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Pellinen J, Sillau S, Morrison C, Maruff P, O'Brien TJ, Penovich P, French J, Knupp KG, Meador KJ. Engagement in online cognitive testing with the Cogstate brief battery among a multinational cohort of people with focal epilepsy. Epilepsy Behav 2024; 159:109953. [PMID: 39121756 DOI: 10.1016/j.yebeh.2024.109953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 07/12/2024] [Accepted: 07/14/2024] [Indexed: 08/12/2024]
Abstract
OBJECTIVE The Human Epilepsy Project (HEP) is a large multinational cohort study of people with newly diagnosed and treated focal epilepsy. HEP utilized the Cogstate Brief Battery (CBB) as a self-directed online assessment to examine cognitive outcomes in study participants. The CBB has previously been validated in healthy individuals and people with various brain disorders, but its use in adults participating in HEP has not been assessed. In this study, we describe how the CBB was used in the HEP cohort and assess factors associated with test completion among study participants. METHODS Enrollment data for HEP included 408 participants with comprehensive enrollment records, of whom 249 completed CBB assessments. HEP enrolled cognitively normal-range participants between the ages of 12 and 60 from June 29, 2012, to November 7, 2017, with newly diagnosed focal epilepsy and within 4 months of initial treatment. Baseline participant characteristics were analyzed, including demographics, pre-treatment seizure histories, MRI abnormalities, and the presence of any learning difficulties while in school, including formal learning disability diagnoses, repeated grades, and remediation. HEP participant characteristics for those who completed CBB testing were compared to those who did not using multiple logistic regression. RESULTS The analysis of HEP participants who completed CBB testing showed that, after controlling for other factors, male participants were more likely to engage in testing (OR 2.14, 95 % CI 1.29 to 3.5, p < 0.01), Black subjects were less likely (OR 0.45, 95 % CI 0.22 to 0.9, p = 0.02), primary English speakers were more likely (OR 3.1, 95 % CI 1.21 to 7.96, p = 0.02), and those with a history of learning challenges were less likely (OR 0.69, 95 % CI 0.49 to 0.97, p = 0.03). There were no significant associations between completing CBB testing and age, employment (employed or student vs not), education (higher education vs not), diagnostic delay, pre-diagnostic seizure burden, or initial seizure semiology (motor vs non-motor). SIGNIFICANCE The findings from this study highlight factors associated with the application of remote and unsupervised assessments of cognition in a prospective cohort of adults with focal epilepsy. These factors can be considered when interpreting performance on the CBB in HEP, as well as assisting the design of future studies that use similar approaches.
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Affiliation(s)
- Jacob Pellinen
- University of Colorado School of Medicine, Department of Neurology, Aurora, CO, USA.
| | - Stefan Sillau
- University of Colorado School of Medicine, Department of Neurology, Aurora, CO, USA
| | - Chris Morrison
- New York University Grossman School of Medicine and NYU Langone Health, Comprehensive Epilepsy Center, New York, NY, USA
| | - Paul Maruff
- Cogstate and The Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Terence J O'Brien
- Monash University, Department of Neuroscience, The School of Translational Medicine, Melbourne, Victoria, Australia
| | | | - Jacqueline French
- New York University Grossman School of Medicine and NYU Langone Health, Comprehensive Epilepsy Center, New York, NY, USA
| | - Kelly G Knupp
- University of Colorado School of Medicine, Departments of Pediatrics, Aurora, CO, USA
| | - Kimford J Meador
- Stanford University Neuroscience Health Center, Palo Alto, CA, USA
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Gaynor AM, Ahsan A, Jung D, Schofield E, Li Y, Ryan E, Ahles TA, Root JC. Novel computerized neurocognitive test battery is sensitive to cancer-related cognitive deficits in survivors. J Cancer Surviv 2024; 18:466-478. [PMID: 35939254 PMCID: PMC11274167 DOI: 10.1007/s11764-022-01232-w] [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: 03/23/2022] [Accepted: 06/28/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE There is increasing interest in developing new methods to improve sensitivity in detecting subtle cognitive deficits associated with cancer and its treatments. The current study aimed to evaluate the ability of a novel computerized battery of cognitive neuroscience-based tests to discriminate between cognitive performance in breast cancer survivors and controls. METHODS Breast cancer survivors (N = 174) and age-matched non-cancer controls (N = 183) completed the Enformia Cogsuite Battery of cognitive assessments, comprised of 7 computerized tests of multiple cognitive domains. Primary outcome measures included accuracy, reaction times (RT), and coefficients of variation (CV) for each task, as well as global scores of accuracy, RT, and CV aggregated across tests. RESULTS Linear regressions adjusting for age, education, and remote vs. in-office administration showed that compared to non-cancer controls, survivors had significantly lower performance on measures of attention, executive function, working memory, verbal ability, visuospatial ability, and motor function. Survivors had significantly greater CV on measures of attention, working memory, and processing speed, and significantly slower RT on measures of verbal fluency. CONCLUSIONS The Cogsuite battery demonstrates sensitivity to cancer-related cognitive dysfunction across multiple domains, and is capable of identifying specific cognitive processes that may be affected in survivors. IMPLICATIONS FOR CANCER SURVIVORS The sensitivity of these tasks to subtle cognitive deficits has advantages for initial diagnosis of cancer-related cognitive dysfunction, as well as detecting changes in survivors' cognitive function over time. The remote delivery of the battery may help overcome barriers associated with in-office administration and increase access to neurocognitive evaluation.
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Affiliation(s)
- Alexandra M Gaynor
- Department of Psychiatry and Behavioral Sciences, Neurocognitive Research Laboratory, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7thFloor, New York, NY, 10022, USA.
- Taub Institute for Research On Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA.
- Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY, USA.
| | - Anam Ahsan
- Department of Psychiatry and Behavioral Sciences, Neurocognitive Research Laboratory, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7thFloor, New York, NY, 10022, USA
| | | | - Elizabeth Schofield
- Department of Psychiatry and Behavioral Sciences, Neurocognitive Research Laboratory, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7thFloor, New York, NY, 10022, USA
| | - Yuelin Li
- Department of Psychiatry and Behavioral Sciences, Neurocognitive Research Laboratory, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7thFloor, New York, NY, 10022, USA
| | - Elizabeth Ryan
- Department of Psychiatry and Behavioral Sciences, Neurocognitive Research Laboratory, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7thFloor, New York, NY, 10022, USA
| | - Tim A Ahles
- Department of Psychiatry and Behavioral Sciences, Neurocognitive Research Laboratory, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7thFloor, New York, NY, 10022, USA
| | - James C Root
- Department of Psychiatry and Behavioral Sciences, Neurocognitive Research Laboratory, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7thFloor, New York, NY, 10022, USA
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Corney KB, Pasco JA, Stuart AL, Kavanagh BE, Mohebbi M, Sui SX, Williams LJ. Social determinants of health and cognitive function: A cross-sectional study among men without dementia. Brain Behav 2023; 13:e3235. [PMID: 37652752 PMCID: PMC10636419 DOI: 10.1002/brb3.3235] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/09/2023] [Accepted: 08/15/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Certain age-related and medical factors have been associated with cognitive dysfunction; however, less is known regarding social determinants of health. The current study aimed to investigate associations between social determinants of health and cognitive function in a population-based sample of men without dementia. METHODS Data were drawn from the ongoing Geelong Osteoporosis Study (n = 536). Cognitive function was determined using the Cog-State Brief Battery. Area-based socioeconomic status (SES) was determined using the Index of Relative Socioeconomic Advantage and Disadvantage, marital status by self-report, and social support by the Multidimensional Scale of Perceived Social Support, which considers family, friends, and significant others. RESULTS Belonging to a higher SES group, being in a relationship (married/de-facto) and perceived social support from a significant other and friends were each associated with better overall cognitive function. In regard to the specific cognitive domains, higher SES was associated with better psychomotor function and visual learning, being in a relationship was associated with better working memory, and perceived social support from a significant other was associated with better attention and working memory, with perceived social support from friends associated with better psychomotor function. There were no associations detected between social support from family and any of the cognitive domains. CONCLUSION Higher SES, being in a relationship, and greater perceived social support from a significant other and friends were associated with better cognitive function. Further studies identifying underlying mechanisms linking social factors with cognition are needed to establish prevention strategies and enhance cognitive health.
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Affiliation(s)
- Kayla B. Corney
- Deakin University, IMPACT – Institute for Mental and Physical Health and Clinical Translation, School of MedicineDeakin UniversityGeelongAustralia
| | - Julie A. Pasco
- Deakin University, IMPACT – Institute for Mental and Physical Health and Clinical Translation, School of MedicineDeakin UniversityGeelongAustralia
- Barwon HealthUniversity Hospital GeelongGeelongAustralia
- Department of Medicine‐Western HealthThe University of MelbourneSt AlbansAustralia
| | - Amanda L. Stuart
- Deakin University, IMPACT – Institute for Mental and Physical Health and Clinical Translation, School of MedicineDeakin UniversityGeelongAustralia
| | - Bianca E. Kavanagh
- Deakin University, IMPACT – Institute for Mental and Physical Health and Clinical Translation, School of MedicineDeakin UniversityGeelongAustralia
- Deakin Rural Health, School of MedicineDeakin UniversityWarrnamboolAustralia
| | - Mohammadreza Mohebbi
- Deakin University, IMPACT – Institute for Mental and Physical Health and Clinical Translation, School of MedicineDeakin UniversityGeelongAustralia
- Faculty of Health, Biostatistics UnitDeakin UniversityGeelongAustralia
| | - Sophia X. Sui
- Deakin University, IMPACT – Institute for Mental and Physical Health and Clinical Translation, School of MedicineDeakin UniversityGeelongAustralia
| | - Lana J. Williams
- Deakin University, IMPACT – Institute for Mental and Physical Health and Clinical Translation, School of MedicineDeakin UniversityGeelongAustralia
- Barwon HealthUniversity Hospital GeelongGeelongAustralia
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Jimenez MP, Elliott EG, DeVille NV, Laden F, Hart JE, Weuve J, Grodstein F, James P. Residential Green Space and Cognitive Function in a Large Cohort of Middle-Aged Women. JAMA Netw Open 2022; 5:e229306. [PMID: 35476063 PMCID: PMC9047638 DOI: 10.1001/jamanetworkopen.2022.9306] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 03/10/2022] [Indexed: 01/13/2023] Open
Abstract
Importance Green space can decelerate cognitive decline by supporting physical activity, psychological restoration, or reducing exposure to air pollution. However, existing studies on the association of green space with cognitive decline are limited. Objective To examine whether residential green space was associated with cognitive function in middle-aged women. Design, Setting, and Participants Starting in 1989, the Nurses' Health Study II enrolled 116 429 female nurses aged 25 to 42 years residing in the US. In 2014 to 2016, 40 082 women were invited to complete an online cognitive battery. This cohort study analyzed women who had data on both green space exposure and cognitive measures. Data analysis was conducted from June to October 2021. Exposures Residential exposure to green space was assessed using the Normalized Difference Vegetation Index, a satellite-derived indicator of the quantity of ground vegetation. Landsat satellite data at 270-m and 1230-m buffers around each participants' residential addresses in 2013 were used. Main Outcomes and Measures In 2014 to 2016, cognitive function was measured using a self-administered online battery, the Cogstate Brief Battery, consisting of 4 tasks measuring psychomotor speed, attention, learning, and working memory; 3 composite scores, averaging together all tasks, psychomotor speed/attention, and learning/working memory, were created. In addition, the study evaluated potential mediators, including air pollution, depression, and physical activity. Results The analytical sample included 13 594 women, of whom 13 293 (98%) were White. Mean (SD) age was 61.2 (4.6) years. In models adjusted for age at assessment, race, childhood, adulthood, and neighborhood socioeconomic status, green space was associated with higher scores on the global Cogstate composite (mean difference per IQR in green space, 0.05; 95% CI, 0.02 to 0.07), and psychomotor speed/attention (mean difference in score, 0.05 standard units; 95% CI, 0.02 to 0.08). This difference in scores is similar to the difference observed in women 1 year apart in age in the data. By contrast, there was no association between green space and learning/working memory (mean difference, 0.0300; 95% CI, -0.0003 to 0.0500). Conclusions and Relevance These findings suggest that increasing residential green space may be associated with modest benefits in cognition in middle-aged women.
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Affiliation(s)
- Marcia P. Jimenez
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Now with Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Elise G. Elliott
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Nicole V. DeVille
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Francine Laden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jaime E. Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jennifer Weuve
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Francine Grodstein
- Department of Internal Medicine, Rush Medical College, Rush Alzheimer’s Disease Center, Chicago, Illinois
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, Massachusetts
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Papp KV, Samaroo A, Chou HC, Buckley R, Schneider OR, Hsieh S, Soberanes D, Quiroz Y, Properzi M, Schultz A, García-Magariño I, Marshall GA, Burke JG, Kumar R, Snyder N, Johnson K, Rentz DM, Sperling RA, Amariglio RE. Unsupervised mobile cognitive testing for use in preclinical Alzheimer's disease. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2021; 13:e12243. [PMID: 34621977 PMCID: PMC8481881 DOI: 10.1002/dad2.12243] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/08/2021] [Accepted: 08/03/2021] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Unsupervised digital cognitive testing is an appealing means to capture subtle cognitive decline in preclinical Alzheimer's disease (AD). Here, we describe development, feasibility, and validity of the Boston Remote Assessment for Neurocognitive Health (BRANCH) against in-person cognitive testing and amyloid/tau burden. METHODS BRANCH is web-based, self-guided, and assesses memory processes vulnerable in AD. Clinically normal participants (n = 234; aged 50-89) completed BRANCH; a subset underwent in-person cognitive testing and positron emission tomography imaging. Mean accuracy across BRANCH tests (Categories, Face-Name-Occupation, Groceries, Signs) was calculated. RESULTS BRANCH was feasible to complete on participants' own devices (primarily smartphones). Technical difficulties and invalid/unusable data were infrequent. BRANCH psychometric properties were sound, including good retest reliability. BRANCH was correlated with in-person cognitive testing (r = 0.617, P < .001). Lower BRANCH score was associated with greater amyloid (r = -0.205, P = .007) and entorhinal tau (r = -0.178, P = .026). DISCUSSION BRANCH reliably captures meaningful cognitive information remotely, suggesting promise as a digital cognitive marker sensitive early in the AD trajectory.
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Affiliation(s)
- Kathryn V Papp
- Center for Alzheimer Research and Treatment Department of Neurology Brigham and Women's Hospital Harvard Medical School Boston Massachusetts USA
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Aubryn Samaroo
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Hsiang-Chin Chou
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Rachel Buckley
- Center for Alzheimer Research and Treatment Department of Neurology Brigham and Women's Hospital Harvard Medical School Boston Massachusetts USA
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
- Melbourne School of Psychological Science University of Melbourne Melbourne Victoria Australia
| | - Olivia R Schneider
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Stephanie Hsieh
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Daniel Soberanes
- Center for Alzheimer Research and Treatment Department of Neurology Brigham and Women's Hospital Harvard Medical School Boston Massachusetts USA
| | - Yakeel Quiroz
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Michael Properzi
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Aaron Schultz
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Iván García-Magariño
- Department of Software Engineering and Artificial Intelligence Complutense University of Madrid Madrid Spain
- Instituto de Tecnología del Conocimiento UCM Madrid Spain
| | - Gad A Marshall
- Center for Alzheimer Research and Treatment Department of Neurology Brigham and Women's Hospital Harvard Medical School Boston Massachusetts USA
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Jane G Burke
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Raya Kumar
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Noah Snyder
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Keith Johnson
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
- Department of Radiology Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Dorene M Rentz
- Center for Alzheimer Research and Treatment Department of Neurology Brigham and Women's Hospital Harvard Medical School Boston Massachusetts USA
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Reisa A Sperling
- Center for Alzheimer Research and Treatment Department of Neurology Brigham and Women's Hospital Harvard Medical School Boston Massachusetts USA
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
| | - Rebecca E Amariglio
- Center for Alzheimer Research and Treatment Department of Neurology Brigham and Women's Hospital Harvard Medical School Boston Massachusetts USA
- Department of Neurology Massachusetts General Hospital Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
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6
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Boivin MJ, Sikorskii A, Haan P, Smith SS, Symonds LL, Khattree R, Giordani B, Blow AJ, Osuch JR. Health-Related Quality of Life: Longitudinal Analysis From the Time of Breast Biopsy Into the Post-treatment Period. Front Glob Womens Health 2021; 2:608787. [PMID: 34816181 PMCID: PMC8593952 DOI: 10.3389/fgwh.2021.608787] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 07/20/2021] [Indexed: 01/11/2023] Open
Abstract
Background: The physical, psychological, social, and spiritual quality of life (QoL) may be affected by breast cancer diagnosis and treatment, with mixed findings for psychological quality of life and cognitive ability performance. The present study aimed to evaluate QoL in women over 1 year from biopsy for a breast abnormality. Methods: Self-reported measures of physical, psychological, social, and spiritual QoL were obtained after biopsy results but prior to treatment initiation (baseline), 4 and 12 months later. CogState computerized neuropsychological screening battery also provided an evaluation of psychological QoL. Three groups of women including those with benign biopsy results, those with malignancy treated with chemotherapy, and those with malignancy not treated with chemotherapy were compared at 4 and 12 months after adjusting for baseline to isolate the effects of treatment. Additional covariates included are age, level of education, and income. Results: Benign biopsy results group included 72 women, whereas malignancy was found in 87 women of whom 33 were treated with chemotherapy and 54 without chemotherapy. At the time of diagnosis, women with cancer had worse psychological and social QoL but better spiritual QoL than those with benign biopsy results. Only CogState monitoring accuracy was worse for women with cancer compared with the controls at the time of biopsy results. After adjusting for QoL at baseline, women treated for cancer had worse physical and social QoL at 4 and 12 months later. Psychological well-being was worse for women with cancer at 4th month but improved at 1 year. No differences in cognition were found at 4 and 12 months when adjusted for baseline cognition and covariates. Discussion: Breast cancer is a traumatic life event for women, affecting psychological and social QoL domains, yet increasing spiritual QoL. Later, cancer treatment worsens physical, psychological, and social QoL compared with those without cancer. Conclusions: These findings suggest that interventions to improve psychological QoL may be especially important at the time of cancer diagnosis, while interventions to improve physical well-being are the most needed during and following cancer treatment. Support to improve social QoL is needed from the time of diagnosis into post-treatment survivorship.
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Affiliation(s)
- Michael J. Boivin
- Department of Psychiatry, Michigan State University, East Lancing, MI, United States
- Department of Neurology & Ophthalmology, Michigan State University, East Lancing, MI, United States
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Alla Sikorskii
- Department of Psychiatry, Michigan State University, East Lancing, MI, United States
| | - Pamela Haan
- Department of Surgery, Michigan State University, East Lancing, MI, United States
| | - Stephanie S. Smith
- Department of Psychiatry, Michigan State University, East Lancing, MI, United States
| | - Laura L. Symonds
- Neuroscience Program, Michigan State University, East Lancing, MI, United States
| | - Ravindra Khattree
- Department of Mathematics and Statistics, Oakland University, Rochester, MI, United States
| | - Bruno Giordani
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Adrian J. Blow
- Department of Human Development and Family Studies, Michigan State University, East Lancing, MI, United States
| | - Janet R. Osuch
- Department of Surgery, Michigan State University, East Lancing, MI, United States
- Department of Epidemiology, Michigan State University, East Lancing, MI, United States
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7
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Fowler C, Rainey-Smith SR, Bird S, Bomke J, Bourgeat P, Brown BM, Burnham SC, Bush AI, Chadunow C, Collins S, Doecke J, Doré V, Ellis KA, Evered L, Fazlollahi A, Fripp J, Gardener SL, Gibson S, Grenfell R, Harrison E, Head R, Jin L, Kamer A, Lamb F, Lautenschlager NT, Laws SM, Li QX, Lim L, Lim YY, Louey A, Macaulay SL, Mackintosh L, Martins RN, Maruff P, Masters CL, McBride S, Milicic L, Peretti M, Pertile K, Porter T, Radler M, Rembach A, Robertson J, Rodrigues M, Rowe CC, Rumble R, Salvado O, Savage G, Silbert B, Soh M, Sohrabi HR, Taddei K, Taddei T, Thai C, Trounson B, Tyrrell R, Vacher M, Varghese S, Villemagne VL, Weinborn M, Woodward M, Xia Y, Ames D. Fifteen Years of the Australian Imaging, Biomarkers and Lifestyle (AIBL) Study: Progress and Observations from 2,359 Older Adults Spanning the Spectrum from Cognitive Normality to Alzheimer's Disease. J Alzheimers Dis Rep 2021; 5:443-468. [PMID: 34368630 PMCID: PMC8293663 DOI: 10.3233/adr-210005] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background: The Australian Imaging, Biomarkers and Lifestyle (AIBL) Study commenced in 2006 as a prospective study of 1,112 individuals (768 cognitively normal (CN), 133 with mild cognitive impairment (MCI), and 211 with Alzheimer’s disease dementia (AD)) as an ‘Inception cohort’ who underwent detailed ssessments every 18 months. Over the past decade, an additional 1247 subjects have been added as an ‘Enrichment cohort’ (as of 10 April 2019). Objective: Here we provide an overview of these Inception and Enrichment cohorts of more than 8,500 person-years of investigation. Methods: Participants underwent reassessment every 18 months including comprehensive cognitive testing, neuroimaging (magnetic resonance imaging, MRI; positron emission tomography, PET), biofluid biomarkers and lifestyle evaluations. Results: AIBL has made major contributions to the understanding of the natural history of AD, with cognitive and biological definitions of its three major stages: preclinical, prodromal and clinical. Early deployment of Aβ-amyloid and tau molecular PET imaging and the development of more sensitive and specific blood tests have facilitated the assessment of genetic and environmental factors which affect age at onset and rates of progression. Conclusion: This fifteen-year study provides a large database of highly characterized individuals with longitudinal cognitive, imaging and lifestyle data and biofluid collections, to aid in the development of interventions to delay onset, prevent or treat AD. Harmonization with similar large longitudinal cohort studies is underway to further these aims.
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Affiliation(s)
- Christopher Fowler
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Stephanie R Rainey-Smith
- Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Australian Alzheimer's Research Foundation (Ralph and Patricia Sarich Neuroscience Research Institute), Nedlands, WA, Australia.,Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, WA, Australia.,School of Psychological Science, University of Western Australia, Crawley, WA, Australia
| | - Sabine Bird
- Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Australian Alzheimer's Research Foundation (Ralph and Patricia Sarich Neuroscience Research Institute), Nedlands, WA, Australia
| | - Julia Bomke
- Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia
| | - Pierrick Bourgeat
- Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia
| | - Belinda M Brown
- Australian Alzheimer's Research Foundation (Ralph and Patricia Sarich Neuroscience Research Institute), Nedlands, WA, Australia.,Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, WA, Australia
| | - Samantha C Burnham
- Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia
| | - Ashley I Bush
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Carolyn Chadunow
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Steven Collins
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - James Doecke
- Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia.,Cooperative Research Council for Mental Health, Melbourne, VIC, Australia
| | - Vincent Doré
- Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia.,Department of Molecular Imaging and Therapy, Austin Health, Heidelberg, VIC, Australia
| | - Kathryn A Ellis
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia.,University of Melbourne Academic Unit for Psychiatry of Old Age, Parkville, VIC, Australia.,Melbourne School of Psychological Sciences, Melbourne, VIC, Australia
| | - Lis Evered
- Department of Anaesthesia and Acute Pain Medicine, St Vincent's Hospital Melbourne, Victoria Parade, Fitzroy, VIC, Australia
| | - Amir Fazlollahi
- Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia
| | - Jurgen Fripp
- Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia
| | - Samantha L Gardener
- Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Australian Alzheimer's Research Foundation (Ralph and Patricia Sarich Neuroscience Research Institute), Nedlands, WA, Australia
| | - Simon Gibson
- Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia
| | - Robert Grenfell
- Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia
| | - Elise Harrison
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Richard Head
- Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia
| | - Liang Jin
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Adrian Kamer
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Fiona Lamb
- Department of Molecular Imaging and Therapy, Austin Health, Heidelberg, VIC, Australia
| | | | - Simon M Laws
- Collaborative Genomics and Translation Group, Centre for Precision Health, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin Health Innovation Research Institute, Curtin University, Bentley, WA, Australia
| | - Qiao-Xin Li
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Lucy Lim
- Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Australian Alzheimer's Research Foundation (Ralph and Patricia Sarich Neuroscience Research Institute), Nedlands, WA, Australia
| | - Yen Ying Lim
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia.,Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Andrea Louey
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - S Lance Macaulay
- Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia
| | - Lucy Mackintosh
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Ralph N Martins
- Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Australian Alzheimer's Research Foundation (Ralph and Patricia Sarich Neuroscience Research Institute), Nedlands, WA, Australia.,Department of Biomedical Sciences, Macquarie University, North Ryde, NSW, Australia
| | | | - Colin L Masters
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Simon McBride
- Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia
| | - Lidija Milicic
- Collaborative Genomics and Translation Group, Centre for Precision Health, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Madeline Peretti
- Collaborative Genomics and Translation Group, Centre for Precision Health, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Kelly Pertile
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Tenielle Porter
- Collaborative Genomics and Translation Group, Centre for Precision Health, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin Health Innovation Research Institute, Curtin University, Bentley, WA, Australia
| | - Morgan Radler
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Alan Rembach
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Joanne Robertson
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Mark Rodrigues
- Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Australian Alzheimer's Research Foundation (Ralph and Patricia Sarich Neuroscience Research Institute), Nedlands, WA, Australia
| | - Christopher C Rowe
- Department of Molecular Imaging and Therapy, Austin Health, Heidelberg, VIC, Australia.,Australian Alzheimer's Research Foundation (Ralph and Patricia Sarich Neuroscience Research Institute), Nedlands, WA, Australia
| | - Rebecca Rumble
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | | | - Greg Savage
- Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Brendan Silbert
- Department of Anaesthesia and Acute Pain Medicine, St Vincent's Hospital Melbourne, Victoria Parade, Fitzroy, VIC, Australia
| | - Magdalene Soh
- Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Australian Alzheimer's Research Foundation (Ralph and Patricia Sarich Neuroscience Research Institute), Nedlands, WA, Australia
| | - Hamid R Sohrabi
- Australian Alzheimer's Research Foundation (Ralph and Patricia Sarich Neuroscience Research Institute), Nedlands, WA, Australia.,Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, WA, Australia.,Department of Biomedical Sciences, Macquarie University, North Ryde, NSW, Australia
| | - Kevin Taddei
- Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Australian Alzheimer's Research Foundation (Ralph and Patricia Sarich Neuroscience Research Institute), Nedlands, WA, Australia
| | - Tania Taddei
- Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Australian Alzheimer's Research Foundation (Ralph and Patricia Sarich Neuroscience Research Institute), Nedlands, WA, Australia
| | - Christine Thai
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Brett Trounson
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Regan Tyrrell
- Department of Molecular Imaging and Therapy, Austin Health, Heidelberg, VIC, Australia
| | - Michael Vacher
- Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia
| | - Shiji Varghese
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Victor L Villemagne
- Department of Molecular Imaging and Therapy, Austin Health, Heidelberg, VIC, Australia.,Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michael Weinborn
- Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Australian Alzheimer's Research Foundation (Ralph and Patricia Sarich Neuroscience Research Institute), Nedlands, WA, Australia.,School of Psychological Science, University of Western Australia, Crawley, WA, Australia
| | - Michael Woodward
- Department of Geriatric Medicine Austin Hospital, Heidelberg, VIC, Australia
| | - Ying Xia
- Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia
| | - David Ames
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia.,University of Melbourne Academic Unit for Psychiatry of Old Age, Parkville, VIC, Australia.,National Ageing Research Institute (NARI), Parkville, VIC, Australia
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8
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Stuckenschneider T, Sanders ML, Devenney KE, Aaronson JA, Abeln V, Claassen JAHR, Guinan E, Lawlor B, Meeusen R, Montag C, Olde Rikkert MGM, Polidori MC, Reuter M, Schulz RJ, Vogt T, Weber B, Kessels RPC, Schneider S. NeuroExercise: The Effect of a 12-Month Exercise Intervention on Cognition in Mild Cognitive Impairment-A Multicenter Randomized Controlled Trial. Front Aging Neurosci 2021; 12:621947. [PMID: 33519425 PMCID: PMC7840533 DOI: 10.3389/fnagi.2020.621947] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 12/11/2020] [Indexed: 01/04/2023] Open
Abstract
Exercise intervention studies in mild cognitive impairment (MCI), a prodromal stage of Alzheimer's disease (AD), have demonstrated inconsistent yet promising results. Addressing the limitations of previous studies, this trial investigated the effects of a 12-month structured exercise program on the progression of MCI. The NeuroExercise study is a multicenter randomized controlled trial across three European countries (Ireland, Netherlands, Germany). Hundred and eighty-three individuals with amnestic MCI were included and were randomized to a 12-month exercise intervention (3 units of 45 min) of either aerobic exercise (AE; n = 60), stretching and toning exercise (ST; n = 65) or to a non-exercise control group (CG; n = 58). The primary outcome, cognitive performance, was determined by an extensive neuropsychological test battery. For the primary complete case (CC) analyses, between-group differences were analyzed with analysis of covariance under two conditions: (1) the exercise group (EG = combined AE and ST groups) compared to the CG and (2) AE compared to ST. Primary analysis of the full cohort (n = 166, 71.5 years; 51.8% females) revealed no between-group differences in composite cognitive score [mean difference (95% CI)], 0.12 [(−0.03, 0.27), p = 0.13] or in any cognitive domain or quality of life. VO2 peak was significantly higher in the EG compared to the CG after 12 months [−1.76 (−3.39, −0.10), p = 0.04]. Comparing the two intervention groups revealed a higher VO2peak level in the aerobic exercise compared to the stretching and toning group, but no differences for the other outcomes. A 12-month exercise intervention did not change cognitive performance in individuals with amnestic MCI in comparison to a non-exercise CG. An intervention effect on physical fitness was found, which may be an important moderator for long term disease progression and warrants long-term follow-up investigations. Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/NCT02913053, identifier: NCT02913053.
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Affiliation(s)
- Tim Stuckenschneider
- Institute of Movement and Neurosciences, German Sport University, Cologne, Germany.,VasoActive Research Group, School of Health and Sport Sciences, University of the Sunshine Coast, Maroochydore, QLD, Australia
| | - Marit L Sanders
- Department of Geriatric Medicine, Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, Netherlands.,Donders Institute for Brain Cognition and Behavior, Nijmegen, Netherlands
| | - Kate E Devenney
- Discipline of Physiotherapy, Trinity College, Dublin, Ireland
| | - Justine A Aaronson
- Donders Institute for Brain Cognition and Behavior, Nijmegen, Netherlands.,Department of Medical Psychology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Vera Abeln
- Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
| | - Jurgen A H R Claassen
- Department of Geriatric Medicine, Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, Netherlands.,Donders Institute for Brain Cognition and Behavior, Nijmegen, Netherlands
| | - Emer Guinan
- Discipline of Physiotherapy, Trinity College, Dublin, Ireland
| | - Brian Lawlor
- Mercer's Institute for Successful Aging, St. James's Hospital and Global Brain Health Institute, Trinity College, Dublin, Ireland
| | - Romain Meeusen
- Department of Human Physiology & Sports Medicine, Vrije Universiteit Brussel, Brussels, Belgium
| | - Christian Montag
- Department of Molecular Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Marcel G M Olde Rikkert
- Department of Geriatric Medicine, Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, Netherlands.,Donders Institute for Brain Cognition and Behavior, Nijmegen, Netherlands
| | - M Cristina Polidori
- Aging Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Martin Reuter
- Center for Economics and Neuroscience, University of Bonn, Bonn, Germany.,Department of Psychology, University of Bonn, Bonn, Germany
| | - Ralf-Joachim Schulz
- Geriatrics Department, University of Cologne Medical Faculty, Cologne, Germany
| | - Tobias Vogt
- Institute of Professional Sport Education and Sport Qualifications, German Sport University, Cologne, Germany.,Waseda University, Faculty of Sport Sciences, Tokorozawa, Japan
| | - Bernd Weber
- Center for Economics and Neuroscience, University of Bonn, Bonn, Germany
| | - Roy P C Kessels
- Donders Institute for Brain Cognition and Behavior, Nijmegen, Netherlands.,Department of Medical Psychology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Stefan Schneider
- Institute of Movement and Neurosciences, German Sport University, Cologne, Germany.,VasoActive Research Group, School of Health and Sport Sciences, University of the Sunshine Coast, Maroochydore, QLD, Australia
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9
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Associations between CLU polymorphisms and memory performance: The role of serum lipids in Alzheimer's disease. J Psychiatr Res 2020; 129:281-288. [PMID: 32882505 DOI: 10.1016/j.jpsychires.2020.07.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/10/2020] [Accepted: 07/15/2020] [Indexed: 11/22/2022]
Abstract
CLU encoding clusterin, has been reported to associate with Alzherimer's disease (AD) by genome-wide association studies (GWAS) based on Caucasian populations. Our previous case-control study has independently confirmed the disease association of CLU in Chinese population. Since little is known about the underlying mechanism of CLU in AD, we have conducted this study to investigate whether the genetic impact of CLU polymorphisms on cognitive functioning is via serum lipid's dysfunction. Three GWAS previously published CLU polymorphisms including rs2279590, rs11136000 and rs9331888, were genotyped in 689 subjects. Serum levels of triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were measured and tested as mediators. Delayed Word Recall Test (DWRT) was used to evaluate subjects' memory performance. Multiple mediation analysis, a nonparametric procedure to create confidence interval, was performed according to Preacher and Hayes's Bootstrapping method. Our findings suggested significant correlation between CLU polymorphism and DWRT scores for rs11136000 (p = 0.045) after adjustment for age, gender, body mass index, and APOEε4 status, with borderline significant correlation for rs2279590 (p = 0.058). Both T allele of rs11136000 and A allele of rs2279590 were negatively correlated with serum TG levels (p = 0.003; p = 0.001, separately). Moreover, A allele of rs2279590 was positively correlated with serum HDL-C levels (p = 0.015). Consistent with our hypotheses, the genetic impact of CLU polymorphisms on memory performance were partially mediated through TG (rs11136000 95% CI [-0.099,-0.003] and rs2279590 95% CI [-0.104, -0.004]), but not through HDL-C and LDL-C. Our findings indicate CLU polymorphisms may modify AD susceptibility through lipid metabolic pathway.
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10
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Hoodin F, LaLonde L, Errickson J, Votruba K, Kentor R, Gatza E, Reddy P, Choi SW. Cognitive Function and Quality of Life in Vorinostat-Treated Patients after Matched Unrelated Donor Myeloablative Conditioning Hematopoietic Cell Transplantation. Biol Blood Marrow Transplant 2019; 25:343-353. [PMID: 30244099 PMCID: PMC6339826 DOI: 10.1016/j.bbmt.2018.09.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 09/10/2018] [Indexed: 12/16/2022]
Abstract
Myeloablative conditioning allogeneic hematopoietic cell transplantation (HCT) puts patients at greater risk for significant cognitive and quality of life decline compared with recipients of reduced-intensity conditioning or autologous HCT. Vorinostat, a histone deacetylase inhibitor, has been shown to have neuroprotective and neurorestorative effects in preclinical models of neurologic diseases. Thus, within the context of a myeloablative conditioning phase II clinical trial of vorinostat combined with tacrolimus and methotrexate for graft-versus-host disease prophylaxis, we conducted an ancillary study to evaluate feasibility of assessing associations between vorinostat and neurocognitive function and quality of life (ClinicalTrials.gov NCT02409134). Nine patients (mean age, 53 years; range, 36 to 66) underwent computerized neuropsychological testing (Cogstate) and completed surveys of mood (Patient Health Questionnaire-9), anxiety (General Anxiety Disorder-7), and quality of life (Functional Assessment of Cancer Therapy-General). Control cohorts from a separate concurrent longitudinal study (19 autologous and 18 allogeneic HCT patients, who matched the vorinostat patients on relevant medical and demographic variables) completed the same test battery. All allogeneic patients received busulfan-based myeloablative conditioning and were transplanted with HLA-matched unrelated donors. The total neurocognitive performance score of vorinostat patients did not change significantly across the study duration (ie, baseline, day 30, day 100, and day 160). Depression, anxiety, and quality of life also did not differ significantly across time. In univariate analyses (analysis of variance), vorinostat-treated patients showed no difference in neurocognitive function or quality of life compared with autologous and allogeneic control subjects. However, when medical variables were accounted for in a linear mixed effects regression model, the total neurocognitive performance of vorinostat-treated patients was comparable with autologous control subjects. Notably, autologous control subjects performed significantly better than allogeneic control subjects (estimate, .64; standard error, .23; P ≤ .01). Moreover, a smaller percentage of vorinostat-treated patients were classified as mildly, moderately, or severely impaired across neurocognitive domains as well as time points compared with both control cohorts. Thus, vorinostat may have neurorestorative or neuroprotective effects in the HCT setting. Accordingly, we recognize the need for a future, full-scale randomized controlled trial to further examine this hypothesis.
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Affiliation(s)
- Flora Hoodin
- Department of Psychiatry, University of Michigan; Ann Arbor, Michigan; Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan
| | - Leah LaLonde
- Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan
| | - Josh Errickson
- Consulting for Statistics, Computing and Analytics Research, University of Michigan, Ann Arbor, Michigan
| | - Kristen Votruba
- Department of Psychiatry, University of Michigan; Ann Arbor, Michigan
| | - Rachel Kentor
- Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan
| | - Erin Gatza
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
| | - Pavan Reddy
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Sung Won Choi
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan.
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11
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Kim H, Kim HK, Kim SY, Kim YI, Yoo HR, Jung IC. Cognitive improvement effects of electro-acupuncture for the treatment of MCI compared with Western medications: a systematic review and Meta-analysis. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 19:13. [PMID: 30621676 PMCID: PMC6325879 DOI: 10.1186/s12906-018-2407-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 12/10/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Almost half of mild cognitive impairment (MCI) patients progress to dementia, which is associated with decreased quality of life and obstacles to independent living. Relevant management is expected to prevent MCI patients from progressing to dementia. In recent years, electroacupuncture (EA) has been used to treat various kinds of neurological disorders including MCI. This study evaluates the use of EA for MCI patients to increase cognitive function through a comparison with Western medications. METHODS Randomized controlled trials (RCT) or systematical reviews (SR) of EA versus Western medications for MCI were searched using the following 10 databases: Pubmed, Cochrane Library, CINAHL, EMBASE, China National Knowledge Infrastructure (CNKI), National Digital Science Library (NDSL), Journal of Oriental Neuropsychiatry (JON), Korean Medical Database (KMBASE), KoreaMed, and OASIS, from October 2007 to August 2017, without language restriction. A methodological quality assessment of RCTs or SRs that met inclusion criteria was conducted using Cochrane Risk of bias (RoB) tool and a meta-analysis by RevMan (Review Manager) 5.3.5 version of Cochrane collaboration. RESULTS Five RCTs with 257 patients met inclusion criteria and those were randomly divided into two groups: the EA group (n = 103) and Western medications group (n = 154). The methodological quality of the included studies showed high risk or/and unclear of risk of bias. The meta-analysis of five studies reported that the EA group was better than the Western medications group, improving the Mini Mental State Examination (MMSE) score by 0.65 [95% CI 0.28~1.01] higher mean difference, Montreal Cognitive Assessment (MoCA) score by 0.66 [95% CI 0.00~1.32] higher mean difference. Adverse effects were not reported in the selected studies. CONCLUSION Electroacupuncture was an effective treatment for MCI patients by improving cognitive function. However, the included studies presented a low methodological quality and no adverse effects were reported. Thus, further comprehensive studies with a design in depth are needed to derive significant results.
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Affiliation(s)
- Hwan Kim
- Department of Oriental Neuropsychiatry, College of Korean Medicine, College of Oriental Medicine, Daejeon University, Yongun-dong, Dong-gu, Daejeon, South Korea
- Clinical Trial Center, Dunsan Korean Medicine Hospital of Daejeon University, Daejeon, South Korea
| | - Hong Kyoung Kim
- Clinical Trial Center, Dunsan Korean Medicine Hospital of Daejeon University, Daejeon, South Korea
- Department of Acupuncture and Moxibustion, College of Oriental Medicine, DaeJeon University, Daejeon, South Korea
| | - Si Yeon Kim
- Clinical Trial Center, Dunsan Korean Medicine Hospital of Daejeon University, Daejeon, South Korea
| | - Young Il Kim
- Department of Acupuncture and Moxibustion, College of Oriental Medicine, DaeJeon University, Daejeon, South Korea
| | - Ho Ryong Yoo
- Department of Circulatory Internal Medicine, College of Oriental Medicine, DaeJeon University, Daejeon, South Korea
| | - In Chul Jung
- Department of Oriental Neuropsychiatry, College of Korean Medicine, College of Oriental Medicine, Daejeon University, Yongun-dong, Dong-gu, Daejeon, South Korea
- Clinical Trial Center, Dunsan Korean Medicine Hospital of Daejeon University, Daejeon, South Korea
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12
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Pillemer S, Papandonatos GD, Crook C, Ott BR, Tremont G. The Modified Telephone-Administered Minnesota Cognitive Acuity Screen for Mild Cognitive Impairment. J Geriatr Psychiatry Neurol 2018; 31:123-128. [PMID: 29764279 DOI: 10.1177/0891988718776131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE This study aimed to compare the sensitivity and specificity of a modified version of the Minnesota Cognitive Acuity Screen (MCAS-m), by adding learning and recognition memory components, to the original version MCAS to distinguish amnestic mild cognitive impairment (aMCI) from healthy controls (HCs). METHODS/DESIGN A total of 30 individuals with aMCI and 30 HCs underwent neuropsychological testing, neurologic examination, laboratory, and brain imaging tests. Once diagnosis was confirmed, participants completed the MCAS and MCAS-m in counterbalanced order. RESULTS The average administration time was 12.6 minutes for the MCAS and 13.5 minutes for the MCAS-m. Receiver operating characteristic curve analyses showed that the MCAS-m demonstrated 97% sensitivity and 97% specificity for distinguishing between aMCI and HC versus 97% and 87%, respectively, for the original MCAS in this sample. CONCLUSIONS Both the MCAS and the MCAS-m were highly sensitive when distinguishing between normal cognition and aMCI; however, the MCAS-m demonstrated a 10% increase in specificity compared to the original version. Improved specificity is particularly relevant to screening in larger community samples with lower base rates of MCI than clinic populations. This modified screening measure presents a brief and cost-effective tool for identifying MCI. Given the risk of progression from aMCI to Alzheimer disease dementia (AD), the MCAS-m represents a modest improvement in telephone-administered methods for the early detection of AD.
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Affiliation(s)
- Sarah Pillemer
- 1 Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA.,2 Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | | | - Cara Crook
- 4 Department of Psychology, Fordham University, Bronx, NY USA
| | - Brian R Ott
- 5 Department of Neurology, Alpert Medical School of Brown University, Providence, RI, USA
| | - Geoffrey Tremont
- 1 Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA.,2 Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
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13
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Racine AM, Clark LR, Berman SE, Koscik RL, Mueller KD, Norton D, Nicholas CR, Blennow K, Zetterberg H, Jedynak B, Bilgel M, Carlsson CM, Christian BT, Asthana S, Johnson SC. Associations between Performance on an Abbreviated CogState Battery, Other Measures of Cognitive Function, and Biomarkers in People at Risk for Alzheimer's Disease. J Alzheimers Dis 2018; 54:1395-1408. [PMID: 27589532 DOI: 10.3233/jad-160528] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
It is not known whether computerized cognitive assessments, like the CogState battery, are sensitive to preclinical cognitive changes or pathology in people at risk for Alzheimer's disease(AD). In 469 late middle-aged participants from the Wisconsin Registry for Alzheimer's Prevention(mean age 63.8±7 years at testing; 67% female; 39% APOE4+), we examined relationships between a CogState abbreviated battery(CAB) of seven tests and demographic characteristics, traditional paper-based neuropsychological tests as well as a composite cognitive impairment index, cognitive impairment status(determined by consensus review), and biomarkers for amyloid and tau(CSF phosphorylated-tau/Aβ42 and global PET-PiB burden) and neural injury(CSF neurofilament light protein). CSF and PET-PiB were collected in n = 71 and n = 91 participants, respectively, approximately four years prior to CAB testing. For comparison, we examined three traditional tests of delayed memory in parallel. Similar to studies in older samples, the CAB was less influenced by demographic factors than traditional tests. CAB tests were generally correlated with most paper-based cognitive tests examined and mapped onto the same cognitive domains. Greater composite cognitive impairment index was associated with worse performance on all CAB tests. Cognitively impaired participants performed significantly worse compared to normal controls on all but one CAB test. Poorer One Card Learning test performance was associated with higher levels of CSF phosphorylated-tau/Aβ42. These results support the use of the CogState battery as measures of early cognitive impairment in studies of people at risk for AD.
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Affiliation(s)
- Annie M Racine
- Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Institute on Aging, University of Wisconsin-Madison, Madison, WI, USA.,Neuroscience & Public Policy Program, University of Wisconsin-Madison, Madison, WI, USA
| | - Lindsay R Clark
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA.,Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Sara E Berman
- Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Rebecca L Koscik
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Kimberly D Mueller
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Derek Norton
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI, USA
| | - Christopher R Nicholas
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA.,Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Institute of Neurology, University College London, London, UK
| | - Bruno Jedynak
- Department of Mathematics and Statistics, Portland State University, Portland, OR, USA
| | - Murat Bilgel
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Laboratory of Behavioral Neuroscience, National Institute on Aging, NIH, Baltimore, MD, USA
| | - Cynthia M Carlsson
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA.,Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Bradley T Christian
- Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin-Madison, Madison, WI, USA.,Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Sanjay Asthana
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA.,Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Sterling C Johnson
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA.,Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Neuroscience & Public Policy Program, University of Wisconsin-Madison, Madison, WI, USA.,Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin-Madison, Madison, WI, USA
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14
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Smith G, Chandler M, Locke DE, Fields J, Phatak V, Crook J, Hanna S, Lunde A, Morris M, Graff-Radford M, Hughes CA, Lepore S, Cuc A, Caselli M, Hurst D, Wethe J, Francone A, Eilertsen J, Lucas P, Hoffman Snyder C, Kuang L, Becker M, Dean P, Diehl N, Lofquist M, Vanderhook S, Myles D, Cochran D. Behavioral Interventions to Prevent or Delay Dementia: Protocol for a Randomized Comparative Effectiveness Study. JMIR Res Protoc 2017; 6:e223. [PMID: 29180344 PMCID: PMC5725623 DOI: 10.2196/resprot.8103] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 09/26/2017] [Accepted: 10/11/2017] [Indexed: 01/21/2023] Open
Abstract
Background Currently, people at risk for dementia and their caregivers are confronted with confusing choices about what behavioral interventions are most effective. Objective The objective of this study is to determine which empirically supported behavioral interventions most impact the outcomes highly valued by patients with mild cognitive impairment and their partners. Methods This protocol describes a comparative effectiveness trial targeting 300 participants with mild cognitive impairment and their study partners. The trial is being conducted at the Mayo Clinic campuses in Arizona, Florida, Minnesota, and the University of Washington in Seattle. The study examines the contribution of five behavioral interventions (yoga, memory compensation training, computerized cognitive training, support groups, and wellness education) on primary outcomes of participant and partner quality of life and self-efficacy. In this unique 10-day multicomponent intervention, groups of couples were randomized to have one of the five interventions withheld while receiving the other four. Although the longitudinal follow-up is still under way, enrollment results are available and reported. Results In total, 272 couples have been enrolled in the trial and follow-up visits continue. Outcomes will be assessed at the end-of-intervention and 6-, 12-, and 18-month follow-ups. We anticipate reporting on our primary and secondary outcomes across time points in the next 2 years. Conclusions This paper describes the protocol for a randomized comparative effectiveness study of behavioral interventions to prevent or delay dementia. We describe of the rationale, design, power analysis, and analysis plan. Also because enrollment is complete and we are in follow-up phases of the study, we have included enrollment data from the trial. Trial Registration ClinicalTrials.gov NCT02265757; http://clinicaltrials.gov/ctsshow/ NCT02265757 (Archived by WebCite at http://www.webcitation.org/6ueRfwSYv)
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Affiliation(s)
- Glenn Smith
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Melanie Chandler
- Department of Psychiatry and Psychology, Mayo Clinic Florida, Jacksonville, FL, United States
| | - Dona Ec Locke
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Scottsdale, AZ, United States
| | - Julie Fields
- Department of Psychiatry and Psychology, Mayo Clinic Minnesota, Rochester, MN, United States
| | - Vaishali Phatak
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, United States
| | - Julia Crook
- Department of Health Sciences Research, Mayo Clinic Florida, Jacksonville, FL, United States
| | - Sherrie Hanna
- Department of Psychiatry and Psychology, Mayo Clinic Minnesota, Rochester, MN, United States
| | - Angela Lunde
- Department of Psychiatry and Psychology, Mayo Clinic Minnesota, Rochester, MN, United States
| | - Miranda Morris
- Department of Psychiatry and Psychology, Mayo Clinic Florida, Jacksonville, FL, United States
| | - Michelle Graff-Radford
- Department of Psychiatry and Psychology, Mayo Clinic Florida, Jacksonville, FL, United States
| | - Christine A Hughes
- Department of Psychiatry and Psychology, Mayo Clinic Minnesota, Rochester, MN, United States
| | - Susan Lepore
- Department of Psychiatry and Psychology, Mayo Clinic Minnesota, Rochester, MN, United States
| | - Andrea Cuc
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Scottsdale, AZ, United States
| | - Maria Caselli
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Scottsdale, AZ, United States
| | - Duane Hurst
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Scottsdale, AZ, United States
| | - Jennifer Wethe
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Scottsdale, AZ, United States
| | - Andrea Francone
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Scottsdale, AZ, United States
| | - Jeanne Eilertsen
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Scottsdale, AZ, United States
| | - Pauline Lucas
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Scottsdale, AZ, United States
| | | | - LeeAnn Kuang
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Scottsdale, AZ, United States
| | | | | | - Nancy Diehl
- Department of Health Sciences Research, Mayo Clinic Florida, Jacksonville, FL, United States
| | - Marvin Lofquist
- Patient and Partner Advisory Group, Minneapolis, MN, United States
| | | | - Diana Myles
- Patient and Partner Advisory Group, Davis, CA, United States
| | - Denise Cochran
- Patient and Partner Advisory Group, Minneapolis, MN, United States
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15
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Prospective computerized monitoring of cognitive functioning before and after blood and marrow transplantation. Bone Marrow Transplant 2017; 52:1215-1217. [PMID: 28604666 DOI: 10.1038/bmt.2017.105] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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16
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Sumner JA, Hagan K, Grodstein F, Roberts AL, Harel B, Koenen KC. Posttraumatic stress disorder symptoms and cognitive function in a large cohort of middle-aged women. Depress Anxiety 2017; 34:356-366. [PMID: 28072503 PMCID: PMC5378624 DOI: 10.1002/da.22600] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Revised: 12/13/2016] [Accepted: 12/17/2016] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) has been linked to cognitive decline, but research in women is generally lacking. We examined whether trauma and elevated PTSD symptoms were associated with worse cognitive function in middle-aged civilian women. A secondary objective was to investigate the possible role of depression in the relation of PTSD symptoms to cognitive function. METHODS The sample comprised 14,029 middle-aged women in the Nurses' Health Study II. Lifetime trauma exposure, lifetime PTSD symptoms, and past-week depressive symptoms were measured in 2008. Cognitive function was measured in 2014-2016 using the Cogstate Brief Battery, a self-administered online cognitive battery that assesses psychomotor speed, attention, learning, and working memory. We used linear regression models to estimate mean differences in cognition across PTSD symptom levels. RESULTS Compared to no trauma, elevated PTSD symptoms consistent with probable PTSD (i.e., 4+ symptoms on a screening questionnaire) were associated with worse performance on psychomotor speed/attention (b = -0.08 standard units, p = .001) and learning/working memory (b = -0.09, p < .001) composites, after adjusting for sociodemographics. Although attenuated, associations remained significant when adjusted for depressive symptoms and other cognitive risk factors. We found the strongest associations among women with comorbid probable PTSD and depression. CONCLUSIONS PTSD symptoms were negatively related to measures of psychomotor speed/attention and learning/working memory in middle-aged women. Our study adds to a growing literature that suggests that mental disorders are associated with worse cognitive function over the life course.
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Affiliation(s)
- Jennifer A. Sumner
- Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA,Corresponding author: Jennifer A. Sumner, Center for Behavioral Cardiovascular Health, Columbia University Medical Center, 622 W. 168 St, PH 9-315, New York, NY 10032 USA. Tel: 212-342-3133; Fax: 212-342-3431;
| | - Kaitlin Hagan
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Fran Grodstein
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Andrea L. Roberts
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | | | - Karestan C. Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA,Psychiatric and Neurodevelopmental Genetics Unit and Department of Psychiatry, Massachusetts General Hospital, Boston, MA
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17
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Russo MJ, Campos J, Vázquez S, Sevlever G, Allegri RF. Adding Recognition Discriminability Index to the Delayed Recall Is Useful to Predict Conversion from Mild Cognitive Impairment to Alzheimer's Disease in the Alzheimer's Disease Neuroimaging Initiative. Front Aging Neurosci 2017; 9:46. [PMID: 28344552 PMCID: PMC5344912 DOI: 10.3389/fnagi.2017.00046] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Accepted: 02/20/2017] [Indexed: 11/13/2022] Open
Abstract
Background: Ongoing research is focusing on the identification of those individuals with mild cognitive impairment (MCI) who are most likely to convert to Alzheimer's disease (AD). We investigated whether recognition memory tasks in combination with delayed recall measure of episodic memory and CSF biomarkers can predict MCI to AD conversion at 24-month follow-up. Methods: A total of 397 amnestic-MCI subjects from Alzheimer's disease Neuroimaging Initiative were included. Logistic regression modeling was done to assess the predictive value of all RAVLT measures, risk factors such as age, sex, education, APOE genotype, and CSF biomarkers for progression to AD. Estimating adjusted odds ratios was used to determine which variables would produce an optimal predictive model, and whether adding tests of interaction between the RAVLT Delayed Recall and recognition measures (traditional score and d-prime) would improve prediction of the conversion from a-MCI to AD. Results: 112 (28.2%) subjects developed dementia and 285 (71.8%) subjects did not. Of the all included variables, CSF Aβ1-42 levels, RAVLT Delayed Recall, and the combination of RAVLT Delayed Recall and d-prime were predictive of progression to AD (χ2 = 38.23, df = 14, p < 0.001). Conclusions: The combination of RAVLT Delayed Recall and d-prime measures may be predictor of conversion from MCI to AD in the ADNI cohort, especially in combination with amyloid biomarkers. A predictive model to help identify individuals at-risk for dementia should include not only traditional episodic memory measures (delayed recall or recognition), but also additional variables (d-prime) that allow the homogenization of the assessment procedures in the diagnosis of MCI.
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18
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Patel SK, Meier AM, Fernandez N, Lo TTY, Moore C, Delgado N. Convergent and criterion validity of the CogState computerized brief battery cognitive assessment in women with and without breast cancer. Clin Neuropsychol 2017; 31:1375-1386. [PMID: 28080264 DOI: 10.1080/13854046.2016.1275819] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Computerized tests have increasingly garnered interest for assessing cognitive functioning due to their potential logistical and financial advantages over traditional 'pencil and-paper' neuropsychological tests. However, psychometric information is necessary to guide decisions about their clinical and research utility with varied populations. We explored the convergent construct validity and criterion validity of the CogState computerized tests in breast cancer survivors, a group known to present with mostly mild, subtle cognitive dysfunction. METHOD Fifty-three post-menopausal women (26 breast cancer survivors, 27 healthy controls) completed the CogState Brief Battery tests with passed performance checks, conceptually matched traditional neuropsychological tests, and a self-report measure of daily functioning, the Functional Activities Questionnaire. RESULTS Significant positive correlations were found between the CogState Brief Battery tests and traditional neuropsychological tests, although the traditional tests specifically hypothesized to correlate with CogState tests did not reach statistical significance. Analysis of Covariance results showed preliminary support for criterion validity, as the patient and control groups differed on the traditional test of working memory (Digits Backwards, p = .01), with a trend towards significance for the CogState test of working memory (One Back, p = .02), controlled for age, race, and mood. CONCLUSIONS The results provide preliminary support for further research to determine if the CogState tests are viable as screening tools to detect subtle cognitive differences between breast cancer survivors and healthy women. Our study was limited by the low base rate of cognitive impairment and small sample size. We recommend further research employing sufficiently powered sample sizes and a longitudinal, repeated measures study design.
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Affiliation(s)
- Sunita K Patel
- a Department of Population Sciences , City of Hope , Duarte , CA , USA.,b Department of Supportive Care Medicine , City of Hope , Duarte , CA , USA
| | - Adrienne M Meier
- a Department of Population Sciences , City of Hope , Duarte , CA , USA.,b Department of Supportive Care Medicine , City of Hope , Duarte , CA , USA
| | | | - Tracy T Y Lo
- a Department of Population Sciences , City of Hope , Duarte , CA , USA.,b Department of Supportive Care Medicine , City of Hope , Duarte , CA , USA
| | - Colleen Moore
- a Department of Population Sciences , City of Hope , Duarte , CA , USA
| | - Nicole Delgado
- a Department of Population Sciences , City of Hope , Duarte , CA , USA
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19
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Curcumin and cognition: a randomised, placebo-controlled, double-blind study of community-dwelling older adults. Br J Nutr 2016; 115:2106-13. [DOI: 10.1017/s0007114516001203] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractCurcumin therapy in animals has produced positive cognitive and behavioural outcomes; results of human trials, however, have been inconsistent. In this study, we report the results of a 12-month, randomised, placebo-controlled, double-blind study that investigated the ability of a curcumin formulation to prevent cognitive decline in a population of community-dwelling older adults. Individuals (n 96) ingested either placebo or 1500 mg/d BiocurcumaxTM for 12 months. A battery of clinical and cognitive measures was administered at baseline and at the 6-month and 12-month follow-up assessments. A significant time×treatment group interaction was observed for the Montreal Cognitive Assessment (repeated-measures analysis; time×treatment; F=3·85, P<0·05). Subsequent analysis revealed that this association was driven by a decline in function of the placebo group at 6 months that was not observed in the curcumin treatment group. No differences were observed between the groups for all other clinical and cognitive measures. Our findings suggest that further longitudinal assessment is required to investigate changes in cognitive outcome measures, ideally in conjunction with biological markers of neurodegeneration.
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20
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Montgomery KS, Edwards G, Levites Y, Kumar A, Myers CE, Gluck MA, Setlow B, Bizon JL. Deficits in hippocampal-dependent transfer generalization learning accompany synaptic dysfunction in a mouse model of amyloidosis. Hippocampus 2016; 26:455-71. [PMID: 26418152 PMCID: PMC4803574 DOI: 10.1002/hipo.22535] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 09/11/2015] [Accepted: 09/17/2015] [Indexed: 11/08/2022]
Abstract
Elevated β-amyloid and impaired synaptic function in hippocampus are among the earliest manifestations of Alzheimer's disease (AD). Most cognitive assessments employed in both humans and animal models, however, are insensitive to this early disease pathology. One critical aspect of hippocampal function is its role in episodic memory, which involves the binding of temporally coincident sensory information (e.g., sights, smells, and sounds) to create a representation of a specific learning epoch. Flexible associations can be formed among these distinct sensory stimuli that enable the "transfer" of new learning across a wide variety of contexts. The current studies employed a mouse analog of an associative "transfer learning" task that has previously been used to identify risk for prodromal AD in humans. The rodent version of the task assesses the transfer of learning about stimulus features relevant to a food reward across a series of compound discrimination problems. The relevant feature that predicts the food reward is unchanged across problems, but an irrelevant feature (i.e., the context) is altered. Experiment 1 demonstrated that C57BL6/J mice with bilateral ibotenic acid lesions of hippocampus were able to discriminate between two stimuli on par with control mice; however, lesioned mice were unable to transfer or apply this learning to new problem configurations. Experiment 2 used the APPswe PS1 mouse model of amyloidosis to show that robust impairments in transfer learning are evident in mice with subtle β-amyloid-induced synaptic deficits in the hippocampus. Finally, Experiment 3 confirmed that the same transfer learning impairments observed in APPswePS1 mice were also evident in the Tg-SwDI mouse, a second model of amyloidosis. Together, these data show that the ability to generalize learned associations to new contexts is disrupted even in the presence of subtle hippocampal dysfunction and suggest that, across species, this aspect of hippocampal-dependent learning may be useful for early identification of AD-like pathology.
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Affiliation(s)
- Karienn S. Montgomery
- Department of Neuroscience and Experimental Therapeutics, Texas A&M Health Science Center, Bryan, TX
| | - George Edwards
- Mitchell Center for Alzheimer’s Disease and Related Brain Disorders, Department of Neurology, University of Texas Health Science Center in Houston, Houston, TX
| | - Yona Levites
- Department of Neuroscience, University of Florida, Gainesville, FL
| | - Ashok Kumar
- Department of Neuroscience, University of Florida, Gainesville, FL
| | - Catherine E. Myers
- VA New Jersey Health Care System, East Orange, NJ 07018
- Department of Pharmacology, Physiology & Neuroscience, New Jersey Medical School, Rutgers University, Newark, NJ
| | - Mark A. Gluck
- Center for Molecular & Behavioral Neuroscience, Rutgers University, Newark, NJ
| | - Barry Setlow
- Department of Psychiatry, University of Florida, Gainesville, FL
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21
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Morrison GE, Simone CM, Ng NF, Hardy JL. Reliability and validity of the NeuroCognitive Performance Test, a web-based neuropsychological assessment. Front Psychol 2015; 6:1652. [PMID: 26579035 PMCID: PMC4630791 DOI: 10.3389/fpsyg.2015.01652] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 10/13/2015] [Indexed: 11/13/2022] Open
Abstract
The NeuroCognitive Performance Test (NCPT) is a brief, repeatable, web-based cognitive assessment platform that measures performance across several cognitive domains. The NCPT platform is modular and includes 18 subtests that can be arranged into customized batteries. Here we present normative data from a sample of 130,140 healthy volunteers for an NCPT battery consisting of 8 subtests. Participants took the NCPT remotely and without supervision. Factor structure and effects of age, education, and gender were evaluated with this normative dataset. Test-retest reliability was evaluated in a subset of participants who took the battery again an average of 78.8 days later. The eight NCPT subtests group into 4 putative cognitive domains, have adequate to good test-retest reliability, and are sensitive to expected age- and education-related cognitive effects. Concurrent validity to standard neuropsychological tests was demonstrated in 73 healthy volunteers. In an exploratory analysis the NCPT battery could differentiate those who self-reported Mild Cognitive Impairment or Alzheimer's disease from matched healthy controls. Overall these results demonstrate the reliability and validity of the NCPT battery as a measure of cognitive performance and support the feasibility of web-based, unsupervised testing, with potential utility in clinical and research settings.
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Affiliation(s)
- Glenn E Morrison
- Department of Research and Development, Lumos Labs San Francisco, CA, USA
| | - Christa M Simone
- Department of Research and Development, Lumos Labs San Francisco, CA, USA
| | - Nicole F Ng
- Department of Research and Development, Lumos Labs San Francisco, CA, USA
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22
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Koyama AK, Hagan KA, Okereke OI, Weisskopf MG, Rosner B, Grodstein F. Evaluation of a Self-Administered Computerized Cognitive Battery in an Older Population. Neuroepidemiology 2015; 45:264-72. [PMID: 26501919 DOI: 10.1159/000439592] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 08/21/2015] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE The aim of this study is to assess the utility of the Cogstate self-administered computerized neuropsychological battery in a large population of older men. METHODS We invited 7,167 men (mean age of 75 years) from the Health Professionals Follow-up Study, a prospective cohort of male health professionals. We considered individual Cogstate scores and composite scores measuring psychomotor speed and attention, learning and working memory and overall cognition. Multivariate linear regression was used to assess the association between risk factors measured 4 and 28 years prior to cognitive testing and each outcome. RESULTS The 1,866 men who agreed to complete Cogstate testing were similar to the 5,301 non-responders. Many expected risk factors were associated with Cogstate scores in multivariate adjusted models. Increasing age was significantly associated with worse performance on all outcomes (p < 0.001). For risk factors measured 4 years prior to testing and overall cognition, a history of hypertension was significantly associated with worse performance (mean difference of -0.08 standard units (95% CI -0.16, 0.00)) and higher consumption of nuts was significantly associated with better performance (>2 servings/week vs. <1 serving/month: 0.15 (0.03, 0.27)). CONCLUSIONS The self-administered Cogstate battery showed significant associations with several risk factors known to be associated with cognitive function. Future studies of cognitive aging may benefit from the numerous advantages of self-administered computerized testing.
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Affiliation(s)
- Alain K Koyama
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass., USA
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23
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Lemos R, Marôco J, Simões MR, Santiago B, Tomás J, Santana I. The free and cued selective reminding test for predicting progression to Alzheimer's disease in patients with mild cognitive impairment: A prospective longitudinal study. J Neuropsychol 2015; 11:40-55. [PMID: 26058529 DOI: 10.1111/jnp.12075] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 05/06/2015] [Indexed: 12/01/2022]
Abstract
Amnestic mild cognitive impairment (aMCI) patients carry a greater risk of conversion to Alzheimer's disease (AD). Therefore, the International Working Group (IWG) on AD aims to consider some cases of aMCI as symptomatic prodromal AD. The core diagnostic marker of AD is a significant and progressive memory deficit, and the Free and Cued Selective Reminding Test (FCSRT) was recommended by the IWG to test memory in cases of possible prodromal AD. This study aims to investigate whether the performance on the FCSRT would enhance the ability to predict conversion to AD in an aMCI group. A longitudinal study was conducted on 88 aMCI patients, and neuropsychological tests were analysed on the relative risk of conversion to AD. During follow-up (23.82 months), 33% of the aMCI population converted to AD. An impaired FCSRT TR was significantly associated with the risk of conversion to dementia, with a mean time to conversion of 25 months. The FCSRT demonstrates utility for detecting AD at its prodromal stage, thus supporting its use as a valid clinical marker.
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Affiliation(s)
- Raquel Lemos
- Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal.,Visual Neuroscience Laboratory, Institute of Biomedical Research in Light and Image, Faculty of Medicine, University of Coimbra, Portugal
| | - João Marôco
- Psychology and Health Research Unit (UIPES), Department of Psychological Sciences, ISPA - Instituto Universitário, Lisboa, Portugal
| | - Mário R Simões
- Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal
| | - Beatriz Santiago
- Neurology Department of the Coimbra Hospital and University Center, Portugal
| | - José Tomás
- Neurology Department of the Coimbra Hospital and University Center, Portugal
| | - Isabel Santana
- Neurology Department of the Coimbra Hospital and University Center, Portugal.,Faculty of Medicine, University of Coimbra, Portugal
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24
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Bruce KM, Robinson SR, Smith JA, Yelland GW. Validity of a screening tool for detecting subtle cognitive impairment in the middle-aged and elderly. Clin Interv Aging 2014; 9:2165-76. [PMID: 25540581 PMCID: PMC4270303 DOI: 10.2147/cia.s68363] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The present study tested 121 middle-aged and elderly community-dwelling individuals on the computer-based Subtle Cognitive Impairment Test (SCIT) and compared their performance with that on several neuropsychological tests. The SCIT had excellent internal consistency, as demonstrated by a high split-half reliability measure (0.88-0.93). Performance on the SCIT was unaffected by the confounding factors of sex, education level, and mood state. Many participants demonstrated impaired performance on one or more of the neuropsychological tests (Controlled Oral Word Association Task, Rey Auditory and Verbal Learning Task, Grooved Pegboard [GP], Complex Figures). Performance on SCIT subtests correlated significantly with performance on many of the neuropsychological subtests, and the best and worst performing quartiles on the SCIT subtest discriminated between good and poor performers on other subtests, collectively indicating concurrent validity of the SCIT. Principal components analysis indicated that SCIT performance does not cluster with performance on most of the other cognitive tests, and instead is associated with decision-making efficacy, and processing speed and efficiency. Thus, the SCIT is responsive to the processes that underpin multiple cognitive domains, rather than being specific for a single domain. Since the SCIT is quick and easy to administer, and is well tolerated by the elderly, it may have utility as a screening tool for detecting cognitive impairment in middle-aged and elderly populations.
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Affiliation(s)
- Kathryn M Bruce
- Department of Surgery (MMC), Monash University, Clayton, VIC, Australia
| | | | - Julian A Smith
- Department of Surgery (MMC), Monash University, Clayton, VIC, Australia
| | - Gregory W Yelland
- School of Health Sciences, RMIT University, Bundoora, VIC, Australia ; Central Clinical School, Monash University, Alfred Health, Melbourne, VIC, Australia
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25
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Maruff P, Lim YY, Darby D, Ellis KA, Pietrzak RH, Snyder PJ, Bush AI, Szoeke C, Schembri A, Ames D, Masters CL. Clinical utility of the cogstate brief battery in identifying cognitive impairment in mild cognitive impairment and Alzheimer's disease. BMC Psychol 2013; 1:30. [PMID: 25566378 PMCID: PMC4269990 DOI: 10.1186/2050-7283-1-30] [Citation(s) in RCA: 140] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Accepted: 12/16/2013] [Indexed: 11/10/2022] Open
Abstract
Background Previous studies have demonstrated the utility and sensitivity of the CogState Brief Battery (CBB) in detecting cognitive impairment in Alzheimer’s disease (AD) and mild cognitive impairment (MCI) and in assessing cognitive changes in the preclinical stages of AD. Thus, the CBB may be a useful screening tool to assist in the management of cognitive function in clinical settings. In this study, we aimed to determine the utility of the CBB in identifying the nature and magnitude of cognitive impairments in MCI and AD. Methods Healthy adults (n = 653) adults with amnestic MCI (n = 107), and adults with AD (n = 44) who completed the CBB participated in this study. Composite Psychomotor/Attention and Learning/Working Memory scores were computed from the individual CBB tests. Differences in composite scores were then examined between the three groups; and sensitivity and specificity analyses were conducted to determine cut scores for the composite scores that were optimal in identifying MCI- and AD-related cognitive impairment. Results Large magnitude impairments in MCI (g = 2.2) and AD (g = 3.3) were identified for the learning/working memory composite, and smaller impairments were observed for the attention/psychomotor composite (g’s = 0.5 and 1, respectively). The cut-score associated with optimal sensitivity and specificity in identifying MCI-related cognitive impairment on the learning/working memory composite was -1SD, and in the AD group, this optimal value was -1.7SD. Both composite scores showed high test-retest reliability (r = 0.95) over four months. Poorer performance on the memory composite was also associated with worse performance on the Mini Mental State Exam and increasing severity on the Clinical Dementia Rating Scale sum of boxes score. Conclusions Results of this study suggest that the CogState learning/working memory composite score is reduced significantly in CI and AD, correlate well with measures of disease classification and are useful in identifying memory impairment related to MCI- and AD.
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Affiliation(s)
- Paul Maruff
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria Australia ; CogState Ltd, Melbourne, Victoria Australia
| | - Yen Ying Lim
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria Australia
| | - David Darby
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria Australia
| | - Kathryn A Ellis
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria Australia ; Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Kew, Victoria Australia ; National Ageing Research Institute, Parkville, Victoria Australia
| | - Robert H Pietrzak
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Peter J Snyder
- Lifespan Hospital System & Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI USA
| | - Ashley I Bush
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria Australia
| | - Cassandra Szoeke
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria Australia ; National Ageing Research Institute, Parkville, Victoria Australia ; CSIRO Preventative Health Flagship, Parkville, Victoria Australia
| | | | - David Ames
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Kew, Victoria Australia ; National Ageing Research Institute, Parkville, Victoria Australia
| | - Colin L Masters
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria Australia
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Parsey CM, Schmitter-Edgecombe M. Applications of technology in neuropsychological assessment. Clin Neuropsychol 2013; 27:1328-61. [PMID: 24041037 DOI: 10.1080/13854046.2013.834971] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Most neuropsychological assessments include at least one measure that is administered, scored, or interpreted by computers or other technologies. Despite supportive findings for these technology-based assessments, there is resistance in the field of neuropsychology to adopt additional measures that incorporate technology components. This literature review addresses the research findings of technology-based neuropsychological assessments, including computer- and virtual reality-based measures of cognitive and functional abilities. We evaluate the strengths and limitations of each approach, and examine the utility of technology-based assessments to obtain supplemental cognitive and behavioral information that may be otherwise undetected by traditional paper-and-pencil measures. We argue that the potential of technology use in neuropsychological assessment has not yet been realized, and continued adoption of new technologies could result in more comprehensive assessment of cognitive dysfunction and in turn, better informed diagnosis and treatments. Recommendations for future research are also provided.
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Affiliation(s)
- Carolyn M Parsey
- a Department of Psychology , Washington State University , Pullman , WA , USA
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Lim YY, Jaeger J, Harrington K, Ashwood T, Ellis KA, Stoffler A, Szoeke C, Lachovitzki R, Martins RN, Villemagne VL, Bush A, Masters CL, Rowe CC, Ames D, Darby D, Maruff P. Three-Month Stability of the CogState Brief Battery in Healthy Older Adults, Mild Cognitive Impairment, and Alzheimer's Disease: Results from the Australian Imaging, Biomarkers, and Lifestyle-Rate of Change Substudy (AIBL-ROCS). Arch Clin Neuropsychol 2013; 28:320-30. [DOI: 10.1093/arclin/act021] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Pietrzak RH, Scott JC, Harel BT, Lim YY, Snyder PJ, Maruff P. A process-based approach to characterizing the effect of acute alprazolam challenge on visual paired associate learning and memory in healthy older adults. Hum Psychopharmacol 2012; 27:549-58. [PMID: 23027677 DOI: 10.1002/hup.2263] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2011] [Accepted: 09/02/2012] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Alprazolam is a benzodiazepine that, when administered acutely, results in impairments in several aspects of cognition, including attention, learning, and memory. However, the profile (i.e., component processes) that underlie alprazolam-related decrements in visual paired associate learning has not been fully explored. METHODS In this double-blind, placebo-controlled, randomized cross-over study of healthy older adults, we used a novel, "process-based" computerized measure of visual paired associate learning to examine the effect of a single, acute 1-mg dose of alprazolam on component processes of visual paired associate learning and memory. RESULTS Acute alprazolam challenge was associated with a large magnitude reduction in visual paired associate learning and memory performance (d = 1.05). Process-based analyses revealed significant increases in distractor, exploratory, between-search, and within-search error types. Analyses of percentages of each error type suggested that, relative to placebo, alprazolam challenge resulted in a decrease in the percentage of exploratory errors and an increase in the percentage of distractor errors, both of which reflect memory processes. CONCLUSIONS Results of this study suggest that acute alprazolam challenge decreases visual paired associate learning and memory performance by reducing the strength of the association between pattern and location, which may reflect a general breakdown in memory consolidation, with less evidence of reductions in executive processes (e.g., working memory) that facilitate visual paired associate learning and memory.
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Affiliation(s)
- Robert H Pietrzak
- National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, USA.
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Darby DG, Pietrzak RH, Fredrickson J, Woodward M, Moore L, Fredrickson A, Sach J, Maruff P. Intraindividual cognitive decline using a brief computerized cognitive screening test. Alzheimers Dement 2012; 8:95-104. [PMID: 22404851 DOI: 10.1016/j.jalz.2010.12.009] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2010] [Revised: 11/23/2010] [Accepted: 12/15/2010] [Indexed: 10/28/2022]
Abstract
BACKGROUND Progressive intraindividual decline in memory and cognition is characteristic of dementia and may be useful in detecting very early Alzheimer's disease pathology. METHODS This study evaluated the slopes of cognitive performance over a 12-month period in 263 healthy, community-dwelling, adult volunteers aged ≥50 years. Participants completed a brief computerized battery of cognitive tests (CogState) at baseline and during 3-, 6-, 9-, and 12-month follow-up assessments. Linear mixed models were used to estimate age-adjusted mean slopes and 95% confidence intervals of change for each of the cognitive measures. RESULTS By defining age-adjusted mean slopes, and 95% confidence intervals for a measure of episodic memory, individuals with greater than expected decline (equal to or lower than the fifth percentile level of decline) were identified. From these, four individuals completed a full medical, neurologic, and neuropsychological evaluation, with none of them fulfilling criteria for mild cognitive impairment, but three (75%) having positive amyloid-positron emission tomographic scans. CONCLUSIONS Intraindividual decline in cognitive performance can be detected in otherwise healthy, community-dwelling, older persons, and this may deserve further study as a potential indicator of early Alzheimer's disease pathology.
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Hammers D, Spurgeon E, Ryan K, Persad C, Barbas N, Heidebrink J, Darby D, Giordani B. Validity of a brief computerized cognitive screening test in dementia. J Geriatr Psychiatry Neurol 2012; 25:89-99. [PMID: 22689701 DOI: 10.1177/0891988712447894] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND While preliminary evidence supports the criterion validity of the CogState computerized brief battery in mild cognitive impairment (MCI) and Alzheimer disease (AD), definitive validation studies examining a wider range of dementia-related disorders relative to conventional neuropsychological techniques are necessary. METHODS Participants satisfying clinical consensus criteria for dementia (AD, n = 37; frontotemporal dementia, n = 7; and dementia with Lewy bodies, n = 5), MCI (n = 16), and the healthy controls (n = 22) were administered a battery of brief neuropsychological and select computerized (CogState) cognitive tests. The battery, administered through the University of Michigan Alzheimer's Disease Research Center, included measures of processing speed, attention, working memory, and learning. RESULTS CogState and standard neuropsychological task scores were significantly lower for dementia participants than that of the nondementia groups (P < .05), with a single CogState test distinguishing control from MCI participants, but minimal differentiation existing between dementias using the CogState. Correlations were modest between conventional and computerized test scores, covering matching domains and mostly reflecting the multidimensional nature of cognitive paradigms. CONCLUSIONS Results support the clinical validity of this brief computerized screening battery when used in established dementias, but not to differentiate between various dementias, and suggest that the select CogState battery's effectiveness in identifying MCI from controls was not as strong as identifying specific dementias.
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Affiliation(s)
- Dustin Hammers
- Department of Neurology, Center for Alzheimer's Care, Imaging, and Research, University of Utah, UT 84108, USA.
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Silva D, Guerreiro M, Maroco J, Santana I, Rodrigues A, Bravo Marques J, de Mendonça A. Comparison of four verbal memory tests for the diagnosis and predictive value of mild cognitive impairment. Dement Geriatr Cogn Dis Extra 2012; 2:120-31. [PMID: 22590473 PMCID: PMC3347876 DOI: 10.1159/000336224] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background Mild cognitive impairment (MCI) is considered to be an early stage of a neurodegenerative disorder, particularly Alzheimer's disease, and the clinical diagnosis requires the objective demonstration of cognitive deficits. The aim of the present study was to evaluate the predictive value of MCI for the conversion to dementia when using four different verbal memory tests (Logical Memory, LM; California Verbal Learning Test, CVLT; Verbal Paired-Associate Learning, VPAL; and Digit Span, DS) in the MCI criteria. Methods Participants were consecutive patients with subjective cognitive complaints who performed a comprehensive neuropsychological evaluation and were not demented, observed in a memory clinic setting. Results At baseline, 272 non-demented patients reporting subjective cognitive complaints were included. During the follow-up time (3.0 ± 1.9 years), 58 patients converted to dementia and 214 did not. Statistically significant differences between the converters and non-converters were present in LM, VPAL, and CVLT. A multivariate Cox regression analysis combining the four memory tests revealed that only the CVLT test remained significant as a predictor of conversion to dementia. Non-demented patients with cognitive complaints diagnosed as having MCI according to abnormal (<1.5 SD) learning in the CVLT test had a 3.61 higher risk of becoming demented during the follow-up. Conclusion The verbal memory assessment using the CVLT should be preferred in the diagnostic criteria of MCI for a more accurate prediction of conversion to dementia.
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Affiliation(s)
- Dina Silva
- Dementia Clinics, Faculty of Medicine, University of Lisbon, Lisbon
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Lim YY, Ellis KA, Harrington K, Ames D, Martins RN, Masters CL, Rowe C, Savage G, Szoeke C, Darby D, Maruff P, The Aibl Research Group. Use of the CogState Brief Battery in the assessment of Alzheimer's disease related cognitive impairment in the Australian Imaging, Biomarkers and Lifestyle (AIBL) study. J Clin Exp Neuropsychol 2012; 34:345-58. [PMID: 22248010 DOI: 10.1080/13803395.2011.643227] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The aim of this study was to validate the CogState Brief Battery, which assesses psychomotor, attentional, working memory, and visual learning functions, in healthy older people and in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD), enrolled in the Australian Imaging, Biomarkers and Lifestyle (AIBL) study. In healthy older adults, weak relationships between demographic variables (e.g., education, depression) and cognitive performance were observed. In AD and MCI groups, the magnitude of impairment was greatest for tasks of working memory and memory, with a negative influence of apolipoprotein E ϵ4 status on learning but not working memory. These results suggest that the CogState Brief Battery can be used to screen for AD-related cognitive changes.
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Affiliation(s)
- Yen Ying Lim
- Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia.
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Using cognitive decline in novel trial designs for primary prevention and early disease-modifying therapy trials of Alzheimer's disease. Int Psychogeriatr 2011; 23:1376-85. [PMID: 21477408 DOI: 10.1017/s1041610211000354] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Ideally putative disease-modifying therapies for Alzheimer's disease (AD) should be tested in patients who have minimal morbidity. Current barriers to such trials in early disease include the lack of disease-specific early biomarkers, insensitivity of quantitative cognitive outcome measures, and expensive trial designs requiring large sample sizes and long duration. This paper describes principles and progress towards a novel trial design that overcomes these problems, utilizing wide-scale cognitive performance screening to define pre-trial cognitive decline trajectories which can serve as trial outcome measures to assess AD disease-modifying efficacy. METHODS Theoretical principles important for the detection of intra-individual cognitive decline and a practical example are described. RESULTS Serial evaluations of community-based volunteers demonstrate how a screening tool method to detect subtle cognitive decline can predict in vivo amyloid pathology as a trigger for etiological evaluation. Trajectories of decline appear consistent over at least two years, suggesting they could be used as a trial inclusion criterion and ameliorable outcome measure together with other AD biomarkers. Informative trial durations could be 6-12 months, or extend to incorporate staggered random withdrawal or start designs, with as few as 20 individuals per treatment arm. CONCLUSIONS This trial methodology offers significant advantages over current AD trial designs, including treatment at earlier stages of disease, shorter trial duration, obviation of informed consent difficulties, smaller sample sizes, reduced cost and--given adequate screening programs--sufficient subjects for multiple simultaneous trials. Importantly, it allows the rapid evaluation of putative treatments that may only be efficacious in pre-dementia states.
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O'Donnell J, Pietrzak RH, Ellis KC, Snyder PJ, Maruff P. Understanding failure of visual paired associate learning in amnestic mild cognitive impairment. J Clin Exp Neuropsychol 2011; 33:1069-78. [DOI: 10.1080/13803395.2011.596821] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Jade O'Donnell
- a School of Psychology , Royal Melbourne Institute of Technology , Melbourne, VIC, Australia
| | - Robert H. Pietrzak
- b National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Psychiatry, Yale University School of Medicine , New Haven, CT, USA
| | - Kathryn C. Ellis
- c Department of Psychiatry , University of Melbourne , Melbourne, VIC, Australia
| | - Peter J. Snyder
- d Lifespan Hospital System & Department of Neurology , The Warren Alpert Medical School of Brown University , Providence, RI, USA
| | - Paul Maruff
- e Centre for Neuroscience, University of Melbourne , Melbourne, VIC, Australia
- f CogState Ltd. , Melbourne, VIC, Australia
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Thompson TAC, Wilson PH, Snyder PJ, Pietrzak RH, Darby D, Maruff P, Buschke H. Sensitivity and Test-Retest Reliability of the International Shopping List Test in Assessing Verbal Learning and Memory in Mild Alzheimer's Disease. Arch Clin Neuropsychol 2011; 26:412-24. [DOI: 10.1093/arclin/acr039] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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Cockayne NL, Glozier N, Naismith SL, Christensen H, Neal B, Hickie IB. Internet-based treatment for older adults with depression and co-morbid cardiovascular disease: protocol for a randomised, double-blind, placebo controlled trial. BMC Psychiatry 2011; 11:10. [PMID: 21232162 PMCID: PMC3034669 DOI: 10.1186/1471-244x-11-10] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Accepted: 01/14/2011] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Depression, cardiovascular disease (CVD) risk factors and cognitive impairment are important causes of disability and poor health outcomes. In combination they lead to an even worse prognosis. Internet or web-based interventions have been shown to deliver efficacious psychological intervention programs for depression on a large scale, yet no published studies have evaluated their impact among patients with co-existing physical conditions. The aims of this randomised controlled trial are to determine the effects of an evidence-based internet intervention program for depression on depressive mood symptoms, cognitive function and treatment adherence in patients at risk of CVD. METHODS/DESIGN This study is an internet-based, double-blind, parallel group randomised controlled trial. The trial will compare the effectiveness of online cognitive behavioural therapy with an online attention control placebo. The trial will consist of a 12-week intervention phase with a 40-week follow-up. It will be conducted in urban and rural New South Wales, Australia and will recruit a community-based sample of adults aged 45 to 75 years. Recruitment, intervention, cognitive testing and follow-up data collection will all be internet-based and automated. The primary outcome is a change in severity of depressive symptoms from baseline to three-months. Secondary outcomes are changes in cognitive function and adherence to treatment for CVD from baseline to three, six and 12-months. DISCUSSION Prior studies of depression amongst patients with CVD have targeted those with previous vascular events and major depression. The potential for intervening earlier in these disease states appears to have significant potential and has yet to be tested. Scalable psychological programs using web-based interventions could deliver care to large numbers in a cost effective way if efficacy were proved. This study will determine the effects of a web-based intervention on depressive symptoms and adherence to treatment among patients at risk of CVD. In addition it will also precisely and reliably define the effects of the intervention upon aspects of cognitive function that are likely to be affected early in at risk individuals, using sensitive and responsive measures. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12610000085077.
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Affiliation(s)
- Nicole L Cockayne
- Brain & Mind Research Institute, The University of Sydney, 100 Mallet Street, Camperdown NSW 2050, Australia
| | - Nick Glozier
- Brain & Mind Research Institute, The University of Sydney, 100 Mallet Street, Camperdown NSW 2050, Australia,Disciplines of Psychiatry and Sleep Medicine, Sydney Medical School, The University of Sydney NSW 2006, Australia
| | - Sharon L Naismith
- Brain & Mind Research Institute, The University of Sydney, 100 Mallet Street, Camperdown NSW 2050, Australia
| | - Helen Christensen
- Centre for Mental Health Research, The Australian National University, Canberra ACT 0200, Australia
| | - Bruce Neal
- The George Institute for Global Health, PO Box M201 Missenden Road, Sydney NSW 2050, Australia
| | - Ian B Hickie
- Brain & Mind Research Institute, The University of Sydney, 100 Mallet Street, Camperdown NSW 2050, Australia
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Subjective memory complaints, neuropsychological performance and psychiatric variables in memory clinic attendees: A 3-year follow-up study. Arch Gerontol Geriatr 2010; 51:e110-4. [DOI: 10.1016/j.archger.2010.02.009] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2009] [Revised: 02/03/2010] [Accepted: 02/05/2010] [Indexed: 01/05/2023]
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Humphreys MS, Smith S, Pachana NA, Tehan G, Byrne GJ. Measuring episodic memory: A novel approach with an indefinite number of alternative forms. APPLIED COGNITIVE PSYCHOLOGY 2010. [DOI: 10.1002/acp.1591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Kessels RPC, Meulenbroek O, Fernández G, Olde Rikkert MGM. Spatial Working Memory in Aging and Mild Cognitive Impairment: Effects of Task Load and Contextual Cueing. AGING NEUROPSYCHOLOGY AND COGNITION 2010; 17:556-74. [DOI: 10.1080/13825585.2010.481354] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Lewis MS, Dingwall KM, Berkhout N, Sayers S, Maruff P, Cairney S. Assessment of cognition in an adolescent Indigenous population. AUSTRALIAN PSYCHOLOGIST 2010. [DOI: 10.1080/00050060903352998] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | | | - Nicole Berkhout
- Menzies School of Health Research, Darwin, Northern Territory
| | - Susan Sayers
- Menzies School of Health Research, Darwin, Northern Territory
| | - Paul Maruff
- Centre for Neuroscience, University of Melbourne
- CogState, Melbourne, Victoria, Australia
| | - Sheree Cairney
- Menzies School of Health Research, Darwin, Northern Territory
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Rabin LA, Paré N, Saykin AJ, Brown MJ, Wishart HA, Flashman LA, Santulli RB. Differential memory test sensitivity for diagnosing amnestic mild cognitive impairment and predicting conversion to Alzheimer's disease. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2009; 16:357-76. [PMID: 19353345 PMCID: PMC3114447 DOI: 10.1080/13825580902825220] [Citation(s) in RCA: 171] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Episodic memory is the first and most severely affected cognitive domain in Alzheimer's disease (AD), and it is also the key early marker in prodromal stages including amnestic mild cognitive impairment (MCI). The relative ability of memory tests to discriminate between MCI and normal aging has not been well characterized. We compared the classification value of widely used verbal memory tests in distinguishing healthy older adults (n = 51) from those with MCI (n = 38). Univariate logistic regression indicated that the total learning score from the California Verbal Learning Test-II (CVLT-II) ranked highest in terms of distinguishing MCI from normal aging (sensitivity = 90.2; specificity = 84.2). Inclusion of the delayed recall condition of a story memory task (i.e., WMS-III Logical Memory, Story A) enhanced the overall accuracy of classification (sensitivity = 92.2; specificity = 94.7). Combining Logical Memory recognition and CVLT-II long delay best predicted progression from MCI to AD over a 4-year period (accurate classification = 87.5%). Learning across multiple trials may provide the most sensitive index for initial diagnosis of MCI, but inclusion of additional variables may enhance overall accuracy and may represent the optimal strategy for identifying individuals most likely to progress to dementia.
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Affiliation(s)
- Laura A Rabin
- Department of Psychology, Brooklyn College and the Graduate Center of the City University of New York, Brooklyn, NY 11210, USA.
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Maruff P, Thomas E, Cysique L, Brew B, Collie A, Snyder P, Pietrzak RH. Validity of the CogState brief battery: relationship to standardized tests and sensitivity to cognitive impairment in mild traumatic brain injury, schizophrenia, and AIDS dementia complex. Arch Clin Neuropsychol 2009; 24:165-78. [PMID: 19395350 DOI: 10.1093/arclin/acp010] [Citation(s) in RCA: 433] [Impact Index Per Article: 28.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
This study examined the validity of the four standard psychological paradigms that have been operationally defined within the CogState brief computerized cognitive assessment battery. Construct validity was determined in a large group of healthy adults. CogState measures of processing speed, attention, working memory, and learning showed strong correlations with conventional neuropsychological measures of these same constructs (r's = .49 to .83). Criterion validity was determined by examining patterns of performance on the CogState tasks in groups of individuals with mild head injury, schizophrenia, and AIDS dementia complex. Each of these groups was impaired on the CogState performance measures (Cohen's d's = -.60 to -1.80) and the magnitude and nature of this impairment was qualitatively and quantitatively similar in each group. Taken together, the results suggest that the cognitive paradigms operationally defined in the CogState brief battery have acceptable construct and criterion validity in a neuropsychological context.
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Affiliation(s)
- Paul Maruff
- CogState Ltd., 7/21 Victoria Street, Melbourne 3000, Australia.
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May BH, Yang AWH, Zhang AL, Owens MD, Bennett L, Head R, Cobiac L, Li CG, Hugel H, Story DF, Xue CCL. Chinese herbal medicine for Mild Cognitive Impairment and Age Associated Memory Impairment: a review of randomised controlled trials. Biogerontology 2008; 10:109-23. [DOI: 10.1007/s10522-008-9163-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2008] [Accepted: 07/24/2008] [Indexed: 10/21/2022]
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Cargin JW, Maruff P, Collie A, Shafiq-Antonacci R, Masters C. Decline in verbal memory in non-demented older adults. J Clin Exp Neuropsychol 2008; 29:706-18. [PMID: 17891680 DOI: 10.1080/13825580600954256] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Decline in memory function was detected in 30% of healthy community-dwelling elderly over 6 years using a task assessing delayed word list recall. Individuals with memory decline over time also demonstrated relative deficits on additional tasks of memory and learning, a task of working memory and executive function, and on a verbal (category) fluency task at their most recent assessment. These relative deficits in the performance of individuals with memory decline cannot be explained by age-related changes, education, intelligence, mood, health-related factors, or the individuals' APOE epsilon 4 status. Decline in memory performance did not result in greater complaints of cognitive difficulties when compared with normal elderly, nor did it limit overall participation in life activities. Although the significance of memory decline in the current study was not determined quantitatively, memory decline is consistent with the early deterioration characteristic of mild cognitive impairment and preclinical Alzheimer's disease and confirms the need to monitor individuals with objective memory decline, even when these individuals fall within normal limits for a given neuropsychological task.
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Affiliation(s)
- J Weaver Cargin
- School of Psychological Science, La Trobe University, Melbourne, Australia.
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Villemagne VL, Pike KE, Darby D, Maruff P, Savage G, Ng S, Ackermann U, Cowie TF, Currie J, Chan SG, Jones G, Tochon-Danguy H, O'Keefe G, Masters CL, Rowe CC. Abeta deposits in older non-demented individuals with cognitive decline are indicative of preclinical Alzheimer's disease. Neuropsychologia 2008; 46:1688-97. [PMID: 18343463 DOI: 10.1016/j.neuropsychologia.2008.02.008] [Citation(s) in RCA: 162] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2007] [Revised: 12/28/2007] [Accepted: 02/01/2008] [Indexed: 12/20/2022]
Abstract
Approximately 30% of healthy persons aged over 75 years show Abeta deposition at autopsy. It is postulated that this represents preclinical Alzheimer's disease (AD). We evaluated the relationship between Abeta burden as assessed by PiB PET and cognitive decline in a well-characterized, non-demented, elderly cohort. PiB PET studies and cognitive tests were performed on 34 elderly participants (age 73+/-6) from the longitudinal Melbourne Healthy Aging Study (MHAS). Subjects were classified as being cognitively 'stable' or 'declining' by an independent behavioural neurologist based on clinical assessment and serial word-list recall scores from the preceding 6-10 years. Decline was calculated from the slope of the word-list recall scores. Abeta burden was quantified using Standardized Uptake Value normalized to cerebellar cortex. Ten subjects were clinically classified as declining. At the time of the PET scans, three of the declining subjects had mild cognitive impairment, one had AD, and six were declining but remained within the normal range for age on cognitive tests. Declining subjects were much more likely to show cortical PiB binding than stable subjects (70% vs. 17%, respectively). Neocortical Abeta burden correlated with word-list recall slopes (r=-0.78) and memory function (r=-0.85) in the declining group. No correlations were observed in the stable group. Abeta burden correlated with incident memory impairment and the rate of memory decline in the non-demented ageing population. These observations suggest that neither memory decline nor Abeta deposition are part of normal ageing and likely represent preclinical AD. Further longitudinal observations are required to confirm this hypothesis.
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Affiliation(s)
- V L Villemagne
- Department of Nuclear Medicine, Centre for PET, Austin Health, 145 Studley Road, Heidelberg, VIC 3084, Australia.
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Characterizing the memory changes in persons with mild cognitive impairment. PROGRESS IN BRAIN RESEARCH 2008; 169:365-75. [PMID: 18394487 DOI: 10.1016/s0079-6123(07)00023-4] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Persons with mild cognitive impairment (MCI) do not meet criteria for Alzheimer's disease (AD) but are at high risk for developing the disease. Presence of a memory deficit is a key component in the characterization of MCI. This chapter presents empirical studies that attempt to describe and understand the nature of the memory deficit in MCI with a focus on episodic memory and working memory. Cross-sectional studies report prominent deficits of episodic memory characterized by impaired encoding of the contextual information that makes up complex events. This results in reduced free and cued recall, impaired recognition, and impaired associative learning. Although semantic encoding is found to be impaired in conditions that rely on explicit and intentional retrieval, preserved semantic processing is found with automatic conditions of testing. Studies indicate the presence of a partial deficit of working memory with the ability to divide attention being most severely impaired. However, there appears to be heterogeneity as to the extent of the working memory impairment. The presence of vascular anomalies on MRI, as well as being in a more advanced stage in the continuum from MCI to AD, are associated with more severe and more pervasive working memory deficits. Finally, longitudinal studies indicate that the combination of episodic and working memory deficits represents a strong predictor of progression from MCI to AD.
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Kaye J. Home-based technologies: a new paradigm for conducting dementia prevention trials. Alzheimers Dement 2007; 4:S60-6. [PMID: 18632003 DOI: 10.1016/j.jalz.2007.10.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2007] [Accepted: 10/24/2007] [Indexed: 11/17/2022]
Abstract
The approach toward treatment of Alzheimer's disease has evolved out of a large body of research, resulting in a common trial paradigm directed toward establishing efficacy and safety of putative treatments for dementia. To achieve the ultimate goal of preventing dementia, the future will build on this model but will need to incorporate new paradigms to more efficiently detect meaningful change over time. Among new innovations needed is the capability for assessing trajectories of change over many years. Intrinsic to this success is the ability to capture increasing variability as well as subject heterogeneity inherent in longitudinal aging cohorts. New methods of ubiquitous embedded home sensing and computing afford the opportunity to assess volunteers not only during long periods of time but with greater frequency and convenience. Clinical studies identifying the optimal ways of using these methods are needed.
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Affiliation(s)
- Jeffrey Kaye
- NIA - Layton Aging & Alzheimer's Disease Center and ORCATECH, the Oregon Center for Aging & Technology, Oregon Health & Science University, Portland, OR, USA.
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48
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Neuropsychological testing and assessment for dementia. Alzheimers Dement 2007; 3:299-317. [DOI: 10.1016/j.jalz.2007.07.011] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2007] [Accepted: 07/12/2007] [Indexed: 11/23/2022]
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Falleti MG, Maruff P, Collie A, Darby DG. Practice Effects Associated with the Repeated Assessment of Cognitive Function Using the CogState Battery at 10-minute, One Week and One Month Test-retest Intervals. J Clin Exp Neuropsychol 2007; 28:1095-112. [PMID: 16840238 DOI: 10.1080/13803390500205718] [Citation(s) in RCA: 285] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
There are many situations in which cognitive tests need to be administered on more than two occasions and at very brief test-retest intervals to detect change in group performance. However, previous literature has not specifically addressed these important issues. The main aim of the current study was to examine these two factors by using a computerized cognitive battery designed specifically for the repeated assessment of cognition (i.e., CogState) in healthy young adult individuals. A further aim of the study was to examine how many times the battery needed to be completed before performance, as measured by the battery, stabilized. Forty-five adults (age range: 18-40 years) completed the battery four times at 10-minute test-retest intervals, and a fifth time at an interval of one week. The results illustrated that when brief test-retest intervals were used (i.e., 10 minutes), performance stabilized after the second assessment, as significant practice effects were generally observed between the first and the second assessments. Practice effects were also observed on some of the tasks at a one-week test-retest interval. Due to these findings, 55 adults (age range: 18-40 years) completed the battery twice at 10-minute test-retest intervals (i.e., to eliminate the initial practice effect), and a third time at an interval of one month. No practice effects were observed. The implications of the results are discussed in terms of methods that can be adopted in order to minimize practice effects when this particular cognitive battery is used.
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Lewis MC, Nevo I, Paniagua MA, Ben-Ari A, Pretto E, Eisdorfer S, Davidson E, Matot I, Eisdorfer C. Uncomplicated general anesthesia in the elderly results in cognitive decline: does cognitive decline predict morbidity and mortality? Med Hypotheses 2006; 68:484-92. [PMID: 17141964 DOI: 10.1016/j.mehy.2006.08.030] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2006] [Accepted: 08/16/2006] [Indexed: 11/22/2022]
Abstract
Elderly surgical patients constitute a unique surgical group. They require special consideration in order to preempt the long term adverse effects of anesthesia. This paper examines the proposition that general anesthesia causes harm to elderly patients with its impact being felt long after the anesthetic agents are cleared from the body. One complication, Postoperative Cognitive Decline (POCD), is associated with the administration of anesthesia and deep sedation. Its' occurrence may herald an increase in morbidity and mortality. Based on both human and animal data, this paper outlines a unitary theoretical framework to explain these phenomena. If this hypothesis proves to be correct, anesthesiologist should consider regional rather than general anesthesia for equivalent surgical procedures to reduce POCD and consequently achieving superior patient outcome.
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Affiliation(s)
- M C Lewis
- Miller School of Medicine, University of Miami, Miami, FL 33101, USA.
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