1
|
Siddiquee AT, Hwang YH, Kim S, Shin SJ, Lee JS, Kang JC, Lee MH, Kim HJ, Lee SK, Shin C. Middle-age cerebral small vessel disease and cognitive function in later life: a population-based prospective cohort study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2025; 55:101284. [PMID: 39896231 PMCID: PMC11787597 DOI: 10.1016/j.lanwpc.2024.101284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2024] [Revised: 12/26/2024] [Accepted: 12/26/2024] [Indexed: 02/04/2025]
Abstract
Background Cerebral small vessel disease (cSVD) is a major pathologic substrate of vascular contribution to cognitive impairment. However, population based long-term longitudinal cognitive function data in relation to cSVD are rare. We investigated the relationship between cSVD and cognitive decline over time in middle-aged through elderly population. Methods This prospective cohort study was conducted in a community-based adult population (avg. age 58.5 ± 6.4) who underwent both magnetic resonance imaging (MRI) and comprehensive neuropsychological tests at baseline (2011-2014). The participants were followed-up with the same neuropsychological test battery 4-yearly in two more cycles (in 2015-2018 and 2019-2022). A total of 2454 participants who were free of dementia and cerebrovascular disease at baseline with cognitive function testing at least 2 time points over the time were analyzed. Data analysis was performed from May 1, 2023 to January 31, 2024. SVD was defined by the presence of any of the visible MRI markers (age-related white matter change, lacunes and cerebral microbleeds) at baseline. The main outcomes were multivariable adjusted mean differences of cognitive test performances by cSVD groups over time. The neuropsychological assessment battery included verbal and visual memory, verbal fluency, Digit Symbol-coding, Trail Making Test-A, and Stroop Test. To examine the relationship between cSVD and cognitive function, we used linear mixed model for repeated measurements to compare the means (95% CIs) by cSVD groups. Findings Of the total, 908 (37.0%) participants had cSVD on MRI reading at baseline. By location, cSVD were mostly found in the frontal lobe followed by basal ganglia area of the brain. None of the cognitive test scores, except Trail Making Test-A, were significantly different between the cSVD groups at baseline. At 8-year follow-up, participants without cSVD performed significantly better than participants with cSVD in Stroop-color reading [Mean difference 1.19 (95% CI: 0.02-2.36), p = 0.0451] and visual reproduction-recognition [Mean difference 0.11 (95% CI: 0.01-0.21), p = 0.0221]. While no other cognitive tests showed any differential changes by cSVD groups, logical memory (Story Recall Tests) increased and Stroop-word reading decreased over time in both cSVD groups almost identically. Interpretation Silent cSVD was independently associated with decline in executive functioning over 8-year follow-up period in this Korean middle-aged through elderly general population. Future studies considering wider spectrum of cSVD and longer follow-up durations may help predict further cognitive outcomes. Funding This study was funded by the Korea Centers for Disease Control and Prevention.
Collapse
Affiliation(s)
- Ali Tanweer Siddiquee
- Institute of Human Genomic Study, College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Yoon Ho Hwang
- Institute of Human Genomic Study, College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Soriul Kim
- College of Medicine, Korea University, Seoul, Republic of Korea
- Department of Paramedicine, Seowon University, Cheongju, Chungbuk, Republic of Korea
| | - Sung Jin Shin
- Institute of Human Genomic Study, College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Ji Soo Lee
- Institute of Human Genomic Study, College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - June Christoph Kang
- Institute of Human Genomic Study, College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
- Institute of Brain Engineering, Korea University College of Informatics, Seoul, Republic of Korea
| | - Min-Hee Lee
- Institute of Human Genomic Study, College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Hyeon Jin Kim
- College of Medicine, Korea University, Seoul, Republic of Korea
- Department of Neurology, Asan Medical Center, Seoul, Republic of Korea
| | - Seung Ku Lee
- Institute of Human Genomic Study, College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
- College of Medicine, Korea University, Seoul, Republic of Korea
| | - Chol Shin
- Institute of Human Genomic Study, College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
- Biomedical Research Center, Korea University Ansan Hospital, Ansan, Republic of Korea
| |
Collapse
|
2
|
Duff K, Vehar JV, Weintraub D. Short-term cognitive practice effects in Parkinson's disease: More than meets the eye. Parkinsonism Relat Disord 2025; 131:107245. [PMID: 39705907 PMCID: PMC11769728 DOI: 10.1016/j.parkreldis.2024.107245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2024] [Revised: 12/06/2024] [Accepted: 12/15/2024] [Indexed: 12/23/2024]
Abstract
INTRODUCTION Although practice effects (PE) on repeated cognitive testing have received growing interest in Alzheimer's disease, they have been understudied in Parkinson's disease (PD). The current paper examined PE across one week in a sample of patients with PD via traditional methods and regression-based change scores, as well as if these change scores relate to clinical variables in PD. METHODS Thirty-five patients with PD were administered a brief cognitive battery twice across approximately one week. Using both simple-difference and standardized regression-based change scores, a series of one-sample and independent t-tests were calculated to assess for PE across the test battery. Pearson correlations examined both types of change scores and measures of mood and severity of motor symptoms. RESULTS Whereas traditional analyses (i.e., simple difference scores and dependent t-tests) did not reveal any changes on test scores over this interval, regression-based change scores did identify that these individuals showed significantly smaller-than-expected PE on three of the seven cognitive scores. Furthermore, when these regression-based change scores were trichotomized (decline/stable/improve), four of the seven tests showed significantly more decline than expected in this sample. Finally, these regression-based change scores significantly correlated with motor measures, with smaller PE being associated with worse motor functioning. CONCLUSION Although these results are preliminary and need to be replicated in larger and more diverse samples, smaller-than-expected PE are seen in PD and they may signal more advanced disease.
Collapse
Affiliation(s)
- Kevin Duff
- Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road (Mail Code: CR131), Portland, OR, 97239, USA.
| | - Julia V Vehar
- Department of Psychology, University of Utah, 380 1530 E Rm. 701, Salt Lake City, UT, 84112, USA.
| | - Daniel Weintraub
- Department of Psychiatry, University of Pennsylvania School of Medicine, 3615 Chestnut St., #330, Philadelphia, PA, 19104, USA.
| |
Collapse
|
3
|
Vafa S, Thanaraju A, Chan JK, Harris HA, Chan XW, Todi K, Arokiaraj AS, Chia YC, Jenkins M, Marzuki AA. The effectiveness of real-life cognitive and physical interventions on cognitive functioning in healthy older adults: A systematic review of the effects of education and training duration. Appl Psychol Health Well Being 2025; 17:e12651. [PMID: 39822168 DOI: 10.1111/aphw.12651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2024] [Accepted: 01/03/2025] [Indexed: 01/19/2025]
Abstract
Physical and cognitive interventions are deemed the primary methods of improving cognitive functioning in healthy older adults. However, the effectiveness of these interventions is still debated. This systematic review, synthesised findings from the literature on four different types of interventions: physical activities, cognitive training, cognitive stimulation and a combined intervention. We searched six databases for each intervention category. Findings demonstrated that 65% of the studies across all intervention groups reported improvement in the experimental group following the intervention. Furthermore, memory, executive and global cognitive functions were the most reported improvements post-intervention. Additionally, participants with higher education benefited more from cognitive training (an intervention that targets a specific cognitive domain), while those with lower education gained more following cognitive stimulation (an intervention that targets general domains). Lastly, in sub-types of physical activity, cognitive stimulation and combined category, longer durations (more than 20 sessions) were associated with significant cognitive improvements. Conversely, in cognitive training, having less than 20 sessions led to significant results. Findings indicated an interaction of education and intervention duration with significant outcomes post-intervention. In conclusion, this review demonstrated the importance of intervention type, duration and education in understanding cognitive improvement post-intervention.
Collapse
Affiliation(s)
- Samira Vafa
- Department of Psychology, School of Medical and Life Sciences, Sunway University, Malaysia
- Ageing, Health and Well-Being Centre, Sunway University, Malaysia
| | - Arjun Thanaraju
- Ageing, Health and Well-Being Centre, Sunway University, Malaysia
- Department of Biology, School of Medical and Life Sciences, Sunway University, Malaysia
| | - Jee Kei Chan
- Department of Psychology, Monash University, Malaysia
| | | | - Xiou Wen Chan
- Department of Psychology, Monash University, Malaysia
| | - Khushi Todi
- Department of Psychology, Monash University, Malaysia
| | - Annette Shamala Arokiaraj
- Centre for Research in Psychology and Human Well-Being, Faculty of Social Sciences and Humanities, UKM (University Kebangsaan Malaysia), Malaysia
| | - Yook Chin Chia
- Ageing, Health and Well-Being Centre, Sunway University, Malaysia
- Department of Medicine, School of Medical and Life Sciences, Sunway University, Malaysia
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Malaysia
| | - Michael Jenkins
- Department of Psychology, School of Medical and Life Sciences, Sunway University, Malaysia
- Ageing, Health and Well-Being Centre, Sunway University, Malaysia
| | - Aleya A Marzuki
- Department of Psychiatry and Psychotherapy, Medical School and University Hospital, 11 Eberhard Karls University of Tübingen, Tübingen, Germany
- German Centre for Mental Health (DZPG), Tübingen, Germany
| |
Collapse
|
4
|
McDonnell SC, Graham-Engeland JE, Sliwinski MJ, Engeland CG, Knight EL. Cognotoxemia: endotoxemia and gender predict changes in working memory performance in healthy adults. Front Neurosci 2024; 18:1453325. [PMID: 39568668 PMCID: PMC11577790 DOI: 10.3389/fnins.2024.1453325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2024] [Accepted: 10/17/2024] [Indexed: 11/22/2024] Open
Abstract
Introduction Examining the contribution of peripheral systems to cognitive function under healthy circumstances may improve our understanding of the systems that confer risk or resilience in diseased states. Endotoxemia-a pro-inflammatory response to the translocation of bacteria that reside in the gut on other sources (e.g., respiratory tract; infection) into the blood-was hypothesized to relate to worsened cognitive functioning. Gender was explored as a moderator. Methods A sample of 162 healthy adults (25-65 years old) provided plasma, from which a measure of endotoxemia was determined [i.e., the ratio of lipopolysaccharide binding protein (LBP) to soluble cluster of differentiation 14 receptors (sCD14)]. Participants performed an array of laboratory and ambulatory cognitive tasks at three timepoints, each separated by 9 months. Two sets of multilevel models were used: Prospective models, linking endotoxemia at baseline with changes in cognition across time, and coupling models, which examine correlations of endotoxemia with cognition across time. Results A prospective model indicated lower levels of endotoxemia at baseline predicted improvements in working memory across the three timepoints; higher levels were associated with no change in cognitive performance. Gender was not found to modulate this finding. Interestingly, a coupling analysis of endotoxemia and gender across time showed that in men, those with higher endotoxemia performed better at the working memory task overall; in women, working memory performance was similar regardless of endotoxemia level. Conclusion This work provides initial evidence that endotoxemia may be associated with a dampening of improvement in working memory, improvement consistent with practice effects, which should be expected in a sample of healthy, relatively young adults. The findings also provide preliminary evidence that, at least for men, higher degrees of endotoxemia are not inherently negative, and may link with short term positive outcomes for working memory.
Collapse
Affiliation(s)
- Sally C McDonnell
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, United States
| | - Jennifer E Graham-Engeland
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, United States
- Center for Healthy Aging, Pennsylvania State University, University Park, PA, United States
| | - Martin J Sliwinski
- Center for Healthy Aging, Pennsylvania State University, University Park, PA, United States
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA, United States
| | - Christopher G Engeland
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, United States
- Center for Healthy Aging, Pennsylvania State University, University Park, PA, United States
- Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park, PA, United States
| | - Erik L Knight
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, United States
| |
Collapse
|
5
|
Duff K. Mild Cognitive Impairment: Quantifying a Qualitative Disorder. Neurol Clin 2024; 42:781-792. [PMID: 39343474 DOI: 10.1016/j.ncl.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2024]
Abstract
Mild cognitive impairment (MCI) has been described as a transitional state between normal aging and dementia, which can be both identified and tracked over time from qualitative and/or quantitative perspectives. Each definition of MCI involves some subjective cognitive complaint, some level of objective cognitive impairment, and generally intact daily functioning. Progression to dementia is common on follow-up in MCI, but stability and reversion to normal cognition can also occur. Quantitative methods might allow health care providers to evaluate and follow the subtle declines in MCI, as well as examine possible benefits of interventions with this at-risk condition.
Collapse
Affiliation(s)
- Kevin Duff
- Department of Neurology, Layton Aging & Alzheimer's Disease Research Center, Oregon Health & Science University, 3181 Southwest Sam Jackson Park Road (Mail code: CR131), Portland, OR 97239, USA.
| |
Collapse
|
6
|
Wang Y, Liu S, Spiteri AG, Huynh ALH, Chu C, Masters CL, Goudey B, Pan Y, Jin L. Understanding machine learning applications in dementia research and clinical practice: a review for biomedical scientists and clinicians. Alzheimers Res Ther 2024; 16:175. [PMID: 39085973 PMCID: PMC11293066 DOI: 10.1186/s13195-024-01540-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 07/21/2024] [Indexed: 08/02/2024]
Abstract
Several (inter)national longitudinal dementia observational datasets encompassing demographic information, neuroimaging, biomarkers, neuropsychological evaluations, and muti-omics data, have ushered in a new era of potential for integrating machine learning (ML) into dementia research and clinical practice. ML, with its proficiency in handling multi-modal and high-dimensional data, has emerged as an innovative technique to facilitate early diagnosis, differential diagnosis, and to predict onset and progression of mild cognitive impairment and dementia. In this review, we evaluate current and potential applications of ML, including its history in dementia research, how it compares to traditional statistics, the types of datasets it uses and the general workflow. Moreover, we identify the technical barriers and challenges of ML implementations in clinical practice. Overall, this review provides a comprehensive understanding of ML with non-technical explanations for broader accessibility to biomedical scientists and clinicians.
Collapse
Affiliation(s)
- Yihan Wang
- The Florey Institute of Neuroscience and Mental Health, 30 Royal Parade, Parkville, VIC, 3052, Australia
- Florey Department of Neuroscience and Mental Health, The University of Melbourne, 30 Royal Parade, Parkville, VIC, 3052, Australia
| | - Shu Liu
- The Florey Institute of Neuroscience and Mental Health, 30 Royal Parade, Parkville, VIC, 3052, Australia
- Florey Department of Neuroscience and Mental Health, The University of Melbourne, 30 Royal Parade, Parkville, VIC, 3052, Australia
- The ARC Training Centre in Cognitive Computing for Medical Technologies, The University of Melbourne, Carlton, VIC, 3010, Australia
| | - Alanna G Spiteri
- The Florey Institute of Neuroscience and Mental Health, 30 Royal Parade, Parkville, VIC, 3052, Australia
| | - Andrew Liem Hieu Huynh
- Department of Aged Care, Austin Health, Heidelberg, VIC, 3084, Australia
- Department of Medicine, Austin Health, University of Melbourne, Heidelberg, VIC, 3084, Australia
| | - Chenyin Chu
- The Florey Institute of Neuroscience and Mental Health, 30 Royal Parade, Parkville, VIC, 3052, Australia
- Florey Department of Neuroscience and Mental Health, The University of Melbourne, 30 Royal Parade, Parkville, VIC, 3052, Australia
| | - Colin L Masters
- The Florey Institute of Neuroscience and Mental Health, 30 Royal Parade, Parkville, VIC, 3052, Australia
| | - Benjamin Goudey
- Florey Department of Neuroscience and Mental Health, The University of Melbourne, 30 Royal Parade, Parkville, VIC, 3052, Australia
- The ARC Training Centre in Cognitive Computing for Medical Technologies, The University of Melbourne, Carlton, VIC, 3010, Australia
| | - Yijun Pan
- The Florey Institute of Neuroscience and Mental Health, 30 Royal Parade, Parkville, VIC, 3052, Australia.
- Florey Department of Neuroscience and Mental Health, The University of Melbourne, 30 Royal Parade, Parkville, VIC, 3052, Australia.
| | - Liang Jin
- The Florey Institute of Neuroscience and Mental Health, 30 Royal Parade, Parkville, VIC, 3052, Australia
- Florey Department of Neuroscience and Mental Health, The University of Melbourne, 30 Royal Parade, Parkville, VIC, 3052, Australia
| |
Collapse
|
7
|
Duff K, Sevigny‐Resetco D. Validation of regression-based change formulae for mild cognitive impairment and Alzheimer's disease. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2024; 16:e70008. [PMID: 39309598 PMCID: PMC11413409 DOI: 10.1002/dad2.70008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 07/15/2024] [Accepted: 07/17/2024] [Indexed: 09/25/2024]
Abstract
INTRODUCTION Identification of cognitive decline is critical in older adults at risk for dementia. In a 2020 study reported in Archives of Clinical Neuropsychology, Kiselica and colleagues developed standardized regression-based (SRB) change formulae for the Uniform Data Set 3.0 Neuropsychological Battery in cognitively unimpaired older adults. However, validation of their applicability in impaired individuals is needed. METHODS Using longitudinal data on 5974 participants (cognitively unimpaired, mild cognitive impairment, dementia) from the National Alzheimer's Coordinating Center, SRB change scores were calculated for each individual and compared across groups. RESULTS Across 6 to 24 months, minimal cognitive change was observed in cognitively unimpaired participants. Modest declines were seen in those with mild cognitive impairment and substantial declines in those with dementia. Change scores were negatively correlated with the Clinical Dementia Rating scale. In impaired individuals, SRB scores indicated more decline in those with positive amyloid scans. DISCUSSION Validation of SRB scores affords greater confidence in employing them in clinical and research settings. Highlights Validation of regression-based cognitive change scores in impaired samples.Clear differences on change scores across three groups (intact, MCI, dementia).Largely stable scores in intact participants, but notable decline in MCI and dementia.Moderate to strong relationship between change scores and the Clinical Dementia Rating scale sum of boxes.
Collapse
Affiliation(s)
- Kevin Duff
- Layton Aging & Alzheimer's Disease Center, Department of Neurology
Oregon Health & Science UniversityPortlandOregonUSA
| | - Deborah Sevigny‐Resetco
- Department of Psychiatry, Department of Behavioral NeuroscienceOregon Health & Science UniversityPortlandOregonUSA
| |
Collapse
|
8
|
Papp KV, Jutten RJ, Soberanes D, Weizenbaum E, Hsieh S, Molinare C, Buckley R, Betensky RA, Marshall GA, Johnson KA, Rentz DM, Sperling R, Amariglio RE. Early Detection of Amyloid-Related Changes in Memory among Cognitively Unimpaired Older Adults with Daily Digital Testing. Ann Neurol 2024; 95:507-517. [PMID: 37991080 PMCID: PMC10922126 DOI: 10.1002/ana.26833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/28/2023] [Accepted: 10/23/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVE This study was undertaken to determine whether assessing learning over days reveals Alzheimer disease (AD) biomarker-related declines in memory consolidation that are otherwise undetectable with single time point assessments. METHODS Thirty-six (21.9%) cognitively unimpaired older adults (aged 60-91 years) were classified with elevated β-amyloid (Aβ+) and 128 (78%) were Aβ- using positron emission tomography with 11C Pittsburgh compound B. Participants completed the multiday Boston Remote Assessment for Neurocognitive Health (BRANCH) for 12 min/day on personal devices (ie, smartphones, laptops), which captures the trajectory of daily learning of the same content on 3 repeated tests (Digit Signs, Groceries-Prices, Face-Name). Learning is computed as a composite of accuracy across all 3 measures. Participants also completed standard in-clinic cognitive tests as part of the Preclinical Alzheimer's Cognitive Composite (PACC-5), with 123 participants undergoing PACC-5 follow-up after 1.07 (standard deviation = 0.25) years. RESULTS At the cross-section, there were no statistically significant differences in performance between Aβ+/- participants on any standard in-clinic cognitive tests (eg, PACC-5) or on day 1 of multiday BRANCH. Aβ+ participants exhibited diminished 7-day learning curves on multiday BRANCH after 4 days of testing relative to Aβ- participants (Cohen d = 0.49, 95% confidence interval = 0.10-0.87). Diminished learning curves were associated with greater annual PACC-5 decline (r = 0.54, p < 0.001). INTERPRETATION Very early Aβ-related memory declines can be revealed by assessing learning over days, suggesting that failures in memory consolidation predate other conventional amnestic deficits in AD. Repeated digital memory assessments, increasingly feasible and uniquely able to assess memory consolidation over short time periods, have the potential to be transformative for detecting the earliest cognitive changes in preclinical AD. ANN NEUROL 2024;95:507-517.
Collapse
Affiliation(s)
- Kathryn V. Papp
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Roos J. Jutten
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Daniel Soberanes
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Emma Weizenbaum
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02129
| | - Stephanie Hsieh
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Cassidy Molinare
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Rachel Buckley
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Rebecca A. Betensky
- Department of Biostatistics, New York University School of Global Public Health, New York, NY, 10003
| | - Gad A. Marshall
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Keith A Johnson
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
- Department of Radiology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Dorene M. Rentz
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Reisa Sperling
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Rebecca E. Amariglio
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| |
Collapse
|
9
|
Weizenbaum EL, Soberanes D, Hsieh S, Molinare CP, Buckley RF, Betensky RA, Properzi MJ, Marshall GA, Rentz DM, Johnson KA, Sperling RA, Amariglio RE, Papp KV. Capturing learning curves with the multiday Boston Remote Assessment of Neurocognitive Health (BRANCH): Feasibility, reliability, and validity. Neuropsychology 2024; 38:198-210. [PMID: 37971862 PMCID: PMC10841660 DOI: 10.1037/neu0000933] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVE Unsupervised remote digital cognitive assessment makes frequent testing feasible and allows for measurement of learning over repeated evaluations on participants' own devices. This provides the opportunity to derive individual multiday learning curve scores over short intervals. Here, we report feasibility, reliability, and validity, of a 7-day cognitive battery from the Boston Remote Assessment for Neurocognitive Health (Multiday BRANCH), an unsupervised web-based assessment. METHOD Multiday BRANCH was administered remotely to 181 cognitively unimpaired older adults using their own electronic devices. For 7 consecutive days, participants completed three tests with associative memory components (Face-Name, Groceries-Prices, Digit Signs), using the same stimuli, to capture multiday learning curves for each test. We assessed the feasibility of capturing learning curves across the 7 days. Additionally, we examined the reliability and associations of learning curves with demographics, and traditional cognitive and subjective report measures. RESULTS Multiday BRANCH was feasible with 96% of participants completing all study assessments; there were no differences dependent on type of device used (t = 0.71, p = .48) or time of day completed (t = -0.08, p = .94). Psychometric properties of the learning curves were sound including good test-retest reliability of individuals' curves (intraclass correlation = 0.94). Learning curves were positively correlated with in-person cognitive tests and subjective report of cognitive complaints. CONCLUSIONS Multiday BRANCH is a feasible, reliable, and valid cognitive measure that may be useful for identifying subtle changes in learning and memory processes in older adults. In the future, we will determine whether Multiday BRANCH is predictive of the presence of preclinical Alzheimer's disease. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Collapse
Affiliation(s)
- Emma L Weizenbaum
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School
| | - Daniel Soberanes
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School
| | - Stephanie Hsieh
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School
| | - Cassidy P Molinare
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School
| | - Rachel F Buckley
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School
| | - Rebecca A Betensky
- Department of Biostatistics, School of Global Public Health, New York University
| | - Michael J Properzi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School
| | - Gad A Marshall
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School
| | - Dorene M Rentz
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School
| | - Keith A Johnson
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School
| | - Reisa A Sperling
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School
| | - Rebecca E Amariglio
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School
| | - Kathryn V Papp
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School
| |
Collapse
|
10
|
Duff K, Dixon A, Embree L. A Closer Look at Practice Effects in Mild Cognitive Impairment and Alzheimer's Disease. Arch Clin Neuropsychol 2024; 39:1-10. [PMID: 37323010 PMCID: PMC10802223 DOI: 10.1093/arclin/acad046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2023] [Indexed: 06/17/2023] Open
Abstract
Practice effects have become a potentially important variable regarding the diagnosis, prognosis, and treatment recommendations in mild cognitive impairment (MCI) and Alzheimer's disease (AD). However, the understanding of these short-term changes in test scores remains unclear. The current observational study sought to examine variables that influence the magnitude of short-term practice effects in MCI and AD, including demographic information, cognitive performance, daily functioning, and medical comorbidities. One hundred sixty-six older adults classified as cognitively intact, amnestic MCI, or mild AD were tested twice across 1 week with a brief battery of neuropsychological tests. Correlational and regression analyses examined the relationship of practice effects with demographic and clinical variables. Results indicated that practice effects were minimally related to demographic variables and medical comorbidities, but they were significantly related to cognitive variables, depressive symptoms, and daily functioning. These findings expand our understanding of practice effects in MCI and AD, and they may allow a better appreciation of how they could affect clinical care and research.
Collapse
Affiliation(s)
- Kevin Duff
- Layton Aging and Alzheimer’s Disease Center, Department of Neurology, Oregon Health & Science University, Portland, OR, USA
- Center for Alzheimer’s Care, Imaging and Research, Department of Neurology, University of Utah, Salt Lake City UT, USA
| | - Ava Dixon
- Center for Alzheimer’s Care, Imaging and Research, Department of Neurology, University of Utah, Salt Lake City UT, USA
| | - Lindsay Embree
- Center for Alzheimer’s Care, Imaging and Research, Department of Neurology, University of Utah, Salt Lake City UT, USA
| |
Collapse
|
11
|
Duff K, Hammers DB, Koppelmans V, King JB, Hoffman JM. Short-Term Practice Effects on Cognitive Tests Across the Late Life Cognitive Spectrum and How They Compare to Biomarkers of Alzheimer's Disease. J Alzheimers Dis 2024; 99:321-332. [PMID: 38669544 PMCID: PMC11465692 DOI: 10.3233/jad-231392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
Background Practice effects on cognitive testing in mild cognitive impairment (MCI) and Alzheimer's disease (AD) remain understudied, especially with how they compare to biomarkers of AD. Objective The current study sought to add to this growing literature. Methods Cognitively intact older adults (n = 68), those with amnestic MCI (n = 52), and those with mild AD (n = 45) completed a brief battery of cognitive tests at baseline and again after one week, and they also completed a baseline amyloid PET scan, a baseline MRI, and a baseline blood draw to obtain APOE ɛ4 status. Results The intact participants showed significantly larger baseline cognitive scores and practice effects than the other two groups on overall composite measures. Those with MCI showed significantly larger baseline scores and practice effects than AD participants on the composite. For amyloid deposition, the intact participants had significantly less tracer uptake, whereas MCI and AD participants were comparable. For total hippocampal volumes, all three groups were significantly different in the expected direction (intact > MCI > AD). For APOE ɛ4, the intact had significantly fewer copies of ɛ4 than MCI and AD. The effect sizes of the baseline cognitive scores and practice effects were comparable, and they were significantly larger than effect sizes of biomarkers in 7 of the 9 comparisons. Conclusion Baseline cognition and short-term practice effects appear to be sensitive markers in late life cognitive disorders, as they separated groups better than commonly-used biomarkers in AD. Further development of baseline cognition and short-term practice effects as tools for clinical diagnosis, prognostic indication, and enrichment of clinical trials seems warranted.
Collapse
Affiliation(s)
- Kevin Duff
- Department of Neurology, Layton Aging and Alzheimer’s Disease Center, Oregon Health & Science University, Portland, OR, USA
- Department of Neurology, Center for Alzheimer’s Care, Imaging and Research, University of Utah, Salt Lake City, UT, USA
| | - Dustin B. Hammers
- Department of Neurology, Indiana University School of Medicine, Indiana, USA
| | | | - Jace B. King
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA
| | - John M. Hoffman
- Department of Neurology, Center for Alzheimer’s Care, Imaging and Research, University of Utah, Salt Lake City, UT, USA
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA
- University of Utah Center for Quantitative Cancer Imaging, Huntsman Cancer Institute, Salt Lake City, UT, USA
| |
Collapse
|
12
|
Na S, Lee C, Ho S, Hong YJ, Jeong JH, Park KH, Kim S, Wang MJ, Choi SH, Han S, Kang SW, Kang S, Yang DW. A Longitudinal Study on Memory Enhancement in Subjective Cognitive Decline Patients: Clinical and Neuroimaging Perspectives. J Alzheimers Dis 2024; 97:193-204. [PMID: 38108349 DOI: 10.3233/jad-230667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
BACKGROUND Subjective cognitive decline (SCD) refers to the self-reported persistent cognitive decline despite normal objective testing, increasing the risk of dementia compared to cognitively normal individuals. OBJECTIVE This study aims to investigate the attributes of SCD patients who demonstrated memory function improvement. METHODS In this prospective study of SCD, a total of 120 subjects were enrolled as part of a multicenter cohort study aimed at identifying predictors for the clinical progression to mild cognitive impairment or dementia (CoSCo study). All subjects underwent 18F-florbetaben PET and brain MRI scans at baseline and annual neuropsychological tests. At the 24-month follow-up, we classified SCD patients based on changes in memory function, the z-score of the Seoul verbal learning test delayed recall. RESULTS Of the 120 enrolled patients, 107 successfully completed the 24-month follow-up assessment. Among these, 80 patients (74.8%) with SCD exhibited memory function improvements. SCD patients with improved memory function had a lower prevalence of coronary artery disease at baseline and performed better in the trail-making test part B compared to those without improvement. Anatomical and biomarker analysis showed a lower frequency of amyloid PET positivity and larger volumes in the left and right superior parietal lobes in subjects with improved memory function. CONCLUSIONS Our prospective study indicates that SCD patients experiencing memory improvement over a 24-month period had a lower amyloid burden, fewer cardiovascular risk factors, and superior executive cognitive function. Identifying these key factors associated with cognitive improvement may assist clinicians in predicting future memory function improvements in SCD patients.
Collapse
Affiliation(s)
- Seunghee Na
- Department of Neurology, College of Medicine, The Catholic University of Korea, Incheon St. Mary's Hospital, Incheon, South Korea
| | - Chonghwee Lee
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, South Korea
| | - SeongHee Ho
- Department of Neurology, Hanyang University Hanmaeum Changwon Hospital, Changwon, Korea
| | - Yun Jeong Hong
- Department of Neurology, College of Medicine, The Catholic University of Korea, Uijeongbu St. Mary's Hospital, Uijeongbu, South Korea
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, South Korea
| | - Kee Hyung Park
- Department of Neurology, Gachon University Gil Hospital, Incheon, South Korea
| | - SangYun Kim
- Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | | | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, South Korea
| | | | - Seung Wan Kang
- Data Center for Korean EEG, College of Nursing, Seoul National University, Seoul, South Korea
- iMediSync Inc. Seoul, South Korea
| | - Sungmin Kang
- Research and Development, PeopleBio Inc., Seongnam-si, Gyeonggi-do, South Korea
| | - Dong Won Yang
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, South Korea
| |
Collapse
|
13
|
Ben-Porat T, Alberga A, Audet MC, Belleville S, Cohen TR, Garneau PY, Lavoie KL, Marion P, Mellah S, Pescarus R, Rahme E, Santosa S, Studer AS, Vuckovic D, Woods R, Yousefi R, Bacon SL. Understanding the impact of radical changes in diet and the gut microbiota on brain function and structure: rationale and design of the EMBRACE study. Surg Obes Relat Dis 2023; 19:1000-1012. [PMID: 37088645 DOI: 10.1016/j.soard.2023.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 01/18/2023] [Accepted: 02/24/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND Bariatric surgery leads to profound changes in gut microbiota and dietary patterns, both of which may interact to impact gut-brain communication. Though cognitive function improves postsurgery, there is a large variability in outcomes. How bariatric surgery-induced modifications in the gut microbiota and dietary patterns influence the variability in cognitive function is still unclear. OBJECTIVES To elucidate the associations between bariatric surgery-induced changes in dietary and gut microbiota patterns with cognition and brain structure. SETTING University hospital. METHODS A total of 120 adult patients (≥30 years) scheduled to undergo a primary bariatric surgery along with 60 age-, sex-, and body mass index-matched patients on the surgery waitlist will undergo assessments 3-months presurgery and 6- and 12-month postsurgery (or an equivalent time for the waitlist group). Additionally, 60 age-and sex-matched nonbariatric surgery eligible individuals will complete the presurgical assessments only. Evaluations will include sociodemographic and health behavior questionnaires, physiological assessments (anthropometrics, blood-, urine-, and fecal-based measures), neuropsychological cognitive tests, and structural magnetic resonance imaging. Cluster analyses of the dietary and gut microbiota changes will define the various dietary patterns and microbiota profiles, then using repeated measures mixed models, their associations with global cognitive and structural brain alterations will be explored. RESULTS The coordinating study site (Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, QC, Canada), provided the primary ethical approval (Research Ethics Board#: MP-32-2022-2412). CONCLUSIONS The insights generated from this study can be used to develop individually-targeted neurodegenerative disease prevention strategies, as well as providing critical mechanistic information.
Collapse
Affiliation(s)
- Tair Ben-Porat
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, Quebec, Canada; Montreal Behavioural Medicine Centre (MBMC), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Quebec, Canada
| | - Angela Alberga
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, Quebec, Canada
| | - Marie-Claude Audet
- School of Nutrition Sciences, University of Ottawa, Ontario, Canada; The Royal's Institute of Mental Health Research, Ottawa, Ontario, Canada
| | - Sylvie Belleville
- Research centre of the Institut Universitaire de Gériatrie de Montréal (CRIUGM), Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal (CIUSSS-CSMTL), Montreal, Quebec, Canada; Department of Psychology, University of Montreal, Montreal, Quebec, Canada
| | - Tamara R Cohen
- Faculty of Land and Food Systems, University of British Columbia (UBC), Vancouver, British Columbia, Canada
| | - Pierre Y Garneau
- Division of Bariatric Surgery, CIUSSS-NIM, Montreal, Canada; Department of Surgery, Université de Montréal, Montréal, Canada
| | - Kim L Lavoie
- Montreal Behavioural Medicine Centre (MBMC), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Quebec, Canada; Department of Psychology, Université du Québec a Montréal (UQAM), Montreal, Quebec, Canada
| | - Patrick Marion
- Montreal Behavioural Medicine Centre (MBMC), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Quebec, Canada
| | - Samira Mellah
- Research centre of the Institut Universitaire de Gériatrie de Montréal (CRIUGM), Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal (CIUSSS-CSMTL), Montreal, Quebec, Canada
| | - Radu Pescarus
- Division of Bariatric Surgery, CIUSSS-NIM, Montreal, Canada; Department of Surgery, Université de Montréal, Montréal, Canada
| | - Elham Rahme
- Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada; Center for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre (MUHC), Montreal, Quebec, Canada
| | - Sylvia Santosa
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, Quebec, Canada; Metabolism, Obesity and Nutrition Lab, PERFORM Centre, Concordia University, Montreal, Quebec, Canada; Research Centre, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Quebec, Canada
| | - Anne-Sophie Studer
- Division of Bariatric Surgery, CIUSSS-NIM, Montreal, Canada; Department of Surgery, Université de Montréal, Montréal, Canada
| | - Dajana Vuckovic
- Department of Chemistry and Biochemistry, Concordia University, Montreal, Quebec, Canada
| | - Robbie Woods
- Montreal Behavioural Medicine Centre (MBMC), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Quebec, Canada; Department of Psychology, Concordia University, Montreal, Quebec, Canada
| | - Reyhaneh Yousefi
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, Quebec, Canada; Montreal Behavioural Medicine Centre (MBMC), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Quebec, Canada
| | - Simon L Bacon
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, Quebec, Canada; Montreal Behavioural Medicine Centre (MBMC), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Quebec, Canada.
| |
Collapse
|
14
|
Sanderson-Cimino M, Chen R, Tu XM, Elman JA, Jak AJ, Kremen WS. Misinterpreting cognitive change over multiple timepoints: When practice effects meet age-related decline. Neuropsychology 2023; 37:568-581. [PMID: 37079809 PMCID: PMC10313772 DOI: 10.1037/neu0000903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
OBJECTIVE Practice effects (PE) on cognitive testing have been shown to delay detection of impairment and impede our ability to assess change. When decline over time is expected, as with older adults or progressive diseases, failure to adequately address PEs may lead to inaccurate conclusions because PEs artificially boost scores while pathology- or age-related decline reduces scores. Unlike most methods, a participant-replacement approach can separate pathology- or age-related decline from PEs; however, this approach has only been used across two timepoints. More than two timepoints make it possible to determine if PEs level out after the first follow-up, but it is analytically challenging because individuals may not be assessed at every timepoint. METHOD We examined 1,190 older adults who were cognitively unimpaired (n = 809) or had mild cognitive impairment (MCI; n = 381). Participants completed six neuropsychological measures at three timepoints (baseline, 12-month, 24-month). We implemented a participant-replacement method using generalized estimating equations in comparisons of matched returnees and replacements to calculate PEs. RESULTS Without accounting for PEs, cognitive function appeared to improve or stay the same. However, with the participant-replacement method, we observed significant PEs within both groups at all timepoints. PEs did not uniformly decrease across time; some-specifically on episodic memory measures-continued to increase beyond the first follow-up. CONCLUSION A replacement method of PE adjustment revealed significant PEs across two follow-ups. As expected in these older adults, accounting for PEs revealed cognitive decline. This, in turn, means earlier detection of cognitive deficits, including progression to MCI, and more accurate characterization of longitudinal change. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Collapse
Affiliation(s)
- Mark Sanderson-Cimino
- Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco
- Center for Behavior Genetics of Aging, University of California, San Diego
| | - Ruohui Chen
- Division of Biostatistics and Bioinformatics, Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego
| | - Xin M. Tu
- School of Medicine, University of California, San Diego
- Family Medicine and Public Health, University of California San Diego
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego
| | - Jeremy A. Elman
- Center for Behavior Genetics of Aging, University of California, San Diego
- School of Medicine, University of California, San Diego
| | - Amy J. Jak
- Center for Behavior Genetics of Aging, University of California, San Diego
- Center of Excellence for Stress and Mental Health, Veterans Affairs San Diego Healthcare System
| | - William S. Kremen
- Center for Behavior Genetics of Aging, University of California, San Diego
- School of Medicine, University of California, San Diego
| |
Collapse
|
15
|
Chan E, Gal AM, Van Harskamp N, Adams ME, Brown MM, Werring DJ, Cipolotti L, Simister R. Long-term study of the cognitive profile of Moyamoya Disease in adults. J Stroke Cerebrovasc Dis 2023; 32:107064. [PMID: 36996746 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107064] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/15/2023] [Accepted: 02/25/2023] [Indexed: 03/29/2023] Open
Abstract
Moyamoya Disease (MMD) is a rare cerebrovascular disorder which can have significant cognitive consequences. The aim of the current study was to describe comprehensively the domain-specific cognitive profile of adult patients with MMD and to assess whether this changes in the absence of recurrent stroke over long-term follow-up. Comprehensive neuropsychological assessment covering seven cognitive domains was conducted on 61 adult patients with MMD at baseline and then at up to 3 further time points during follow up (median=2.31, 4.87 and 7.12 years). Although 27 patients had had prior surgical revasculariation, none had surgery between neuropsychological assessments. Cognitive impairment was common. At baseline, impairment in executive functions was most frequent (57%), followed by performance IQ (36%), speed of information processing (31%) and visual memory (30%). We found that the neuropsychological profile remains broadly stable over long-term follow-up with no clear indication of improvement or significant decline. The pattern of impairment also did not differ depending on age of onset or whether there was a history of either prior stroke at presentation or revascularisation surgery at presentation.
Collapse
Affiliation(s)
- Edgar Chan
- Department of Neuropsychology, National Hospital for Neurology and Neurosurgery, Box 37, Queen Square, London WC1N 3BG, United Kingdom; Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, Russell Square House, London, United Kingdom.
| | - Ana-Marija Gal
- Department of Neuropsychology, National Hospital for Neurology and Neurosurgery, Box 37, Queen Square, London WC1N 3BG, United Kingdom
| | - Natasja Van Harskamp
- Department of Neuropsychology, National Hospital for Neurology and Neurosurgery, Box 37, Queen Square, London WC1N 3BG, United Kingdom
| | - Matthew E Adams
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom
| | - Martin M Brown
- Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, Russell Square House, London, United Kingdom
| | - David J Werring
- Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, Russell Square House, London, United Kingdom
| | - Lisa Cipolotti
- Department of Neuropsychology, National Hospital for Neurology and Neurosurgery, Box 37, Queen Square, London WC1N 3BG, United Kingdom; Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, Russell Square House, London, United Kingdom
| | - Robert Simister
- Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, Russell Square House, London, United Kingdom
| |
Collapse
|
16
|
Reed C, Calamia M, Sanderson-Cimino M, DeVito A, Toups R, Keller J. Four year practice effects on the RBANS in a longitudinal study of older adults. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-7. [PMID: 36877817 DOI: 10.1080/23279095.2023.2180361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
OBJECTIVE The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a widely used measure in neuropsychological assessment. Studies of practice effects on the RBANS have typically been assessed over one or two repeated assessments. The aim of the current study is to examine practice effects across four-years after baseline in a longitudinal study of cognitively healthy older adults. METHOD 453 Participants from the Louisiana Aging Brain Study (LABrainS) completed the RBANS Form A on up to four annual assessments after baseline. Practice effects were calculated using a modified participants-replacement method where scores of returnees are compared to the baseline scores of matched participants with additional adjustment for attrition effects. RESULTS Practice effects were observed primarily in the immediate memory, delayed memory, and total score indices. These index scores continued to increase with repeated assessments. CONCLUSIONS These findings extend past work on the RBANS showing the susceptibility of memory measures to practice effects. Given that memory and total score indices of the RBANS have the most robust relationships with pathological cognitive decline, these findings raise concerns about the ability to recruit those at risk for decline from longitudinal studies using the same form of the RBANS for multiple years.
Collapse
Affiliation(s)
- Christopher Reed
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Matthew Calamia
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Mark Sanderson-Cimino
- Memory and Aging Center, University of California San Francisco, San Francisco, CA, USA
| | - Alyssa DeVito
- Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA
| | - Robert Toups
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Jeffrey Keller
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| |
Collapse
|
17
|
Sacripante R, Girtler N, Doglione E, Nobili F, Della Sala S. Forgetting Rates of Prose Memory in Mild Cognitive Impairment. J Alzheimers Dis 2023; 91:1385-1394. [PMID: 36641670 DOI: 10.3233/jad-220803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Some authors report steeper slopes of forgetting in early Alzheimer's disease (AD), while others do not. Contrasting findings are thought to be due to methodological inconsistencies or variety of testing methods, yet they also emerge when people are assessed on the same testing procedure. OBJECTIVE We aimed to assess if forgetting slopes of people with mild cognitive impairment due to AD (MCI-AD) are different from age-matched healthy controls (HC) by using a prose paradigm. METHODS Twenty-nine people with MCI-AD and twenty-six HC listened to a short prose passage and were asked to freely recall it after delays of 1 h and 24 h. RESULTS Generalized linear mixed modelling revealed that, compared to HC, people with MCI-AD showed poorer encoding at immediate recall and steeper forgetting up to 1 h in prose memory as assessed by free recall and with repeated testing of the same material. Forgetting rates between groups did not differ from 1 h to 24 h. CONCLUSION The differences observed in MCI-AD could be due to a post-encoding deficit. These findings could be accounted either by a differential benefit from retrieval practice, whereby people with MCI-AD benefit less than HC, or by a working memory deficit in people with MCI-AD, which fails to support their memory performance from immediate recall to 1 h.
Collapse
Affiliation(s)
- Riccardo Sacripante
- Human Cognitive Neuroscience, Department of Psychology, The University of Edinburgh, Edinburgh, UK
| | - Nicola Girtler
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy.,IRCSS Ospedale Policlinco San Martino, Genoa, Italy
| | | | - Flavio Nobili
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy.,IRCSS Ospedale Policlinco San Martino, Genoa, Italy
| | - Sergio Della Sala
- Human Cognitive Neuroscience, Department of Psychology, The University of Edinburgh, Edinburgh, UK
| |
Collapse
|
18
|
Young CB, Mormino EC, Poston KL, Johnson KA, Rentz DM, Sperling RA, Papp KV. Computerized cognitive practice effects in relation to amyloid and tau in preclinical Alzheimer's disease: Results from a multi-site cohort. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12414. [PMID: 36950699 PMCID: PMC10026103 DOI: 10.1002/dad2.12414] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 02/10/2023] [Accepted: 02/14/2023] [Indexed: 03/22/2023]
Abstract
Scalable cognitive paradigms that provide metrics such as the Computerized Cognitive Composite (C3) may be sensitive enough to relate to Alzheimer's disease biomarkers in the preclinical clinically unimpaired (CU) stage. We examined CU older adults (n = 3287) who completed alternate versions of the C3 approximately 51 days apart. A subset of CU with abnormal amyloid also completed tau positron emission tomography (PET) imaging. C3 initial performance and practice effects were examined in relation to amyloid status and continuous regional tau burden. Initial C3 performance was associated with amyloid status across all participants, and with tau burden in the medial temporal lobe and early cortical regions in CU with abnormal amyloid. Short-term practice effects were associated with reduced tau in these regions in CU with abnormal amyloid, but were not associated with amyloid status. Thus, computerized cognitive testing repeated over a short follow-up period provides additional insights into early Alzheimer's disease processes.
Collapse
Affiliation(s)
- Christina B. Young
- Department of Neurology and Neurological ScienceStanford University School of MedicineStanfordCaliforniaUSA
| | - Elizabeth C. Mormino
- Department of Neurology and Neurological ScienceStanford University School of MedicineStanfordCaliforniaUSA
| | - Kathleen L. Poston
- Department of Neurology and Neurological ScienceStanford University School of MedicineStanfordCaliforniaUSA
| | - Keith A. Johnson
- Center for Alzheimer Research and TreatmentDepartment of NeurologyBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Dorene M. Rentz
- Center for Alzheimer Research and TreatmentDepartment of NeurologyBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Reisa A. Sperling
- Center for Alzheimer Research and TreatmentDepartment of NeurologyBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Kathryn V. Papp
- Center for Alzheimer Research and TreatmentDepartment of NeurologyBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| |
Collapse
|
19
|
Choi J, Lee S, Motter JN, Kim H, Andrews H, Doraiswamy PM, Devanand DP, Goldberg TE. Models of depressive pseudoamnestic disorder. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12335. [PMID: 36523848 PMCID: PMC9746884 DOI: 10.1002/trc2.12335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 06/29/2022] [Accepted: 06/30/2022] [Indexed: 12/15/2022]
Abstract
Objective Little effort has been made in the past to validate depressive pseudodementia based on hypothesis-driven approaches. We extended this concept to individuals with amnestic Mild Cognitive Impairment and Major Depression, that is, pseudodepressive amnestic disorder. We tested two hypotheses consistent with the presentations and mechanisms associated with this potential syndrome: improvements in cognition would be significantly correlated with improvements in depression after treatment (Hypothesis 1), and if not confirmed, the presence of such an association could be identified once moderator variables were taken into account (Hypothesis 2). Methods Within a clinical trial, 61 individuals received open label serotonin reuptake inhibitor (citalopram or venlafaxine) treatment over a 16-week period. Selective Reminding Test and Hamilton Depression scale were conducted serially to measure change in memory and depression, respectively. Magnetic resonance imaging, other cognitive measures (Alzheimer's Disease Assessment Scale-Cognitive and speed of processing tests), and additional depression measure (Beck Depression Inventory [BDI]) were also administered. Results No significant associations between improvement in depression and improvement in cognition were observed. Sensitivity analyses with other cognitive measures, the BDI, and exclusion of possible "placebo" responders were negative as well. There were no significant moderation effects for baseline Hamilton Rating Scale for Depression as a measure of symptom severity or age. APOE ε4 genotype and white matter hyperintensity burden yielded counter-intuitive, albeit marginally significant results. Conclusions Negative findings cast doubt on the frequency of depressive pseudoamnestic disorder in older populations with documented depression and memory impairments.
Collapse
Affiliation(s)
- Jongwoo Choi
- Division of Mental Health Data Science New York State Psychiatric Institute New York New York USA
| | - Seonjoo Lee
- Division of Mental Health Data Science New York State Psychiatric Institute New York New York USA
- Department of Biostatistics Mailman School of Public Health Columbia University New York New York USA
- Department of Psychiatry Columbia University Medical Center New York New York USA
| | - Jeffrey N Motter
- Division of Geriatric Psychiatry New York State Psychiatric Institute New York New York USA
| | - Hyun Kim
- Division of Geriatric Psychiatry New York State Psychiatric Institute New York New York USA
| | - Howard Andrews
- Department of Biostatistics Mailman School of Public Health Columbia University New York New York USA
- Department of Psychiatry Columbia University Medical Center New York New York USA
| | - P Murali Doraiswamy
- Department of Psychiatry and Behavioral Sciences Duke University School of Medicine Durham North Carolina USA
| | - D P Devanand
- Division of Geriatric Psychiatry New York State Psychiatric Institute New York New York USA
| | - Terry E Goldberg
- Department of Psychiatry Columbia University Medical Center New York New York USA
- Division of Geriatric Psychiatry New York State Psychiatric Institute New York New York USA
- Department of Anesthesiology Columbia University Medical Center New York New York USA
| |
Collapse
|
20
|
Holm SP, Wolfer AM, Pointeau GH, Lipsmeier F, Lindemann M. Practice effects in performance outcome measures in patients living with neurologic disorders – A systematic review. Heliyon 2022; 8:e10259. [PMID: 36082322 PMCID: PMC9445299 DOI: 10.1016/j.heliyon.2022.e10259] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 03/05/2021] [Accepted: 08/05/2022] [Indexed: 10/26/2022] Open
|
21
|
Hammers DB, Suhrie KR, Porter SM, Dixon AM, Duff K. Validation of one-year reliable change in the RBANS for community-dwelling older adults with amnestic mild cognitive impairment. Clin Neuropsychol 2022; 36:1304-1327. [PMID: 32819188 PMCID: PMC7909751 DOI: 10.1080/13854046.2020.1807058] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 07/24/2020] [Accepted: 08/01/2020] [Indexed: 10/23/2022]
Abstract
Objective: The current study sought to externally validate previously published standardized regression-based (SRB) equations for the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Indexes administered twice over a one-year period. Method: Hammers and colleagues' SRB prediction equations were applied to two independent samples of community-dwelling older adults with amnestic Mild Cognitive Impairment (MCI), including those recruited from the community (n = 64) and those recruited from a memory disorders clinic (n = 58). Results: While Observed Baseline and Observed Follow-up performances were generally comparable for both MCI samples over one year, both samples possessed significantly lower Observed One-Year Follow-up scores than were predicted based on Hammers and colleagues' development sample across many RBANS Indexes. Relatedly, both amnestic MCI samples possessed a greater percentage of participants either "declining" or failing to exhibit a long-term practice effect over one year relative to expectation across most Indexes. Further, the clinic-recruited amnestic MCI sample displayed worse baseline performances, smaller long-term practice effects, and greater proportions of individual participants exhibiting a decline across one year relative to the community amnestic MCI sample. Conclusions: These findings validate Hammers and colleagues' SRB prediction equations by (1) indicating their ability to identify clinically meaningful change across RBANS Indexes in independent samples, and (2) discriminating rates of cognitive change among cognitively nuanced samples.
Collapse
Affiliation(s)
- Dustin B. Hammers
- Center for Alzheimer’s Care, Imaging, and Research, Department of Neurology, University of Utah
- Center on Aging, University of Utah
| | - Kayla R. Suhrie
- Center for Alzheimer’s Care, Imaging, and Research, Department of Neurology, University of Utah
| | - Sariah M. Porter
- 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
| | - Kevin Duff
- Center for Alzheimer’s Care, Imaging, and Research, Department of Neurology, University of Utah
- Center on Aging, University of Utah
| |
Collapse
|
22
|
Hooyman A, VanGilder JL, Schaefer SY. Mediation Analysis of the Effect of Visuospatial Memory on Motor Skill Learning in Older Adults. J Mot Behav 2022; 55:68-77. [PMID: 35902117 PMCID: PMC9792432 DOI: 10.1080/00222895.2022.2105793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 06/10/2022] [Accepted: 07/20/2022] [Indexed: 02/02/2023]
Abstract
There is high inter-individual variability in motor skill learning among older adults. Identifying the nature of these individual differences remains challenging due to interactions between participant characteristics (e.g., age, cognition) and task-related factors (e.g., nature of task, level of skill pre-training), making it difficult to determine plausibly causal relationships. This study addresses these competing explanations by using mediation analysis to examine plausible causal inference between visuospatial memory and one-month retention of both gross and fine motor components of a functional upper-extremity task following training. Results suggest that better visuospatial memory results in more retention of fine but not gross motor skill, expanding on previous correlational studies in older adults and informing future interventions for maximizing motor learning in geriatric populations.
Collapse
Affiliation(s)
- Andrew Hooyman
- School of Biological and Health Systems Engineering,
Arizona State University, Tempe, AZ, USA
- The Arizona Alzheimer's Consortium, Phoenix, AZ,
USA
| | | | - Sydney Y. Schaefer
- School of Biological and Health Systems Engineering,
Arizona State University, Tempe, AZ, USA
- The Arizona Alzheimer's Consortium, Phoenix, AZ,
USA
| |
Collapse
|
23
|
Vesperman CJ, Wang R, Schultz SA, Law LL, Dougherty RJ, Ma Y, Oh JM, Edwards DF, Gallagher CL, Chin NA, Asthana S, Hermann BP, Sager MA, Johnson SC, Cook DB, Okonkwo OC. Cardiorespiratory fitness and cognition in persons at risk for Alzheimer's disease. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12330. [PMID: 35845261 PMCID: PMC9270660 DOI: 10.1002/dad2.12330] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 05/02/2022] [Accepted: 05/10/2022] [Indexed: 01/25/2023]
Abstract
Introduction This study examined the relationship between cardiorespiratory fitness (CRF) and longitudinal cognitive functioning in a cohort enriched with risk factors for Alzheimer's disease (AD). Methods A total of 155 enrollees in the Wisconsin Registry for Alzheimer's Prevention completed repeat comprehensive neuropsychological evaluations that assessed six cognitive domains. Peak oxygen consumption (VO2peak) was the primary measure of CRF. Random effects regression was used to investigate the effect of CRF on cognitive trajectories. Results Higher CRF was associated with slower decline in the cognitive domains of verbal learning and memory (P < .01) and visual learning and memory (P < .042). Secondary analyses indicated that these effects were stronger among men than women, and for noncarriers of the apolipoprotein E ε4 allele. Discussion Higher CRF was associated with a slower rate of the decline in episodic memory that occurs as a natural consequence of aging in a cohort enriched with risk factors for AD.
Collapse
Affiliation(s)
- Clayton J. Vesperman
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Rui Wang
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- The Swedish School of Sport and Health SciencesGIHStockholmSweden
- Department of NeurobiologyCare Sciences and SocietyKarolinska InstitutetStockholmSweden
| | - Stephanie A. Schultz
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Department of RadiologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Department of RadiologyWashington University in St. Louis School of MedicineSt. LouisMissouriUSA
| | - Lena L. Law
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Ryan J. Dougherty
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Department of KinesiologyUniversity of Wisconsin School of EducationMadisonWisconsinUSA
| | - Yue Ma
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Jennifer M. Oh
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Dorothy F. Edwards
- Department of KinesiologyUniversity of Wisconsin School of EducationMadisonWisconsinUSA
| | - Catherine L. Gallagher
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Department of NeurologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Nathaniel A. Chin
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Sanjay Asthana
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Geriatric Research Education and Clinical CenterWilliam S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
| | - Bruce P. Hermann
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Department of NeurologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Mark A. Sager
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's InstituteUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Sterling C. Johnson
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Geriatric Research Education and Clinical CenterWilliam S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
- Wisconsin Alzheimer's InstituteUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Dane B. Cook
- Department of KinesiologyUniversity of Wisconsin School of EducationMadisonWisconsinUSA
- Research ServiceWilliam S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
| | - Ozioma C. Okonkwo
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Geriatric Research Education and Clinical CenterWilliam S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
- Wisconsin Alzheimer's InstituteUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| |
Collapse
|
24
|
Patients with amnestic MCI Fail to Adapt Executive Control When Repeatedly Tested with Semantic Verbal Fluency Tasks. J Int Neuropsychol Soc 2022; 28:620-627. [PMID: 34187616 DOI: 10.1017/s1355617721000849] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Semantic verbal fluency (SVF) tasks require individuals to name items from a specified category within a fixed time. An impaired SVF performance is well documented in patients with amnestic Mild Cognitive Impairment (aMCI). The two leading theoretical views suggest either loss of semantic knowledge or impaired executive control to be responsible. METHOD We assessed SVF 3 times on 2 consecutive days in 29 healthy controls (HC) and 29 patients with aMCI with the aim to answer the question which of the two views holds true. RESULTS When doing the task for the first time, patients with aMCI produced fewer and more common words with a shorter mean response latency. When tested repeatedly, only healthy volunteers increased performance. Likewise, only the performance of HC indicated two distinct retrieval processes: a prompt retrieval of readily available items at the beginning of the task and an active search through semantic space towards the end. With repeated assessment, the pool of readily available items became larger in HC, but not patients with aMCI. CONCLUSION The production of fewer and more common words in aMCI points to a smaller search set and supports the loss of semantic knowledge view. The failure to improve performance as well as the lack of distinct retrieval processes point to an additional impairment in executive control. Our data did not clearly favour one theoretical view over the other, but rather indicates that the impairment of patients with aMCI in SVF is due to a combination of both.
Collapse
|
25
|
Sullivan EV, Thompson WK, Brumback T, Prouty D, Tapert SF, Brown SA, De Bellis MD, Nooner KB, Baker FC, Colrain IM, Clark DB, Nagel BJ, Pohl KM, Pfefferbaum A. Prior test experience confounds longitudinal tracking of adolescent cognitive and motor development. BMC Med Res Methodol 2022; 22:177. [PMID: 35751025 PMCID: PMC9233356 DOI: 10.1186/s12874-022-01606-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 04/14/2022] [Indexed: 11/23/2022] Open
Abstract
Background Accurate measurement of trajectories in longitudinal studies, considered the gold standard method for tracking functional growth during adolescence, decline in aging, and change after head injury, is subject to confounding by testing experience. Methods We measured change in cognitive and motor abilities over four test sessions (baseline and three annual assessments) in 154 male and 165 female participants (baseline age 12–21 years) from the National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA) study. At each of the four test sessions, these participants were given a test battery using computerized administration and traditional pencil and paper tests that yielded accuracy and speed measures for multiple component cognitive (Abstraction, Attention, Emotion, Episodic memory, Working memory, and General Ability) and motor (Ataxia and Speed) functions. The analysis aim was to dissociate neurodevelopment from testing experience by using an adaptation of the twice-minus-once tested method, which calculated the difference between longitudinal change (comprising developmental plus practice effects) and practice-free initial cross-sectional performance for each consecutive pairs of test sessions. Accordingly, the first set of analyses quantified the effects of learning (i.e., prior test experience) on accuracy and after speed domain scores. Then developmental effects were determined for each domain for accuracy and speed having removed the measured learning effects. Results The greatest gains in performance occurred between the first and second sessions, especially in younger participants, regardless of sex, but practice gains continued to accrue thereafter for several functions. For all 8 accuracy composite scores, the developmental effect after accounting for learning was significant across age and was adequately described by linear fits. The learning-adjusted developmental effects for speed were adequately described by linear fits for Abstraction, Emotion, Episodic Memory, General Ability, and Motor scores, although a nonlinear fit was better for Attention, Working Memory, and Average Speed scores. Conclusion Thus, what appeared as accelerated cognitive and motor development was, in most cases, attributable to learning. Recognition of the substantial influence of prior testing experience is critical for accurate characterization of normal development and for developing norms for clinical neuropsychological investigations of conditions affecting the brain.
Collapse
Affiliation(s)
- Edith V Sullivan
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine (MC5723), 401 Quarry Road, Stanford, CA, 94305-5723, USA.
| | - Wesley K Thompson
- Division of Biostatistics and Dept of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Ty Brumback
- Department of Psychological Sciences, Northern Kentucky University, Highland Heights, KY, USA
| | - Devin Prouty
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Susan F Tapert
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Sandra A Brown
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Michael D De Bellis
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Kate B Nooner
- Department of Psychology, University of North Carolina Wilmington, Wilmington, NC, USA
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Ian M Colrain
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Duncan B Clark
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Bonnie J Nagel
- Departments of Psychiatry and Behavioral Neuroscience, Oregon Health & Sciences University, Portland, OR, USA
| | - Kilian M Pohl
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine (MC5723), 401 Quarry Road, Stanford, CA, 94305-5723, USA.,Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Adolf Pfefferbaum
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine (MC5723), 401 Quarry Road, Stanford, CA, 94305-5723, USA.,Center for Health Sciences, SRI International, Menlo Park, CA, USA
| |
Collapse
|
26
|
Aschenbrenner AJ, Hassenstab J, Wang G, Li Y, Xiong C, McDade E, Clifford DB, Salloway S, Farlow M, Yaari R, Cheng EYJ, Holdridge KC, Mummery CJ, Masters CL, Hsiung GY, Surti G, Day GS, Weintraub S, Honig LS, Galvin JE, Ringman JM, Brooks WS, Fox NC, Snyder PJ, Suzuki K, Shimada H, Gräber S, Bateman RJ. Avoid or Embrace? Practice Effects in Alzheimer's Disease Prevention Trials. Front Aging Neurosci 2022; 14:883131. [PMID: 35783127 PMCID: PMC9244171 DOI: 10.3389/fnagi.2022.883131] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/19/2022] [Indexed: 12/02/2022] Open
Abstract
Demonstrating a slowing in the rate of cognitive decline is a common outcome measure in clinical trials in Alzheimer's disease (AD). Selection of cognitive endpoints typically includes modeling candidate outcome measures in the many, richly phenotyped observational cohort studies available. An important part of choosing cognitive endpoints is a consideration of improvements in performance due to repeated cognitive testing (termed "practice effects"). As primary and secondary AD prevention trials are comprised predominantly of cognitively unimpaired participants, practice effects may be substantial and may have considerable impact on detecting cognitive change. The extent to which practice effects in AD prevention trials are similar to those from observational studies and how these potential differences impact trials is unknown. In the current study, we analyzed data from the recently completed DIAN-TU-001 clinical trial (TU) and the associated DIAN-Observational (OBS) study. Results indicated that asymptomatic mutation carriers in the TU exhibited persistent practice effects on several key outcomes spanning the entire trial duration. Critically, these practice related improvements were larger on certain tests in the TU relative to matched participants from the OBS study. Our results suggest that the magnitude of practice effects may not be captured by modeling potential endpoints in observational studies where assessments are typically less frequent and drug expectancy effects are absent. Using alternate instrument forms (represented in our study by computerized tasks) may partly mitigate practice effects in clinical trials but incorporating practice effects as outcomes may also be viable. Thus, investigators must carefully consider practice effects (either by minimizing them or modeling them directly) when designing cognitive endpoint AD prevention trials by utilizing trial data with similar assessment frequencies.
Collapse
Affiliation(s)
| | - Jason Hassenstab
- Washington University in St. Louis School of Medicine, St. Louis, MO, United States
| | - Guoqiao Wang
- Washington University in St. Louis School of Medicine, St. Louis, MO, United States
| | - Yan Li
- Washington University in St. Louis School of Medicine, St. Louis, MO, United States
| | - Chengjie Xiong
- Washington University in St. Louis School of Medicine, St. Louis, MO, United States
| | - Eric McDade
- Washington University in St. Louis School of Medicine, St. Louis, MO, United States
| | - David B. Clifford
- Washington University in St. Louis School of Medicine, St. Louis, MO, United States
| | - Stephen Salloway
- Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Martin Farlow
- Indiana University School of Medicine, Indianapolis, IN, United States
| | - Roy Yaari
- Eli Lilly and Company, Indianapolis, IN, United States
| | | | | | | | | | | | - Ghulam Surti
- The University of Rhode Island, Kingston, RI, United States
| | | | - Sandra Weintraub
- Feiniberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Lawrence S. Honig
- Columbia University Irving Medical Center, New York, NY, United States
| | - James E. Galvin
- Miller School of Medicine, University of Miami, Miami, FL, United States
| | - John M. Ringman
- University of Southern California, Los Angeles, CA, United States
| | - William S. Brooks
- Neuroscience Research Australia, University of New South Wales Medicine, Randwick, NSW, Australia
| | - Nick C. Fox
- Dementia Research Center, University College London, London, United Kingdom
| | | | | | | | - Susanne Gräber
- German Center for Neurodegenerative Disease (DZNE), Tübingen, Germany
| | - Randall J. Bateman
- Washington University in St. Louis School of Medicine, St. Louis, MO, United States
| |
Collapse
|
27
|
Tamburri N, McDowell C, MacDonald SWS. Parameterizing Practice in a Longitudinal Measurement Burst Design to Dissociate Retest Effects From Developmental Change: Implications for Aging Neuroscience. Front Aging Neurosci 2022; 14:885621. [PMID: 35721020 PMCID: PMC9204065 DOI: 10.3389/fnagi.2022.885621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 05/05/2022] [Indexed: 11/23/2022] Open
Abstract
Background: In longitudinal designs, the extraneous influence of retest effects can confound and obscure estimates of developmental change. The current study provides a novel approach to independently parameterize short-term retest effects and long-term developmental change estimates by leveraging a measurement burst design and three-level multilevel modeling. We further employ these short- and long-term slopes as predictors of cognitive status at long-term follow-up assessments. Methods: Participants included 304 older adults from Project MIND: a longitudinal measurement burst study assessing cognitive performance across both biweekly sessions and annual retests. Participants were classified as either Healthy controls (HC) or Cognitively Impaired, not Demented (CIND) at baseline, the final burst assessment (Year 4), and at an additional four-year follow-up (Year 8). Response time inconsistencies (RTI) were computed at each burst occasion for a simple choice response time (CRT) task and a one-back response time (BRT) task. Three-level multilevel models were employed to simultaneously examine change in RTI for both CRT and BRT across weeks within years, as well as across years, in order to dissociate within-individual retest effects (short-term) from developmental (long-term) change slopes. Individual slopes were then extracted and utilized in a series of multinomial logistic regression equations to contrast short- vs. long-term RTI change as predictors of cognitive status. Results: Separately parameterizing short- and long-term change estimates yielded distinct patterns of variation. CRT RTI remained stable across short-term weekly assessments, while significantly increasing across years. In contrast, BRT RTI decreased significantly across short-term assessments but showed no change across long-term assessments. After dissociating change estimates, short-term BRT as well as long-term CRT and BRT estimates predicted cognitive status at long-term follow-ups; increases in RTI, suggesting either an inability to benefit from retest or process-based developmental decline, were associated with an increased likelihood of being classified as CIND. Conclusions: We showcase an innovative approach to dissociate retest effects from developmental change across and within individuals. Accurately parameterizing these distinct change estimates can both reduce systematic bias in longitudinal trend estimates as well as provide a clinically useful tool by utilizing retest effects to predict cognitive health and impairment.
Collapse
Affiliation(s)
- Nicholas Tamburri
- Brain Aging and Neurocognitive Health Laboratory, Department of Psychology, University of Victoria, Victoria, BC, Canada
| | - Cynthia McDowell
- Brain Aging and Neurocognitive Health Laboratory, Department of Psychology, University of Victoria, Victoria, BC, Canada
- Institute on Aging and Lifelong Health, University of Victoria, Victoria, BC, Canada
| | - Stuart W. S. MacDonald
- Brain Aging and Neurocognitive Health Laboratory, Department of Psychology, University of Victoria, Victoria, BC, Canada
- Institute on Aging and Lifelong Health, University of Victoria, Victoria, BC, Canada
- *Correspondence: Stuart W. S. MacDonald
| |
Collapse
|
28
|
Sanderson-Cimino M, Elman JA, Tu XM, Gross AL, Panizzon MS, Gustavson DE, Bondi MW, Edmonds EC, Eppig JS, Franz CE, Jak AJ, Lyons MJ, Thomas KR, Williams ME, Kremen WS. Practice Effects in Mild Cognitive Impairment Increase Reversion Rates and Delay Detection of New Impairments. Front Aging Neurosci 2022; 14:847315. [PMID: 35547623 PMCID: PMC9083463 DOI: 10.3389/fnagi.2022.847315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 03/21/2022] [Indexed: 01/27/2023] Open
Abstract
Objective Cognitive practice effects (PEs) can delay detection of progression from cognitively unimpaired to mild cognitive impairment (MCI). They also reduce diagnostic accuracy as suggested by biomarker positivity data. Even among those who decline, PEs can mask steeper declines by inflating cognitive scores. Within MCI samples, PEs may increase reversion rates and thus impede detection of further impairment. Within an MCI sample at baseline, we evaluated how PEs impact prevalence, reversion rates, and dementia progression after 1 year. Methods We examined 329 baseline Alzheimer's Disease Neuroimaging Initiative MCI participants (mean age = 73.1; SD = 7.4). We identified test-naïve participants who were demographically matched to returnees at their 1-year follow-up. Since the only major difference between groups was that one completed testing once and the other twice, comparison of scores in each group yielded PEs. PEs were subtracted from each test to yield PE-adjusted scores. Biomarkers included cerebrospinal fluid phosphorylated tau and amyloid beta. Cox proportional models predicted time until first dementia diagnosis using PE-unadjusted and PE-adjusted diagnoses. Results Accounting for PEs increased MCI prevalence at follow-up by 9.2% (272 vs. 249 MCI), and reduced reversion to normal by 28.8% (57 vs. 80 reverters). PEs also increased stability of single-domain MCI by 12.0% (164 vs. 147). Compared to PE-unadjusted diagnoses, use of PE-adjusted follow-up diagnoses led to a twofold increase in hazard ratios for incident dementia. We classified individuals as false reverters if they reverted to cognitively unimpaired status based on PE-unadjusted scores, but remained classified as MCI cases after accounting for PEs. When amyloid and tau positivity were examined together, 72.2% of these false reverters were positive for at least one biomarker. Interpretation Even when PEs are small, they can meaningfully change whether some individuals with MCI retain the diagnosis at a 1-year follow-up. Accounting for PEs resulted in increased MCI prevalence and altered stability/reversion rates. This improved diagnostic accuracy also increased the dementia-predicting ability of MCI diagnoses.
Collapse
Affiliation(s)
- Mark Sanderson-Cimino
- University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University, San Diego, CA, United States,Center for Behavior Genetics of Aging, University of California, San Diego, San Diego, CA, United States,*Correspondence: Mark Sanderson-Cimino,
| | - Jeremy A. Elman
- Center for Behavior Genetics of Aging, University of California, San Diego, San Diego, CA, United States,Department of Psychiatry, School of Medicine, University of California, San Diego, San Diego, CA, United States
| | - Xin M. Tu
- Department of Psychiatry, School of Medicine, University of California, San Diego, San Diego, CA, United States,Department of Family Medicine and Public Health, University of California, San Diego, San Diego, CA, United States,Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, San Diego, CA, United States
| | - Alden L. Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MA, United States
| | - Matthew S. Panizzon
- Center for Behavior Genetics of Aging, University of California, San Diego, San Diego, CA, United States,Department of Psychiatry, School of Medicine, University of California, San Diego, San Diego, CA, United States
| | - Daniel E. Gustavson
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Mark W. Bondi
- Department of Psychiatry, School of Medicine, University of California, San Diego, San Diego, CA, United States,Psychology Service, VA San Diego Healthcare System, San Diego, CA, United States
| | - Emily C. Edmonds
- Department of Psychiatry, School of Medicine, University of California, San Diego, San Diego, CA, United States,Research Service, VA San Diego Healthcare System, San Diego, CA, United States
| | - Joel S. Eppig
- Rehabilitation Institute of Washington, Seattle, WA, United States
| | - Carol E. Franz
- Center for Behavior Genetics of Aging, University of California, San Diego, San Diego, CA, United States,Department of Psychiatry, School of Medicine, University of California, San Diego, San Diego, CA, United States
| | - Amy J. Jak
- Center for Behavior Genetics of Aging, University of California, San Diego, San Diego, CA, United States,Center of Excellence for Stress and Mental Health, Veterans Affairs San Diego Healthcare System, San Diego, CA, United States
| | - Michael J. Lyons
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, United States
| | - Kelsey R. Thomas
- Department of Psychiatry, School of Medicine, University of California, San Diego, San Diego, CA, United States,Research Service, VA San Diego Healthcare System, San Diego, CA, United States
| | - McKenna E. Williams
- University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University, San Diego, CA, United States,Center for Behavior Genetics of Aging, University of California, San Diego, San Diego, CA, United States
| | - William S. Kremen
- Center for Behavior Genetics of Aging, University of California, San Diego, San Diego, CA, United States,Department of Psychiatry, School of Medicine, University of California, San Diego, San Diego, CA, United States,Center of Excellence for Stress and Mental Health, Veterans Affairs San Diego Healthcare System, San Diego, CA, United States
| |
Collapse
|
29
|
Wang G, Liu L, Li Y, Aschenbrenner AJ, Bateman RJ, Delmar P, Schneider LS, Kennedy RE, Cutter GR, Xiong C. Proportional constrained longitudinal data analysis models for clinical trials in sporadic Alzheimer's disease. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12286. [PMID: 35415211 PMCID: PMC8984094 DOI: 10.1002/trc2.12286] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 02/16/2022] [Accepted: 03/03/2022] [Indexed: 11/07/2022]
Abstract
Introduction Clinical trials for sporadic Alzheimer's disease generally use mixed models for repeated measures (MMRM) or, to a lesser degree, constrained longitudinal data analysis models (cLDA) as the analysis model with time since baseline as a categorical variable. Inferences using MMRM/cLDA focus on the between-group contrast at the pre-determined, end-of-study assessments, thus are less efficient (eg, less power). Methods The proportional cLDA (PcLDA) and proportional MMRM (pMMRM) with time as a categorical variable are proposed to use all the post-baseline data without the linearity assumption on disease progression. Results Compared with the traditional cLDA/MMRM models, PcLDA or pMMRM lead to greater gain in power (up to 20% to 30%) while maintaining type I error control. Discussion The PcLDA framework offers a variety of possibilities to model longitudinal data such as proportional MMRM (pMMRM) and two-part pMMRM which can model heterogeneous cohorts more efficiently and model co-primary endpoints simultaneously.
Collapse
Affiliation(s)
- Guoqiao Wang
- Division of BiostatisticsWashington University School of MedicineSt. LouisMissouriUSA
- Department of NeurologyWashington University School of MedicineSt. LouisMissouriUSA
| | - Lei Liu
- Division of BiostatisticsWashington University School of MedicineSt. LouisMissouriUSA
| | - Yan Li
- Department of NeurologyWashington University School of MedicineSt. LouisMissouriUSA
| | | | - Randall J. Bateman
- Department of NeurologyWashington University School of MedicineSt. LouisMissouriUSA
| | | | - Lon S. Schneider
- Department of Psychiatry and The Behavioral SciencesDepartment of NeurologyKeck School of MedicineUniversity of Southern CaliforniaLos AngelesUSA
| | | | - Gary R. Cutter
- Department of BiostatisticsUniversity of Alabama at BirminghamBirminghamUSA
| | - Chengjie Xiong
- Division of BiostatisticsWashington University School of MedicineSt. LouisMissouriUSA
- Department of NeurologyWashington University School of MedicineSt. LouisMissouriUSA
| |
Collapse
|
30
|
Sanderson‐Cimino M, Elman JA, Tu XM, Gross AL, Panizzon MS, Gustavson DE, Bondi MW, Edmonds EC, Eglit GM, Eppig JS, Franz CE, Jak AJ, Lyons MJ, Thomas KR, Williams ME, Kremen WS. Cognitive practice effects delay diagnosis of MCI: Implications for clinical trials. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12228. [PMID: 35128027 PMCID: PMC8804942 DOI: 10.1002/trc2.12228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 07/12/2021] [Accepted: 11/15/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Practice effects (PEs) on cognitive tests obscure decline, thereby delaying detection of mild cognitive impairment (MCI). Importantly, PEs may be present even when there are performance declines, if scores would have been even lower without prior test exposure. We assessed how accounting for PEs using a replacement-participants method impacts incident MCI diagnosis. METHODS Of 889 baseline cognitively normal (CN) Alzheimer's Disease Neuroimaging Initiative (ADNI) participants, 722 returned 1 year later (mean age = 74.9 ± 6.8 at baseline). The scores of test-naïve demographically matched "replacement" participants who took tests for the first time were compared to returnee scores at follow-up. PEs-calculated as the difference between returnee follow-up scores and replacement participants scores-were subtracted from follow-up scores of returnees. PE-adjusted cognitive scores were then used to determine if individuals were below the impairment threshold for MCI. Cerebrospinal fluid amyloid beta, phosphorylated tau, and total tau were used for criterion validation. In addition, based on screening and recruitment numbers from a clinical trial of amyloid-positive individuals, we estimated the effect of earlier detection of MCI by accounting for cognitive PEs on a hypothetical clinical trial in which the key outcome was progression to MCI. RESULTS In the ADNI sample, PE-adjusted scores increased MCI incidence by 19% (P < .001), increased proportion of amyloid-positive MCI cases (+12%), and reduced proportion of amyloid-positive CNs (-5%; P's < .04). Additional calculations showed that the earlier detection and increased MCI incidence would also substantially reduce necessary sample size and study duration for a clinical trial of progression to MCI. Cost savings were estimated at ≈$5.41 million. DISCUSSION Detecting MCI as early as possible is of obvious importance. Accounting for cognitive PEs with the replacement-participants method leads to earlier detection of MCI, improved diagnostic accuracy, and can lead to multi-million-dollar cost reductions for clinical trials.
Collapse
Affiliation(s)
- Mark Sanderson‐Cimino
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical PsychologySan DiegoCaliforniaUSA
- Center for Behavior Genetics of AgingUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
| | - Jeremy A. Elman
- Center for Behavior Genetics of AgingUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
- Department of PsychiatrySchool of MedicineUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
| | - Xin M. Tu
- Department of PsychiatrySchool of MedicineUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
- Family Medicine and Public HealthUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
- Sam and Rose Stein Institute for Research on AgingUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
| | - Alden L. Gross
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Matthew S. Panizzon
- Center for Behavior Genetics of AgingUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
- Department of PsychiatrySchool of MedicineUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
| | - Daniel E. Gustavson
- Department of MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Mark W. Bondi
- Department of PsychiatrySchool of MedicineUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
- Psychology ServiceVA San Diego Healthcare SystemSan DiegoCaliforniaUSA
| | - Emily C. Edmonds
- Department of PsychiatrySchool of MedicineUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
- Research ServiceVA San Diego Healthcare SystemSan DiegoCaliforniaUSA
| | - Graham M.L. Eglit
- Center for Behavior Genetics of AgingUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
- Department of PsychiatrySchool of MedicineUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
- Sam and Rose Stein Institute for Research on AgingUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
| | | | - Carol E. Franz
- Center for Behavior Genetics of AgingUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
- Department of PsychiatrySchool of MedicineUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
| | - Amy J. Jak
- Center for Behavior Genetics of AgingUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
- Center of Excellence for Stress and Mental HealthVeterans Affairs San Diego Healthcare SystemSan DiegoCaliforniaUSA
| | - Michael J. Lyons
- Department of Psychological and Brain SciencesBoston UniversityBostonMassachusettsUSA
| | - Kelsey R. Thomas
- Department of PsychiatrySchool of MedicineUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
- Research ServiceVA San Diego Healthcare SystemSan DiegoCaliforniaUSA
| | - McKenna E. Williams
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical PsychologySan DiegoCaliforniaUSA
- Center for Behavior Genetics of AgingUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
| | - William S. Kremen
- Center for Behavior Genetics of AgingUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
- Department of PsychiatrySchool of MedicineUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
| | | |
Collapse
|
31
|
Oltra-Cucarella J, Sánchez-SanSegundo M, Ferrer-Cascales R. Predicting Alzheimer's disease with practice effects, APOE genotype and brain metabolism. Neurobiol Aging 2022; 112:111-121. [DOI: 10.1016/j.neurobiolaging.2021.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 12/17/2021] [Accepted: 12/28/2021] [Indexed: 11/26/2022]
|
32
|
Ho JK, Nation DA. Neuropsychological Decline Stratifies Dementia Risk in Cognitively Unimpaired and Impaired Older Adults. Front Aging Neurosci 2022; 14:838459. [PMID: 35923551 PMCID: PMC9339652 DOI: 10.3389/fnagi.2022.838459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Validation and widespread use of markers indicating decline in serial neuropsychological exams has remained elusive despite potential value in prognostic and treatment decision-making. This study aimed to operationalize neuropsychological decline, termed "neuropsychological (NP) decline," in older adults followed over 12 months in order to aid in the stratification of dementia risk along the cognitively unimpaired-to-mild cognitive impairment (MCI) spectrum. Methods A prospective cohort study utilized 6,794 older adults from the National Alzheimer's Coordinating Center (NACC) database with a baseline diagnosis of normal cognition, impaired without MCI or with MCI. Operationalization of NP decline over 12-month follow-up used regression-based norms developed in a robustly normal reference sample. The extent to which each participant's 12-month follow-up score deviated from norm-referenced expectations was quantified and standardized to an NP decline z-score. Cox regression evaluated whether the NP decline metric predicted future dementia. Results Participant's NP decline scores predicted future all-cause dementia in the total sample, χ2 = 110.71, hazard ratio (HR) = 1.989, p < 0.001, and in the subset diagnosed with normal cognition, χ2 = 40.84, HR = 2.006, p < 0.001, impaired without MCI diagnosis, χ2 = 14.89, HR = 2.465, p < 0.001, and impaired with MCI diagnosis, χ2 = 55.78, HR = 1.916, p < 0.001. Conclusion Operationalizing NP decline over 12 months with a regression-based norming method allows for further stratification of dementia risk along the cognitively unimpaired-to-MCI spectrum. The use of NP decline as an adjunctive marker of risk beyond standard cognitive diagnostic practices may aid in prognosis and clinical decision-making.
Collapse
Affiliation(s)
- Jean K Ho
- Institute for Memory Disorders and Neurological Impairments, University of California, Irvine, Irvine, CA, United States
| | - Daniel A Nation
- Institute for Memory Disorders and Neurological Impairments, University of California, Irvine, Irvine, CA, United States.,Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
| |
Collapse
|
33
|
De Simone MS, Perri R, Rodini M, Fadda L, De Tollis M, Caltagirone C, Carlesimo GA. A Lack of Practice Effects on Memory Tasks Predicts Conversion to Alzheimer Disease in Patients With Amnestic Mild Cognitive Impairment. J Geriatr Psychiatry Neurol 2021; 34:582-593. [PMID: 32734799 DOI: 10.1177/0891988720944244] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The aim of the current study was to test the accuracy of practice effects, that is, improvement in test performance due to repeated neuropsychological evaluations, in identifying patients with amnestic mild cognitive impairment (a-MCI) at greater risk of conversion to Alzheimer disease (AD). For this purpose, we conducted a longitudinal study of 54 patients diagnosed with a-MCI at the first assessment and followed-up for 4 years. During this time, 18 patients converted to AD. Baseline and 6- to 12-month follow-up performances on a large set of neuropsychological tests were analyzed to determine their diagnostic ability to predict later conversion to dementia. Results demonstrate that a lack of practice effects on episodic memory tests is an accurate prognostic indicator of late conversion to AD in a-MCI patients. In fact, even though the performance of both groups was substantially comparable at the baseline evaluation, stable a-MCI patients greatly improved their memory performance at retest after 6 to 12 months; instead, scores of converter a-MCI remained stable or decreased passing from baseline to follow-up. Standardized z-change scores on memory tasks, which were computed as a reliable measure of performance change, classified group membership with very good overall accuracy, which was higher than the classification of converter and stable a-MCIs provided by baseline or follow-up scores. We hypothesize that the lack of practice effects on memory tasks mirrors the early involvement of medial temporal lobe areas in converter a-MCI that are fundamental for the consolidation of new memory traces.
Collapse
Affiliation(s)
| | - Roberta Perri
- Laboratory of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Marta Rodini
- Laboratory of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Lucia Fadda
- Laboratory of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy.,Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Massimo De Tollis
- Laboratory of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Carlo Caltagirone
- Laboratory of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy.,Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Giovanni Augusto Carlesimo
- Laboratory of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy.,Department of Systems Medicine, Tor Vergata University, Rome, Italy
| |
Collapse
|
34
|
Hooyman A, Talboom JS, DeBoth MD, Ryan L, Huentelman M, Schaefer SY. Remote, Unsupervised Functional Motor Task Evaluation in Older Adults across the United States Using the MindCrowd Electronic Cohort. Dev Neuropsychol 2021; 46:435-446. [PMID: 34612107 PMCID: PMC8671381 DOI: 10.1080/87565641.2021.1979005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/01/2021] [Accepted: 09/04/2021] [Indexed: 10/20/2022]
Abstract
COVID-19 has impacted the ability to evaluate motor function in older adults, as motor assessments typically require face-to-face interaction. One hundred seventy-seven older adults nationwide completed an unsupervised functional upper-extremity assessment at home. Data were compared to data from an independent sample of community-dwelling older adults (N = 250) assessed in lab. The effect of age on performance was similar between the in-lab and at-home groups. Practice effects were also similar. Assessing upper-extremity motor function remotely is feasible and reliable in community-dwelling older adults. This test offers a practical solution for telehealth practice and other research involving remote or geographically isolated individuals.
Collapse
Affiliation(s)
- Andrew Hooyman
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, USA
- The Arizona Alzheimer’s Consortium, Phoenix, AZ, USA
| | - Joshua S. Talboom
- The Arizona Alzheimer’s Consortium, Phoenix, AZ, USA
- Neurogenomics Division, The Translational Genomics Research Institute (TGen), Phoenix, AZ, USA
| | - Matthew D. DeBoth
- The Arizona Alzheimer’s Consortium, Phoenix, AZ, USA
- Neurogenomics Division, The Translational Genomics Research Institute (TGen), Phoenix, AZ, USA
| | - Lee Ryan
- The Arizona Alzheimer’s Consortium, Phoenix, AZ, USA
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Matt Huentelman
- The Arizona Alzheimer’s Consortium, Phoenix, AZ, USA
- Neurogenomics Division, The Translational Genomics Research Institute (TGen), Phoenix, AZ, USA
| | - Sydney Y. Schaefer
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, USA
- The Arizona Alzheimer’s Consortium, Phoenix, AZ, USA
| |
Collapse
|
35
|
Dixon JS, Coyne AE, Duff K, Ready RE. Predictors of cognitive decline in a multi-racial sample of midlife women: A longitudinal study. Neuropsychology 2021; 35:514-528. [PMID: 34014752 PMCID: PMC8352567 DOI: 10.1037/neu0000743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Objective: Hypertension, diabetes, depressive symptoms, and smoking are predictors of cognitive decline in late life. It is unknown if these risk factors are associated with cognition during midlife or if the associations between these risk factors and cognition vary by race. This longitudinal study examined (a) risk factors for decline in episodic memory, processing speed, and working memory in midlife women and (b) if the associations between risk factors and cognitive decline were moderated by race. Method: Participants (aged 42-52) were European American (n = 1,000), African American (n = 516), and Asian American (n = 437) women from the Study of Women's Health Across the Nation. Two-level hierarchical linear models tested risk factors, race, and their interactions as predictors of cognitive change over time. Results: African Americans had poorer baseline episodic memory, processing speed, and working memory and greater episodic memory decline compared to European Americans. Asian Americans had poorer episodic memory and working memory, but better processing speed than European Americans. Depressive symptoms were associated with poorer episodic memory and processing speed at baseline; further, diabetes was associated with poorer processing speed at baseline. Greater depressive symptoms were associated with poorer episodic memory at baseline for African Americans but not European Americans. Conclusions: Our study results highlight racial disparities in cognition during midlife. Depressive symptoms may be particularly detrimental to the cognitive health of African Americans. Clinical and public health interventions for healthy cognitive aging should be tailored to the unique risks of racial groups. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
Affiliation(s)
- Jasmine S. Dixon
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA
| | - Alice E. Coyne
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA
| | - Kevin Duff
- Department of Neurology, University of Utah, Salt Lake City, UT
| | - Rebecca E. Ready
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA
| |
Collapse
|
36
|
Araújo N, Severo M, Lopes-Conceição L, Fontes F, Dias T, Branco M, Morais S, Cruz VT, Ruano L, Pereira S, Lunet N. Trajectories of cognitive performance over five years in a prospective cohort of patients with breast cancer (NEON-BC). Breast 2021; 58:130-137. [PMID: 34023557 PMCID: PMC8165446 DOI: 10.1016/j.breast.2021.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 04/08/2021] [Accepted: 05/13/2021] [Indexed: 12/20/2022] Open
Abstract
Purpose To identify trajectories of cognitive performance up to five years since diagnosis and their predictors, in a cohort of patients with breast cancer (BCa). Methods A total of 464 women with BCa admitted to the Portuguese Institute of Oncology, Porto, during 2012, were evaluated with the Montreal Cognitive Assessment (MoCA) before any treatment, and after one, three and five years. Probable cognitive impairment (PCI) at baseline was defined based on normative age- and education-specific reference values. Mclust was used to define MoCA trajectories. Receiver Operating Characteristic curves were used to assess the predictive accuracy for cognitive trajectories. Results Two trajectories were identified, one with higher scores and increasing overtime, and the other, including 25.9% of the participants, showing a continuous decline. To further characterize each trajectory, participants were also classified as scoring above or below the median baseline MoCA scores. This resulted in four groups: 1) highest baseline scores, stable overtime (0.0% with PCI); 2) lowest baseline scores (29.5% with PCI); 3) mid-range scores at baseline, increasing overtime (10.5% with PCI); 4) mid-range scores at baseline, decreasing overtime (0.0% with PCI). Adding the change in MoCA during the first year to baseline variables significantly increased the accuracy to predict the downward trajectory (area under the curve [AUC] = 0.732 vs. AUC = 0.841, P < 0.001). Conclusion Four groups of patients with BCa with different cognitive performance trends were identified. The assessment of cognitive performance before treatments and after one year allows for the identification of patients more likely to have cognitive decline in the long term. 5-year cognitive trajectories since diagnosis of breast cancer were identified. 25.9% of breast cancer survivors had a declining cognitive trajectory. Cognitive performance during the 1st year predicted the 5-year trajectory.
Collapse
Affiliation(s)
- Natália Araújo
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas, 135, 4050-600, Porto, Portugal
| | - Milton Severo
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas, 135, 4050-600, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Luisa Lopes-Conceição
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas, 135, 4050-600, Porto, Portugal; Instituto Português de Oncologia do Porto Francisco Gentil, Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal
| | - Filipa Fontes
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas, 135, 4050-600, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal; Instituto Português de Oncologia do Porto Francisco Gentil, Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal
| | - Teresa Dias
- Instituto Português de Oncologia do Porto Francisco Gentil, Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal
| | - Mariana Branco
- Centro Hospitalar de Entre Douro e Vouga, Rua Dr. Cândido de Pinho, 4520-211, Santa Maria da Feira, Portugal
| | - Samantha Morais
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas, 135, 4050-600, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Vítor Tedim Cruz
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas, 135, 4050-600, Porto, Portugal; Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Rua Dr. Eduardo Torres, 4464-513, Senhora da Hora, Portugal
| | - Luis Ruano
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas, 135, 4050-600, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal; Centro Hospitalar de Entre Douro e Vouga, Rua Dr. Cândido de Pinho, 4520-211, Santa Maria da Feira, Portugal
| | - Susana Pereira
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas, 135, 4050-600, Porto, Portugal; Instituto Português de Oncologia do Porto Francisco Gentil, Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal
| | - Nuno Lunet
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas, 135, 4050-600, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal.
| |
Collapse
|
37
|
Hammers DB, Suhrie KR, Dixon A, Porter S, Duff K. Validation of one-week reliable change methods in cognitively intact community-dwelling older adults. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2021; 28:472-492. [PMID: 32613913 PMCID: PMC7775875 DOI: 10.1080/13825585.2020.1787942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 06/23/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Reliable change methods can assist the determination of whether observed changes in performance are meaningful. The current study sought to validate previously published standardized regression-based (SRB) equations for commonly administered cognitive tests using a cognitively intact sample of older adults, and extend findings by including relevant demographic and test-related variables known to predict cognitive performance. Method: This study applied previously published SRB prediction equations to 107 cognitively intact older adults assessed twice over one week. Prediction equations were also updated by pooling the current validation sample with 93 cognitively intact participants from original development sample to create a combined development sample. Results: Significant improvements were seen between observed baseline and follow-up scores on most measures. However, few differences were seen between observed follow-up scores and those predicted from these SRB algorithms, and the level of practice effects observed based on these equations were consistent with expectations. When SRBs were re-calculated from this combined development sample, predicted follow-up scores were mostly comparable with these equations, but standard errors of the estimate were consistently smaller. Conclusions: These results help support the validity of of these SRB equations to predict cognitive performance on these measures when repeated administration is necessary over short intervals. Findings also highlight the utility of expanding SRB models when predicting follow-up performance serially to provide more accurate assessment of reliable change at the level of the individual. As short-term practice effects are shown to predict cognitive performance annually, they possess the potential to inform clinical decision-making about individuals along the Alzheimer's continuum.
Collapse
Affiliation(s)
- Dustin B. Hammers
- Center for Alzheimer’s Care, Imaging, and Research, Department of Neurology, University of Utah
- Center on Aging, University of Utah
| | - Kayla R. Suhrie
- Center for Alzheimer’s Care, Imaging, and Research, Department of Neurology, University of Utah
| | - Ava Dixon
- Center for Alzheimer’s Care, Imaging, and Research, Department of Neurology, University of Utah
| | - Sariah Porter
- Center for Alzheimer’s Care, Imaging, and Research, Department of Neurology, University of Utah
| | - Kevin Duff
- Center for Alzheimer’s Care, Imaging, and Research, Department of Neurology, University of Utah
- Center on Aging, University of Utah
| |
Collapse
|
38
|
Hammers DB, Suhrie KR, Dixon A, Porter S, Duff K. Reliable change in cognition over 1 week in community-dwelling older adults: a validation and extension study. Arch Clin Neuropsychol 2021; 36:347-358. [PMID: 32026948 PMCID: PMC8245079 DOI: 10.1093/arclin/acz076] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 11/15/2019] [Accepted: 11/18/2019] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE Reliable change methods can aid neuropsychologists in understanding if performance differences over time represent clinically meaningful change or reflect benefit from practice. The current study sought to externally validate the previously published standardized regression-based (SRB) prediction equations developed by Duff for commonly administered cognitive measures. METHOD This study applied Duff's SRB prediction equations to an independent sample of community-dwelling participants with amnestic mild cognitive impairment (MCI) assessed twice over a 1-week period. A comparison of MCI subgroups (e.g., single v. multi domain) on the amount of change observed over 1 week was also examined. RESULTS Using pairwise t-tests, large and statistically significant improvements were observed on most measures across 1 week. However, the observed follow-up scores were consistently below expectation compared with predictions based on Duff's SRB algorithms. In individual analyses, a greater percentage of MCI participants showed smaller-than-expected practice effects based on normal distributions. In secondary analyses, smaller-than-expected practice effects were observed in participants with worse baseline memory impairment and a greater number of impaired cognitive domains, particularly for measures of executive functioning/speeded processing. CONCLUSIONS These findings help to further support the validity of Duff's 1-week SRB prediction equations in MCI samples and extend previous research by showing incrementally smaller-than-expected benefit from practice for increasingly impaired amnestic MCI subtypes.
Collapse
Affiliation(s)
- Dustin B Hammers
- Department of Neurology, Center for Alzheimer’s Care, Imaging, and Research, University of Utah
- Center on Aging, University of Utah
| | - Kayla R Suhrie
- Department of Neurology, Center for Alzheimer’s Care, Imaging, and Research, University of Utah
| | - Ava Dixon
- Department of Neurology, Center for Alzheimer’s Care, Imaging, and Research, University of Utah
| | - Sariah Porter
- Department of Neurology, Center for Alzheimer’s Care, Imaging, and Research, University of Utah
| | - Kevin Duff
- Department of Neurology, Center for Alzheimer’s Care, Imaging, and Research, University of Utah
- Center on Aging, University of Utah
| |
Collapse
|
39
|
Moradi K, Faghani S, Abdolalizadeh A, Khomeijani-Farahani M, Ashraf-Ganjouei A. Biological Features of Reversion from Mild Cognitive Impairment to Normal Cognition: A Study of Cerebrospinal Fluid Markers and Brain Volume. J Alzheimers Dis Rep 2021; 5:179-186. [PMID: 33981955 PMCID: PMC8075565 DOI: 10.3233/adr-200229] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Mild cognitive impairment (MCI) is a transitional condition between normal cognition and dementia. Although a significant proportion of the population with MCI experience reversion to normal cognition, it is still poorly understood. OBJECTIVE This study was designed to extend the present evidence regarding the difference between stable and reverting MCI by including whole brain atrophy measures as possible parameters involved. METHODS 405 patients diagnosed with MCI at baseline were selected. After one-year follow-up period, 337 patients (83.2%) were categorized as stable MCI and 68 patients (16.8%) reverted to cognitively normal status (reversion group). Several baseline biomarkers including cerebrospinal fluid (CSF) biomarkers of AD, including Aβ42, t-tau, and p-tau and MRI-based atrophy measurements were compared. RESULTS Participants with stable MCI demonstrated greater brain atrophy as well as lower Aβ and higher tau proteins in the CSF. The atrophy rate was found to be associated with CSF biomarkers merely in the stable group, after adjustment for confounding variables. CONCLUSION These findings provide novel evidence regarding the biological perspective of the reversion phenomenon in individuals with MCI.
Collapse
Affiliation(s)
- Kamyar Moradi
- Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Interdisciplinary Neuroscience Research Program (INRP), Tehran University of Medical Sciences, Tehran, Iran
| | - Shahriar Faghani
- Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Interdisciplinary Neuroscience Research Program (INRP), Tehran University of Medical Sciences, Tehran, Iran
| | - AmirHussein Abdolalizadeh
- Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Interdisciplinary Neuroscience Research Program (INRP), Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Khomeijani-Farahani
- Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Interdisciplinary Neuroscience Research Program (INRP), Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Ashraf-Ganjouei
- Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Interdisciplinary Neuroscience Research Program (INRP), Tehran University of Medical Sciences, Tehran, Iran
| | | |
Collapse
|
40
|
Hammers DB, Porter S, Dixon A, Suhrie KR, Duff K. Validating 1-Year Reliable Change Methods. Arch Clin Neuropsychol 2021; 36:87-98. [PMID: 32885234 PMCID: PMC7809650 DOI: 10.1093/arclin/acaa055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/24/2020] [Accepted: 07/01/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE reliable change methods can assist in the determination of whether observed changes in performance are meaningful. The current study sought to validate previously published 1-year standardized regression-based (SRB) equations for commonly administered neuropsychological measures that incorporated baseline performances, demographics, and 1-week practice effects. METHOD Duff et al.'s SRB prediction equations were applied to an independent sample of 70 community-dwelling older adults with either normal cognition or mild cognitive impairment, assessed at baseline, at 1 week, and at 1 year. RESULTS minimal improvements or declines were seen between observed baseline and observed 1-year follow-up scores, or between observed 1-year and predicted 1-year scores, on most measures. Relatedly, a high degree of predictive accuracy was observed between observed 1-year and predicted 1-year scores across cognitive measures in this repeated battery. CONCLUSIONS these results, which validate Duff et al.'s SRB equations, will permit clinicians and researchers to have more confidence when predicting cognitive performance on these measures over 1 year.
Collapse
Affiliation(s)
- Dustin B Hammers
- Department of Neurology, Center for Alzheimer’s Care, Imaging, and Research, University of Utah, Salt Lake City, UT, USA
- Center on Aging, University of Utah, Salt Lake City, UT, USA
| | - Sariah Porter
- Department of Neurology, Center for Alzheimer’s Care, Imaging, and Research, University of Utah, Salt Lake City, UT, USA
| | - Ava Dixon
- Department of Neurology, Center for Alzheimer’s Care, Imaging, and Research, University of Utah, Salt Lake City, UT, USA
| | - Kayla R Suhrie
- Department of Neurology, Center for Alzheimer’s Care, Imaging, and Research, University of Utah, Salt Lake City, UT, USA
| | - Kevin Duff
- Department of Neurology, Center for Alzheimer’s Care, Imaging, and Research, University of Utah, Salt Lake City, UT, USA
- Center on Aging, University of Utah, Salt Lake City, UT, USA
| |
Collapse
|
41
|
Sanderson-Cimino M, Elman JA, Tu XM, Gross AL, Panizzon MS, Gustavson DE, Bondi MW, Edmonds EC, Eglit GM, Eppig JS, Franz CE, Jak AJ, Lyons MJ, Thomas KR, Williams ME, Kremen WS. Cognitive Practice Effects Delay Diagnosis; Implications for Clinical Trials. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.11.03.20224808. [PMID: 33173908 PMCID: PMC7654904 DOI: 10.1101/2020.11.03.20224808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Practice effects on cognitive tests obscure decline, thereby delaying detection of mild cognitive impairment (MCI). This reduces opportunities for slowing Alzheimer's disease progression and can hinder clinical trials. Using a novel method, we assessed the ability of practice-effect-adjusted diagnoses to detect MCI earlier, and tested the validity of these diagnoses based on AD biomarkers. METHODS Of 889 Alzheimer's Disease Neuroimaging Initiative participants who were cognitively normal (CN) at baseline, 722 returned at 1-year-follow-up (mean age=74.9±6.8). Practice effects were calculated by comparing returnee scores at follow-up to demographically-matched individuals who had only taken the tests once, with an additional adjustment for attrition effects. Practice effects for each test were subtracted from follow-up scores. The lower scores put additional individuals below the impairment threshold for MCI. CSF amyloid-beta, phosphorylated tau, and total tau were measured at baseline and used for criterion validation. RESULTS Practice-effect-adjusted scores increased MCI incidence by 26% (p<.001). Adjustment increased proportions of amyloid-positive MCI cases (+20%) and reduced proportions of amyloid-positive CNs (-6%) (ps<.007). With the increased MCI base rate, adjustment for practice effects would reduce the sample size needed for detecting significant drug treatment effects by an average of 21%, which we demonstrate would result in multi-million-dollar savings in a clinical trial. INTERPRETATION Adjusting for practice effects on cognitive testing leads to earlier detection of MCI. When MCI is an outcome, this reduces recruitment needed for clinical trials, study duration, staff and participant burden, and can dramatically lower costs. Importantly, biomarker evidence also indicates improved diagnostic accuracy.
Collapse
Affiliation(s)
- Mark Sanderson-Cimino
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Jeremy A. Elman
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
- Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Xin M. Tu
- Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA, USA
- Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, USA
| | - Alden L. Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MA, USA
| | - Matthew S. Panizzon
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
- Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Daniel E. Gustavson
- Department of Medicine, Vanderbilt University Medical Center, Nashville TN, USA
| | - Mark W. Bondi
- Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA, USA
- Psychology Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Emily C. Edmonds
- Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA, USA
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Graham M.L. Eglit
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
- Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA, USA
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, USA
| | | | - Carol E. Franz
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
- Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Amy J. Jak
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
- Center of Excellence for Stress and Mental Health, Veterans Affairs San Diego Healthcare System, La Jolla, CA, USA
| | - Michael J. Lyons
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Kelsey R. Thomas
- Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA, USA
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - McKenna E. Williams
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - William S. Kremen
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
- Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA, USA
- Center of Excellence for Stress and Mental Health, Veterans Affairs San Diego Healthcare System, La Jolla, CA, USA
| | | |
Collapse
|
42
|
Vaskivuo L, Hokkanen L, Hänninen T, Antikainen R, Bäckman L, Laatikainen T, Paajanen T, Stigsdotter-Neely A, Strandberg T, Tuomilehto J, Soininen H, Kivipelto M, Ngandu T. Self and Informant Memory Reports in FINGER: Associations with Two-Year Cognitive Change. J Alzheimers Dis 2020; 71:785-795. [PMID: 31424391 DOI: 10.3233/jad-190133] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Subjective memory complaints (SMCs) may be the first sign of cognitive decline in aging. OBJECTIVE To examine whether SMCs reported by oneself and informant predict cognitive change over 2 years among at-risk elderly people, and to determine the relationship of different types of SMCs (prospective and retrospective memory complaints) and change in cognitive function. METHODS This investigation is part of the FINGER project, which is a multicenter randomized controlled trial aiming at preventing cognitive decline in cognitively healthy older adults with increased risk of dementia. A subsample of 303 control-group participants (aged 60-80 years) and their informants (n = 261) rated the frequency of SMCs, using the Prospective and Retrospective Memory Questionnaire (PRMQ). Cognitive performance was measured at baseline and at 1- and 2-year follow-up visits using a neuropsychological test battery. RESULTS Participants who reported more SMCs improved less in global cognition, executive function, and memory during the subsequent 2 years in the fully-adjusted analyses. Self-reported retrospective memory problems predicted less improvement in all cognitive domains, whereas prospective memory problems did not. Informant-reported memory problems were not linked to subsequent change in cognition. CONCLUSION Our results indicate that self-reported SMCs, measured with PRMQ, predict future cognitive change in several cognitive domains. By contrast, reports by informants were not linked to changes in cognition. Among cognitively healthy at-risk elderly individuals, the persons themselves observe more easily problems relevant for their future cognitive trajectories than their informants.
Collapse
Affiliation(s)
- Laura Vaskivuo
- Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland.,Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Laura Hokkanen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Tuomo Hänninen
- Neurocenter/ Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Riitta Antikainen
- University of Oulu, Center for Life Course Health Research, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and Oulu City Hospital, Oulu, Finland
| | - Lars Bäckman
- Aging Research Center, Karolinska Institutet-Stockholm University, Stockholm, Sweden
| | - Tiina Laatikainen
- Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Hospital District of North Karelia, Joensuu, Finland
| | - Teemu Paajanen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Anna Stigsdotter-Neely
- Department of Psychology, Umeå University, Umeå, Sweden and Department of Social and Psychological Sciences, Karlstad University, Karlstad, Sweden
| | - Timo Strandberg
- University of Oulu, Center for Life Course Health Research, Oulu, Finland.,University of Helsinki, Clinicum, and Helsinki University Hospital, Helsinki, Finland
| | - Jaakko Tuomilehto
- Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland.,South Ostrobothnia Central Hospital, Seinäjoki, Finland and Department of Public Health, University of Helsinki, Helsinki, Finland.,Dasman Diabetes Institute, Kuwait City, Kuwait, Danube University Kerms, Krems, Austria and Kind Abdulaziz University, Jeddah, Saudi Arabia
| | - Hilkka Soininen
- Neurocenter/ Neurology, Kuopio University Hospital, Kuopio, Finland.,Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland
| | - Miia Kivipelto
- Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland.,Aging Research Center, Karolinska Institutet-Stockholm University, Stockholm, Sweden.,Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland.,Karolinska Institutet Center for Alzheimer Research, Stockholm, Sweden
| | - Tiia Ngandu
- Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland.,Karolinska Institutet Center for Alzheimer Research, Stockholm, Sweden
| |
Collapse
|
43
|
Wearn AR, Saunders-Jennings E, Nurdal V, Hadley E, Knight MJ, Newson M, Kauppinen RA, Coulthard EJ. Accelerated long-term forgetting in healthy older adults predicts cognitive decline over 1 year. ALZHEIMERS RESEARCH & THERAPY 2020; 12:119. [PMID: 32988418 PMCID: PMC7523317 DOI: 10.1186/s13195-020-00693-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 09/16/2020] [Indexed: 01/17/2023]
Abstract
Background Here, we address a pivotal factor in Alzheimer’s prevention—identifying those at risk early, when dementia can still be avoided. Recent research highlights an accelerated forgetting phenotype as a risk factor for Alzheimer’s disease. We hypothesized that delayed recall over 4 weeks would predict cognitive decline over 1 year better than 30-min delayed recall, the current gold standard for detecting episodic memory problems which could be an early clinical manifestation of incipient Alzheimer’s disease. We also expected hippocampal subfield volumes to improve predictive accuracy. Methods Forty-six cognitively healthy older people (mean age 70.7 ± 7.97, 21/46 female), recruited from databases such as Join Dementia Research, or a local database of volunteers, performed 3 memory tasks on which delayed recall was tested after 30 min and 4 weeks, as well as Addenbrooke’s Cognitive Examination III (ACE-III) and CANTAB Paired Associates Learning. Medial temporal lobe subregion volumes were automatically measured using high-resolution 3T MRI. The ACE-III was repeated after 12 months to assess the change in cognitive ability. We used univariate linear regressions and ROC curves to assess the ability of tests of delayed recall to predict cognitive decline on ACE-III over the 12 months. Results Fifteen of the 46 participants declined over the year (≥ 3 points lost on ACE-III). Four-week verbal memory predicted cognitive decline in healthy older people better than clinical gold standard memory tests and hippocampal MRI. The best single-test predictor of cognitive decline was the 4-week delayed recall on the world list (R2 = .123, p = .018, β = .418). Combined with hippocampal subfield volumetry, 4-week verbal recall identifies those at risk of cognitive decline with 93% sensitivity and 86% specificity (AUC = .918, p < .0001). Conclusions We show that a test of accelerated long-term forgetting over 4 weeks can predict cognitive decline in healthy older people where traditional tests of delayed recall cannot. Accelerated long-term forgetting is a sensitive, easy-to-test predictor of cognitive decline in healthy older people. Used alone or with hippocampal MRI, accelerated forgetting probes functionally relevant Alzheimer’s-related change. Accelerated forgetting will identify early-stage impairment, helping to target more invasive and expensive molecular biomarker testing.
Collapse
Affiliation(s)
- Alfie R Wearn
- Bristol Medical School, University of Bristol, Bristol, UK. .,Institute of Clinical Neurosciences, North Bristol NHS Trust, Bristol, UK.
| | | | - Volkan Nurdal
- Bristol Medical School, University of Bristol, Bristol, UK.,Department of Psychology, University of Bath, Bath, UK
| | - Emma Hadley
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Michael J Knight
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Margaret Newson
- Institute of Clinical Neurosciences, North Bristol NHS Trust, Bristol, UK.,School of Psychological Science, University of Bristol, Bristol, UK
| | | | - Elizabeth J Coulthard
- Bristol Medical School, University of Bristol, Bristol, UK.,Institute of Clinical Neurosciences, North Bristol NHS Trust, Bristol, UK
| |
Collapse
|
44
|
Jutten RJ, Grandoit E, Foldi NS, Sikkes SAM, Jones RN, Choi S, Lamar ML, Louden DKN, Rich J, Tommet D, Crane PK, Rabin LA. Lower practice effects as a marker of cognitive performance and dementia risk: A literature review. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2020; 12:e12055. [PMID: 32671181 PMCID: PMC7346865 DOI: 10.1002/dad2.12055] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/27/2020] [Accepted: 05/27/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Practice effects (PEs) are improvements in performance after repeated exposure to test materials, and typically viewed as a source of bias in repeated cognitive assessments. We aimed to determine whether characterizing PEs could also provide a useful marker of early cognitive decline. METHODS We conducted a systematic review of the literature, searching PsycInfo (Ebsco) and PubMed databases for articles studying PEs in aging and dementia populations. Articles published between 1920 and 2019 were included. RESULT We identified 259 articles, of which 27 studied PEs as markers of cognitive performance. These studies consistently showed that smaller, less-robust PEs were associated with current diagnostic status and/or future cognitive decline. In addition, lower PEs were associated with Alzheimer's disease risk factors and neurodegeneration biomarkers. CONCLUSION PEs provide a potentially useful marker of cognitive decline, and could prove valuable as part of a cost-effective strategy to select individuals who are at-risk for dementia for future interventions.
Collapse
Affiliation(s)
- Roos J. Jutten
- Alzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam UMCVrije UniversiteitAmsterdamthe Netherlands
| | | | - Nancy S. Foldi
- Queens College and The Graduate Center of The City University of New YorkQueensNew YorkUSA
| | - Sietske A. M. Sikkes
- Alzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam UMCVrije UniversiteitAmsterdamthe Netherlands
| | - Richard N. Jones
- Warren Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Seo‐Eun Choi
- School of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Melissa L. Lamar
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
| | | | - Joanne Rich
- University Libraries, University of WashingtonSeattleWashingtonUSA
| | - Douglas Tommet
- Warren Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Paul K. Crane
- School of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Laura A. Rabin
- Brooklyn College and The Graduate Center of The City University of New YorkBrooklynNew YorkUSA
| |
Collapse
|
45
|
Duff K, Hammers DB. Practice effects in mild cognitive impairment: A validation of Calamia et al. (2012). Clin Neuropsychol 2020; 36:571-583. [PMID: 32594886 DOI: 10.1080/13854046.2020.1781933] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: In a meta-analysis examining practice effects on repeated neuropsychological testing, Calamia et al. (2012) provided information to predict practice effects in healthy and clinical samples across a range of cognitive domains. However, these estimates have not been validated.Method: This study used these prediction estimate calculations to predict follow-up scores across one year on a brief battery of neuropsychological tests in a sample of 93 older adults with amnestic mild cognitive impairment. The predicted follow-up scores were compared to observed follow-up scores.Results: Using Calamia et al. model's intercept, age, retest interval, clinical status, and specific cognitive tests, three of the seven observed follow-up scores in this cognitive battery were significantly lower than the Calamia et al. predicted follow-up scores. Differences between individual participants' observed and predicted follow-up scores were more striking. For example, on Delayed Recall of the Hopkins Verbal Learning Test - Revised, 40% of the sample had Calamia et al. predicted scores that were one or more standard deviations above their observed scores. These differences were most notable on tests that were not in Calamia et al.'s cognitive battery, suggesting the meta-analysis results may not generalize as well to other tests.Conclusions: Although Calamia et al. provided a method for predicting practice effects and follow-up scores, these results raise caution when using them in MCI, especially on cognitive tests that were not in their meta-analysis.
Collapse
Affiliation(s)
- Kevin Duff
- Center for Alzheimer's Care, Imaging and Research, Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - Dustin B Hammers
- Center for Alzheimer's Care, Imaging and Research, Department of Neurology, University of Utah, Salt Lake City, UT, USA
| |
Collapse
|
46
|
Duff K. Cognitive composites in AD trials? Drinking the Kool-Aid and paying the price? ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2020; 12:e12011. [PMID: 32699816 PMCID: PMC7369402 DOI: 10.1002/dad2.12011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 02/03/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Kevin Duff
- Department of Neurology University of Utah Salt Lake City Utah USA
| |
Collapse
|
47
|
Gelonch O, Cano N, Vancells M, Bolaños M, Farràs-Permanyer L, Garolera M. The Effects of Exposure to Recent Autobiographical Events on Declarative Memory in Amnestic Mild Cognitive Impairment: A Preliminary Pilot Study. Curr Alzheimer Res 2020; 17:158-167. [PMID: 32183672 DOI: 10.2174/1567205017666200317093341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 01/20/2020] [Accepted: 02/11/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Individuals with amnestic Mild Cognitive Impairment (aMCI) are at heightened risk of developing Alzheimer's dementia. In recent years, much attention has been given to the search for new interventions to slow down the progression of cognitive decline of these patients. Wearable digital camera devices are one form of new technology that captures images of one's life events, so they constitute a promising method to be used as a means to stimulate recent autobiographical memory. OBJECTIVE This preliminary study investigates the ability of a new cognitive intervention based on exposure to recent autobiographical memory captured by wearable cameras to improve episodic memory in patients with aMCI. METHODS Seventeen subjects wore a wearable camera while they went about their daily activities. The images captured were converted into eight different 3-minute films containing the most relevant information of each event. The intervention involved eight individualized weekly sessions during which patients were exposed to a different autobiographical event each week. Besides, several specific questions were formulated within each session. Clinical questionnaires assessing cognitive reserve, premorbid intelligence, depression, and anxiety were administered at baseline. Measures of objective episodic memory were applied at baseline and at post-treatment. RESULTS Significant improvements were observed at post-treatment in memory measures, and significant associations were found between memory change scores and age and cognitive reserve. Anyway, these associations did not reach statistical significance after adjusting for multiple comparisons. CONCLUSION The present study provides preliminary evidence that aMCI patients may benefit from a cognitive intervention program based on re-experiencing recent autobiographical events. However, future studies incorporating a control group will be needed to confirm these preliminary findings.
Collapse
Affiliation(s)
- Olga Gelonch
- Clinical Research Group for Brain, Cognition and Behavior, Hospital de Terrassa, Consorci Sanitari de Terrassa, Spain
| | - Neus Cano
- Clinical Research Group for Brain, Cognition and Behavior, Hospital de Terrassa, Consorci Sanitari de Terrassa, Spain
| | - Marta Vancells
- Clinical Research Group for Brain, Cognition and Behavior, Hospital de Terrassa, Consorci Sanitari de Terrassa, Spain
| | - Marc Bolaños
- Department of Mathematics and Computer Science, Universitat de Barcelona, Barcelona, Spain
| | - Laia Farràs-Permanyer
- Department of Social Psychology and Quantitative Psychology, Universitat de Barcelona, Barcelona, Spain
| | - Maite Garolera
- Clinical Research Group for Brain, Cognition and Behavior, Hospital de Terrassa, Consorci Sanitari de Terrassa, Spain
| |
Collapse
|
48
|
Wang G, Kennedy RE, Goldberg TE, Fowler ME, Cutter GR, Schneider LS. Using practice effects for targeted trials or sub-group analysis in Alzheimer's disease: How practice effects predict change over time. PLoS One 2020; 15:e0228064. [PMID: 32084191 PMCID: PMC7034859 DOI: 10.1371/journal.pone.0228064] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 01/07/2020] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE To describe the presence of practice effects in persons with Alzheimer disease (AD) or mild cognitive impairment (MCI) and to evaluate how practice effects affect cognitive progression and the outcome of clinical trials. METHODS Using data from a meta-database consisting of 18 studies including participants from the Alzheimer disease Cooperative Study (ADCS) and the Alzheimer Disease Neuroimaging Initiative (ADNI) with ADAS-Cog11 as the primary outcome, we defined practice effects based on the improvement in the first two ADAS-Cog11 scores and then estimated the presence of practice effects and compared the cognitive progression between participants with and without practice effects. The robustness of practice effects was investigated using CDR SB, an outcome independent the definition itself. Furthermore, we evaluated how practice effects can affect sample size estimation. RESULTS The overall percent of practice effects for AD participants was 39.0% and 53.3% for MCI participants. For AD studies, the mean change from baseline to 2 years was 12.8 points for the non-practice effects group vs 7.4 for the practice effects group; whereas for MCI studies, it was 4.1 for non-practice effects group vs 0.2 for the practice effects group. AD participants without practice effects progressed 0.9 points faster than those with practice effects over a period of 2 years in CDR-SB; whereas for MCI participants, the difference is 0.7 points. The sample sizes can be different by over 35% when estimated based on participants with/without practice effects. CONCLUSION Practice effects were prevalent and robust in persons with AD or MCI and affected the cognitive progression and sample size estimation. Planning of future AD or MCI clinical trials should account for practice effects to avoid underpower or considers target trials or stratification analysis based on practice effects.
Collapse
Affiliation(s)
- Guoqiao Wang
- Division of Biostatistics, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - Richard E. Kennedy
- Comprehensive Center of Aging Health, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Terry E. Goldberg
- Department of Psychiatry, Columbia University, New York, New York, United States of America
| | - Mackenzie E. Fowler
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Gary R. Cutter
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Lon S. Schneider
- Department of Psychiatry and The Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| |
Collapse
|
49
|
Verberk IMW, Hendriksen HMA, van Harten AC, Wesselman LMP, Verfaillie SCJ, van den Bosch KA, Slot RER, Prins ND, Scheltens P, Teunissen CE, Van der Flier WM. Plasma amyloid is associated with the rate of cognitive decline in cognitively normal elderly: the SCIENCe project. Neurobiol Aging 2020; 89:99-107. [PMID: 32081465 DOI: 10.1016/j.neurobiolaging.2020.01.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 12/12/2019] [Accepted: 01/13/2020] [Indexed: 12/16/2022]
Abstract
Plasma biomarkers are promising prognostic tools in individuals with subjective cognitive decline (SCD). We aimed to investigate the relationships of baseline plasma amyloid beta (Aβ)42/Aβ40 and total Tau (tTau) with rate of cognitive decline, in comparison to relationships of baseline cerebrospinal fluid (CSF) Aβ42, tTau, and phosphorylated tau181 (pTau181) with rate of cognitive decline. We included 241 subjects with SCD (age = 61 ± 9, 40% female, Mini-Mental State Examination = 28 ± 2) with follow-up (average: 2 ± 2 years, median visits: 3 [range: 1-11]) for re-evaluation of neuropsychological test performance (attention, memory, language, and executive functioning domains). Using age, gender and education-adjusted linear mixed models, we found that lower plasma Aβ42/Aβ40 was associated with steeper rate of decline on tests for attention, memory, and executive functioning, but not language. Lower CSF Aβ42 was associated with steeper decline on tests covering all domains. Associations for plasma amyloid and cognitive decline mirror those of CSF amyloid. Plasma tTau was not associated with rate of cognitive decline, whereas CSF tTau and pTau181 were on multiple tests covering all domains.
Collapse
Affiliation(s)
- Inge M W Verberk
- Alzheimer Center, Department of Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands; Neurochemistry Laboratory, Department of Clinical Chemistry, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.
| | - Heleen M A Hendriksen
- Alzheimer Center, Department of Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Argonde C van Harten
- Alzheimer Center, Department of Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Linda M P Wesselman
- Alzheimer Center, Department of Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Sander C J Verfaillie
- Alzheimer Center, Department of Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Karlijn A van den Bosch
- Alzheimer Center, Department of Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Rosalinde E R Slot
- Alzheimer Center, Department of Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Niels D Prins
- Alzheimer Center, Department of Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Philip Scheltens
- Alzheimer Center, Department of Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Wiesje M Van der Flier
- Alzheimer Center, Department of Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands; Department of Epidemiology and Biostatistics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| |
Collapse
|
50
|
Burhanullah MH, Tschanz JT, Peters ME, Leoutsakos JM, Matyi J, Lyketsos CG, Nowrangi MA, Rosenberg PB. Neuropsychiatric Symptoms as Risk Factors for Cognitive Decline in Clinically Normal Older Adults: The Cache County Study. Am J Geriatr Psychiatry 2020; 28:64-71. [PMID: 31186157 PMCID: PMC6874723 DOI: 10.1016/j.jagp.2019.03.023] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 02/17/2019] [Accepted: 03/18/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION There has been considerable progress in identifying early cognitive and biomarker predictors of Alzheimer's disease (AD). Neuropsychiatric symptoms (NPS) are common in AD and appear to predict progression after the onset of mild cognitive impairment or dementia. OBJECTIVES The objective of the study is to examine the relationship between NPS in clinically normal older adults and subsequent cognitive decline in a population-based sample. METHODS The Cache County Study on Memory in Aging consists of a population-based sample of 5,092 older adults. We identified 470 clinically normal adults who were followed for an average period of 5.73 years. NPS were evaluated at the baseline clinical assessment using the Neuropsychiatric Inventory (NPI). NPI domain scores were quantified as the product of frequency X severity in individual NPI domains, and then summed for the NPI-Total. Neuropsychological measures were collected at baseline and at each subsequent follow-up wave. Linear mixed-effects models assessed the association of NPI-Total, NPI-Depression, and NPI-Anxiety scores (obtained at baseline) on longitudinal change in neuropsychological performance, controlling for age, sex, and education. RESULTS Baseline NPI-Total score was associated with a more rapid rate of decline in word list memory, praxis recall, and animal fluency. Baseline NPI-Depression was not associated with later decline on any of the cognitive tests, while baseline NPI-Anxiety was associated with decline in Symbol Digit Modality. CONCLUSION In conclusion, among clinically normal older adults derived from this population-based study, total burden of NPS was associated with longitudinal cognitive decline. These results add to the evidence that NPS are risk factors for or clinical indicators of preclinical dementia syndrome. Our study was an exploratory study and we did not control for multiple comparisons.
Collapse
|