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Kiselica AM, Karr JE, Mikula CM, Ranum RM, Benge JF, Medina LD, Woods SP. Recent Advances in Neuropsychological Test Interpretation for Clinical Practice. Neuropsychol Rev 2024; 34:637-667. [PMID: 37594687 DOI: 10.1007/s11065-023-09596-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 04/28/2023] [Indexed: 08/19/2023]
Abstract
Much attention in the field of clinical neuropsychology has focused on adapting to the modern healthcare environment by advancing telehealth and promoting technological innovation in assessment. Perhaps as important (but less discussed) are advances in the development and interpretation of normative neuropsychological test data. These techniques can yield improvement in diagnostic decision-making and treatment planning with little additional cost. Brooks and colleagues (Can Psychol 50: 196-209, 2009) eloquently summarized best practices in normative data creation and interpretation, providing a practical overview of norm development, measurement error, the base rates of low scores, and methods for assessing change. Since the publication of this seminal work, there have been several important advances in research on development and interpretation of normative neuropsychological test data, which may be less familiar to the practicing clinician. Specifically, we provide a review of the literature on regression-based normed scores, item response theory, multivariate base rates, summary/factor scores, cognitive intraindividual variability, and measuring change over time. For each topic, we include (1) an overview of the method, (2) a rapid review of the recent literature, (3) a relevant case example, and (4) a discussion of limitations and controversies. Our goal was to provide a primer for use of normative neuropsychological test data in neuropsychological practice.
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Affiliation(s)
- Andrew M Kiselica
- Department of Health Psychology, University of Missouri, 115 Business Loop 70 W, Columbia, MO, 65203, USA.
| | - Justin E Karr
- Department of Psychology, University of Kentucky, Lexington, KY, USA
| | - Cynthia M Mikula
- Institute of Human Nutrition, Columbia University, New York, NY, USA
| | - Rylea M Ranum
- Department of Health Psychology, University of Missouri, 115 Business Loop 70 W, Columbia, MO, 65203, USA
| | - Jared F Benge
- Department of Neurology, University of Texas-Austin, TX, Austin, USA
| | - Luis D Medina
- Department of Psychology, University of Houston, Houston, TX, USA
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2
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Blumberg MJ, Petersson AM, Jones PW, Jones AA, Panenka WJ, Leonova O, Vila-Rodriguez F, Lang DJ, Barr AM, MacEwan GW, Buchanan T, Honer WG, Gicas KM. Differential sensitivity of intraindividual variability dispersion and global cognition in the prediction of functional outcomes and mortality in precariously housed and homeless adults. Clin Neuropsychol 2024:1-24. [PMID: 38444068 DOI: 10.1080/13854046.2024.2325167] [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: 10/01/2023] [Accepted: 02/23/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE To examine cognitive intraindividual variability (IIV) dispersion as a predictor of everyday functioning and mortality in persons who are homeless or precariously housed. METHOD Participants were 407 community-dwelling adults, followed for up to 13 years. Neurocognition was assessed at baseline and IIV dispersion was derived using a battery of standardized tests. Functional outcomes (social, physical) were obtained at baseline and last follow-up. Mortality was confirmed with Coroner's reports and hospital records (N = 103 deaths). Linear regressions were used to predict current social and physical functioning from IIV dispersion. Repeated measures Analysis of Covariance were used to predict long-term change in functioning. Cox regression models examined the relation between IIV dispersion and mortality. Covariates included global cognition (i.e. mean-level performance), age, education, and physical comorbidities. RESULTS Higher IIV dispersion predicted poorer current physical functioning (B = -0.46 p = .010), while higher global cognition predicted better current (B = 0.21, p = .015) and change in social functioning over a period of up to 13 years (F = 4.23, p = .040). Global cognition, but not IIV dispersion, predicted mortality in individuals under 55 years old (HR = 0.50, p = .013). CONCLUSIONS Our findings suggest that indices of neurocognitive functioning (i.e. IIV dispersion and global cognition) may be differentially related to discrete dimensions of functional outcomes in an at-risk population. IIV dispersion may be a complimentary marker of emergent physical health dysfunction in precariously housed adults and may be best used in conjunction with traditional neuropsychological indices.
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Affiliation(s)
| | - Anna M Petersson
- Department of Psychology, Simon Fraser University, Burnaby, Canada
| | - Paul W Jones
- Department of Psychology, Simon Fraser University, Burnaby, Canada
| | - Andrea A Jones
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - William J Panenka
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Olga Leonova
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | | | - Donna J Lang
- Department of Radiology, University of British Columbia, Vancouver, Canada
| | - Alasdair M Barr
- Department of Anesthesiology, Pharmacology, and Therapeutics, University of British Columbia, Vancouver, Canada
| | - G William MacEwan
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Tari Buchanan
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - William G Honer
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Kristina M Gicas
- Department of Psychology, York University, Toronto, Canada
- Department of Psychology, University of the Fraser Valley, Abbotsford, Canada
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Duff K, Dixon AM, Embree L, Hoffman JM. Change on the Repeatable Battery for the Assessment of Neuropsychological Status and its relationship to brain amyloid. J Clin Exp Neuropsychol 2023; 45:105-117. [PMID: 37224404 PMCID: PMC10330480 DOI: 10.1080/13803395.2023.2216920] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/13/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) has been associated with commonly used biomarkers of Alzheimer's disease (AD), including brain amyloid plaque density. However, less is known about if changes in the RBANS across time are also related to brain amyloid deposition. The current study sought to expand on prior work by examining the relationship between changes over time on the RBANS and amyloid deposition via positron emission tomography (PET). METHOD One-hundred twenty-six older adults with intact or impaired cognition and daily functioning underwent repeat assessment with the RBANS across nearly 16 months, as well as had a baseline amyloid PET scan. RESULTS In the entire sample, amyloid deposition was significantly related to change on all five Indexes and the Total Scale score of the RBANS, with greater amyloid being associated with worsening cognition. This pattern was also observed in 11 of 12 subtests. CONCLUSIONS Whereas prior studies have identified a relationship between baseline RBANS and amyloid status, the current findings support that changes in the RBANS are also indicative of AD brain pathology, even if these findings are mediated by cognitive status. Although replication in a more diverse sample is needed, these results continue to support the use of the RBANS in AD clinical trials.
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Affiliation(s)
- Kevin Duff
- Layton Aging and Alzheimer’s Disease Center, Department of Neurology, Oregon Health & Science University
- Center for Alzheimer’s Care, Imaging and Research, Department of Neurology, University of Utah
| | - Ava M. Dixon
- Center for Alzheimer’s Care, Imaging and Research, Department of Neurology, University of Utah
| | - Lindsay Embree
- Center for Alzheimer’s Care, Imaging and Research, Department of Neurology, University of Utah
| | - John M. Hoffman
- Center for Quantitative Cancer Imaging, Huntsman Cancer Institute
- Department of Radiology and Imaging Sciences, University of Utah
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4
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Duff K, Suhrie KR, Hammers DB, Dixon AM, King JB, Koppelmans V, Hoffman JM. Repeatable battery for the assessment of neuropsychological status and its relationship to biomarkers of Alzheimer's disease. Clin Neuropsychol 2023; 37:157-173. [PMID: 34713772 PMCID: PMC9271322 DOI: 10.1080/13854046.2021.1995050] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 10/14/2021] [Indexed: 02/07/2023]
Abstract
The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) has been associated with commonly used biomarkers of Alzheimer's disease (AD). However, prior studies have typically utilized small and poorly characterized samples, and they have not analyzed the subtests of the RBANS. The current study sought to expand on prior work by examining the relationship between the Indexes and subtest scores of the RBANS and three AD biomarkers: amyloid deposition via positron emission tomography, hippocampal volume via magnetic resonance imaging, and APOE ε4 status. One-hundred twenty-one older adults across the AD continuum (intact, amnestic Mild Cognitive Impairment, mild AD), who were mostly Caucasian and well-educated, underwent assessment with the RBANS and collection of the three biomarkers. Greater amyloid deposition was significantly related to lower scores on all five Indexes and the Total Scale score of the RBANS, as well as 11 of 12 subtests. For bilateral hippocampal volume, significant correlations were observed for 4 of the 5 Indexes, Total Scale score, and 9 of 12 subtests, with smaller hippocampi being related to lower RBANS scores. Participants with at least one APOE ε4 allele had significantly lower scores on 3 of the 5 Indexes, Total Scale score, and 8 of the 12 subtests. In this sample of participants across the dementia spectrum, most RBANS Indexes and subtests showed relationships with the amyloid deposition, hippocampal volumes, and APOE status, with poorer performance on the RBANS being associated with biomarker positivity. Although memory scores on the RBANS have traditionally been linked to biomarkers in AD, other Index and subtest scores also hold promise as indicators of AD. Replication in a more diverse sample is needed.
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Affiliation(s)
- Kevin Duff
- Center for Alzheimer’s Care, Imaging and Research, Department of Neurology, University of Utah
| | - Kayla R. Suhrie
- Center for Alzheimer’s Care, Imaging and Research, Department of Neurology, University of Utah
| | - Dustin B. Hammers
- Center for Alzheimer’s Care, Imaging and Research, Department of Neurology, University of Utah
| | - Ava M. Dixon
- Center for Alzheimer’s Care, Imaging and Research, Department of Neurology, University of Utah
| | - Jace B. King
- Department of Radiology and Imaging Sciences, University of Utah, United States
| | | | - John M. Hoffman
- Center for Quantitative Cancer Imaging, Huntsman Cancer Institute, University of Utah
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Lin SSH, McDonough IM. Intra-individual cognitive variability in neuropsychological assessment: a sign of neural network dysfunction. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2022; 29:375-399. [PMID: 34963423 DOI: 10.1080/13825585.2021.2021134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Intra-Individual Cognitive Variability (IICV) predicts progression in neurocognitive disorders . Given important clinical applications, we investigated the association between IICV and multiple brain metrics across 17 networks to better understand the brain mechanisms underlying this performance measure. Sixty-three middle-aged and older adults without dementia underwent a neuropsychological battery, resting-state fMRI, and structural MRI scans. In a linear mixed effect model, higher IICV was associated with lower functional connectivity in control C network relative to medial occipital network (the reference). A multivariate partial least squares analysis revealed that lower mean and higher variability were both associated with lower connectivity in sensorimotor and default mode networks, while higher mean and higher variability were associated with lower volume in default mode and limbic networks. This study suggests that IICV signals widespread network dysfunction across multiple brain networks. These brain abnormalities offer new insights into mechanisms of early cognitive dysfunction. Clinical implications are discussed.
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Affiliation(s)
- Shayne S-H Lin
- Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Ian M McDonough
- Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA
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Đapić B, Schernhammer E, Haslacher H, Stögmann E, Lehrner J. No effect of thyroid hormones on 5-year mortality in patients with subjective cognitive decline, mild cognitive disorder, and Alzheimer's disease. J Neuroendocrinol 2022; 34:e13107. [PMID: 35213057 PMCID: PMC9286816 DOI: 10.1111/jne.13107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/28/2022] [Accepted: 02/08/2022] [Indexed: 11/30/2022]
Abstract
The present study aimed to investigate differences in circulating thyroid hormone levels, gender, education, depressive symptoms, and cognitive performance among patients with cognitive impairment, and also to examine their associations, as well as that of cognitive decline, with 5-year mortality. Between 1998 and 2017, a hospital-based, single-centre (Neurology Department of the General Hospital in Vienna, Austria), retrospective follow-up study enrolled 2102 patients with mild to severe cognitive impairment (grouped into subjective cognitive decline, mild cognitive impairment, and Alzheimer's disease). Cox proportional hazards models were used to calculate hazard ratios (HRs), with 95% confidence intervals (CIs), as well as to calculate stepwise adjustments for demographic variables (age, gender, and education), depressive symptoms (Geriatric Depression Scale, GDS-15), and neuropsychological abilities (four domains of a neuropsychological test battery of Vienna, NTVB). In univariate analyses, total triiodothyronine (TT3) levels differed significantly between Alzheimer's disease and mild cognitive impairment patients (pdiff = .001). No other differences in cognitive impairment subgroups with any of the measured thyroid hormones were observed. Furthermore, in multivariate models, circulating TT3 was not associated with mortality (multivariable-adjusted HR per unit increase in TT3 = 0.56; 95% CI = 0.29-1.07). In multivariate models, we observed significantly lower 5-year mortality among women (HR = 0.56; 95% CI = 0.43-0.73) and those who scored higher on any of the four domains of the NBTV (e.g., attention and perceptual speed, HR = 0.63; 95% CI = 0.54-0.72); we also observed significantly higher 5-year mortality among patients with depressive symptoms (HR per one point score increase in GDS-15 = 1.06; 95% CI = 1.02-1.10), regardless of cognitive impairment subgroup. Among patients with various degrees of cognitive impairment, we found no associations of thyroid hormone levels with 5-year mortality. Gender, neuropsychological abilities, and depressive symptoms were each significant predictors of 5-year mortality. These results suggest that a neurocognitive test performance could serve as an important predictor of 5-year mortality among patients with cognitive impairment, although further studies with a more complete adjustment for comorbidities are needed to confirm these findings.
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Affiliation(s)
- Blaž Đapić
- Department of NeurologyMedical University of ViennaViennaAustria
| | - Eva Schernhammer
- Department of EpidemiologyCenter for Public HealthMedical University of ViennaViennaAustria
| | - Helmuth Haslacher
- Department of Laboratory MedicineMedical University of ViennaViennaAustria
| | | | - Johann Lehrner
- Department of NeurologyMedical University of ViennaViennaAustria
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Gray M, Madero EN, Gills JL, Paulson S, Jones MD, Campitelli A, Myers J, Bott NT, Glenn JM. Intervention for a Digital, Cognitive, Multi-Domain Alzheimer Risk Velocity Study: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e31841. [PMID: 35119374 PMCID: PMC8857690 DOI: 10.2196/31841] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/04/2021] [Accepted: 10/26/2021] [Indexed: 01/09/2023] Open
Abstract
Background In the United States, more than 6 million adults live with Alzheimer disease (AD) that affects 1 out of every 3 older adults. Although there is no cure for AD currently, lifestyle-based interventions aimed at slowing the rate of cognitive decline or delaying the onset of AD have shown promising results. However, most studies primarily focus on older adults (>55 years) and use in-person interventions. Objective The aim of this study is to determine the effects of a 2-year digital lifestyle intervention on AD risk among at-risk middle-aged and older adults (45-75 years) compared with a health education control. Methods The lifestyle intervention consists of a digitally delivered, personalized health coaching program that directly targets the modifiable risk factors for AD. The primary outcome measure is AD risk as determined by the Australian National University-Alzheimer Disease Risk Index; secondary outcome measures are functional fitness, blood biomarkers (inflammation, glucose, cholesterol, and triglycerides), and cognitive function (Repeatable Battery for the Assessment of Neuropsychological Status and Neurotrack Cognitive Battery). Screening commenced in January 2021 and was completed in June 2021. Results Baseline characteristics indicate no difference between the intervention and control groups for AD risk (mean −1.68, SD 7.31; P=.90). Conclusions The intervention in the Digital, Cognitive, Multi-domain Alzheimer Risk Velocity is uniquely designed to reduce the risk of AD through a web-based health coaching experience that addresses the modifiable lifestyle-based risk factors. Trial Registration ClinicalTrials.gov NCT04559789; https://clinicaltrials.gov/show/NCT04559789 International Registered Report Identifier (IRRID) DERR1-10.2196/31841
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Affiliation(s)
- Michelle Gray
- Exercise Science Research Center, Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, AR, United States
| | - Erica N Madero
- Neurotrack Technologies, Inc, Redwood City, CA, United States
| | - Joshua L Gills
- Exercise Science Research Center, Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, AR, United States
| | - Sally Paulson
- Exercise Science Research Center, Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, AR, United States
| | - Megan D Jones
- Exercise Science Research Center, Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, AR, United States
| | - Anthony Campitelli
- Exercise Science Research Center, Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, AR, United States
| | - Jennifer Myers
- Neurotrack Technologies, Inc, Redwood City, CA, United States
| | - Nicholas T Bott
- Neurotrack Technologies, Inc, Redwood City, CA, United States
| | - Jordan M Glenn
- Neurotrack Technologies, Inc, Redwood City, CA, United States
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Suhrie KR, Hammers DB, Porter SM, Dixon AM, King JB, Anderson JS, Duff K, Hoffman JM. Predicting biomarkers in intact older adults and those with amnestic Mild Cognitive Impairment, and mild Alzheimer's Disease using the Repeatable Battery for the Assessment of Neuropsychological Status. J Clin Exp Neuropsychol 2021; 43:861-878. [PMID: 35019815 DOI: 10.1080/13803395.2021.2023476] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 12/23/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) has been associated, to varying degrees, with commonly used biomarkers of Alzheimer's disease (AD). Given the ease of RBANS administration as a screening tool for clinical trials and other applications, a better understanding of how RBANS performance is associated with presence of APOE ε4 allele[s], cerebral amyloid burden, and hippocampal volume is warranted. METHOD One hundred twenty-one older adults who were classified as intact, amnestic Mild Cognitive Impairment, or mild AD underwent cognitive assessment with the RBANS, genetic analysis, and quantitative brain imaging. APOE ε4 carrier status, 18F-Flutemetamol composite standardized uptake value ratio (SUVR), and hippocampal volume were each regressed on demographic variables and RBANS Total Scale score, Index scores, and subtest scores. RESULTS Lower RBANS Total Scale score or Delayed Memory Index (DMI) predicted the presence of APOE ε4 allele[s], higher cerebral amyloid burden, and lower hippocampal volumes. DMI was a slightly better predictor than Total Scale score for most AD biomarkers. No demographic variables consistently contributed to these models. CONCLUSIONS The RBANS - DMI in particular - is sensitive to AD pathology. As such, it could be used as a predictive tool, particularly in clinical drug trials to enrich samples prior to less accessible AD biomarker investigation.
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Affiliation(s)
- Kayla R Suhrie
- Center for Alzheimer's Care, Imaging and Research, Department of Neurology, University of Utah, Salt Lake City, Utah, USA
| | - Dustin B Hammers
- Center for Alzheimer's Care, Imaging and Research, Department of Neurology, University of Utah, Salt Lake City, Utah, USA
| | - Sariah M Porter
- Center for Alzheimer's Care, Imaging and Research, Department of Neurology, University of Utah, Salt Lake City, Utah, USA
| | - Ava M Dixon
- Center for Alzheimer's Care, Imaging and Research, Department of Neurology, University of Utah, Salt Lake City, Utah, USA
| | - Jace B King
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Jeffrey S Anderson
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Kevin Duff
- Center for Alzheimer's Care, Imaging and Research, Department of Neurology, University of Utah, Salt Lake City, Utah, USA
| | - John M Hoffman
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah, USA
- Center for Quantitative Cancer Imaging, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
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Watermeyer T, Goerdten J, Johansson B, Muniz-Terrera G. Cognitive dispersion and ApoEe4 genotype predict dementia diagnosis in 8-year follow-up of the oldest-old. Age Ageing 2021; 50:868-874. [PMID: 33196771 DOI: 10.1093/ageing/afaa232] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 09/03/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cognitive dispersion, or inconsistencies in performance across cognitive domains, has been posited as a cost-effective tool to predict conversion to dementia in older adults. However, there is a dearth of studies exploring cognitive dispersion in the oldest-old (>80 years) and its relationship to dementia incidence. OBJECTIVE The main aim of this study was to examine whether higher cognitive dispersion at baseline was associated with dementia incidence within an 8-year follow-up of very old adults, while controlling for established risk factors and suggested protective factors for dementia. METHODS Participants (n = 468) were from the Origins of Variance in the Old-Old: Octogenarian Twins study, based on the Swedish Twin Registry. Cox regression analyses were performed to assess the association between baseline cognitive dispersion scores and dementia incidence, while controlling for sociodemographic variables, ApoEe4 carrier status, co-morbidities, zygosity and lifestyle engagement scores. An additional model included a composite of average cognitive performance. RESULTS Cognitive dispersion and ApoEe4 were significantly associated with dementia diagnosis. These variables remained statistically significant when global cognitive performance was entered into the model. Likelihood ratio tests revealed that cognitive dispersion and cognitive composite scores entered together in the same model was superior to either predictor alone in the full model. CONCLUSIONS The study underscores the usefulness of cognitive dispersion metrics for dementia prediction in the oldest-old and highlights the influence of ApoEe4 on cognition in very late age. Our findings concur with others suggesting that health and lifestyle factors pose little impact upon cognition in very advanced age.
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Affiliation(s)
- Tam Watermeyer
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- Faculty of Health and Life Sciences, Department of Psychology, Northumbria University, Newcastle, UK
| | - Jantje Goerdten
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology–BIPS, Bremen, Germany
| | - Boo Johansson
- Department of Psychology, Centre for Ageing and Health (AgeCap), University of Gothenburg, Gothenburg, Sweden
| | - Graciela Muniz-Terrera
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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Paxton JL, Resch ZJ, Cation B, Lapitan F, Obolsky MA, Calderone V, Fink JW, Lee RC, Soble JR, Pliskin NH. The relationship between neuropsychological dispersion, processing speed and memory after electrical injury. J Clin Exp Neuropsychol 2021; 43:144-155. [PMID: 33648409 DOI: 10.1080/13803395.2021.1889989] [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: 10/22/2022]
Abstract
Introduction: Previous studies of neuropsychological performance in electrical injury (EI) patients have produced evidence of deficits in various cognitive domains, but studies have yet to investigate relationships among performance in cognitive domains post-EI. This study examined whether dispersion among neuropsychological test scores was associated with injury parameters and neuropsychological performance in EI patients. Additionally, we examined whether dispersion, processing speed and/or executive abilities explain variance in episodic verbal and visual memory performance among EI patients.Method: Data from 52 post-acute EI patients undergoing outpatient evaluation with objectively-verified valid neuropsychological test performance were examined. Tests included measures of verbal and visual memory, processing speed, and executive functioning. Dispersion was calculated from executive functioning and processing speed scores.Results: Dispersion was not related to mean performance or injury characteristics, but was significantly negatively correlated with performance on a test of processing speed, suggesting that increased dispersion is associated with reduced cognitive efficiency post-EI. Delayed visual memory was related to both dispersion scores and processing speed. Stepwise regression equations predicting delayed memory determined that processing speed most significantly predicted delayed visual memory, even after controlling for immediate visual memory. No significant relationships emerged between verbal memory and non-memory neuropsychological scores.Conclusions: This is the first study to examine neuropsychological dispersion and relationships among domains of cognitive functioning in EI. Current results suggested that neuropsychological dispersion is not a marker of general functioning or severity of injury in EI patients, but may represent more specific processing speed abilities. Processing speed predicts delayed visual memory performance in EI patients, which should be considered in interpreting test scores during evaluations.
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Affiliation(s)
- Jessica L Paxton
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA.,Department of Psychology, Roosevelt University, Chicago, IL, USA
| | - Zachary J Resch
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA.,Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Bailey Cation
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA.,Department of Psychology, Roosevelt University, Chicago, IL, USA
| | - Franchezka Lapitan
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA.,Department of Psychology, Roosevelt University, Chicago, IL, USA
| | - Maximillian A Obolsky
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA.,Department of Psychology, Roosevelt University, Chicago, IL, USA
| | - Veroly Calderone
- The Chicago Electrical Trauma Rehabilitation Institute (CETRI), Chicago, IL, USA
| | - Joseph W Fink
- The Chicago Electrical Trauma Rehabilitation Institute (CETRI), Chicago, IL, USA.,Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Raphael C Lee
- The Chicago Electrical Trauma Rehabilitation Institute (CETRI), Chicago, IL, USA.,Departments of Surgery, Medicine and Organismal Biology, University of Chicago, Chicago, IL, USA
| | - Jason R Soble
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA.,Department of Neurology, University of Illinois College of Medicine, Chicago, IL, USA
| | - Neil H Pliskin
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA.,The Chicago Electrical Trauma Rehabilitation Institute (CETRI), Chicago, IL, USA.,Department of Neurology, University of Illinois College of Medicine, Chicago, IL, USA
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11
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DesRuisseaux LA, Williams VJ, McManus AJ, Gupta AS, Carlyle BC, Azami H, Gerber JA, Bolling AM, Cook CL, Betensky RA, Arnold SE. A pilot protocol to assess the feasibility of a virtual multiple crossover, randomized controlled trial design using methylphenidate in mild cognitive impairment. Trials 2020; 21:1016. [PMID: 33308285 PMCID: PMC7729136 DOI: 10.1186/s13063-020-04752-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 09/17/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The conventional clinical trial design in Alzheimer's disease (AD) and AD-related disorders (ADRDs) is the parallel-group randomized controlled trial. However, in heterogeneous disorders like AD/ADRDs, this design requires large sample sizes to detect meaningful effects in an "average" patient. They are very costly and, despite many attempts, have not yielded new treatments for many years. An alternative, the multi-crossover, randomized control trial (MCRCT) is a design in which each patient serves as their own control across successive, randomized blocks of active treatment and placebo. This design overcomes many limitations of parallel-group trials, yielding an unbiased assessment of treatment effect at the individual level ("N-of-1") regardless of unique patient characteristics. The goal of the present study is to pilot a MCRCT of a potential symptomatic treatment, methylphenidate, for mild-stage AD/ADRDs, testing feasibility and compliance of participants in this design and efficacy of the drug using both standard and novel outcome measures suited for this design. METHODS Ten participants with mild cognitive impairment or mild-stage dementia due to AD/ADRDs will undergo a 4-week lead-in period followed by three, month-long treatment blocks (2 weeks of treatment with methylphenidate, 2 weeks placebo in random order). This trial will be conducted entirely virtually with an optional in-person screening visit. The primary outcome of interest is feasibility as measured by compliance and retention, with secondary and exploratory outcomes including cognition as measured by neuropsychological assessment at the end of each treatment period and daily brain games played throughout the study, actigraphy, and neuropsychiatric and functional assessments. DISCUSSION This pilot study will gauge the feasibility of conducting a virtual MCRCT for symptomatic treatment in early AD/ADRD. It will also compare home-based daily brain games with standard neuropsychological measures within a clinical trial for AD/ADRD. Particular attention will be paid to compliance, tolerability of drug and participation, learning effects, trends and stability of daily measures across blocks, medication carryover effects, and correlations between standard and brief daily assessments. These data will provide guidance for more efficient trial design and the use of potentially more robust, ecological outcome measures in AD/ADRD research. TRIAL REGISTRATION ClinicalTrials.gov, NCT03811847 . Registered on 21 January 2019.
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Affiliation(s)
- Libby A. DesRuisseaux
- MGH Interdisciplinary Brain Center, Department of Neurology, Massachusetts General Hospital, Boston, MA USA
| | - Victoria J. Williams
- MGH Interdisciplinary Brain Center, Department of Neurology, Massachusetts General Hospital, Boston, MA USA
| | - Alison J. McManus
- MGH Interdisciplinary Brain Center, Department of Neurology, Massachusetts General Hospital, Boston, MA USA
| | - Anoopum S. Gupta
- MGH Interdisciplinary Brain Center, Department of Neurology, Massachusetts General Hospital, Boston, MA USA
| | - Becky C. Carlyle
- MGH Interdisciplinary Brain Center, Department of Neurology, Massachusetts General Hospital, Boston, MA USA
| | - Hamed Azami
- MGH Interdisciplinary Brain Center, Department of Neurology, Massachusetts General Hospital, Boston, MA USA
| | - Jessica A. Gerber
- MGH Interdisciplinary Brain Center, Department of Neurology, Massachusetts General Hospital, Boston, MA USA
| | - Anna M. Bolling
- MGH Interdisciplinary Brain Center, Department of Neurology, Massachusetts General Hospital, Boston, MA USA
| | - Carolyn L. Cook
- University of Heidelberg, Heidelberg, Baden Württemberg Germany
| | - Rebecca A. Betensky
- College of Public Global Health, Department of Biostatistics, New York University, New York, NY USA
| | - Steven E. Arnold
- MGH Interdisciplinary Brain Center, Department of Neurology, Massachusetts General Hospital, Boston, MA USA
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Pitton Rissardo J, Fornari Caprara A. Parkinson’s disease rating scales: a literature review. ANNALS OF MOVEMENT DISORDERS 2020. [DOI: 10.4103/aomd.aomd_33_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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13
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Merritt VC, Clark AL, Crocker LD, Sorg SF, Werhane ML, Bondi MW, Schiehser DM, Delano-Wood L. Repetitive mild traumatic brain injury in military veterans is associated with increased neuropsychological intra-individual variability. Neuropsychologia 2018; 119:340-348. [DOI: 10.1016/j.neuropsychologia.2018.08.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 08/24/2018] [Accepted: 08/29/2018] [Indexed: 11/26/2022]
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Wood MD, Maslove DM, Muscedere J, Scott SH, Boyd JG. Robotic technology provides objective and quantifiable metrics of neurocognitive functioning in survivors of critical illness:A feasibility study. J Crit Care 2018; 48:228-236. [PMID: 30243203 DOI: 10.1016/j.jcrc.2018.09.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 08/27/2018] [Accepted: 09/10/2018] [Indexed: 01/18/2023]
Abstract
PURPOSE To assess the feasibility of using an integrated multimodal data collection strategy to characterize the post-intensive care syndrome (PICS). MATERIALS AND METHODS Adult patients admitted to the ICU requiring invasive mechanical ventilation for >24 h and/or requiring vasopressor support were eligible for enrollment. We assessed cognitive and sensorimotor function at 3- and 12-months after ICU discharge with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and with the KINARM robot. RESULTS At 3- and 12-months after ICU discharge, 28/70 (40%) and 22/70 (31%) returned for follow-up testing, respectively. Prominent reasons for declining testing at 3- and 12-months included: not interested (40% and 38%) and health complications (31% and 31%). The majority of returning participants completed all tasks (96%-100%) and 100% of available data was recorded. On the RBANS, 54% (3 months) and 32% (12 months) of individuals were impaired in visuospatial/constructional skills. Similarly, the KINARM assessments demonstrated that 56% of individuals had visuospatial/executive dysfunction at 3 months, and 40% had impairment at 12 months. Individual scores indicated substantial variability. CONCLUSIONS We demonstrated that it was feasible to quantify neurological dysfunction among participants that returned for follow-up testing. However, future investigations will need to implement multiple retention strategies. TRIAL REGISTRATION This trial is registered on clinicaltrials.gov (Identifier: NCT02344043), retrospectively registered January 8, 2015.
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Affiliation(s)
- Michael D Wood
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.
| | - David M Maslove
- Department of Critical Care Medicine, Queen's University, Kingston Health Sciences Centre, Kingston, ON, Canada.
| | - John Muscedere
- Department of Critical Care Medicine, Queen's University, Kingston Health Sciences Centre, Kingston, ON, Canada.
| | - Stephen H Scott
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada; Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada; Department of Medicine (Neurology), Queen's University, Kingston Health Sciences Centre, Kingston, ON, Canada.
| | - J Gordon Boyd
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada; Department of Critical Care Medicine, Queen's University, Kingston Health Sciences Centre, Kingston, ON, Canada; Department of Medicine (Neurology), Queen's University, Kingston Health Sciences Centre, Kingston, ON, Canada.
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Sullivan KL, Woods SP, Bucks RS, Loft S, Weinborn M. Intraindividual variability in neurocognitive performance is associated with time-based prospective memory in older adults. J Clin Exp Neuropsychol 2018; 40:733-743. [PMID: 29463204 PMCID: PMC6140338 DOI: 10.1080/13803395.2018.1432571] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Older adults demonstrate poorer prospective memory (PM) performance than younger adults, particularly for time-based cues and other strategically demanding PM tasks. Intraindividual variability (IIV) in neurocognitive test performance is an index of cognitive control that may be related to the execution of strategically demanding PM tasks. METHOD Participants included 194 older Australian adults (age 50 to 88 years) who completed the Memory for Intentions Screening Test (MIST), the Prospective and Retrospective Memory Questionnaire (PRMQ), and clinical measures of executive functions. A measure of naturalistic time-based PM was also administered, in which participants were asked to call the examiner 24 hours after their appointment to report how many hours they slept. IIV was calculated as the mean-adjusted coefficient of variation (CoV) across subtests of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). RESULTS IIV was significantly associated with time-based PM in the laboratory, independent of demographics. Additionally, IIV significantly predicted performance on a naturalistic time-based PM trial, independent of demographics and chronic medical conditions. IIV was not related to event-based laboratory PM or self-reported PM symptoms in daily life. Clinical measures of executive functions were similarly associated with time-based PM and the naturalistic PM task, but not with event-based PM or subjective PM symptoms. CONCLUSIONS These results indicate that cognitive control, as indexed by IIV in neurocognitive performance, may play a role in naturalistic PM, as well as in highly strategic, but not automatic, laboratory-based PM among older adults.
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Affiliation(s)
- Kelli L. Sullivan
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX 77004-5022, USA
| | - Steven Paul Woods
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX 77004-5022, USA
- School of Psychological Science, University of Western Australia, Crawley 6009 WA, Australia
| | - Romola S. Bucks
- School of Psychological Science, University of Western Australia, Crawley 6009 WA, Australia
| | - Shayne Loft
- School of Psychological Science, University of Western Australia, Crawley 6009 WA, Australia
| | - Michael Weinborn
- School of Psychological Science, University of Western Australia, Crawley 6009 WA, Australia
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16
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Huebner DM, McGarrity LA, Smith TW, Perry NS, Suchy Y. Changes in Executive Function Following a Stressful Interpersonal Task Are Associated With Condomless Anal Intercourse Among Men Who Have Sex With Men. Ann Behav Med 2018; 52:406-411. [PMID: 29684134 DOI: 10.1093/abm/kax020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Executive functioning (EF) describes a set of neurocognitive processes critical to enacting complex health behaviors. However, theoretical frameworks for understanding sexual risk behavior have generally neglected neurocognitive constructs, and beyond a few studies of individuals selected for high substance use, the literature contains virtually no research on this topic with other adults at risk for HIV infection, such as men who have sex with men (MSM). Purpose This study tested whether EF was associated with condomless anal intercourse (CAI) among MSM. Methods Seventy MSM completed cognitive tests assessing EF at two time points-baseline, and approximately 30 min later after engaging in a stressful interpersonal task. Men also reported their sexual behaviors over the past 3 months, including the frequency of CAI. Results Baseline EF was unrelated to CAI. However, CAI was associated with the degree to which performance improved from baseline to post-stressor administration. Compared with norms for practice effects, men who reported CAI improved less than expected from baseline to post-stressor EF performance, whereas men who reported no CAI exhibited a more normative practice effect. Conclusions MSM with histories of greater sexual risk improved less than anticipated from baseline to post-stressor on tests of EF, suggesting that they might be more cognitively depleted by the stressful interpersonal task they engaged in between administrations. It is possible that certain individuals struggle to maintain executive control in stressful interpersonal situations, a finding that could contribute to the difficulty some individuals face executing precautionary behaviors during a sexual encounter.
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Affiliation(s)
- David M Huebner
- Department of Prevention and Community Health, George Washington University, Washington, DC
| | | | - Timothy W Smith
- Department of Psychology, University of Utah, Salt Lake City, UT
| | - Nicholas S Perry
- Department of Psychology, University of Utah, Salt Lake City, UT
| | - Yana Suchy
- Department of Psychology, University of Utah, Salt Lake City, UT
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Hammers DB, Atkinson TJ, Dalley BCA, Suhrie KR, Beardmore BE, Burrell LD, Horn KP, Rasmussen KM, Foster NL, Duff K, Hoffman JM. Relationship between 18F-Flutemetamol uptake and RBANS performance in non-demented community-dwelling older adults. Clin Neuropsychol 2017; 31:531-543. [PMID: 28077020 DOI: 10.1080/13854046.2016.1278039] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) has been used extensively for clinical care and in research for patients with mild cognitive impairment and Alzheimer's disease (AD); however, relatively few studies have evaluated the relationship between RBANS performance and AD imaging biomarkers. The purpose of the current study was to evaluate the association between a relatively new amyloid positron emission tomography imaging biomarker and performance on the RBANS. METHODS Twenty-seven nondemented community-dwelling adults over the age of 65 underwent 18F-Flutemetamol amyloid- positron emission tomography imaging, along with cognitive testing using the RBANS and select behavioral measures. Partial correlation coefficients were used to identify relationships between the imaging and behavioral markers. RESULTS After controlling for age and education, amyloid deposition and RBANS Indexes of Immediate Memory, Delayed Memory, and Total Scale score were significantly correlated (p's < .001, r's = -.73 to -.77, d's = 2.13-2.39), with greater amyloid burden being associated with lower RBANS scores. The Delayed Memory Index was particularly highly associated with 18F-Flutemetamol binding (r2 = .59, p < .001, d = 2.39). Neither 18F-Flutemetamol binding nor RBANS performance was significantly correlated with levels of depression, subjective cognitive difficulties, or premorbid intellect. CONCLUSIONS Because of the limited use of amyloid imaging in clinical settings due to high cost and lack of reimbursement, these findings suggest that in particular RBANS Delayed Memory Index may be a cost-efficient tool to identify early signs of AD pathology, and its use may enlighten clinical decision-making regarding potential progression to dementia due to AD.
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Affiliation(s)
- Dustin B Hammers
- a Department of Neurology, Center for Alzheimer's Care, Imaging, and Research , 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
| | - Bonnie C A Dalley
- 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
| | - Britney E Beardmore
- b Center for Quantitative Cancer Imaging, Huntsman Cancer Institute , University of Utah , Salt Lake City , UT , USA
| | - Lance D Burrell
- b Center for Quantitative Cancer Imaging, Huntsman Cancer Institute , University of Utah , Salt Lake City , UT , USA
| | - Kevin P Horn
- b Center for Quantitative Cancer Imaging, Huntsman Cancer Institute , University of Utah , Salt Lake City , UT , USA
| | - Kelli M Rasmussen
- b Center for Quantitative Cancer Imaging, Huntsman Cancer Institute , University of Utah , Salt Lake City , UT , USA
| | - Norman L Foster
- a Department of Neurology, Center for Alzheimer's Care, Imaging, and Research , University of Utah , Salt Lake City , UT , USA
| | - Kevin Duff
- a Department of Neurology, Center for Alzheimer's Care, Imaging, and Research , University of Utah , Salt Lake City , UT , USA
| | - John M Hoffman
- b Center for Quantitative Cancer Imaging, Huntsman Cancer Institute , University of Utah , Salt Lake City , UT , USA
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Malek-Ahmadi M, Lu S, Chan Y, Perez SE, Chen K, Mufson EJ. Cognitive Domain Dispersion Association with Alzheimer's Disease Pathology. J Alzheimers Dis 2017; 58:575-583. [PMID: 28453479 PMCID: PMC6314665 DOI: 10.3233/jad-161233] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Within neuropsychology, the term dispersion refers to the degree of variation in performance between different cognitive domains for an individual. Previous studies have demonstrated that cognitively normal individuals with higher dispersion are at an increased risk for progressing to mild cognitive impairment (MCI) and Alzheimer's disease (AD). Therefore, we determined 1) whether increased dispersion in older adults was associated with amyloid plaques and neurofibrillary tangles (NFTs) and 2) whether increased cognitive dispersion accurately differentiated MCI and AD from non-cognitively impaired (NCI) individuals. The intra-subject standard deviation (ISD) was used to quantify cognitive dispersion, and receiver operator characteristic (ROC) analysis determined whether ISD differentiated MCI and AD from NCI. Neuropathological scores for diffuse plaques (DPs), neuritic plaques (NPs), and NFTs were used as outcome measures in a series of negative binomial regression models. Regression analyses found that increased ISD was associated with increased NFT pathology (β= 10.93, SE = 3.82, p = 0.004), but not with DPs (β= 1.33, SE = 8.85, p = 0.88) or NPs (β= 14.64, SE = 8.45, p = 0.08) after adjusting for age at death, gender, education, APOE ɛ4 status, and clinical diagnosis. An interaction term of ISD with age at death also showed a significant negative association (β= -0.13, SE = 0.04, p = 0.004), revealing an age-dependent association between ISD with NFTs. The ISD failed to show an acceptable level of diagnostic accuracy for MCI (AUC = 0.60). These findings suggest that increased cognitive dispersion is related to NFT pathology where age significantly affects this association.
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Affiliation(s)
| | - Sophie Lu
- Williams College, Williamstown, MA, USA
| | | | - Sylvia E. Perez
- Department of Neurobiology and Neurology, Barrow Neurological Institute, Phoenix, AZ, USA
| | - Kewei Chen
- Banner Alzheimer’s Institute, Phoenix, AZ, USA
| | - Elliott J. Mufson
- Department of Neurobiology and Neurology, Barrow Neurological Institute, Phoenix, AZ, USA
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Goldstein G, Mayfield J, Thaler NS, Walker J, Allen DN. Cognitive and academic achievement changes associated with day hospital rehabilitation in children with acquired brain injury. APPLIED NEUROPSYCHOLOGY-CHILD 2016; 7:110-116. [PMID: 27854141 DOI: 10.1080/21622965.2016.1253478] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
An evaluation was made of the outcome of a day hospital rehabilitation program for children who experienced an acquired neurological illness, mainly traumatic brain injury. Participants were administered neuropsychological and academic evaluations upon entry to the program, immediately upon discharge and several months after discharge Repeated measures ANOVA results for variables selected from the Reynolds Intellectual Assessment and the Delis-Kaplan Executive Function System found that comparisons showed significant (≥p < .01) improvement occurred between the first and second assessment, generally with large effect sizes. There were some nonsignificant decrements in performance between the discharge and follow-up assessments. A correlational analysis showed that while the association between cognitive function and academic achievement was robust, correlation coefficients did not differ in strength before and following rehabilitation. The study demonstrates significant improvement in children with acquired neurological disorders following rehabilitation.
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Affiliation(s)
- Gerald Goldstein
- a Mental Illness Research, Educational and Clinical Center (VISN-4) VA Pittsburgh Healthcare System , Pittsburgh , Pennsylvania , USA
| | | | | | - Jon Walker
- a Mental Illness Research, Educational and Clinical Center (VISN-4) VA Pittsburgh Healthcare System , Pittsburgh , Pennsylvania , USA
| | - Daniel N Allen
- d Department of Psychology , University of Nevada Las Vegas , Las Vegas , Nevada , USA
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