditions.
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Affiliation(s)
- Kevin Duff
- a Department of Neurology, Center for Alzheimer's Care, Imaging and Research , University of Utah , Salt Lake City , UT , USA.,b Center on Aging , University of Utah , Salt Lake City , UT , USA
| | - Taylor J Atkinson
- a Department of Neurology, Center for Alzheimer's Care, Imaging and Research , University of Utah , Salt Lake City , UT , USA
| | - Kayla R Suhrie
- a Department of Neurology, Center for Alzheimer's Care, Imaging and Research , University of Utah , Salt Lake City , UT , USA
| | - Bonnie C Allred Dalley
- a Department of Neurology, Center for Alzheimer's Care, Imaging and Research , University of Utah , Salt Lake City , UT , USA
| | - Sydney Y Schaefer
- b Center on Aging , University of Utah , Salt Lake City , UT , USA.,c School of Biological and Health Systems Engineering , Arizona State University , Tempe , AZ , USA
| | - Dustin B Hammers
- a Department of Neurology, Center for Alzheimer's Care, Imaging and Research , University of Utah , Salt Lake City , UT , USA.,b Center on Aging , University of Utah , Salt Lake City , UT , USA
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Abstract
Objectives Growing evidence demonstrates that (a) executive functioning (EF) becomes deleteriously affected by engagement in the emotion regulation strategy known as expressive suppression and (b) EF shows considerable functional and neuroanatomical overlap with motor output. The current study aimed to bridge these two literatures by examining the relationships between naturally occurring expressive suppression and several different aspects of motor output, including action planning, action learning, and motor-control speed and accuracy. In addition, we investigated whether any identified relationships could be explained by EF. Methods Fifty-one healthy young adults completed selected subtests from the Delis-Kaplan Executive Function System as indices of EF, a self-report measure of expressive suppression, and a computerized motor sequencing task (Push Turn Taptap task; PTT) designed to assess action planning, action learning, and motor control speed and accuracy. Results Hierarchical regressions using each aspect of PTT performance as the dependent variable revealed that higher than usual self-reported expressive suppression on the day of testing (relative to the 2 weeks preceding testing) was associated with longer action-planning latencies. This relationship was fully explained by EF. No other PTT variables related to expressive suppression on the day of testing. Conclusions These results suggest that increased expressive suppression in daily life is associated with slower action planning, an aspect of motor output that is reliant on EF, highlighting the importance of factors that lead to intra-individual fluctuations in EF and motor performance. (JINS, 2016, 22, 671-681).
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Neuropsychological Practice Effects in the Context of Cognitive Decline: Contributions from Learning and Task Novelty. J Int Neuropsychol Soc 2016; 22:453-66. [PMID: 26790693 DOI: 10.1017/s1355617715001332] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Although cognitive decline is typically associated with decreasing practice effects (PEs) (presumably due to declining memory), some studies show increased PEs with declines in cognition. One explanation for these inconsistencies is that PEs reflect not only memory, but also rebounds from adapting to task novelty (i.e., novelty effect), leading to increased PEs. We examined a theoretical model of relationships among novelty effects, memory, cognitive decline, and within-session PEs. Sixty-six older adults ranging from normal to severely impaired completed measures of memory, novelty effects, and two trials each of Wechsler Adult Intelligence Scale, 4 th Edition Symbol Search and Coding. Interrelationships among variables were examined using regression analyses. PEs for Symbol Search and Coding (a) were related to different proposed PE components (i.e., memory and novelty effects), such that novelty effect predicted Symbol Search PE (R2 =.239, p<.001) and memory predicted Coding PE (R2 =.089, p=.015), and (b) showed different patterns across stages of cognitive decline, such that the greatest cognitive decline was associated with smallest Coding PE (R2 =.125, p=.004), whereas intermediate cognitive decline was associated with the greatest Symbol Search PE (R2 =.097, p=.040). The relationship between cognitive decline and PE for Symbol Search was partially mediated by novelty effect among older adults with abnormal cognitive decline (model R2 =.286, p<.001). These findings (a) suggest that PE is not a unitary construct, (b) offer an explanation for contradictory findings in the literature, and (c) highlight the need for a better understanding of component processes of PE across different neuropsychological measures.
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Duff K, Horn KP, Foster NL, Hoffman JM. Short-Term Practice Effects and Brain Hypometabolism: Preliminary Data from an FDG PET Study. Arch Clin Neuropsychol 2016; 30:264-70. [PMID: 25908614 DOI: 10.1093/arclin/acv018] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Practice effects are improvements in cognitive test scores due to repeated exposure to the same tests. Typically viewed as error, short-term practice effects have been shown to provide valuable clinical information about diagnosis, prognosis, and treatment outcomes in older patients with mild cognitive impairments. This study examined short-term practice effects across one week and brain hypometabolism on fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) in 25 older adults (15 intact, 10 Mild Cognitive Impairment). Averaged cerebral brain metabolism on FDG PET was correlated with multiple cognitive scores at baseline in those with Mild Cognitive Impairment, and short-term practice effects accounted for additional variance in these same subjects. The relationship between brain metabolism and cognition (either at baseline or practice effects) was minimal in the intact individuals. Although needing replication in larger samples, short-term practice effects on tests of executive functioning and memory may provide valuable information about biomarkers of Alzheimer's disease.
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Affiliation(s)
- Kevin Duff
- Center for Alzheimer's Care, Imaging, and Research, Department of Neurology, University of Utah, Salt Lake City, USA
| | - Kevin P Horn
- Center for Quantitative Cancer Imaging, Huntsman Cancer Institute, University of Utah, Salt Lake City, USA
| | - Norman L Foster
- Center for Alzheimer's Care, Imaging, and Research, Department of Neurology, University of Utah, Salt Lake City, USA
| | - John M Hoffman
- Center for Quantitative Cancer Imaging, Huntsman Cancer Institute, University of Utah, Salt Lake City, USA
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Schaefer SY, Duff K. Rapid Responsiveness to Practice Predicts Longer-Term Retention of Upper Extremity Motor Skill in Non-Demented Older Adults. Front Aging Neurosci 2015; 7:214. [PMID: 26635601 PMCID: PMC4649025 DOI: 10.3389/fnagi.2015.00214] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 11/02/2015] [Indexed: 11/13/2022] Open
Abstract
Skill acquisition is a form of motor learning that may provide key insights into the aging brain. Although previous work suggests that older adults learn novel motor tasks slower and to a lesser extent than younger adults, we have recently demonstrated no significant effect of chronological age on the rates and amounts of skill acquisition, nor on its long-term retention, in adults over the age of 65. To better understand predictors of skill acquisition in non-demented older adults, we now explore the relationship between early improvements in motor performance due to practice (i.e., rapid responsiveness) and longer-term retention of an upper extremity motor skill, and whether the extent of rapid responsiveness was associated with global cognitive status. Results showed significant improvements in motor performance within the first five (of 150) trials, and that this “rapid responsiveness” was predictive of skill retention 1 month later. Notably, the extent of rapid responsiveness was not dependent on global cognitive status, as measured by the Montreal Cognitive Assessment (MoCA). Thus, rapid responsiveness appears to be an important variable in longer-term neurorehabilitative efforts with older adults, regardless of their cognitive status.
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Affiliation(s)
- Sydney Y Schaefer
- Motor Rehabilitation and Learning Laboratory, Utah State University Logan, UT, USA ; Department of Physical Therapy, University of Utah Salt Lake City, UT, USA ; Center on Aging, University of Utah Salt Lake City, UT, USA
| | - Kevin Duff
- Center on Aging, University of Utah Salt Lake City, UT, USA ; Department of Neurology, University of Utah Salt Lake City, UT, USA ; Center for Alzheimer's Care, Imaging and Research, University of Utah Salt Lake City, UT, USA
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Age Moderates the Association of Aerobic Exercise with Initial Learning of an Online Task Requiring Cognitive Control. J Int Neuropsychol Soc 2015; 21:802-15. [PMID: 26581792 DOI: 10.1017/s1355617715000685] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The aim of this study was to examine whether people differed in change in performance across the first five blocks of an online flanker task and whether those trajectories of change were associated with self-reported aerobic or resistance exercise frequency according to age. A total of 8752 men and women aged 13-89 completed a lifestyle survey and five 45-s games (each game was a block of ~46 trials) of an online flanker task. Accuracy of the congruent and incongruent flanker stimuli was analyzed using latent class and growth curve modeling adjusting for time between blocks, whether the blocks occurred on the same or different days, education, smoking, sleep, caffeinated coffee and tea use, and Lumosity training status ("free play" or part of a "daily brain workout"). Aerobic and resistance exercise were unrelated to first block accuracies. For the more cognitively demanding incongruent flanker stimuli, aerobic activity was positively related to the linear increase in accuracy [B=0.577%, 95% confidence interval (CI), 0.112 to 1.25 per day above the weekly mean of 2.8 days] and inversely related to the quadratic deceleration of accuracy gains (B=-0.619% CI, -1.117 to -0.121 per day). An interaction of aerobic activity with age indicated that active participants younger than age 45 had a larger linear increase and a smaller quadratic deceleration compared to other participants. Age moderates the association between self-reported aerobic, but not self-reported resistance, exercise and changes in cognitive control that occur with practice during incongruent presentations across five blocks of a 45-s online, flanker task.
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Practice effects and amyloid deposition: preliminary data on a method for enriching samples in clinical trials. Alzheimer Dis Assoc Disord 2015; 28:247-52. [PMID: 24614265 DOI: 10.1097/wad.0000000000000021] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Clinical trials in Alzheimer disease are moving toward prevention studies in prodromal individuals with amyloid burden. However, methods are needed to identify individuals expected to be amyloid positive for these studies to be feasible and cost-effective. The current study sought to determine whether short-term practice effects on cognitive tests can identify those with notable uptake on amyloid imaging. Twenty-five, nondemented older adults (15 cognitively intact, 10 with mild cognitive impairment) underwent amyloid imaging through F-flutemetamol and 2 cognitive testing sessions across 1 week to determine practice effects on a visual memory test. Results indicated that, whereas F-flutemetamol uptake showed little association with baseline performance on a visual memory test (r=-0.04, P=0.85), it was significantly correlated with practice effects across 1 week on that same memory measure (r=-0.45, P=0.02), with greater uptake being associated with lower practice effects. The odds ratio of notable F-flutemetamol uptake was 5 times higher in individuals with low practice effects compared with high practice effects. Although these preliminary results need to be replicated in larger samples, short-term practice effects on cognitive tests may provide an affordable screening method to identify individuals who are amyloid positive, which could enrich samples for preventative clinical trials in Alzheimer disease.
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Jackson SA, Kleitman S, Aidman E. Low cognitive load and reduced arousal impede practice effects on executive functioning, metacognitive confidence and decision making. PLoS One 2014; 9:e115689. [PMID: 25549327 PMCID: PMC4280140 DOI: 10.1371/journal.pone.0115689] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 11/27/2014] [Indexed: 12/01/2022] Open
Abstract
The present study investigated the effects of low cognitive workload and the absence of arousal induced via external physical stimulation (motion) on practice-related improvements in executive (inhibitory) control, short-term memory, metacognitive monitoring and decision making. A total of 70 office workers performed low and moderately engaging passenger tasks in two successive 20-minute simulated drives and repeated a battery of decision making and inhibitory control tests three times – before, between and after these drives. For half the participants, visual simulation was synchronised with (moderately arousing) motion generated through LAnd Motion Platform, with vibration levels corresponding to a well-maintained unsealed road. The other half performed the same simulated drive without motion. Participants’ performance significantly improved over the three test blocks, which is indicative of typical practice effects. The magnitude of these improvements was the highest when both motion and moderate cognitive load were present. The same effects declined either in the absence of motion (low arousal) or following a low cognitive workload task, thus suggesting two distinct pathways through which practice-related improvements in cognitive performance may be hampered. Practice, however, degraded certain aspects of metacognitive performance, as participants became less likely to detect incorrect decisions in the decision-making test with each subsequent test block. Implications include consideration of low cognitive load and arousal as factors responsible for performance decline and targets for the development of interventions/strategies in low load/arousal conditions such as autonomous vehicle operations and highway driving.
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Affiliation(s)
- Simon A. Jackson
- School of Psychology, University of Sydney, Sydney, Australia
- * E-mail:
| | - Sabina Kleitman
- School of Psychology, University of Sydney, Sydney, Australia
| | - Eugene Aidman
- Land Division, Defence Science and Technology Organisation, Adelaide, South Australia, Australia
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Gidley Larson JC, Suchy Y. The contribution of verbalization to action. PSYCHOLOGICAL RESEARCH 2014; 79:590-608. [DOI: 10.1007/s00426-014-0586-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 06/04/2014] [Indexed: 11/28/2022]
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Williams PG, Suchy Y, Kraybill ML. Preliminary evidence for low openness to experience as a pre-clinical marker of incipient cognitive decline in older adults. JOURNAL OF RESEARCH IN PERSONALITY 2013. [DOI: 10.1016/j.jrp.2013.09.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Suchy Y, Lee JN, Marchand WR. Aberrant cortico–subcortical functional connectivity among women with poor motor control: Toward uncovering the substrate of hyperkinetic perseveration. Neuropsychologia 2013; 51:2130-41. [DOI: 10.1016/j.neuropsychologia.2013.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 06/12/2013] [Accepted: 07/04/2013] [Indexed: 11/28/2022]
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Sales-Galan A, Melendez-Moral JC, Mayordomo-Rodriguez T. Using a Cognitive Plasticity Measure to Detect Mild Cognitive Impairment. Arch Clin Neuropsychol 2013; 28:763-70. [DOI: 10.1093/arclin/act064] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Cognitive performance in high-altitude climbers: a comparative study of saccadic eye movements and neuropsychological tests. Eur J Appl Physiol 2013; 113:2025-37. [PMID: 23563571 DOI: 10.1007/s00421-013-2635-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 03/23/2013] [Indexed: 10/27/2022]
Abstract
Impairment of cognitive performance during and after high-altitude climbing has been described in numerous studies and has mostly been attributed to cerebral hypoxia and resulting functional and structural cerebral alterations. To investigate the hypothesis that high-altitude climbing leads to cognitive impairment, we used of neuropsychological tests and measurements of eye movement (EM) performance during different stimulus conditions. The study was conducted in 32 mountaineers participating in an expedition to Muztagh Ata (7,546 m). Neuropsychological tests comprised figural fluency, line bisection, letter and number cancellation, and a modified pegboard task. Saccadic performance was evaluated under three stimulus conditions with varying degrees of cortical involvement: visually guided pro- and anti-saccades, and visuo-visual interaction. Typical saccade parameters (latency, mean sequence, post-saccadic stability, and error rate) were computed off-line. Measurements were taken at a baseline level of 440 m and at altitudes of 4,497, 5,533, 6,265, and again at 440 m. All subjects reached 5,533 m, and 28 reached 6,265 m. The neuropsychological test results did not reveal any cognitive impairment. Complete eye movement recordings for all stimulus conditions were obtained in 24 subjects at baseline and at least two altitudes and in 10 subjects at baseline and all altitudes. Measurements of saccade performances showed no dependence on any altitude-related parameter and were well within normal limits. Our data indicates that acclimatized climbers do not seem to suffer from significant cognitive deficits during or after climbs to altitudes above 7,500 m. We demonstrated that investigation of EMs is feasible during high-altitude expeditions.
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Duff K, Callister C, Dennett K, Tometich D. Practice effects: a unique cognitive variable. Clin Neuropsychol 2012; 26:1117-27. [PMID: 23020261 DOI: 10.1080/13854046.2012.722685] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Practice effects are improvements in cognitive test performance due to repeated evaluation with the same or similar test materials. Prior studies have reported that these improvements can vary with age, education/intellect, and disease status. However, additional information is needed about variables that influence practice effects. The current study prospectively quantified short-term practice effects in 268 community-dwelling older adults and compared these practice effects to demographic variables, global cognition, premorbid intellect, depression, and individual cognitive domains. Overall, practice effects were not significantly related to most demographic and clinical characteristics or individual cognitive domains, which was contrary to our hypotheses. However, since practice effects appear to be uninfluenced by many variables that typically affect cognitive scores, they may be a unique and valuable tool that could be applied in a number of diverse patient groups.
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Affiliation(s)
- Kevin Duff
- Department of Neurology, University of Utah, Salt Lake City, UT 84108, USA.
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Neurocognitive speed and inconsistency in Parkinson's disease with and without incipient dementia: an 18-month prospective cohort study. J Int Neuropsychol Soc 2012; 18:764-72. [PMID: 22621940 PMCID: PMC3804032 DOI: 10.1017/s1355617712000422] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We examined two-wave longitudinal changes in two indicators of neurocognitive speed (i.e., mean rate, intraindividual variability) using one simple and three complex reaction time tasks. Participants included idiopathic Parkinson's disease (PD) patients, with and without incipient dementia, and normal controls. At baseline, there were 45 patients (26 men, 19 women) with idiopathic PD who ranged from 65 to 84 years (M = 71.3; SD = 4.5) and 47 matched controls (27 men, 20 women) who ranged from 65 to 84 years (M = 71.4; SD = 4.9). The 18-month longitudinal sample comprised of 74 returning participants (43 controls; 31 PD patients) who had no cognitive impairment or dementia at both waves. Ten of the 31 PD patients returning for Time 3 had dementia or cognitive impairment. These constituted the PD with incipient dementia (PDID) group. Repeated measures analyses of variance showed that the PD and PDID groups were slower over time on the reaction time tasks, whereas the controls improved their performance over time on all tasks. Inconsistency distinguished the two clinical groups (i.e., the PDID group but not the PD group became more inconsistent over time). Changes in neurocognitive speed and inconsistency may be valid clinical markers of PDID.
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Duff K. Evidence-based indicators of neuropsychological change in the individual patient: relevant concepts and methods. Arch Clin Neuropsychol 2012; 27:248-61. [PMID: 22382384 DOI: 10.1093/arclin/acr120] [Citation(s) in RCA: 271] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Repeated assessments are a relatively common occurrence in clinical neuropsychology. The current paper will review some of the relevant concepts (e.g., reliability, practice effects, alternate forms) and methods (e.g., reliable change index, standardized based regression) that are used in repeated neuropsychological evaluations. The focus will be on the understanding and application of these concepts and methods in the evaluation of the individual patient through examples. Finally, some future directions for assessing change will be described.
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Affiliation(s)
- Kevin Duff
- Center for Alzheimer's Care, Imaging, and Research, Department of Neurology, University of Utah, Salt Lake City, USA.
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Duff K, Chelune G, Dennett K. Within-session practice effects in patients referred for suspected dementia. Dement Geriatr Cogn Disord 2012; 33:245-9. [PMID: 22813981 PMCID: PMC3448265 DOI: 10.1159/000339268] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/04/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Practice effects are improvements in cognitive test performance associated with repeated administrations of same or similar measures and are traditionally seen as error variance. However, there is growing evidence that practice effects provide clinically useful information. METHODS Within-session practice effects (WISPE) across 2 h were collected from 61 non-consecutive patients referred for suspected dementia and compared to the Mini Mental Status Examination (MMSE), a screening measure of dementia severity. RESULTS In all patients, WISPE on two cognitive measures were significantly correlated with MMSE, even after controlling for baseline cognitive scores (partial r = 0.47, p < 0.001; partial r = 0.26, p = 0.046). In patients diagnosed with probable Alzheimer's disease, the trend was even stronger (partial r = 0.72, p < 0.01; partial r = 0.58, p = 0.046). In both groups, lower WISPE were associated with lower MMSE scores (i.e. greater dementia severity), even after controlling for initial cognitive scores. CONCLUSION If future research validates these findings with longitudinal studies, then WISPE may have important clinical applications in dementia evaluations.
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Affiliation(s)
- Kevin Duff
- Department of Neurology, Center for Alzheimer's Care, Imaging and Research, University of Utah, Salt Lake City, Utah 84108, USA.
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