Estimating Intelligence in Spanish: Regression Equations With the Word Accentuation Test and Demographic Variables in Latin America

Estimation of cognitive reserve and its impact on cognitive performance in older adults

OBJECTIVES

Cognitive reserve provides evidence in the search for answers regarding the role that lifestyle has in the protection of cognition in old age. Through a structural equations model, different things were analyzed: the relative weight of education, occupational complexity, free time activities and the intelligence quotient in cognitive reserve; and its impact on three cognitive domains: memory, language and executive functions.

DESIGN

A trail analysis was executed, using structural equations procedure.

PARTICIPANTS

167 older participants (mean = 76.74 years, standard deviation = 6.8 years).

MEASUREMENTS

Participants were assessed with: Sociodemographic Questionnaire, Occupational Activity Agency Questionnaire, Social Participation Questionnaire and Neuropsychological Evaluation Battery for: memory, language and executive functions.

RESULTS

The cognitive reserve factor is well represented by the measures included, with values ​​between .43 and .86, and shows a direct effect on language (β = .52, p < .001), executive functions (β = .77, p <.001), and memory (β = .36, p = .003).

CONCLUSIONS

In conclusion, lifestyle factors, such as education, occupational complexity, leisure time activities and intelligence quotient have an impact on the conformation of cognitive reserve and performance in some psychological processes.

Medical comorbidities and ethnicity impact plasma Alzheimer's disease biomarkers: Important considerations for clinical trials and practice

INTRODUCTION

Despite the clinical implementation, there remain significant gaps in our knowledge regarding the impact of race/ethnicity or common medical comorbidity on plasma Alzheimer's disease (AD) biomarkers.

METHODS

Plasma biomarkers of amyloid beta (Aβ)_40, Aβ₄₂ , total tau, and neurofilament light chain (NfL) were measured across cognitively normal Mexican Americans (n = 445) and non-Hispanic Whites (n = 520).

RESULTS

Dyslipidemia was associated with elevated Aβ₄₀ (P = .01) and Aβ₄₂ (P = .001) while hypertension was associated with elevated Aβ₄₀ (P = .003), Aβ₄₂ (P < .001), and total tau (P = .002) levels. Diabetes was associated with higher Aβ₄₀ (P < .001), Aβ₄₂ (P < .001), total tau (P < .001), and NfL (P < .001) levels. Chronic kidney disease (CKD) was associated with elevations in Aβ₄₀ (P < .001), Aβ₄₂ (P < .001), total tau (P < .001), and NfL (P < .001) levels. Mexican Americans had significantly lower Aβ₄₀ (P < .001) and higher total tau (P = .005) levels.

DISCUSSION

Plasma AD biomarkers vary significantly in association with common medical comorbidities as well as ethnicity. These findings are important for those using these biomarkers in clinical practice and clinical trials.

Perspective taking deficits and their relationship with theory of mind abilities in patients with relapsing-remitting multiple sclerosis (RRMS)

Introduction and objectives: In recent years, research has reported that between 45% and 70% of patients with Multiple Sclerosis (MS) have cognitive deficits, the most prominent being those associated with the frontal lobe. Among these deficits, we can find Theory of Mind (ToM), which is the ability to infer feelings and thoughts of others. Although it has been suggested that ToM relies on more basic skills, such as perspective taking (PT), no studies have investigated this association in patients with MS. The aim of this study was to investigate PT abilities in patients with MS and to establish their relationship with ToM deficits. Material and methods: 36 patients with relapsing-remitting multiple sclerosis (RRMS) and 42 healthy controls matched by age, sex and educational level were evaluated. Both groups were tested to estimate premorbid and current intellectual capacity, PT, ToM (Reading the Mind in the Eyes Test -RMET- and Faux Pas) and complementary scales (fatigue, depression and disability). Results: Patients with RRMS presented significant differences from controls in both PT and ToM tests. The PT test showed positive correlation with RMET, one of our ToM tests. Conclusion: The results show that there is a relationship between ToM and PT abilities. Our findings are of clinical and academic relevance to both the assessment and interpretation as well as the rehabilitation of social deficits in MS.

Depression is differentially related to cognitive and biomarker outcomes among Mexican Americans

Introduction

Despite tremendous advancements in the research of Alzheimer's disease (AD), Mexican Americans, who reflect 65% of the US Hispanic community, remain severely underrepresented in research. Our data demonstrate that risk factors for, and biomarkers of, AD are different among Mexican Americans as compared with non-Hispanic whites. Here, we examined the impact of depressive symptoms on cognitive and AD-relevant biomarker outcomes among the Mexican Americans.

Methods

Data were examined from 1,633 (852 Mexican Americans and 781 non-Hispanic whites) of the Health and Aging Brain Study-Health Disparities (HABS-HD). Depression was assessed using the Geriatric Depression Scale while cognition was measured using detailed neuropsychological testing. Plasma biomarkers of Aβ40, Aβ42, total tau, and NfL were examined in addition to MRI-based neurodegeneration. PET amyloid data were available in a subset of participants.

Results

Depressive symptoms were significantly associated with cognitive testing results among both Mexican Americans and non-Hispanic whites. However, depression was only significantly associated with cognitive outcomes and plasma biomarkers among the Mexican American APOEε4 non-carriers.

Discussion

Depressive symptoms are more commonly endorsed by Mexican Americans and these symptoms are more strongly associated with cognitive and AD-biomarker outcomes among this ethnic group. However, depression scores were only related to AD outcomes among APOEε4 non-carriers within the Mexican American group. These findings can aid in the development of a population-informed precision medicine for treating and preventing cognitive loss among the Mexican Americans.

Evidence for the reliability and validity of a Spanish translation of the Medication Management Ability Assessment administered via tele-assessment

We translated the Medication Management Ability Assessment (MMAA) from English to Spanish for use via tele-assessment and examined its reliability and validity. Following International Test Commission Guidelines for Translating and Adapting Tests, we used translation/back-translation and a small focus group (n = 6) to adapt a Spanish version of the MMAA. Eighty-six Spanish-speaking adults completed the adapted MMAA via tele-assessment at baseline and at a two-week follow-up visit. Participants also completed several self-report and performance-based cognitive and functional measures. The internal consistency of the MMAA was excellent (standardized Cronbach's α = 0.90). Performance-based functional assessments (PBFAs) and objective cognition were positively associated with the MMAA at small to medium effect sizes. Self-report measures of daily function and cognition, measures of health literacy, and estimates of premorbid intellectual functioning were not significantly associated with MMAA performance. The test-retest reliability of the MMAA was good (CCC = 0.73, 95% CI [0.62, 0.81]; rs = 0.37, p < 0.001) and demonstrated a small practice effect (Cohen's d = 0.36, p = 0.001). Preliminary evidence for the construct validity of a Spanish-language MMAA administered via tele-assessment further expands the potential clinical utility of PBFAs in culturally diverse, Spanish-speaking populations.

APOEε4 Genotype Is Related to Brain Amyloid Among Mexican Americans in the HABS-HD Study

Introduction

Despite the fact that Hispanics are expected to experience the greatest increase in Alzheimer's disease (AD) and related dementias (ADRDs) by 2060, very little data is available regarding the fundamental biomarkers of AD among Mexican Americans who reflect the majority of Hispanics in the U.S. Here we sought to examine the link between APOEε4 genotype and brain amyloid among Mexican Americans as compared to non-Hispanic white participants from the Health & Aging Brain Study - Health Disparities (HABS-HD) cohort.

Methods

PET amyloid (florbetaben) data were analyzed from 105 Mexican American and 150 non-Hispanic white participants.

Results

Among Mexican Americans, APOEε4 genotype presence was associated with Global SUVR (p = 0.003) as well as amyloid burden in the frontal (p < 0.001), lateral parietal (p = 0.003), lateral temporal (p = 0.008) and anterior-posterior cingulate (p = 0.005) regions of interest (ROIs). Among non-Hispanic white participants, APOEε4 genotype presence was associated with Global SUVR (p < 0.001) as well as amyloid burden in the frontal (p < 0.001), lateral parietal (p < 0.001), lateral temporal (p < 0.001) and anterior-posterior cingulate (p < 0.001) regions of interest (ROIs). The association between APOEε4 genotype and cerebral amyloid was strongest among non-Hispanic white participants.

Discussion/Conclusion

Despite the fact that the APOEε4 genotype is significantly less frequent among Mexican Americans, its presence remains to be a significant risk factor among this group for AD pathological burden across all regions. Additional work is needed to understand the presence, progression, and clinical impact of brain amyloid among Mexican Americans.

Neurodegeneration from the AT(N) framework is different among Mexican Americans compared to non-Hispanic Whites: A Health & Aging Brain among Latino Elders (HABLE) Study

INTRODUCTION

We sought to examine a magnetic resonance imaging (MRI)-based marker of neurodegeneration from the AT(N) (amyloid/tau/neurodegeneration) framework among a multi-ethnic, community-dwelling cohort.

METHODS

Community-dwelling Mexican Americans and non-Hispanic White adults and elders were recruited. All participants underwent comprehensive assessments including an interview, functional exam, clinical labs, informant interview, neuropsychological testing and 3T MRI of the brain. A neurodegeneration MRI meta-region of interest (ROI) biomarker for the AT(N) framework was calculated.

RESULTS

Data were examined from n = 1305 participants. Mexican Americans experienced N at significantly younger ages. The N biomarker was significantly associated with cognitive outcomes. N was significantly impacted by cardiovascular factors (e.g., total cholesterol, low-density lipoprotein) among non-Hispanic Whites whereas diabetes (glucose, HbA1c, duration of diabetes) and sociocultural (household income, acculturation) factors were strongly associated with N among Mexican Americans.

DISCUSSION

The prevalence, progression, timing, and sequence of the AT(N) biomarkers must be examined across diverse populations.

Characterizing plasma NfL in a community-dwelling multi-ethnic cohort: Results from the HABLE study

INTRODUCTION

No large-scale characterizations of neurofilament light chain (NfL) have been conducted in diverse populations.

METHODS

Baseline data were analyzed among n = 890 Mexican Americans and n = 813 non-Hispanic Whites from the multi-ethnic Health & Aging Brain among Latino Elders (HABLE) study. Plasma NfL was measured on the Simoa platform.

RESULTS

In unadjusted models, NfL was significantly associated with age (P < .001), hypertension (P  < .001), dyslipidemia (P = .02), and diabetes (P  < .001). Covarying for age and sex, NfL was associated with neurodegeneration (P  < .001) and global amyloid burden levels (P = .02) in a subset with available data. NfL levels were significantly associated with diagnostic groups (Normal Cognition [NC], mild cognitive impairment [MCI], Dementia; P  < .001); however, there was no cut-score that yielded acceptable diagnostic accuracy. NfL levels produced a sensitivity of 0.60 and specificity of 0.78 with negative predictive value of 89% for detecting amyloid positivity.

DISCUSSION

Plasma NfL levels are significantly impacted by age and medical co-morbidities that are common among older adults, which complicate its utility as a diagnostic biomarker.

Metabolic Factors Are Related to Brain Amyloid Among Mexican Americans: A HABS-HD Study

BACKGROUND

Despite the tremendous amount of research on Alzheimer's disease (AD) biomarkers, very little data is available regarding the fundamental biomarkers of AD among Mexican Americans.

OBJECTIVE

Here we sought to examine the link between metabolic markers and brain amyloid among Mexican Americans as compared to non-Hispanic whites from the Health & Aging Brain Study -Health Disparities (HABS-HD) cohort.

METHODS

PET amyloid (florbetaben) data was analyzed from 34 Mexican American and 22 non-Hispanic white participants.

RESULTS

Glucagon (t = 3.84, p < 0.001) and insulin (t = -2.56, p = 0.02) were both significantly related to global SUVR levels among Mexican Americans. Glucagon and insulin were both related to most ROIs. No metabolic markers were significantly related to brain amyloid levels among non-Hispanic whites.

CONCLUSION

Metabolic markers are related to brain amyloid burden among Mexican Americans. Given the increased risk for diabetes, additional research is needed to determine the impact of diabetes on core AD biomarkers among this underserved population.

Proteomic Profiles of Neurodegeneration Among Mexican Americans and Non-Hispanic Whites in the HABS-HD Study

BACKGROUND

Hispanics are expected to experience the largest increase in Alzheimer's disease (AD) and AD related dementias over the next several decades. However, few studies have examined biomarkers of AD among Mexican Americans, the largest segment of the U.S. Hispanic population.

OBJECTIVE

We sought to examine proteomic profiles of an MRI-based marker of neurodegeneration from the AT(N) framework among a multi-ethnic, community-dwelling cohort.

METHODS

Community-dwelling Mexican Americans and non-Hispanic white adults and elders were recruited. All participants underwent comprehensive assessments including an interview, functional exam, clinical labs, informant interview, neuropsychological testing, and 3T MRI of the brain. A neurodegeneration MRI meta-ROI biomarker for the AT(N) framework was calculated.

RESULTS

Data was examined from n = 1,291 participants. Proteomic profiles were highly accurate for detecting neurodegeneration (i.e., N+) among both Mexican Americans (AUC = 1.0) and non-Hispanic whites (AUC = 0.98). The proteomic profile of N + was different between ethnic groups. Further analyses revealed that the proteomic profiles of N + varied by diagnostic status (control, MCI, dementia) and ethnicity (Mexican American versus non-Hispanic whites) though diagnostic accuracy was high for all classifications.

CONCLUSION

A proteomic profile of neurodegeneration has tremendous value and point towards novel diagnostic and intervention opportunities. The current findings demonstrate that the underlying biological factors associated with neurodegeneration are different between Mexican Americans versus non-Hispanic whites as well as at different levels of disease progression.

Characterization of Mild Cognitive Impairment and Dementia among Community-Dwelling Mexican Americans and Non-Hispanic Whites

BACKGROUND

Despite tremendous advancements in the field, our understanding of mild cognitive impairment (MCI) and Alzheimer's disease (AD) among Mexican Americans remains limited.

OBJECTIVE

The aim of this study was to characterize MCI and dementia among Mexican Americans and non-Hispanic whites.

METHODS

Baseline data were analyzed from n = 1,705 (n = 890 Mexican American; n = 815 non-Hispanic white) participants enrolled in the Health and Aging Brain Study-Health Disparities (HABS-HD).

RESULTS

Among Mexican Americans, age (OR = 1.07), depression (OR = 1.09), and MRI-based neurodegeneration (OR = 0.01) were associated with dementia, but none of these factors were associated with MCI. Among non-Hispanic whites, male gender (OR = 0.33), neighborhood deprivation (OR = 1.34), depression (OR = 1.09), and MRI-based neurodegeneration (OR = 0.03) were associated with MCI, while depression (OR = 1.09) and APOEɛ4 genotype (OR = 4.38) were associated with dementia.

CONCLUSION

Findings from this study revealed that the demographic, clinical, sociocultural and biomarker characteristics of MCI and dementia are different among Mexican Americans as compared to non-Hispanic whites.

Prenatal PM2.5 exposure in the second and third trimesters predicts neurocognitive performance at age 9-10 years: A cohort study of Mexico City children

INTRODUCTION

Prenatal exposure to fine particulate matter air pollution (PM2.5) is an important, under-studied risk factor for neurodevelopmental dysfunction. We describe the relationships between prenatal PM2.5 exposure and vigilance and inhibitory control, executive functions related to multiple health outcomes in Mexico City children.

METHODS

We studied 320 children enrolled in Programming Research in Obesity, GRowth, Environment and Social Stressors, a longitudinal birth cohort study in Mexico City. We used a spatio-temporal model to estimate daily prenatal PM2.5 exposure at each participant's residential address. At age 9-10 years, children performed three Go/No-Go tasks, which measure vigilance and inhibitory control ability. We used Latent class analysis (LCA) to classify performance into subgroups that reflected neurocognitive performance and applied multivariate regression and distributed lag regression modeling (DLM) to test overall and time-dependent associations between prenatal PM2.5 exposure and Go/No-Go performance.

RESULTS

LCA detected two Go/No-Go phenotypes: high performers (Class 1) and low performers (Class 2). Predicting odds of Class 1 vs Class 2 membership based on prenatal PM2.5 exposure timing, logistic regression modeling showed that average prenatal PM2.5 exposure in the second and third trimesters correlated with increased odds of membership in low-performance Class 2 (OR = 1.59 (1.16, 2.17), p = 0.004). Additionally, DLM analysis identified a critical window consisting of gestational days 103-268 (second and third trimesters) in which prenatal PM2.5 exposure predicted poorer Go/No-Go performance.

DISCUSSION

Increased prenatal PM2.5 exposure predicted decreased vigilance and inhibitory control at age 9-10 years. These findings highlight the second and third trimesters of gestation as critical windows of PM2.5 exposure for the development of vigilance and inhibitory control in preadolescent children. Because childhood development of vigilance and inhibitory control informs behavior, academic performance, and self-regulation into adulthood, these results may help to describe the relationship of prenatal PM2.5 exposure to long-term health and psychosocial outcomes. The integrative methodology of this study also contributes to a shift towards more holistic analysis.

Memory Support System in Spanish: A Pilot Study

Subjective cognitive decline (SCD) is prevalent in the general population, particularly among Hispanic adults. SCD increases the risk of mild cognitive impairment (MCI) and dementia. While non-pharmacologic interventions are recommended to mitigate cognitive decline and preserve daily function in SCD and MCI, such interventions are not readily available for Spanish-speaking Hispanic adults with SCD. This pilot study, preregistered at clinicialtrials.gov, aimed to develop a linguistically and culturally appropriate adaptation of an existing memory compensation intervention, the Memory Support System (MSS), from English to Spanish, and to gather data to assess its impact in this population. Twenty Spanish-speaking Hispanic adults with SCD and 16 support partners were recruited. Measures of treatment adherence, daily function, self-efficacy for memory, quality of life, mood, anxiety, and caregiver burden were assessed at baseline, treatment end, and 8-week follow-up. By treatment end, participants with SCD improved their general functional status, daily activities requiring organizational skills, and depression and anxiety symptoms. Partners reported improvement in anxiety by treatment end and in caregiver burden at follow-up. The MSS was successfully translated into Spanish and readily learned by participants with SCD and their partners. The MSS in Spanish may help with daily functioning and aspects of patient and family well-being.

The Health & Aging Brain among Latino Elders (HABLE) study methods and participant characteristics

INTRODUCTION

Mexican Americans remain severely underrepresented in Alzheimer's disease (AD) research. The Health & Aging Brain among Latino Elders (HABLE) study was created to fill important gaps in the existing literature.

METHODS

Community-dwelling Mexican Americans and non-Hispanic White adults and elders (age 50 and above) were recruited. All participants underwent comprehensive assessments including an interview, functional exam, clinical labs, informant interview, neuropsychological testing, and 3T magnetic resonance imaging (MRI) of the brain. Amyloid and tau positron emission tomography (PET) scans were added at visit 2. Blood samples were stored in the Biorepository.

RESULTS

Data was examined from n = 1705 participants. Significant group differences were found in medical, demographic, and sociocultural factors. Cerebral amyloid and neurodegeneration imaging markers were significantly different between Mexican Americans and non-Hispanic Whites.

DISCUSSION

The current data provide strong support for continued investigations that examine the risk factors for and biomarkers of AD among diverse populations.

White matter fiber density abnormalities in cognitively normal adults at risk for late-onset Alzheimer's disease

Tau accumulation affecting white matter tracts is an early neuropathological feature of late-onset Alzheimer's disease (LOAD). There is a need to ascertain methods for the detection of early LOAD features to help with disease prevention efforts. The microstructure of these tracts and anatomical brain connectivity can be assessed by analyzing diffusion MRI (dMRI) data. Considering that family history increases the risk of developing LOAD, we explored the microstructure of white matter through dMRI in 23 cognitively normal adults who are offspring of patients with Late-Onset Alzheimer's Disease (O-LOAD) and 22 control subjects (CS) without family history of AD. We also evaluated the relation of white matter microstructure metrics with cortical thickness, volumetry, in vivo amyloid deposition (with the help of PiB positron emission tomography -PiB-PET) and regional brain metabolism (as FDG-PET) measures. Finally we studied the association between cognitive performance and white matter microstructure metrics. O-LOAD exhibited lower fiber density and fractional anisotropy in the posterior portion of the corpus callosum and right fornix when compared to CS. Among O-LOAD, reduced fiber density was associated with lower amyloid deposition in the right hippocampus, and greater cortical thickness in the left precuneus, while higher mean diffusivity was related with greater cortical thickness of the right superior temporal gyrus. Additionally, compromised white matter microstructure was associated with poorer semantic fluency. In conclusion, white matter microstructure metrics may reveal early differences in O-LOAD by virtue of parental history of the disorder, when compared to CS without a family history of LOAD. We demonstrate that these differences are associated with lower fiber density in the posterior portion of the corpus callosum and the right fornix.

The sampling precision of research in five major areas of psychology

After obtaining a sample of published, peer-reviewed articles from journals with high and low impact factors in social, cognitive, neuro-, developmental, and clinical psychology, we used a priori equations recently derived by Trafimow (Educational and Psychological Measurement, 77, 831-854, 2017; Trafimow & MacDonald in Educational and Psychological Measurement, 77, 204-219, 2017) to compute the articles' median levels of precision. Our findings indicate that developmental research performs best with respect to precision, whereas cognitive research performs the worst; however, none of the psychology subfields excelled. In addition, we found important differences in precision between journals in the upper versus lower echelons with respect to impact factors in cognitive, neuro-, and clinical psychology, whereas the difference was dramatically attenuated for social and developmental psychology. Implications are discussed.

Signal-detection analysis of the WMS faces subtest: Results in amyotrophic lateral sclerosis patients

About 30% of patients with amyotrophic lateral sclerosis (ALS) suffer from cognitive impairment and 10-15% suffer from frontotemporal dementia (FTD). Due to the patients' reduced motor function, a neuropsychological assessment with a low motor demand can be an advantage when evaluating patients, aiding its application. The present work has studied the usefulness of the Faces subtest of the Wechsler Memory Scale in 42 patients with ALS and 42 healthy volunteers applying Holdnack's Two-High Threshold model. The ALS group performed significantly worse in immediate and delayed discriminability. With respect to the presence of cognitive impairment, it seemed to be independent of the indexes proposed by Holdnack and Delis. On the other hand, motor problems were associated with delayed recognition while behavior alterations were linked to problems with delayed discriminability. ALS patients do not express differences in the bias index, in line with other types of previously studied pathologies.

Development of a word accentuation test for predicting cognitive performance in Portuguese-speaking populations

The Word Accentuation Test (WAT) has been used to predict premorbid intelligence and cognitive performance in Spanish-speaking populations. It requires participants to read a list of words without the accent marks that indicate the stressed syllable. Label="OBJECTIVE">As Portuguese pronunciation is also strongly based on accent marks, our aim was to develop a Brazilian version of the WAT. METHODS An initial pool of 60 items was constructed and a final version of 40 items (named WAT-Br) was derived by item response theory. A sample of 206 older adults underwent the WAT-Br and a standardized neuropsychological battery. Independent ratings were performed by two observers in 58 random participants. RESULTS The items showed moderate to high discrimination (α between 0.93 and 25.04) and spanned a wide range of difficulty (β between -2.07 and 1.40). The WAT-Br was shown to have an excellent internal consistency (Kuder-Richardson Formula 20 = 0.95) and inter-rater reliability (intraclass correlation coefficient = 0.92). It accounted for 61% of the variance in global cognitive performance. CONCLUSION A version of the WAT for Portuguese-speaking populations was developed and proved to be a valuable tool for estimating cognitive performance.

Efecto de concretud inverso en Afasia Progresiva Primaria-variante semántica: Estudio longitudinal de un paciente

La Afasia Progresiva Primaria (APP) es una patología neurodegenerativa que se presenta con afectación insidiosa y progresiva del lenguaje. Los criterios diagnósticos actuales diferencian tres subtipos de APP, cada una con perfiles neurolingüísticos específicos. Diversas investigaciones han propuesto que un síntoma característico de la APP variante semántica (APP-vs) es un mayor compromiso en el procesamiento de conceptos concretos que de abstractos (Efecto de Concretud Inverso - ECI). Para explicar este ECI se han propuesto diferentes explicaciones: (a). el patrón de compromiso neural, (b). el nivel educativo de los pacientes, (c). el estadio de la enfermedad. El objetivo del presente trabajo es estudiar en forma longitudinal la progresión en el procesamiento de conceptos concretos y abstractos en un paciente diagnosticado con APP-vs. Para ello se utilizó una tarea de juicios de sinonimia donde se debe identificar si dos palabras son sinónimos o no. La tarea cuenta con pares de conceptos concretos y abstractos. Se evaluó al paciente en tres momentos (2014, 2015 y 2016). Se observó un mejor desempeño de conceptos abstractos en la primera evaluación. El ECI desaparece en la segunda evaluación. El patrón se revierte en la tercera. Estos resultados apoyan la propuesta de que el ECI observado en pacientes con APP-vs es un síntoma de los estadios iniciales de la enfermedad. Este ECI se relacionaría con la afectación temprana de las porciones del Lóbulo Temporal Anterior que procesan rasgos visuales, que serían más relevantes para los conceptos concretos.

Executive functioning in cognitively normal middle-aged offspring of late-onset Alzheimer's disease patients

Episodic memory deficits are traditionally seen as the hallmark cognitive impairment during the prodromal continuum of late-onset Alzheimer's disease (LOAD). Previous studies identified early brain alterations in regions subserving executive functions in asymptomatic, middle-aged offspring of patients with LOAD (O-LOAD), suggesting that premature episodic memory deficits could be associated to executive dysfunction in this model. We hypothesized that O-LOAD would exhibit reduced executive performance evidenced by increased errors and decreased strategy use on an episodic memory task. We assessed 32 asymptomatic middle-aged O-LOAD and 28 age-equivalent control subjects (CS) with several tests that measure executive functions and the Rey Auditory Verbal Learning Test (RAVLT) to measure memory performance. All tests were scored using both traditional and process scores (quantification of errors and strategies underlying overall performance). T-tests were used to compare performance between both groups and Spearman correlations were implemented to measure associations between variables. O-LOAD participants exhibited decreased executive performance compared to CS as it relates to initiation time (Tower of London), mental switching (Trail Making Test B), and interference effects (Stroop Word-Color condition). Traditional RAVLT measures showed a poorer performance by O-LOAD and RAVLT process scores revealed increased interference effects on this group. Positive correlations (r_s) were found between the executive measures and several RAVLT measures for O-LOAD but not for CS. In conclusion, O-LOAD participants exhibited early subtle cognitive changes in executive processing. Observed memory difficulties may be associated in part to executive deficits suggesting an interplay between memory and executive functions. Process score impairments were observed earlier than clinical decline on neuropsychological scores in this at-risk cohort and might be useful cognitive markers of preclinical LOAD.

Demographically Calibrated Norms for Two Premorbid Intelligence Measures: The Word Accentuation Test and Pseudo-Words Reading Subtest

The Word Accentuation Test (WAT, Spanish adaptation of the NART) and the Pseudo-Words (PW) Reading subtest from the Battery for Reading Processes Assessment-Revised (PROLEC-R) are measures to estimate premorbid IQ. This study aims to develop demographically calibrated norms for these premorbid measures in a representative sample of the adult Spanish population in terms of age, education, and sex. A sample of 700 healthy participants from 18 to 86 years old completed the WAT and the PW Reading subtest. The effect of age, years of formal education, and sex on WAT total score, PW total score, and time to complete the PW task (PW time) were analyzed. Percentiles and scalar scores were obtained for each raw score according to nine age ranges and individual education levels. The results indicated a significant effect of age and education on the premorbid performance assessed, with no significant effect of sex. Age and education explained from 1.9 to 33.2% of the variance in premorbid IQ variables. Older participants with fewer years of education obtained worse premorbid IQ estimates. This premorbid IQ estimation decline started in the 56-65 age range for WAT total score and PW time, whereas it started in the 71-75 age range for PW total score. This study reports the first demographic-calibrated norms for WAT and PW Reading subtest for Spanish-speaking population. Even though the influence of age and years of education on premorbid IQ measures was confirmed, the PW Reading subtest showed to be more resistant to decline in elderly population than the WAT.

Limitations of a Short Demographic Questionnaire for Bedside Estimation of Patients’ Global Cognitive Functioning in Epilepsy Patients

Objectives

The German socio-demographic estimation scale was developed by Jahn et al. (1) to quickly predict premorbid global cognitive functioning in patients. So far, it has been validated in healthy adults and has shown a good correlation with the full and verbal IQ of the Wechsler Adult Intelligence Scale (WAIS) in this group. However, there are no data regarding its use as a bedside test in epilepsy patients.

Methods

Forty native German speaking adult patients with refractory epilepsy were included. They completed a neuropsychological assessment, including a nine scale short form of the German version of the WAIS-III and the German socio-demographic estimation scale by Jahn et al. (1) during their presurgical diagnostic stay in our center. We calculated means, correlations, and the rate of concordance (range ±5 and ±7.5 IQ score points) between these two measures for the whole group, and a subsample of 19 patients with a global cognitive functioning level within 1 SD of the mean (IQ score range 85–115) and who had completed their formal education before epilepsy onset.

Results

The German demographic estimation scale by Jahn et al. (1) showed a significant mean overestimation of the global cognitive functioning level of eight points in the epilepsy patient sample compared with the short form WAIS-III score. The accuracy within a range of ±5 or ±7.5 IQ score points for each patient was similar to that of the healthy controls reported by Jahn et al. (1) in our subsample, but not in our whole sample.

Conclusion

Our results show that the socio-demographic scale by Jahn et al. (1) is not sufficiently reliable as an estimation tool of global cognitive functioning in epilepsy patients. It can be used to estimate global cognitive functioning in a subset of patients with a normal global cognitive functioning level who have completed their formal education before epilepsy onset, but it does not reliably predict global cognitive functioning in epilepsy patients in general, who often do not fulfill these criteria. It is therefore not a useful tool to be applied in the general neuropsychological presurgical evaluation of epilepsy patients.

Development of the Korean Adult Reading Test (KART) to estimate premorbid intelligence in dementia patients

We aimed to develop a word-reading test for Korean-speaking adults using irregularly pronounced words that would be useful for estimation of premorbid intelligence. A linguist who specialized in Korean phonology selected 94 words that have irregular relationship between orthography and phonology. Sixty cognitively normal elderly (CN) and 31 patients with Alzheimer's disease (AD) were asked to read out loud the words and were administered the Wechsler Adult Intelligence Scale, 4th edition, Korean version (K-WAIS-IV). Among the 94 words, 50 words that did not show a significant difference between the CN and the AD group were selected and constituted the KART. Using the 30 CN calculation group (CNc), a linear regression equation was obtained in which the observed full-scale IQ (FSIQ) was regressed on the reading errors of the KART, where education was included as an additional variable. When the regressed equation computed from the CNc was applied to 30 CN individuals of the validation group (CNv), the predicted FSIQ adequately fit the observed FSIQ (R2 = 0.63). In addition, independent sample t-test showed that the KART-predicted IQs were not significantly different between the CNv and AD groups, whereas the performance of the AD group was significantly worse in the observed IQs. In addition, an extended validation of the KART was performed with a separate sample consisted of 84 CN, 56 elderly with mild cognitive impairment (MCI), and 43 AD patients who were administered comprehensive neuropsychological assessments in addition to the KART. When the equation obtained from the CNc was applied to the extended validation sample, the KART-predicted IQs of the AD, MCI and the CN groups did not significantly differ, whereas their current global cognition scores significantly differed between the groups. In conclusion, the results support the validity of KART-predicted IQ as an index of premorbid IQ in individuals with AD.