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A Narrative Review of the Effects of Citrus Peels and Extracts on Human Brain Health and Metabolism. Nutrients 2022; 14:nu14091847. [PMID: 35565814 PMCID: PMC9103913 DOI: 10.3390/nu14091847] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 12/04/2022] Open
Abstract
As life expectancy increases, age-associated diseases such as Alzheimer's disease (AD) become a major health problem. The onset of AD involves neurological dysfunction due to amyloid-β accumulation, tau hyperphosphorylation, oxidative stress, and neuroinflammation in the brain. In addition, lifestyle-related diseases-such as dyslipidemia, diabetes, obesity, and vascular dysfunction-increase the risk of developing dementia. The world population ages, prompting the development of new strategies to maintain brain health and prevent the onset of dementia in older and preclinical patients. Citrus fruits are abundant polymethoxylated flavone and flavanone sources. Preclinical studies reported that these compounds have neuroprotective effects in models of dementia such as AD. Interestingly, clinical and epidemiological studies appear to support preclinical evidence and show improved cognitive function and reduced associated disease risk in healthy individuals and/or patients. This review summarizes the recent evidence of the beneficial effects of citrus peels and extracts on human cognition and related functions.
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2
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Feinkohl I, Kozma P, Borchers F, van Montfort SJT, Kruppa J, Winterer G, Spies C, Pischon T. Contribution of IQ in young adulthood to the associations of education and occupation with cognitive ability in older age. BMC Geriatr 2021; 21:346. [PMID: 34090365 PMCID: PMC8180039 DOI: 10.1186/s12877-021-02290-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 05/17/2021] [Indexed: 11/25/2022] Open
Abstract
Background Studies suggest that a higher education and occupation are each associated with a higher late-life cognitive ability, but their inter-relationships in their association with cognitive ability and the contribution of peak IQ in young adulthood (‘pre-morbid IQ’) often remain unclear. Methods Cross-sectional analysis of 623 participants aged ≥65 years of the BioCog study. Education was coded according to the International Standard Classification of Education (ISCED; range 1 to 6). Occupation was coded as ‘semi/unskilled’, ‘skilled manual’, ‘skilled non-manual’, ‘managerial’, ‘professional’. A summary score of global ability (‘g’) was constructed from six cognitive tests. Pre-morbid IQ was estimated from vocabulary. The Geriatric Depression Scale assessed symptoms of depression. Age- and sex-adjusted analyses of covariance were performed. Results Education (partial eta2 0.076; p < 0.001) and occupation (partial eta2 = 0.037; p < 0.001) were each significantly associated with g. For education, the association was attenuated but remained statistically significant when pre-morbid IQ was controlled for (partial eta2 0.036; p < 0.001) and was unchanged with additional adjustment for depression (partial eta2 0.037; p < 0.001). For occupation, the association with g was no longer significant when pre-morbid IQ (partial eta2 = 0.015; p = 0.06) and depression (partial eta2 = 0.011; p = 0.18) were entered as covariates in separate steps. When education and occupation were entered concurrently into the fully adjusted model, only education was independently associated with g (partial eta2 0.030; p < 0.001; occupation, p = 0.93). Conclusion While a higher education and a higher occupation were each associated with a higher late-life cognitive ability, only for education some unique contribution to cognitive ability remained over and above its relationship with pre-morbid IQ, depression, and occupation. Further research is needed to address whether a longer time spent in education may promote late-life cognitive ability. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02290-y.
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Affiliation(s)
- Insa Feinkohl
- Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Robert-Rössle Str. 10, 13092, Berlin, Germany.
| | - Petra Kozma
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Friedrich Borchers
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | | | - Jochen Kruppa
- Berlin Institute of Health (BIH) at Charité - Universitätsmedizin Berlin, Berlin, Germany.,Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Georg Winterer
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Claudia Spies
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Tobias Pischon
- Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Robert-Rössle Str. 10, 13092, Berlin, Germany.,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Biobank Technology Platform, Berlin, Germany.,Berlin Institute of Health (BIH) at Charité - Universitätsmedizin Berlin, Core Facility Biobank, Berlin, Germany
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3
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Neurological soft signs and cognition in the late course of chronic schizophrenia: a longitudinal study. Eur Arch Psychiatry Clin Neurosci 2021; 271:1465-1473. [PMID: 32417958 PMCID: PMC8563630 DOI: 10.1007/s00406-020-01138-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 05/04/2020] [Indexed: 02/07/2023]
Abstract
Neurological soft signs (NSS) are minor ('soft') neurological abnormalities in sensory and motor performances, which are frequently reported in patients with schizophrenia at any stage of their illness. It has been demonstrated that NSS vary in the clinical course of the disorder: longitudinally NSS decrease in parallel with remission of psychopathological symptoms, an effect which mainly applies to patients with a remitting course. These findings are primarily based on patients with a first episode of the disorder, while the course of NSS in patients with chronic schizophrenia and persisting symptoms is rather unknown. Therefore, we investigated NSS twice in 21 patients with chronic schizophrenia (initial mean duration of illness: 23 ± 11 years) with a mean follow-up interval of 7 years. NSS were evaluated by the Heidelberg Scale, established instruments were used to rate neuropsychological performance and psychopathological symptoms. NSS showed significant increases on the subscales "motor coordination" and "integrative functions", while positive and negative symptoms, including apathy, showed only minor, non-significant changes. Verbal memory, verbal fluency, and cognitive flexibility along with severity of global cognitive deficits demonstrated a significant deterioration. Regression analyses identified executive dysfunction (cognitive flexibility and verbal fluency) at baseline as significant predictors of NSS increase at follow-up. Our findings indicate that NSS deteriorate in the long-term course of chronic schizophrenia. This effect may be accounted for by a decrease of executive functions and logical memory, which can be attributed to premature brain aging.
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Serre-Miranda C, Roque S, Santos NC, Costa P, Sousa N, Palha JA, Correia-Neves M. Cognition Is Associated With Peripheral Immune Molecules in Healthy Older Adults: A Cross-Sectional Study. Front Immunol 2020; 11:2045. [PMID: 32983153 PMCID: PMC7493640 DOI: 10.3389/fimmu.2020.02045] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/28/2020] [Indexed: 12/14/2022] Open
Abstract
Background Cognition in the elderly is heterogeneous. Senescence of the immune system is increasingly considered as a potential player in cognitive performance. We explored here the interplay between cognitive performance and peripheral immune molecules in healthy older individuals. Methods A cross-sectional study of clinically well characterized senior healthy individuals (120; 51-87 years old) previously clustered as "Good" and "Poor" performers based on established tests that evaluate memory and executive function. A plasma concentration of 30 immune molecules was assessed by multiplex analysis and correlated with parameters of cognitive performance. Results Participants with worse cognitive performance ("Poor") exhibited increased concentrations of IL-1β, IL-8, IL-13, and tumor necrosis factor (TNF) when compared to individuals with a better cognitive performance ("Good"). The cognitive dimensions memory and executive function, when considered separately, displayed a negative association with several immune molecules (IL-1β, IL-1RA, IL-6, IL-13, IP-10, and TNF with memory and only IL-1β with executive function), even controlling for age, sex, years of formal education, mood, and use of anti-inflammatory drugs. Regression analysis showed that several of these molecules (IL-1β, IL-6, IL-8, and IL-13) contribute to predicting whether an individual belongs to the "Good" or "Poor" cognitive performance group. Conclusion These results strengthen the hypothesis that increased concentrations of peripheral immune molecules, like IL-1β, are associated with worse cognitive performance in senior healthy individuals. It further highlights that some poorly studied immune molecules should be considered in the context of cognitive aging, such as IL-13, here revealed as a new player in such interaction.
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Affiliation(s)
- Cláudia Serre-Miranda
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Susana Roque
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Nadine Correia Santos
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Clinical Academic Center - Braga, Braga, Portugal
| | - Patrício Costa
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Clinical Academic Center - Braga, Braga, Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Clinical Academic Center - Braga, Braga, Portugal
| | - Joana Almeida Palha
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Margarida Correia-Neves
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
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Valsdottir V, Haraldsson M, Gylfason HF, Sigurdsson E, Magnusdottir BB. Schizophrenia, cognition, and aging: cognitive deficits and the relationship between test performance and aging. AGING NEUROPSYCHOLOGY AND COGNITION 2019; 27:40-51. [PMID: 30707655 DOI: 10.1080/13825585.2019.1572100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Most measures of cognitive function decline with age during adulthood. Research indicates that people with schizophrenia experience considerable cognitive deficits. These deficits appear to become more troublesome with increasing age, but this has been debated. The aim of this research was to better understand the age related cognitive deficits of Icelandic subjects with schizophrenia in comparison to healthy individuals. Cognition of individuals 18 to 64 years of age was evaluated with 10 neuropsychological tests. People with schizophrenia performed significantly worse on all tests, as expected, indicating widespread cognitive deficits compared to healthy individuals, independent of age. Furthermore, the results suggest that people with schizophrenia follow a similar age-related trajectory of cognitive decline as healthy individuals. Overall, we conclude that the cognitive difficulties often experienced by older people with schizophrenia are better explained by lower cognitive function at the time of diagnosis than by faster cognitive decline with increasing age.
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Affiliation(s)
| | - Magnus Haraldsson
- School of Health Sciences, University of Iceland, Reykjavík, Iceland.,Department of Psychiatry, Landspitali University Hospital, Reykjavik, Iceland
| | | | - Engilbert Sigurdsson
- School of Health Sciences, University of Iceland, Reykjavík, Iceland.,Department of Psychiatry, Landspitali University Hospital, Reykjavik, Iceland
| | - Brynja Bjork Magnusdottir
- Psychology, Reykjavik University, Reykjavik, Iceland.,Department of Psychiatry, Landspitali University Hospital, Reykjavik, Iceland
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Ventura J, Subotnik KL, Gretchen-Doorly D, Casaus L, Boucher M, Hellemann GH, Nuechterlein KH, Hellemann GS, Nuechterlein KH. Cognitive remediation can improve negative symptoms and social functioning in first-episode schizophrenia: A randomized controlled trial. Schizophr Res 2019; 203:24-31. [PMID: 29128326 PMCID: PMC6589092 DOI: 10.1016/j.schres.2017.10.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 10/04/2017] [Accepted: 10/06/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Meta-analyses have reported that the effects of cognitive remediation might go beyond improvement in cognition to include unexpected benefits for schizophrenia patients such as negative symptom reduction and improvements in functioning. In addition, some evidence indicated that these potentially beneficial effects are also present in the initial course of schizophrenia, but work in this area is still developing. METHOD A RCT compared Cognitive Remediation (CR) to Healthy Behaviors Training (HBT) in 80 patients (78% male) with a mean age of 21.9years and mean education of 12.3years who had a first psychotic episode within two years of study entry. Participants were trained using CR programs or received HBT involving 50 sessions over 6months and then booster sessions over the next 6months. The SANS and BPRS were used to assess symptoms. The UCLA Social Attainment Survey assessed social functioning. RESULTS Using GLMM, improvements over 12months were found favoring CR for SANS Expressive Symptoms (p<0.01), which was composed of Affective Flattening (p<0.01) and Alogia (p=0.04), and for SANS Experiential Symptoms, composed of Avolition/Apathy (p=0.04) and Anhedonia/Asociality (p<0.01). CR was associated with improvements in social functioning (p=0.05) as compared to HBT. CONCLUSIONS We confirmed that the beneficial effects of CR appear to extend beyond cognition to improvements in negative symptoms and social functioning in early course schizophrenia patients. These results suggest that cognitive remediation might have an impact when the reduction of risk factors for chronicity is most critical for promoting recovery.
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Affiliation(s)
- Joseph Ventura
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States.
| | - Kenneth L. Subotnik
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Denise Gretchen-Doorly
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Laurie Casaus
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Michael Boucher
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Gerhard H. Hellemann
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Keith H. Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles,Department of Psychology, University of California, Los Angeles
| | - Gerhard S Hellemann
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States
| | - Keith H Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States; Department of Psychology, University of California, Los Angeles, United States
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7
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Abstract
BACKGROUND Evidence suggests that schizophrenia may be associated with an increased risk of dementia, but results from prior studies have been inconsistent. This study aimed to estimate the relationship between schizophrenia and incident dementia using a quantitative meta-analysis. METHODS Several databases were used to gather relevant information, including PubMed, Embase, and Web of Science, with the publication date of articles limited up to December 23, 2017. All studies reported a multivariate-adjusted estimate, represented as relative risk (RR) with 95% confidence intervals (CIs), for the association between schizophrenia and risk of dementia incidence. Pooled RRs were calculated using a random-effects model. RESULTS Six studies met our inclusion criteria for this meta-analysis, which included 206,694 cases of dementia and 5,063,316 participants. All individuals were without dementia at baseline. Overall, the quantitative meta-analysis suggested that subjects with schizophrenia were associated with a significantly greater risk of dementia incidence (RR 2.29; 95% CI 1.35-3.88) than those without. CONCLUSION The results of this meta-analysis indicate that individuals with schizophrenia may have an increased risk for the development of dementia. Future studies should explore whether schizophrenia is a modifiable risk factor for dementia.
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Affiliation(s)
- Laisheng Cai
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Jiangxi, China,
| | - Jingwei Huang
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Jiangxi, China,
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Mathias SR, Knowles EEM, Barrett J, Leach O, Buccheri S, Beetham T, Blangero J, Poldrack RA, Glahn DC. The Processing-Speed Impairment in Psychosis Is More Than Just Accelerated Aging. Schizophr Bull 2017; 43:814-823. [PMID: 28062652 PMCID: PMC5472152 DOI: 10.1093/schbul/sbw168] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Processing speed is impaired in patients with psychosis, and deteriorates as a function of normal aging. These observations, in combination with other lines of research, suggest that psychosis may be a syndrome of accelerated aging. But do patients with psychosis perform poorly on tasks of processing speed for the same reasons as older adults? Fifty-one patients with psychotic illnesses and 90 controls with similar mean IQ (aged 19-69 years, all African American) completed a computerized processing-speed task, reminiscent of the classic digit-symbol coding task. The data were analyzed using the drift-diffusion model (DDM), and Bayesian inference was used to determine whether psychosis and aging had similar or divergent effects on the DDM parameters. Psychosis and aging were both associated with poor performance, but had divergent effects on the DDM parameters. Patients had lower information-processing efficiency ("drift rate") and longer nondecision time than controls, and psychosis per se did not influence response caution. By contrast, the primary effect of aging was to increase response caution, and had inconsistent effects on drift rate and nondecision time across patients and controls. The results reveal that psychosis and aging influenced performance in different ways, suggesting that the processing-speed impairment in psychosis is more than just accelerated aging. This study also demonstrates the potential utility of computational models and Bayesian inference for finely mapping the contributions of cognitive functions on simple neurocognitive tests.
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Affiliation(s)
- Samuel R. Mathias
- Neurocognition, Neurocomputation and Neurogenetics (n3) Division, Department of Psychiatry, Yale University School of Medicine, 40 Temple Street, Room 694, New Haven, CT 06511
| | - Emma E. M. Knowles
- Neurocognition, Neurocomputation and Neurogenetics (n3) Division, Department of Psychiatry, Yale University School of Medicine, 40 Temple Street, Room 694, New Haven, CT 06511;,Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT
| | - Jennifer Barrett
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT
| | - Olivia Leach
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT
| | | | - Tamara Beetham
- Neurocognition, Neurocomputation and Neurogenetics (n3) Division, Department of Psychiatry, Yale University School of Medicine, 40 Temple Street, Room 694, New Haven, CT 06511
| | - John Blangero
- South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX
| | | | - David. C. Glahn
- Neurocognition, Neurocomputation and Neurogenetics (n3) Division, Department of Psychiatry, Yale University School of Medicine, 40 Temple Street, Room 694, New Haven, CT 06511;,Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT
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9
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Norlin Bagge E, Esbjörnsson E, Sunnerhagen KS. Cognitive screening and behavioural observation of functional ability in patients with multiple episode schizophrenia: an exploratory study. BMJ Open 2017; 7:e014783. [PMID: 28645961 PMCID: PMC5623419 DOI: 10.1136/bmjopen-2016-014783] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To evaluate the usability of a neuropsychological screening instrument and two observation scales of everyday behaviour to describe cognitive and functional capacity of patients with multiepisode schizophrenia and considerable care needs, who frequently refuse to participate in cognitive testing or performance-based functional measurement. SETTING One psychiatric unit specialised in severe mental illness at the Sahlgrenska University Hospital, Gothenburg, Sweden. PARTICIPANTS Patients were included consecutively from date of admission to the unit. INCLUSION CRITERIA age 18-65 years, International Classification of Diseases 10 diagnoses F20.0-F20.9 (schizophrenia) or F25.0-F25.9 (schizoaffective disorder) since at least 5 years. EXCLUSION CRITERIA acute serious psychotic episodes or physical illness, alcohol or drug abuse during the year before the study, diagnosed cerebral disorder at admission to the unit, and insufficient ability to speak Swedish. 64 patients filled the criteria and 19 accepted participation: 14 males, 5 females, median age 56 years. OUTCOME MEASURES Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) scores, measured by a psychologist; Frontal Systems Behaviour Scale (FrSBe) Family Version and Functional Independence Measure (FIM) V.4.0 scores, measured by nursing staff. Non-parametric statistics were consistently applied to process the data. RESULTS Failure analysis showed differences regarding gender and subdiagnoses between participants and non-participants. All participants had BNIS scores indicating cognitive dysfunction. FrSBe group medians showed apathy and executive problems, indicating possible frontal lobe disturbance. FIM showed dependency on others for linguistic and social communication, everyday problem solving, and remembering persons and daily routines. Correlations between FrSBe and FIM (p≤0.01) suggested executive dysfunction being crucial to explain difficulties in performing activities of daily functioning. CONCLUSIONS Indications of considerable cognitive and functional difficulties found among the participants suggestedthat the instruments are clinically applicable for tentative assessment of cognitive and functional ability among patients with multiepisode schizophrenia and considerable care needs.
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Affiliation(s)
- Eva Norlin Bagge
- Department of Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden
- Institute of Clinical Neuroscience and Rehabilitation, Rehabilitation Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Eva Esbjörnsson
- Department of Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden
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Santos NC, Moreira PS, Castanho TC, Sousa N, Costa PS. Discriminant power of socio-demographic characteristics and mood in distinguishing cognitive performance clusters in older individuals: a cross-sectional analysis. Aging Ment Health 2017; 21:537-542. [PMID: 26756965 DOI: 10.1080/13607863.2015.1128879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Identification of predictors of cognitive trajectories has been a matter of concern on aging research. For this reason, it is of relevance to infer cognitive profiles based on rapid screening variables in order to determine which individuals will be more predisposed to cognitive decline. METHOD In this work, a linear discriminant analysis (LDA) was conducted with socio-demographic variables and mood status as predictors of cognitive profiles, computed in a previous sample, based on different cognitive dimensions. Data were randomly split in two samples. Both samples were representative of the Portuguese population in terms of gender, age and education. The LDA was performed with one sample (n = 506, mean age 65.7 ± 8.98 years) and tested in the second sample (n = 548, mean age 68.5 ± 9.3 years). RESULTS With these variables, we were able to achieve an overall hit rate of 65.9%, which corresponds to a significant increment in comparison to classification by chance. CONCLUSION Although not ideal, this model may serve as a relevant tool to identify cognitive profiles based on a rapid screening when few variables are available.
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Affiliation(s)
- Nadine Correia Santos
- a Life and Health Sciences Research Institute (ICVS), School of Health Sciences , University of Minho , Braga , Portugal.,b ICVS/3B's , PT Government Associate Laboratory , Braga/Guimarães , Portugal
| | - Pedro Silva Moreira
- a Life and Health Sciences Research Institute (ICVS), School of Health Sciences , University of Minho , Braga , Portugal.,b ICVS/3B's , PT Government Associate Laboratory , Braga/Guimarães , Portugal
| | - Teresa Costa Castanho
- a Life and Health Sciences Research Institute (ICVS), School of Health Sciences , University of Minho , Braga , Portugal.,b ICVS/3B's , PT Government Associate Laboratory , Braga/Guimarães , Portugal
| | - Nuno Sousa
- a Life and Health Sciences Research Institute (ICVS), School of Health Sciences , University of Minho , Braga , Portugal.,b ICVS/3B's , PT Government Associate Laboratory , Braga/Guimarães , Portugal
| | - Patrício Soares Costa
- a Life and Health Sciences Research Institute (ICVS), School of Health Sciences , University of Minho , Braga , Portugal.,b ICVS/3B's , PT Government Associate Laboratory , Braga/Guimarães , Portugal
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11
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Harvey PD, Sand M. Pharmacological Augmentation of Psychosocial and Remediation Training Efforts in Schizophrenia. Front Psychiatry 2017; 8:177. [PMID: 28993740 PMCID: PMC5622160 DOI: 10.3389/fpsyt.2017.00177] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 09/06/2017] [Indexed: 12/11/2022] Open
Abstract
Pharmacological approaches to cognitive enhancement have received considerable attention but have not had considerable success in improving their cognitive and functional targets. Other intervention strategies, such as cognitive remediation therapy (CRT), have been shown to enhance cognitive performance but have not been found to improve functional outcomes without additional psychosocial interventions. Recently, several studies have attempted to enhance the effects of CRT by adding pharmacological interventions to the CRT treatments. In addition, as CRT has been shown to synergistically improve the effects of psychosocial interventions, the combination of pharmacological therapies aimed at cognition and psychosocial interventions may itself provide a promising strategy for improving functional outcomes. This review and commentary examines the current state of interventions combining CRT and psychosocial treatments with pharmacological augmentation. Our focus is on the specific level of effect of the pharmacological intervention, which could be enhancing motivation, training efficiency, or the consolidation of therapeutic gains. Different pharmacological strategies (e.g., stimulants, plasticity-inducing agents, or attentional or alertness enhancers) may have the potential to lead to different types of gains when combined with CRT or psychosocial interventions. The relative potential of these different mechanisms for immediate and durable effects is considered.
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Affiliation(s)
- Philip D Harvey
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Michael Sand
- Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, United States
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12
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Schuepbach D, Egger ST, Boeker H, Duschek S, Vetter S, Seifritz E, Herpertz SC. Determinants of cerebral hemodynamics during the Trail Making Test in schizophrenia. Brain Cogn 2016; 109:96-104. [PMID: 27648976 DOI: 10.1016/j.bandc.2016.09.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 09/08/2016] [Accepted: 09/08/2016] [Indexed: 10/21/2022]
Abstract
Patients with schizophrenia show deficits in cognitive functioning, and studies on cerebral hemodynamics have revealed aberrant patterns of mean cerebral blood flow velocity (MFV), an equivalent of cerebral blood flow (CBF). Therefore, we carried out a controlled study that assessed MFV in schizophrenia during a well-known neuropsychological task, the Trail Making Test (TMT). We measured MFV in the middle cerebral arteries using functional transcranial Doppler sonography in 15 schizophrenia patients and 15 healthy subjects. In comparison to healthy subjects, patients performed poorer on the TMT-A and the TMT-B, and there was increased cerebral blood flow velocity during the TMT-B. A comparison of subgroups of patients and controls matched in performance on the TMT-B revealed that these patients still showed significantly increased cerebral blood flow velocity. Increased MFV in schizophrenia suggests specific alterations of cerebral hemodynamics during the Trail Making Test, Part B, which are not detectable during visuomotor activity, and which are independent of performance. These findings emphasize the pathophysiological importance of cognitive functioning in schizophrenia, but cast doubts whether performance in this particular test plays a relevant role for CBF abnormalities in schizophrenia.
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Affiliation(s)
- Daniel Schuepbach
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland; Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany; Klinikum am Weissenhof, Weinsberg, Germany.
| | - Stephan T Egger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Heinz Boeker
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Stefan Duschek
- Institute of Psychology, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - Stefan Vetter
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Sabine C Herpertz
- Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
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Converging models of schizophrenia--Network alterations of prefrontal cortex underlying cognitive impairments. Prog Neurobiol 2015; 134:178-201. [PMID: 26408506 DOI: 10.1016/j.pneurobio.2015.09.010] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 09/10/2015] [Accepted: 09/17/2015] [Indexed: 02/08/2023]
Abstract
The prefrontal cortex (PFC) and its connections with other brain areas are crucial for cognitive function. Cognitive impairments are one of the core symptoms associated with schizophrenia, and manifest even before the onset of the disorder. Altered neural networks involving PFC contribute to cognitive impairments in schizophrenia. Both genetic and environmental risk factors affect the development of the local circuitry within PFC as well as development of broader brain networks, and make the system vulnerable to further insults during adolescence, leading to the onset of the disorder in young adulthood. Since spared cognitive functions correlate with functional outcome and prognosis, a better understanding of the mechanisms underlying cognitive impairments will have important implications for novel therapeutics for schizophrenia focusing on cognitive functions. Multidisciplinary approaches, from basic neuroscience to clinical studies, are required to link molecules, circuitry, networks, and behavioral phenotypes. Close interactions among such fields by sharing a common language on connectomes, behavioral readouts, and other concepts are crucial for this goal.
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Na E, Yim SJ, Lee JN, Kim JM, Hong K, Hong MH, Han H. Relationships among medication adherence, insight, and neurocognition in chronic schizophrenia. Psychiatry Clin Neurosci 2015; 69:298-304. [PMID: 25600955 DOI: 10.1111/pcn.12272] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 12/14/2014] [Accepted: 01/10/2015] [Indexed: 12/21/2022]
Abstract
AIMS In order to improve long-term prognosis in schizophrenia, enhancing medication adherence is essential. The aim of this study was thus to identify the association between medication non-adherence and possible risk factors in a large sample of patients with chronic schizophrenia. METHODS One hundred and four patients with schizophrenia with a disease duration of over 10 years were enrolled in this cross-sectional study. The subjects were assessed with the Scale to Assess Unawareness of Mental Disease-Korean version, the Korean version of the Medication Adherence Rating Scale, a neurocognition battery designed for this study, and the Positive and Negative Symptoms Scale. An anova and multiple regression models were conducted to identify the correlations among variables and the factors that contribute to medication adherence. RESULTS The adherence score measured on the Korean version of the Medication Adherence Rating Scale was 7.60 ± 2.12; 88 (84.62%) patients were categorized as well-adherent and 16 (15.38%) as poorly adherent to their medication. Patients with good insight were more likely to maintain their medication (P = 0.0005), and better executive function was associated with increased medication adherence (P = 0.0008). Furthermore, fewer depressive symptoms were associated with good medication adherence (P = 0.0304). CONCLUSIONS This study is the first in the Republic of Korea to identify the relationship between medication adherence, insight, and neurocognition in a large sample of patients with chronic schizophrenia. These results could be used to establish a strategy for improving the prognosis of chronic schizophrenia.
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Affiliation(s)
- Euihyeon Na
- Department of General Psychiatry, Seoul National Hospital, Seoul, Republic of Korea
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Herold CJ, Lässer MM, Schmid LA, Seidl U, Kong L, Fellhauer I, Thomann PA, Essig M, Schröder J. Neuropsychology, autobiographical memory, and hippocampal volume in "younger" and "older" patients with chronic schizophrenia. Front Psychiatry 2015; 6:53. [PMID: 25954208 PMCID: PMC4404739 DOI: 10.3389/fpsyt.2015.00053] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 03/28/2015] [Indexed: 01/17/2023] Open
Abstract
Despite a wide range of studies on neuropsychology in schizophrenia, autobiographical memory (AM) has been scarcely investigated in these patients. Hence, less is known about AM in older patients and hippocampal contribution to autobiographical memories of varying remoteness. Therefore, we investigated hippocampal volume and AM along with important neuropsychological domains in patients with chronic schizophrenia and the respective relationships between these parameters. We compared 25 older patients with chronic schizophrenia to 23 younger patients and an older healthy control group (N = 21) with respect to AM, additional neuropsychological parameters, and hippocampal volume. Personal episodic and semantic memory was investigated using a semi-structured interview. Additional neuropsychological parameters were assessed by using a battery of standard neuropsychological tests. Structural magnetic resonance imaging data were analyzed with an automated region-of-interest procedure. While hippocampal volume reduction and neuropsychological impairment were more pronounced in the older than in the younger patients, both groups showed equivalent reduced AM performance for recent personal episodes. In the patient group, significant correlations between left hippocampal volume and recent autobiographical episodes as well as personal semantic memories arose. Verbal memory and working memory were significantly correlated with right hippocampal volume; executive functions, however, were associated with bilateral hippocampal volumes. These findings underline the complexity of AM and its impairments in the course of schizophrenia in comparison to rather progressive neuropsychological deficits and address the importance of hippocampal contribution.
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Affiliation(s)
- Christina Josefa Herold
- Section of Geriatric Psychiatry, Department of General Psychiatry, University of Heidelberg , Heidelberg , Germany
| | - Marc Montgomery Lässer
- Section of Geriatric Psychiatry, Department of General Psychiatry, University of Heidelberg , Heidelberg , Germany
| | - Lena Anna Schmid
- Section of Geriatric Psychiatry, Department of General Psychiatry, University of Heidelberg , Heidelberg , Germany
| | - Ulrich Seidl
- Center for Mental Health, Klinikum Stuttgart , Stuttgart , Germany
| | - Li Kong
- Section of Geriatric Psychiatry, Department of General Psychiatry, University of Heidelberg , Heidelberg , Germany
| | - Iven Fellhauer
- Section of Geriatric Psychiatry, Department of General Psychiatry, University of Heidelberg , Heidelberg , Germany
| | - Philipp Arthur Thomann
- Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg , Heidelberg , Germany
| | - Marco Essig
- German Cancer Research Center , Heidelberg , Germany
| | - Johannes Schröder
- Section of Geriatric Psychiatry, Department of General Psychiatry, University of Heidelberg , Heidelberg , Germany ; Institute of Gerontology, University of Heidelberg , Heidelberg , Germany
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Serre-Miranda C, Roque S, Santos NC, Portugal-Nunes C, Costa P, Palha JA, Sousa N, Correia-Neves M. Effector memory CD4(+) T cells are associated with cognitive performance in a senior population. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2014; 2:e54. [PMID: 25566544 PMCID: PMC4277304 DOI: 10.1212/nxi.0000000000000054] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 11/18/2014] [Indexed: 01/24/2023]
Abstract
Objective: Immunosenescence and cognitive decline are common markers of the aging process. Taking into consideration the heterogeneity observed in aging processes and the recently described link between lymphocytes and cognition, we herein explored the possibility of an association between alterations in lymphocytic populations and cognitive performance. Methods: In a cohort of cognitively healthy adults (n = 114), previously characterized by diverse neurocognitive/psychological performance patterns, detailed peripheral blood immunophenotyping of both the innate and adaptive immune systems was performed by flow cytometry. Results: Better cognitive performance was associated with lower numbers of effector memory CD4+ T cells and higher numbers of naive CD8+ T cells and B cells. Furthermore, effector memory CD4+ T cells were found to be predictors of general and executive function and memory, even when factors known to influence cognitive performance in older individuals (e.g., age, sex, education, and mood) were taken into account. Conclusions: This is the first study in humans associating specific phenotypes of the immune system with distinct cognitive performance in healthy aging.
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Affiliation(s)
- Cláudia Serre-Miranda
- Life and Health Sciences Research Institute (ICVS) (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), School of Health Sciences, University of Minho, Braga; ICVS/3B's - PT Government Associate Laboratory (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), Braga/Guimarães; and Clinical Academic Center-Braga (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S.), Braga, Portugal
| | - Susana Roque
- Life and Health Sciences Research Institute (ICVS) (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), School of Health Sciences, University of Minho, Braga; ICVS/3B's - PT Government Associate Laboratory (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), Braga/Guimarães; and Clinical Academic Center-Braga (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S.), Braga, Portugal
| | - Nadine Correia Santos
- Life and Health Sciences Research Institute (ICVS) (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), School of Health Sciences, University of Minho, Braga; ICVS/3B's - PT Government Associate Laboratory (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), Braga/Guimarães; and Clinical Academic Center-Braga (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S.), Braga, Portugal
| | - Carlos Portugal-Nunes
- Life and Health Sciences Research Institute (ICVS) (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), School of Health Sciences, University of Minho, Braga; ICVS/3B's - PT Government Associate Laboratory (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), Braga/Guimarães; and Clinical Academic Center-Braga (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S.), Braga, Portugal
| | - Patrício Costa
- Life and Health Sciences Research Institute (ICVS) (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), School of Health Sciences, University of Minho, Braga; ICVS/3B's - PT Government Associate Laboratory (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), Braga/Guimarães; and Clinical Academic Center-Braga (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S.), Braga, Portugal
| | - Joana Almeida Palha
- Life and Health Sciences Research Institute (ICVS) (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), School of Health Sciences, University of Minho, Braga; ICVS/3B's - PT Government Associate Laboratory (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), Braga/Guimarães; and Clinical Academic Center-Braga (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S.), Braga, Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS) (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), School of Health Sciences, University of Minho, Braga; ICVS/3B's - PT Government Associate Laboratory (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), Braga/Guimarães; and Clinical Academic Center-Braga (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S.), Braga, Portugal
| | - Margarida Correia-Neves
- Life and Health Sciences Research Institute (ICVS) (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), School of Health Sciences, University of Minho, Braga; ICVS/3B's - PT Government Associate Laboratory (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S., M.C.-N.), Braga/Guimarães; and Clinical Academic Center-Braga (C.S.-M., S.R., N.C.S., C.P.-N., P.C., J.A.P., N.S.), Braga, Portugal
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Husa AP, Rannikko I, Moilanen J, Haapea M, Murray GK, Barnett J, Jones PB, Isohanni M, Koponen H, Miettunen J, Jääskeläinen E. Lifetime use of antipsychotic medication and its relation to change of verbal learning and memory in midlife schizophrenia - An observational 9-year follow-up study. Schizophr Res 2014; 158:134-41. [PMID: 25034761 DOI: 10.1016/j.schres.2014.06.035] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Revised: 05/13/2014] [Accepted: 06/16/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND The association between the course of cognition and long-term antipsychotic medication in schizophrenia remains unclear. We analysed the association between cumulative lifetime antipsychotic medication dose and change of verbal learning and memory during a 9-year follow-up. METHOD Forty schizophrenia subjects and 73 controls from the Northern Finland Birth Cohort 1966 were assessed by California Verbal Learning Test (CVLT) at the ages of 34 and 43 years. Data on the lifetime antipsychotic doses in chlorpromazine equivalents were collected. The association between antipsychotic dose-years and baseline performance and change in CVLT was analysed, controlling for baseline performance, gender, age of onset and severity of illness. RESULTS Higher antipsychotic dose-years by baseline were significantly associated with poorer baseline performance in several dimensions of verbal learning and memory, and with a larger decrease in short-delay free recall during the follow-up (p=0.031). Higher antipsychotic dose-years during the follow-up were associated with a larger decrease of immediate free recall of trials 1-5 during the follow-up (p=0.039). Compared to controls, decline was greater in some CVLT variables among those using high-doses, but not among those using low-doses. CONCLUSION This is the first report of an association between cumulative lifetime antipsychotic use and change in cognition in a long-term naturalistic follow-up. The use of high doses of antipsychotics may be associated with a decrease in verbal learning and memory in schizophrenia years after illness onset. The results do not support the view that antipsychotics in general prevent cognitive decline or promote cognitive recovery in schizophrenia.
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Affiliation(s)
- Anja P Husa
- University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, P.O. Box 5000, 90014 University of Oulu, Finland; Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Finland.
| | - Irina Rannikko
- University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, P.O. Box 5000, 90014 University of Oulu, Finland
| | - Jani Moilanen
- University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, P.O. Box 5000, 90014 University of Oulu, Finland; Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Finland; Oulu University Hospital, Department of Psychiatry, P.O. Box 26, 90029 OYS, Finland
| | - Marianne Haapea
- University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, P.O. Box 5000, 90014 University of Oulu, Finland; Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Finland; Oulu University Hospital, Department of Psychiatry, P.O. Box 26, 90029 OYS, Finland; Oulu University Hospital, Department of Diagnostic Radiology, P.O. Box 50, 90029 OYS, Finland
| | - Graham K Murray
- University of Cambridge, Department of Psychiatry, Box 189 Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom; University of Cambridge, Behavioural and Clinical Neuroscience Institute, Herchel Smith Building, Forvie Site, Cambridge Biomedical Campus, Cambridge CB2 0SZ, United Kingdom
| | - Jennifer Barnett
- University of Cambridge, Department of Psychiatry, Box 189 Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom; Cambridge Cognition Ltd, Tunbridge Court, Bottisham, Cambridge, United Kingdom
| | - Peter B Jones
- University of Cambridge, Department of Psychiatry, Box 189 Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom
| | - Matti Isohanni
- University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, P.O. Box 5000, 90014 University of Oulu, Finland; Oulu University Hospital, Department of Psychiatry, P.O. Box 26, 90029 OYS, Finland
| | - Hannu Koponen
- Department of Psychiatry, Institute of Clinical Medicine, University of Helsinki, P.O. Box 22, 00014 Helsinki, Finland; Department of Psychiatry, Helsinki University Hospital, P.O. Box 590, FIN-00029 HUS, Finland
| | - Jouko Miettunen
- University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, P.O. Box 5000, 90014 University of Oulu, Finland; Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Finland; Oulu University Hospital, Department of Psychiatry, P.O. Box 26, 90029 OYS, Finland; University of Oulu, Institute of Health Sciences, P.O. Box 5000, 90014 Oulu, Finland
| | - Erika Jääskeläinen
- University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, P.O. Box 5000, 90014 University of Oulu, Finland; Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Finland; Oulu University Hospital, Department of Psychiatry, P.O. Box 26, 90029 OYS, Finland; University of Oulu, Institute of Health Sciences, P.O. Box 5000, 90014 Oulu, Finland
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Santos NC, Costa PS, Cunha P, Cotter J, Sampaio A, Zihl J, Almeida OFX, Cerqueira JJ, Palha JA, Sousa N. Mood is a key determinant of cognitive performance in community-dwelling older adults: a cross-sectional analysis. AGE (DORDRECHT, NETHERLANDS) 2013; 35:1983-1993. [PMID: 23054829 PMCID: PMC3776101 DOI: 10.1007/s11357-012-9482-y] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Accepted: 09/25/2012] [Indexed: 05/27/2023]
Abstract
Identification of predictors of cognitive trajectories through the establishment of composite or single-parameter dimensional categories of cognition and mood may facilitate development of strategies to improve quality of life in the elderly. Participants (n = 487, aged 50+ years) were representative of the Portuguese population in terms of age, gender, and educational status. Cognitive and mood profiles were established using a battery of neurocognitive and psychological tests. Data were subjected to principal component analysis to identify core dimensions of cognition and mood, encompassing multiple test variables. Dimensions were correlated with age and with respect to gender, education, and occupational status. Cluster analysis was applied to isolate distinct patterns of cognitive performance and binary logistic regression models to explore interrelationships between aging, cognition, mood, and socio-demographic characteristics. Four main dimensions were identified: memory, executive function, global cognitive status, and mood. Based on these, strong and weak cognitive performers were distinguishable. Cluster analysis revealed further distinction within these two main categories into very good, good, poor, and very poor performers. Mood was the principal factor contributing to the separation between very good and good, as well as poor and very poor, performers. Clustering was also influenced by gender and education, albeit to a lesser extent; notably, however, female gender × lower educational background predicted significantly poorer cognitive performance with increasing age. Mood has a significant impact on the rate of cognitive decline in the elderly. Gender and educational level are early determinants of cognitive performance in later life.
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Affiliation(s)
- Nadine Correia Santos
- />Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
- />ICVS/3B’s, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal
- />Clinical Academic Center, 4710-057 Braga, Portugal
| | - Patrício Soares Costa
- />Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
- />ICVS/3B’s, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal
- />Clinical Academic Center, 4710-057 Braga, Portugal
| | - Pedro Cunha
- />Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
- />ICVS/3B’s, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal
- />Centro Hospitalar do Alto Ave–EPE, 4810-055 Guimarães, Portugal
| | - Jorge Cotter
- />Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
- />ICVS/3B’s, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal
- />Centro Hospitalar do Alto Ave–EPE, 4810-055 Guimarães, Portugal
| | - Adriana Sampaio
- />Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
- />Neuropsychophysiology Lab, CIPsi, School of Psychology, University of Minho, 4710-057 Braga, Portugal
| | - Joseph Zihl
- />Department of Psychology–Neuropsychology, University of Munich, D80802 Munich, Germany
- />Max-Planck Institute of Psychiatry, D80804 Munich, Germany
| | | | - João J Cerqueira
- />Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
- />ICVS/3B’s, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal
- />Clinical Academic Center, 4710-057 Braga, Portugal
| | - Joana Almeida Palha
- />Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
- />ICVS/3B’s, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal
- />Clinical Academic Center, 4710-057 Braga, Portugal
| | - Nuno Sousa
- />Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
- />ICVS/3B’s, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal
- />Clinical Academic Center, 4710-057 Braga, Portugal
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Janssen G, van Aken L, De Mey H, Witteman C, Egger J. Decline of Executive Function in a Clinical Population: Age, Psychopathology, and Test Performance on the Cambridge Neuropsychological Test Automated Battery (CANTAB). APPLIED NEUROPSYCHOLOGY-ADULT 2013; 21:210-9. [DOI: 10.1080/09084282.2013.793191] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Gwenny Janssen
- a Centre of Excellence for Neuropsychiatry , Vincent van Gogh Institute for Psychiatry , Venray , The Netherlands
- b Behavioural Science Institute , Radboud University Nijmegen , Nijmegen , The Netherlands
| | - Loes van Aken
- a Centre of Excellence for Neuropsychiatry , Vincent van Gogh Institute for Psychiatry , Venray , The Netherlands
- b Behavioural Science Institute , Radboud University Nijmegen , Nijmegen , The Netherlands
| | - Hubert De Mey
- b Behavioural Science Institute , Radboud University Nijmegen , Nijmegen , The Netherlands
| | - Cilia Witteman
- b Behavioural Science Institute , Radboud University Nijmegen , Nijmegen , The Netherlands
| | - Jos Egger
- a Centre of Excellence for Neuropsychiatry , Vincent van Gogh Institute for Psychiatry , Venray , The Netherlands
- c Behavioural Science Institute and Donders Institute for Brain, Cognition, and Behaviour, Radboud University Nijmegen , Nijmegen , The Netherlands
- d Pompe Institute for Forensic Psychiatry, Pro Persona , Nijmegen , The Netherlands
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O'Leary OF, Cryan JF. Towards translational rodent models of depression. Cell Tissue Res 2013; 354:141-53. [PMID: 23525777 DOI: 10.1007/s00441-013-1587-9] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Accepted: 02/11/2013] [Indexed: 02/02/2023]
Abstract
Rodent models of depression have been developed in an effort to identify novel antidepressant compounds and to further our understanding of the pathophysiology of depression. Various rodent models of depression and antidepressant-like behaviour are currently used but, clearly, none of these current models fully recapitulate all features of depression. Moreover, these models have not resulted in the development of novel non-monoaminergic-based antidepressants with clinical efficacy. Thus, a refinement of the current models of depression is required. The present review outlines the most commonly used models of depression and antidepressant drug-like activity and suggests several factors that should be considered when refining these models.
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Affiliation(s)
- Olivia F O'Leary
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland,
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Gould F, Bowie CR, Harvey PD. The influence of demographic factors on functional capacity and everyday functional outcomes in schizophrenia. J Clin Exp Neuropsychol 2012; 34:467-75. [DOI: 10.1080/13803395.2011.651102] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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22
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Sinnema M, Schrander-Stumpel CT, Maaskant MA, Boer H, Curfs LM. Aging in Prader-Willi syndrome: Twelve persons over the age of 50 years. Am J Med Genet A 2012; 158A:1326-36. [DOI: 10.1002/ajmg.a.35333] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2011] [Accepted: 01/30/2012] [Indexed: 11/06/2022]
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Abstract
The etiology of new psychotic symptoms in late life, including subtle changes in cognition, is a controversial emerging area of study. The development of psychotic symptoms, particularly paranoia, is a common occurrence in late life, and the symptoms of cognitive dysfunction and psychosis are often prominent in dementia, schizophrenia, and mood disorders. This intermixing of symptoms has inescapably led to diagnostic confusion with regard to elderly patients with new-onset psychosis. The complex relationship among different domains of psychopathology makes it difficult to tease apart disorders of affect from psychosis, affect from cognition, and psychosis from cognition. It is therefore potentially useful to modify and expand our approach to how we conceptualize these patients. Emerging evidence suggests that those with dementia, psychotic disorders, and mood disorders suffer from growing cognitive deficits. The article suggests that deficits in social cognition, in particular, may be the unifying deficit that helps to explain why heterogeneous patients may develop paranoia and psychotic symptoms in late life.
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Wang Y, Chan RCK, Qing YH, Yang TX, Yu X, Li ZJ, Hong XH, Cui JF, Deng YY, Gong QY, Shum D. Do Patients with Schizophrenia and Healthy Elderly People show Similar Patterns of Prospective Memory Performance? Arch Clin Neuropsychol 2010; 25:648-55. [DOI: 10.1093/arclin/acq053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Ya Wang
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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25
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Øie M, Sundet K, Rund BR. Neurocognitive decline in early-onset schizophrenia compared with ADHD and normal controls: evidence from a 13-year follow-up study. Schizophr Bull 2010; 36:557-65. [PMID: 18801881 PMCID: PMC2879697 DOI: 10.1093/schbul/sbn127] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The issue of neurodegeneration in schizophrenia is controversial. Although most studies indicate that neurocognitive deficits are relatively stable over the course of the illness, conclusions are limited by relatively short follow-up periods and absence of age-matched control groups. Furthermore, nearly all studies deal with adult-onset schizophrenia, and few studies have considered the possible effect of age of onset. The current study represents the first attempt to compare groups of adolescents with schizophrenia, attention deficit/hyperactivity disorder (ADHD), and normal controls on a comprehensive neurocognitive test battery in a longitudinal design over 13 years. In the baseline study, adolescents with schizophrenia were examined with a broad battery of neurocognitive tests. The comparison groups consisted of adolescents with ADHD and adolescents without a psychiatric diagnosis, between 12 and 18 years of age. In the follow-up study, the schizophrenia group consisted of 15 of the initial 19 individuals, the ADHD group of 19 of the 20 individuals, and the normal comparison group of all 30 individuals. They were reevaluated with the neurocognitive test battery and clinical measures. Subjects with schizophrenia showed a significant decline or arrest in neurocognitive functioning compared with the other 2 groups, particularly in verbal memory, attention, and processing speed. The impairments may be specific to early-onset schizophrenia due to interaction between ongoing brain maturation during adolescence and disease-related mechanisms and/or secondary to neuroleptic treatment in young age and/or social isolation.
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Affiliation(s)
- Merete Øie
- Division Mental Health Care, Innlandet Hospital Trust Lillehammer, Anders Sandvigsgate 17, 2629 Lillehammer, Norway.
| | - Kjetil Sundet
- Center for the Study of Human Cognition, Institute of Psychology, University of Oslo, Norway
| | - Bjørn Rishovd Rund
- Asker and Bærum Hospital Trust, Institute of Psychology, University of Oslo, Norway
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26
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Abstract
Late-life depression is a major health problem and a significant cause of dysfunction that warrants closer evaluation and study. In contrast to younger depressed patients, most depressed older adults suffer more severe variants of the disorder, including significant cognitive impairments. These cognitive changes add to the severity of symptoms and disability that older depressed patients face and likely reflect compromise of certain neural circuits, linking cognitive impairment to late-life depression. Studies examining clinical correlates, neuropsychological testing, and functional and anatomic imaging have yielded a clearer understanding of the neural mechanisms underlying cognitive deficits in late-life depression. This article discusses cognitive impairment in geriatric depression and how developing a better understanding of its neural correlates may lead to improved understanding and outcome of this specific disorder.
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Affiliation(s)
- Elizabeth A Crocco
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1695 Northwest 9th Avenue, Suite 3308, Miami, FL 33136, USA.
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Dotson VM, Zonderman AB, Davatzikos C, Kraut MA, Resnick SM. Frontal Atrophy and Attention Deficits in Older Adults with a History of Elevated Depressive Symptoms. Brain Imaging Behav 2009; 3:358. [PMID: 20161651 DOI: 10.1007/s11682-009-9078-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Studies of older adults with depressive disorders indicate greater cognitive deficits and brain alterations than would be expected for their age. There is some evidence that these findings are present after a single episode of depression, but this work has been cross-sectional in nature. We investigated both cross-sectional and longitudinal associations between a history of elevated depressive symptoms (HDS), frontal lobe volumes, and cognitive performance within the context of normal age-related changes over time in the Baltimore Longitudinal Study of Aging. After controlling for age, HDS was associated with smaller total frontal gray matter volumes and with smaller regional volumes in the cingulate gyrus and orbitofrontal cortex. Men, but not women, with HDS showed deficits in auditory attention span at older ages. Results confirm previous reports that even a single episode of depression is associated with adverse outcomes in older adults but suggest that HDS does not affect longitudinal trajectories of cognitive and brain volume change.
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Affiliation(s)
- Vonetta M Dotson
- Laboratory of Personality and Cognition, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD
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28
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Sanseeha L, Chontawan R, Sethabouppha H, Disayavanish C, Turale S. Illness perspectives of Thais diagnosed with schizophrenia. Nurs Health Sci 2009; 11:306-11. [DOI: 10.1111/j.1442-2018.2009.00474.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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