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Amian JG, Fernandez-Portero C, de la Bella R, Arenilla-Villalba MJ, López-Lluch G, Alarcon D. Cognitive Reserve and Frontotemporal Disorders: Exploring the Relationship Between Education, Physical Activity, and Cognitive Dysfunction in Older Adults. Percept Mot Skills 2024; 131:720-736. [PMID: 38523555 DOI: 10.1177/00315125241241358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
In this study we investigated the relationship between cognitive reserve (CR) proxies, such as education, physical activity (PA), and cognitive dysfunction (CD) in the presence or absence of frontotemporal disorders (FTD). Previous research has suggested that education and PA may delay the onset of CD and reduce the risk of developing dementia. However, it remains unclear whether these CR proxies can protect against CD when FTD is present. We aimed to explore this relationship and determine whether sustained CR may be evident regardless of FTD. We recruited 149 older adults (aged 65-99 years) from community centers where they were voluntarily participating in leisure activities. We used bioelectrical impedance to measure their body composition, and we administered the International PA Questionnaire and the Mini-Mental State Examination to measure their PA and cognitive function, respectively. We used the Frontal Assessment Battery to screen for frontotemporal dementia. Our results showed that people with FTD were older, had lower education, and engaged in less PA, relative to other participants. Regression models revealed that age, education, and PA were significant predictors of FTD. More specifically, FTD was negatively associated with cognitive functioning, and there were significant interaction effects between FTD and education and PA. PA and education were significant predictors of cognitive functioning, and, when values for PA and education were high, they offset the effects of FTD on cognitive function. These findings support impressions that PA and years of education provide an insulating or compensatory effect on cognitive functioning in older adults with executive dysfunction or frontotemporal dementia, highlighting the importance of encouraging both pursuits.
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Affiliation(s)
- Josue G Amian
- Department of Social Anthropology, Psychology and Public Health, Pablo de Olavide University, Seville, Spain
| | - Cristina Fernandez-Portero
- Department of Social Anthropology, Psychology and Public Health, Pablo de Olavide University, Seville, Spain
| | - Rocío de la Bella
- Department of Physiology, Anatomy and Cell Biology, Andalusian Centre of Developmental Biology, Universidad Pablo de Olavide, Seville, Spain
| | | | - Guillermo López-Lluch
- Department of Physiology, Anatomy and Cell Biology, Andalusian Centre of Developmental Biology, Universidad Pablo de Olavide, Seville, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, U729), IICS-Madrid, Madrid, Spain
- Centro de investigación en Rendimiento Físico y Deportivo, Universidad Pablo de Olavide, Sevilla, Spain
| | - David Alarcon
- Department of Social Anthropology, Psychology and Public Health, Pablo de Olavide University, Seville, Spain
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Keller G, Corvalan N, Carello MA, Arruabarrena MM, Martínez-Canyazo C, De Los Santos L, Spehrs J, Vila-Castelar C, Allegri RF, Quiroz YT, Crivelli L. Performance on the Latin American version of the Face-Name Associative Memory Exam (LAS-FNAME) distinguishes individuals with Mild Cognitive Impairment from age-matched controls in a sample from Argentina. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-9. [PMID: 38447166 DOI: 10.1080/23279095.2024.2323627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
INTRODUCTION The Latin American Spanish version of the Face-Name Associative Memory Exam (LAS-FNAME) has shown promise in identifying cognitive changes in those at risk for Alzheimer's disease (AD). However, its applicability for Mild Cognitive Impairment (MCI) detection in the Latin American population remains unexplored. This study aims to analyze the psychometric properties in terms of validity and reliability and diagnostic performance of the LAS-FNAME for the detection of memory disorders in patients with amnestic MCI (aMCI). MATERIALS AND METHODS The study included 31 participants with aMCI, diagnosed by a neurologist according to Petersen's criteria, and 19 healthy controls. Inclusion criteria for the aMCI group were to be 60 years of age or older, report cognitive complaints, have a memory test score (Craft Story 21) below a -1.5 z-score and have preserved functioning in activities of daily living. Participants completed LAS-FNAME and a comprehensive neuropsychological assessment. RESULTS LAS-FNAME showed the ability to discriminate against healthy controls from patients with aMCI (AUC= 75) in comparison with a gold-standard memory test (AUC = 69.1). LAS-FNAME also showed evidence of concurrent and divergent validity with a standard memory test (RAVLT) (r = 0.58, p < .001) and with an attention task (Digit Span) (r = -0.37, p = .06). Finally, the reliability index was very high (α = 0.88). DISCUSSION LAS-FNAME effectively distinguished aMCI patients from healthy controls, suggesting its potential for detecting early cognitive changes in Alzheimer's prodromal stages among Spanish speakers.
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Affiliation(s)
- G Keller
- Department of Cognitive Neurology, Neuropsychology and Neuropsychiatry, FLENI, Buenos Aires, Argentina
| | - N Corvalan
- Department of Cognitive Neurology, Neuropsychology and Neuropsychiatry, FLENI, Buenos Aires, Argentina
| | - M A Carello
- Department of Cognitive Neurology, Neuropsychology and Neuropsychiatry, FLENI, Buenos Aires, Argentina
| | - M M Arruabarrena
- Department of Cognitive Neurology, Neuropsychology and Neuropsychiatry, FLENI, Buenos Aires, Argentina
| | - C Martínez-Canyazo
- Department of Cognitive Neurology, Neuropsychology and Neuropsychiatry, FLENI, Buenos Aires, Argentina
| | - L De Los Santos
- Department of Cognitive Neurology, Neuropsychology and Neuropsychiatry, FLENI, Buenos Aires, Argentina
| | - J Spehrs
- Department of Cognitive Neurology, Neuropsychology and Neuropsychiatry, FLENI, Buenos Aires, Argentina
| | - C Vila-Castelar
- Department of Psychiatry, Multicultural Assessment & Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - R F Allegri
- Department of Cognitive Neurology, Neuropsychology and Neuropsychiatry, FLENI, Buenos Aires, Argentina
- Buenos Aires Argentina, Institute of Neuroscience (INEU) - FLENI-CONICET, Buenos Aires, Argentina
| | - Y T Quiroz
- Department of Psychiatry, Multicultural Assessment & Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - L Crivelli
- Department of Cognitive Neurology, Neuropsychology and Neuropsychiatry, FLENI, Buenos Aires, Argentina
- Buenos Aires Argentina, Institute of Neuroscience (INEU) - FLENI-CONICET, Buenos Aires, Argentina
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Fayemiwo MA, Olowookere TA, Olaniyan OO, Ojewumi TO, Oyetade IS, Freeman S, Jackson P. Immediate word recall in cognitive assessment can predict dementia using machine learning techniques. Alzheimers Res Ther 2023; 15:111. [PMID: 37322550 DOI: 10.1186/s13195-023-01250-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 05/29/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Dementia, one of the fastest-growing public health problems, is a cognitive disorder known to increase in prevalence as age increases. Several approaches had been used to predict dementia, especially in building machine learning (ML) models. However, previous research showed that most models developed had high accuracies, and they suffered from considerably low sensitivities. The authors discovered that the nature and the scope of the data used in this study had not been explored to predict dementia based on cognitive assessment using ML techniques. Therefore, we hypothesized that using word-recall cognitive features could help develop models for the prediction of dementia through ML techniques and emphasized assessing the models' sensitivity performance. METHODS Nine distinct experiments were conducted to determine which responses from either sample person (SP)'s or proxy's responses in the "word-delay," "tell-words-you-can-recall," and "immediate-word-recall" tasks are essential in the prediction of dementia cases, and to what extent the combination of the SP's or proxy's responses can be helpful in the prediction of dementia. Four ML algorithms (K-nearest neighbors (KNN), decision tree, random forest, and artificial neural networks (ANN)) were used in all the experiments to build predictive models using data from the National Health and Aging Trends Study (NHATS). RESULTS In the first scenario of experiments using "word-delay" cognitive assessment, the highest sensitivity (0.60) was obtained from combining the responses from both SP and proxies trained KNN, random forest, and ANN models. Also, in the second scenario of experiments using the "tell-words-you-can-recall" cognitive assessment, the highest sensitivity (0.60) was obtained by combining the responses from both SP and proxies trained KNN model. From the third set of experiments performed in this study on the use of "Word-recall" cognitive assessment, it was equally discovered that the use of combined responses from both SP and proxies trained models gave the highest sensitivity of 1.00 (as obtained from all the four models). CONCLUSION It can be concluded that the combination of responses in a word recall task as obtained from the SP and proxies in the dementia study (based on the NHATS dataset) is clinically useful in predicting dementia cases. Also, the use of "word-delay" and "tell-words-you-can-recall" cannot reliably predict dementia as they resulted in poor performances in all the developed models, as shown in all the experiments. However, immediate-word recall is reliable in predicting dementia, as seen in all the experiments. This, therefore, shows the significance of immediate-word-recall cognitive assessment in predicting dementia and the efficiency of combining responses from both SP and proxies in the immediate-word-recall task.
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Affiliation(s)
- Michael Adebisi Fayemiwo
- Department of Computer Science, Redeemer's University, Ede, Osun State, Nigeria
- School of Nursing, University of Northern British Columbia, Prince George, British Columbia, Canada
- School of Computing, Engineering and Intelligent Systems, Ulster University, Londonderry, Northern Ireland, UK
| | | | | | | | | | - Shannon Freeman
- School of Nursing, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Piper Jackson
- Department of Computing Science, Thompson Rivers University, Kamloops, British Columbia, Canada
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Hurtado-Pomares M, Juárez-Leal I, Company-Devesa V, Sánchez-Pérez A, Peral-Gómez P, Espinosa-Sempere C, Valera-Gran D, Navarrete-Muñoz EM. Psychometric properties of the Spanish version of the Frontal Assessment Battery (FAB-E) and normative values in a representative adult population sample. Neurologia 2022:S2173-5808(22)00113-4. [PMID: 36216225 DOI: 10.1016/j.nrleng.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/15/2022] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND The Frontal Assessment Battery is a short bedside test used to assess executive functions (EF). The aims of the present study were, first, to evaluate the psychometric proprieties of the Spanish version of the FAB (FAB-E) in a representative sample, and second, to establish cut-off points for impairment in executive function according to age and education level. METHODS A sample of 798 healthy Spanish adult subjects aged 19 to 91 participated in this study. Neuropsychological assessment of participants was conducted using the FAB-E, Mini-Mental State Examination (MMSE) and Trail Making Test (TMT). We examined internal consistency, intraclass correlation, test-retest reliability, and concurrent and divergent validity. In addition, we established a cut-off point for detecting executive function impairment based on the 5th percentile by age group and education level. RESULTS The analysis of the psychometric properties of the FAB-E showed good internal consistency (Cronbach's α = 0.60), intraclass correlation (0.72), test-retest reliability (0.70) and concurrent and divergent validity between the TMT (r = -0.523), MMSE (r = 0.426) and the FAB-E. The cut-off points for each age group were 16 points for the ≤ 29 group, 15 points for the 30-39 group, 14 points for the 40-49 and 50-59 groups, 12 points for the 60-69 group, and 10 points for the ≥ 70 age group. CONCLUSIONS The psychometric analysis showed that the FAB-E has good validity and reliability. Thus, FAB-E may be a helpful tool to evaluate EF in a healthy Spanish population. In addition, this study provides information on reference data that will be very valuable for clinicians and researchers.
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Affiliation(s)
- M Hurtado-Pomares
- Grupo de Investigación en Terapia Ocupacional (InTeO), Department of Pathology and Surgery, Miguel Hernandez University, Ctra. Alicante-Valencia, Km. 8,7, 03550 San Juan de Alicante (Alicante), Spain
| | - I Juárez-Leal
- Grupo de Investigación en Terapia Ocupacional (InTeO), Department of Pathology and Surgery, Miguel Hernandez University, Ctra. Alicante-Valencia, Km. 8,7, 03550 San Juan de Alicante (Alicante), Spain
| | - V Company-Devesa
- Department of Pathology and Surgery, Miguel Hernandez University, Ctra. Alicante-Valencia, Km. 8,7, 03550 San Juan de Alicante (Alicante), Spain
| | - A Sánchez-Pérez
- Grupo de Investigación en Terapia Ocupacional (InTeO), Department of Pathology and Surgery, Miguel Hernandez University, Ctra. Alicante-Valencia, Km. 8,7, 03550 San Juan de Alicante (Alicante), Spain; Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Hospital General Universitario de Alicante Doctor Balmis, Avda Pintor Baeza, 12, 03010 Alicante, Spain
| | - P Peral-Gómez
- Grupo de Investigación en Terapia Ocupacional (InTeO), Department of Pathology and Surgery, Miguel Hernandez University, Ctra. Alicante-Valencia, Km. 8,7, 03550 San Juan de Alicante (Alicante), Spain
| | - C Espinosa-Sempere
- Grupo de Investigación en Terapia Ocupacional (InTeO), Department of Pathology and Surgery, Miguel Hernandez University, Ctra. Alicante-Valencia, Km. 8,7, 03550 San Juan de Alicante (Alicante), Spain
| | - D Valera-Gran
- Grupo de Investigación en Terapia Ocupacional (InTeO), Department of Pathology and Surgery, Miguel Hernandez University, Ctra. Alicante-Valencia, Km. 8,7, 03550 San Juan de Alicante (Alicante), Spain.
| | - E-M Navarrete-Muñoz
- Grupo de Investigación en Terapia Ocupacional (InTeO), Department of Pathology and Surgery, Miguel Hernandez University, Ctra. Alicante-Valencia, Km. 8,7, 03550 San Juan de Alicante (Alicante), Spain; Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Hospital General Universitario de Alicante Doctor Balmis, Avda Pintor Baeza, 12, 03010 Alicante, Spain
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Arentsen TJ, Stubbs WJ, Lease SH, Adler MC, Ovrebo E, Jacobson JL. The relationship of the clinician-rated Functional Status Interview with executive functioning. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-13. [PMID: 35694761 DOI: 10.1080/23279095.2022.2084619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Self/informant-report and performance-based instruments are typically used to measure activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Minimal attention has focused on clinician-rated measures. Executive functioning (EF) contributes significantly to functional independence, and the validity of functional status measures has been examined through its relationship to EF scores. The current study used a clinical sample of older U.S. Veterans who completed a neurocognitive evaluation (n = 266). The psychometric properties of a novel, clinician-rated Functional Status Interview (FSI) and its relationship to EF measures, including the Frontal Assessment Battery (FAB) and Trail Making Test (TMT-A and TMT-B), were explored. Two FSI factors (IADL and ADL) emerged with all items loading strongly onto the subscales as predicted. EF correlated strongly with IADL but had small to medium correlations with ADL. In regression models that controlled for sociodemographic variables, all EF measures uniquely contributed to the IADL model, but only FAB and TMT-A contributed to the model for ADL. Notably, results may have been limited by prominent floor effects on TMT-B. Overall, the FSI is a promising measure with demonstrated content validity. Thus, there is preliminary support for clinicians to incorporate multiple sources of information to rate functional status using the FSI.
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Affiliation(s)
- Timothy J Arentsen
- VA Memphis Medical Center, Mental Health Service, Memphis, TN, USA
- The University of Tennessee Health Science Center, Department of Psychiatry, Memphis, TN, USA
| | - Whitney J Stubbs
- G V Montgomery VA Medical Center, Mental Health Service, Jackson, MS, USA
| | - Suzanne H Lease
- The University of Memphis, Department of Counseling, Educational Psychology and Research, Memphis, TN, USA
| | - Marcy C Adler
- VA Memphis Medical Center, Mental Health Service, Memphis, TN, USA
- The University of Tennessee Health Science Center, Department of Psychiatry, Memphis, TN, USA
| | - Elin Ovrebo
- The University of Memphis, Department of Counseling, Educational Psychology and Research, Memphis, TN, USA
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Diagnostic properties of the Frontal Assessment Battery (FAB) in Italian healthy adults. Aging Clin Exp Res 2022; 34:1021-1026. [PMID: 34981429 DOI: 10.1007/s40520-021-02035-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 11/16/2021] [Indexed: 11/01/2022]
Abstract
BACKGROUND Sub-clinical cognitive efficiency deficits of a dysexecutive nature are moderately prevalent in healthy older adults and negatively affect their functional outcomes. To screen for such dysfunctions, the Frontal Assessment Battery (FAB) provided promising evidence, although its diagnostic properties have not been tested to date. This study thus aimed at exploring the performance on the FAB of a large sample of Italian healthy adults and comparing it in individuals aged < 75 years vs. ≥ 75 years. METHODS Four hundred and seventy-five healthy adults (169 males, 306 females, age: 61.1 ± 15.1; education 11.7 ± 4.6) were administered the FAB and the Montreal Cognitive Assessment (MoCA). Sensitivity, specificity, positive and negative predictive values and likelihood ratios were computed through receiver-operating characteristics analyses by addressing an above- vs. below-cutoff performance on the MoCA as the state variable (as including measures of executive functioning). RESULTS The FAB overall showed good accuracy (AUC = 0.71-0.76), although higher for healthy older adults. A trend towards higher specificity (64.4-80.3%) than sensitivity (61.1-77.8%) was found, despite these metrics being comparable in healthy older adults. Negative predictive values (0.98-0.99) were systematically higher than positive predictive values (0.05-0.24), whereas consistent post-test probabilities were detected (positive likelihood ratios: 2.19-3.35; negative likelihood ratios: 0.28-0.48). DISCUSSION The FAB is an accurate test for the first-level assessment of dysexecutive-related global cognitive inefficiency in the general population, despite being moderately conservative as far as both its pre- and post-test features are concerned. Its diagnostic value is more informative for individuals aged ≥ 75 years.
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Hoshi H, Hirata Y, Kobayashi M, Sakamoto Y, Fukasawa K, Ichikawa S, Poza J, Rodríguez-González V, Gómez C, Shigihara Y. Distinctive effects of executive dysfunction and loss of learning/memory abilities on resting-state brain activity. Sci Rep 2022; 12:3459. [PMID: 35236888 PMCID: PMC8891272 DOI: 10.1038/s41598-022-07202-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 02/11/2022] [Indexed: 01/08/2023] Open
Abstract
Dementia is a syndrome characterised by cognitive impairments, with a loss of learning/memory abilities at the earlier stages and executive dysfunction at the later stages. However, recent studies have suggested that impairments in both learning/memory abilities and executive functioning might co-exist. Cognitive impairments have been primarily evaluated using neuropsychological assessments, such as the Mini-Mental State Examination (MMSE). Recently, neuroimaging techniques such as magnetoencephalography (MEG), which assess changes in resting-state brain activity, have also been used as biomarkers for cognitive impairment. However, it is unclear whether these changes reflect dysfunction in executive function as well as learning and memory. In this study, parameters from the MEG for brain activity, MMSE for learning/memory, and Frontal Assessment Battery (FAB) for executive function were compared within 207 individuals. Three MEG parameters were used as representatives of resting-state brain activity: median frequency, individual alpha frequency, and Shannon’s spectral entropy. Regression analysis showed that median frequency was predicted by both the MMSE and FAB scores, while individual alpha frequency and Shannon’s spectral entropy were predicted by MMSE and FAB scores, respectively. Our results indicate that MEG spectral parameters reflect both learning/memory and executive functions, supporting the utility of MEG as a biomarker of cognitive impairment.
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Affiliation(s)
- Hideyuki Hoshi
- Precision Medicine Centre, Hokuto Hospital, Kisen-7-5 Inadacho, Obihiro, Hokkaido, 080-0833, Japan
| | - Yoko Hirata
- Department of Neurosurgery, Kumagaya General Hospital, Kumagaya, 360‑8567, Japan
| | - Momoko Kobayashi
- Precision Medicine Centre, Kumagaya General Hospital, Kumagaya, 360‑8567, Japan
| | - Yuki Sakamoto
- Precision Medicine Centre, Kumagaya General Hospital, Kumagaya, 360‑8567, Japan
| | - Keisuke Fukasawa
- Clinical Laboratory, Kumagaya General Hospital, Kumagaya, 360‑8567, Japan
| | - Sayuri Ichikawa
- Clinical Laboratory, Kumagaya General Hospital, Kumagaya, 360‑8567, Japan
| | - Jesús Poza
- Biomedical Engineering Group, Higher Technical School of Telecommunications Engineering, University of Valladolid, 47011, Valladolid, Castilla y León, Spain.,Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales Y Nanomedicina, (CIBER-BBN), 47011, Valladolid, Castilla y León, Spain.,Instituto de Investigación en Matemáticas (IMUVA), University of Valladolid, 47011, Valladolid, Castilla y León, Spain
| | - Víctor Rodríguez-González
- Biomedical Engineering Group, Higher Technical School of Telecommunications Engineering, University of Valladolid, 47011, Valladolid, Castilla y León, Spain.,Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales Y Nanomedicina, (CIBER-BBN), 47011, Valladolid, Castilla y León, Spain
| | - Carlos Gómez
- Biomedical Engineering Group, Higher Technical School of Telecommunications Engineering, University of Valladolid, 47011, Valladolid, Castilla y León, Spain.,Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales Y Nanomedicina, (CIBER-BBN), 47011, Valladolid, Castilla y León, Spain
| | - Yoshihito Shigihara
- Precision Medicine Centre, Hokuto Hospital, Kisen-7-5 Inadacho, Obihiro, Hokkaido, 080-0833, Japan. .,Precision Medicine Centre, Kumagaya General Hospital, Kumagaya, 360‑8567, Japan.
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Grandi F, Martínez-Pernía D, Parra M, Olavarria L, Huepe D, Alegria P, Aliaga Á, Lillo P, Delgado C, Tenorio M, Rosas R, López O, Becker J, Slachevsky A. Standardization and diagnostic utility of the Frontal Assessment Battery for healthy people and patients with dementia in the Chilean population. Dement Neuropsychol 2022; 16:69-78. [PMID: 35719260 PMCID: PMC9170265 DOI: 10.1590/1980-5764-dn-2021-0059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/06/2021] [Accepted: 09/17/2021] [Indexed: 11/22/2022] Open
Abstract
The Frontal Assessment Battery (FAB) is a screening test that measures executive functions. Although this instrument has been validated in several countries, its diagnostic utility in a Chilean population has not been studied yet. Objectives This study aimed to (1) adapt FAB in a Chilean population; (2) study the psychometric properties of the FAB in a Chilean population; (3) assess the sociodemographic influence in the performance of the FAB in a sample of healthy controls (HC); and (4) develop normative data for this healthy group. Methods A HC (n=344) and a group of patients with dementia (n=156) were assessed with the Chilean version of FAB. Results FAB showed good internal consistency (Cronbach's alpha=0.79) and acceptable validity based on the relationship with other variables. Factor analysis showed the unidimensionality of the instrument. Significant differences were found in the total FAB value between the HC and dementia groups. With the matched sample, the established cutoff point was 13.5, showing a sensitivity of 80.8% and a specificity of 90.4%. Regression analysis showed that education and age significantly predicted FAB performance in the healthy group. Finally, normative data are provided. Conclusions This study shows that FAB is a useful tool to discriminate between healthy people and people with dementia. However, further studies are needed to explore the capacity of the instrument to characterize the dysexecutive syndrome in people with dementia in the Chilean population.
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Affiliation(s)
- Fabrissio Grandi
- Gerosciences Center for Brain Health and Metabolism, Santiago, Chile
- Universidad de Chile, Faculty of Medicine, Hospital del Salvador, Memory and Neuropsychiatric Clinic, Neurology Department, Santiago, Chile
- Universidad de Chile, Faculty of Medicine, Neuropsychology and Clinical Neuroscience Laboratory, Physiopathology Department, Neuroscience and East Neuroscience Departments, Santiago, Chile
- Universidad de los Andes, School of Psychology, Santiago, Chile
| | - David Martínez-Pernía
- Gerosciences Center for Brain Health and Metabolism, Santiago, Chile
- Universidad de Chile, Faculty of Medicine, Hospital del Salvador, Memory and Neuropsychiatric Clinic, Neurology Department, Santiago, Chile
- Universidad Adolfo Ibañez, School of Psychology, Center for Social and Cognitive Neuroscience, Santiago, Chile
| | - Mario Parra
- University of Strathclyde, School of Psychological Sciences and Health, Glasgow, Scotland
| | - Loreto Olavarria
- Universidad de Chile, Faculty of Medicine, Hospital del Salvador, Memory and Neuropsychiatric Clinic, Neurology Department, Santiago, Chile
- Universidad de Chile, Faculty of Medicine, Neuropsychology and Clinical Neuroscience Laboratory, Physiopathology Department, Neuroscience and East Neuroscience Departments, Santiago, Chile
| | - David Huepe
- Universidad Adolfo Ibañez, School of Psychology, Center for Social and Cognitive Neuroscience, Santiago, Chile
| | - Patricia Alegria
- Clínica Alemana, Physical Medicine and Rehabilitation Service, Santiago, Chile
| | - Álvaro Aliaga
- Diego Portales Universidad, School of Psychology, Santiago, Chile
| | - Patricia Lillo
- Gerosciences Center for Brain Health and Metabolism, Santiago, Chile
- Universidad de Chile, Faculty of Medicine, South Neuroscience Department, Santiago, Chile
- Complejo Hospitalario San José, Neurology Unit, Santiago, Chile
| | - Carolina Delgado
- Universidad de Chile, School of Medicine, Department of Neuroscience, Santiago, Chile
- Universidad de Chile, Hospital Clínico, Department of Neurology and Neurosurgery, Healthy Brain Unit, Santiago, Chile
| | - Marcela Tenorio
- Universidad de los Andes, School of Psychology, Santiago, Chile
- Millennium Institute for Caregiving Research, Santiago, Chile
| | - Ricardo Rosas
- Pontificia Universidad Católica de Chile, Center for the Development of Inclusion Technologies, Santiago, Chile
| | - Oscar López
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, PA, USA
- University of Pittsburgh, Department of Neurology, Pittsburgh, PA, USA
| | - James Becker
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, PA, USA
- University of Pittsburgh, Department of Neurology, Pittsburgh, PA, USA
- University of Pittsburgh, Department of Psychology, Pittsburgh, PA, USA
| | - Andrea Slachevsky
- Gerosciences Center for Brain Health and Metabolism, Santiago, Chile
- Universidad de Chile, Faculty of Medicine, Hospital del Salvador, Memory and Neuropsychiatric Clinic, Neurology Department, Santiago, Chile
- Universidad de Chile, Faculty of Medicine, Neuropsychology and Clinical Neuroscience Laboratory, Physiopathology Department, Neuroscience and East Neuroscience Departments, Santiago, Chile
- Universidad del Desarrollo, Clínica Alemana, Department of Medicine, Neurology Unit, Santiago, Chile
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Vasquez-Goñi GA, Papuico-Romero BM, Urrunaga-Pastor D, Runzer-Colmenares FM, Parodi JF. The depressed frail phenotype as a risk factor for mortality in older adults: A prospective cohort in Peru. Heliyon 2022; 8:e08640. [PMID: 35028442 PMCID: PMC8741456 DOI: 10.1016/j.heliyon.2021.e08640] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 08/23/2021] [Accepted: 12/16/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Frailty and depression can coexist as depressed frail phenotype, useful for the comprehensive evaluation of older adults and prevention of adverse outcomes. The objective of this study was to evaluate the role of the depressed frail phenotype and its components as risk factors for mortality in older adults of the Centro Médico Naval (CEMENA) of Peru during 2010-2015. MATERIAL AND METHODS We carried out a secondary data analysis of a prospective cohort that included older adults (60 years and older) treated in the Geriatrics service of CEMENA between the years 2010-2015. Frailty was defined as the presence of three or more Fried phenotype criteria and depression was determined using a Yesavage ultrashort scale score of three or more. The presence of both conditions was defined as depressed frail phenotype. In addition, sociodemographic characteristics, medical and personal history, and performance-based measures were included. We employed crude and adjusted Cox regression models to evaluate the association of interest and estimate Hazard Ratios (HR) with their respective 95% confidence intervals (95% CI). RESULTS 946 older adults were included in the analysis, with a mean age of 78.0 ± 8.5 years. 559 (59.1%) were male, 148 (15.6%) were found to be frail, 231 (24.4%) had depressive symptoms, 105 (11.1%) had depressed frail phenotype, and 79 (8.3%) participants died during follow-up. The adjusted Cox regression analysis revealed that depressed frail phenotype (HR = 3.53; 95%CI: 2.07-6.00; p < 0.001) was a risk factor for mortality in older adults. CONCLUSIONS The depressed frail phenotype was associated with a higher risk of mortality in older adults. It is necessary to develop longitudinal studies that allow estimating this phenotype's impact on mortality and evaluate interventions to improve quality of life and reduce the risk of adverse outcomes.
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Affiliation(s)
- Gabriel A.J. Vasquez-Goñi
- Universidad Científica del Sur, Facultad de Ciencias de la Salud, Carrera de Medicina Humana, Lima, Perú
| | - Basilio M. Papuico-Romero
- Universidad Científica del Sur, Facultad de Ciencias de la Salud, Carrera de Medicina Humana, Lima, Perú
| | - Diego Urrunaga-Pastor
- Universidad Científica del Sur, Facultad de Ciencias de la Salud, Carrera de Medicina Humana, Lima, Perú
| | - Fernando M. Runzer-Colmenares
- Universidad Científica del Sur, Facultad de Ciencias de la Salud, Carrera de Medicina Humana, Lima, Perú
- Universidad de San Martin de Porres, Facultad de Medicina Humana, Centro de Investigación del Envejecimiento (CIEN), Lima, Perú
| | - José F. Parodi
- Universidad de San Martin de Porres, Facultad de Medicina Humana, Centro de Investigación del Envejecimiento (CIEN), Lima, Perú
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10
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Jansen MG, Geerligs L, Claassen JAHR, Overdorp EJ, Brazil IA, Kessels RPC, Oosterman JM. Positive Effects of Education on Cognitive Functioning Depend on Clinical Status and Neuropathological Severity. Front Hum Neurosci 2021; 15:723728. [PMID: 34566608 PMCID: PMC8459869 DOI: 10.3389/fnhum.2021.723728] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/06/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Variability in cognitive functions in healthy and pathological aging is often explained by educational attainment. However, it remains unclear to which extent different disease states alter protective effects of education. We aimed to investigate whether protective effects of education on cognition depend on (1) clinical diagnosis severity, and (2) the neuropathological burden within a diagnosis in a memory clinic setting. Methods: In this cross-sectional study, we included 108 patients with subjective cognitive decline [SCD, median age 71, IQR (66-78), 43% men], 190 with mild cognitive impairment [MCI, median age 78, IQR (73-82), 44% men], and 245 with Alzheimer's disease dementia (AD) [median age 80, IQR (76-84), 35% men]. We combined visual ratings of hippocampal atrophy, global atrophy, and white matter hyperintensities on MRI into a single neuropathology score. To investigate whether the contribution of education to cognitive performance differed across SCD, MCI, and AD, we employed several multiple linear regression models, stratified by diagnosis and adjusted for age, sex, and neurodegeneration. We re-ran each model with an additional interaction term to investigate whether these effects were influenced by neuropathological burden for each diagnostic group separately. False discovery rate (FDR) corrections for multiple comparisons were applied. Results: We observed significant positive associations between education and performance for global cognition and executive functions (all adjusted p-values < 0.05). As diagnosis became more severe, however, the strength of these associations decreased (all adjusted p-values < 0.05). Education related to episodic memory only at relatively lower levels of neuropathology in SCD (β = -0.23, uncorrected p = 0.02), whereas education related to episodic memory in those with higher levels of neuropathology in MCI (β = 0.15, uncorrected p = 0.04). However, these interaction effects did not survive FDR-corrections. Conclusions: Altogether, our results demonstrated that positive effects of education on cognitive functioning reduce with diagnosis severity, but the role of neuropathological burden within a particular diagnosis was small and warrants further investigation. Future studies may further unravel the extent to which different dimensions of an individual's disease severity contribute to the waxing and waning of protective effects in cognitive aging.
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Affiliation(s)
- Michelle G. Jansen
- Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, Netherlands
| | - Linda Geerligs
- Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, Netherlands
| | - Jurgen A. H. R. Claassen
- Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, Netherlands
- Department of Geriatric Medicine, Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Inti A. Brazil
- Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, Netherlands
| | - Roy P. C. Kessels
- Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, Netherlands
- Department of Medical Psychology, Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, Netherlands
- Vincent van Gogh Institute for Psychiatry, Venray, Netherlands
| | - Joukje M. Oosterman
- Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, Netherlands
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11
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The Frontal Assessment Battery 20 years later: normative data for a shortened version (FAB15). Neurol Sci 2021; 43:1709-1719. [PMID: 34410549 DOI: 10.1007/s10072-021-05544-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 07/31/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The Frontal Assessment Battery (FAB) is a neuropsychological tool largely used to assess executive functions. Prior studies found a marked ceiling effect for the prehension behavior subtest (PBT) in healthy and clinical populations. Aims of the present study were (i) to examine the psychometric properties of the FAB without the contribution of PBT and (ii) to provide normative data for a revised version of the FAB after exclusion of PBT (FAB15). METHODS The normative sample included 1,187 healthy participants. PBT had near-zero variance, poor content validity, and no discrimination power. Internal consistency increased when PBT was excluded. We assessed the FAB15 factorial structure, interrater, and test-retest reliabilities. Normative data for the FAB15 were extracted through a regression-based procedure according to sex, age, and education. RESULTS The principal component analysis revealed a single "executive factor" or alternatively a bifactorial solution reflecting the different degree of discriminative capability vs. difficulty of the subtests. The FAB15 demonstrated excellent interrater and test-retest reliabilities. Regression analysis showed that sex (lowly educated women < lowly educated men), higher age, and lower education affected FAB15 score. Accordingly, three grids for adjustment of raw scores (men, women, and both) were constructed. The cut-off was fixed at the non-parametric outer tolerance limit on the fifth centile (9.36, 95% CI). CONCLUSION The observation of a ceiling effect in healthy subjects makes PBT not suitable for inclusion in a neuropsychological battery. The FAB15 may successfully replace the conventional FAB as a more severe and valid short screening tool to assess executive functioning.
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12
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Yap KH, Kessels RPC, Azmin S, van de Warrenburg B, Mohamed Ibrahim N. Neurocognitive Changes in Spinocerebellar Ataxia Type 3: A Systematic Review with a Narrative Design. THE CEREBELLUM 2021; 21:314-327. [PMID: 34231180 DOI: 10.1007/s12311-021-01282-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/17/2021] [Indexed: 12/20/2022]
Abstract
Spinocerebellar ataxia type 3 (SCA3), the commonest dominantly inherited ataxia worldwide, is characterized by disruption in the cerebellar-cerebral and striatal-cortical networks. Findings on SCA3-associated cognitive impairments are mixed. The classification models, tests and scoring systems used, language, culture, ataxia severity, and depressive symptoms are all potential confounders in neuropsychological assessments and may have contributed to the heterogeneity of the neurocognitive profile of SCA3. We conducted a systematic review of studies evaluating neurocognitive function in SCA3 patients. Of 1304 articles identified, 15 articles met the eligibility criteria. All articles were of excellent quality according to the National Institutes of Health quality assessment tool for case-control studies. In line with the disrupted cerebellar-cerebral and striatal-cortical networks in SCA3, this systematic review found that the neurocognitive profile of SCA3 is characterized by a core impairment of executive function that affects processes such as nonverbal reasoning, executive aspects of language, and recall. Conversely, neurocognitive domains such as general intelligence, verbal reasoning, semantic aspect of language, attention/processing speed, recognition, and visuospatial perception and construction are relatively preserved. This review highlights the importance of evaluating neurocognitive function in SCA3 patients. Considering the negative impact of cognitive and affective impairment on quality of life, this review points to the profound impairments that existing or future treatments should prioritize.
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Affiliation(s)
- Kah Hui Yap
- Department of Medicine, UKM Medical Center, 56000, Kuala Lumpur, Malaysia
| | - Roy P C Kessels
- Donders Institute for Brain, Cognition and Behavior, Radboud University, PO Box 9104, 6500 HE, Nijmegen, The Netherlands.,Department of Medical Psychology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.,Vincent Van Gogh Institute for Psychiatry, Venray, The Netherlands
| | - Shahrul Azmin
- Department of Medicine, UKM Medical Center, 56000, Kuala Lumpur, Malaysia
| | - Bart van de Warrenburg
- Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
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13
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van Schooten KS, Taylor ME, Close JCT, Davis JC, Paul SS, Canning CG, Latt MD, Hoang P, Kochan NA, Sachdev PS, Brodaty H, Dean CM, Hulzinga F, Lord SR, Delbaere K. Sensorimotor, Cognitive, and Affective Functions Contribute to the Prediction of Falls in Old Age and Neurologic Disorders: An Observational Study. Arch Phys Med Rehabil 2020; 102:874-880. [PMID: 33253696 DOI: 10.1016/j.apmr.2020.10.134] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 10/22/2020] [Accepted: 10/30/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To determine whether impairments across cognitive and affective domains provide additional information to sensorimotor deficits for fall prediction among various populations. DESIGN We pooled data from 5 studies for this observational analysis of prospective falls. SETTING Community or low-level care facility. PARTICIPANTS Older people (N=1090; 74.0±9.4y; 579 female); 500 neurologically intact (NI) older people and 3 groups with neurologic disorders (cognitive impairment, n=174; multiple sclerosis (MS), n=111; Parkinson disease, n=305). INTERVENTIONS None. MAIN OUTCOME MEASURES Sensorimotor function was assessed with the Physiological Profile Assessment, cognitive function with tests of executive function, affect with questionnaires of depression, and concern about falling with falls efficacy questionnaires. These variables were associated with fall incidence rates, obtained prospectively over 6-12 months. RESULTS Poorer sensorimotor function was associated with falls (incidence rate ratio [95% CI], 1.46 [1.28-1.66]). Impaired executive function was the strongest predictor of falls overall (2.91 [2.27-3.73]), followed by depressive symptoms (2.07 [1.56-2.75]) and concern about falling (2.02 [1.61-2.55]). Associations were similar among groups, except for a weaker relationship with executive impairment in NI persons and a stronger relationship with concern about falling in persons with MS. Multivariable analyses showed that executive impairment, poorer sensorimotor performance, depressive symptoms, and concern about falling were independently associated with falls. CONCLUSIONS Deficits in cognition (executive function) and affect (depressive symptoms) and concern about falling are as important as sensorimotor function for fall prediction. These domains should be included in fall risk assessments for older people and clinical groups.
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Affiliation(s)
- Kimberley S van Schooten
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Sydney, Australia; School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Morag E Taylor
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Sydney, Australia; Prince of Wales Clinical School, Medicine, University of New South Wales, Sydney, Australia
| | - Jacqueline C T Close
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Sydney, Australia; Prince of Wales Clinical School, Medicine, University of New South Wales, Sydney, Australia
| | - Jennifer C Davis
- Faculty of Management, University of British Columbia-Okanagan, Kelowna, British Columbia, Canada; Center for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Serena S Paul
- Faculty of Health Sciences, University of Sydney, Sydney Lidcombe, Sydney, New South Wales, Australia
| | - Colleen G Canning
- Faculty of Health Sciences, University of Sydney, Sydney Lidcombe, Sydney, New South Wales, Australia
| | - Mark D Latt
- Geriatric Medicine Department, University of Sydney, Royal Prince Alfred Hospital, Camperdown, Sydney, New South Wales, Australia
| | - Phu Hoang
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Sydney, Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, Australia; Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, New South Wales, Australia; Dementia Centre for Research Collaboration, School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, Australia; Dementia Centre for Research Collaboration, School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Catherine M Dean
- Department of Health Professions, Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, Sydney, New South Wales, Australia
| | - Femke Hulzinga
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Sydney, Australia; Department of Rehabilitation Sciences, Biomedical Sciences Group, KU Leuven University, Leuven, Belgium
| | - Stephen R Lord
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Sydney, Australia; School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Kim Delbaere
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Sydney, Australia; School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
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14
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Corboy H, Blanco-Campal A, Bates R, Bramham J, Libon DJ, Greene C. The development, validation and normative data study of the English in Ireland adaption of the Philadelphia repeatable Verbal Learning Test (EirPrVLT-12) for use in an older adult population. Clin Neuropsychol 2020; 34:83-109. [PMID: 32924790 DOI: 10.1080/13854046.2020.1815854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Cultural adaptations of verbal serial list-learning tests such as the California Verbal Learning Test (CVLT) and the Philadelphia (repeatable) Verbal Learning Test (P(r)VLT) have been shown to be clinically necessary. This paper aimed to culturally adapt, validate and provide normative data for an English in Ireland adaptation of the P(r)VLT, i.e. the EirPrVLT-12, in order to improve episodic memory assessments for Irish adults. Method: EirPrVLT-12 word lists were constructed using a word frequency study of Irish adults (n = 58). Two twelve-word, four-trial forms were constructed (standard and alternate form). A normative study included 145 participants who met strict inclusion criteria. Results: EirPrVLT-12 performance varied depending on age, gender, education, estimated IQ and socioeconomic status. Construct validity was established by correlations with other cognitive tests. Principal component analysis yielded a three-factor solution relating to general verbal learning, intrusions and interference. Normed EirPrVLT-12 scaled scores and percentiles stratified by age are available on the Open Science Framework at https://osf.io/vjzsp/, as are regression equations to predict individual scores based on age, gender and education. Conclusions: The data obtained underscores the clinical ultility of the EirPrVLT-12 to assess episodic memory in Irish older adults. Future research was recommended to validate the EirPrVLT-12 in a clinical population, extend normative data to younger populations and develop norms for the alternate form.
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Affiliation(s)
- Holly Corboy
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Alberto Blanco-Campal
- Department of Psychiatry for the Older Person, Memory Clinic Services, Health Service Executive, Louth, Ireland
| | - Rachel Bates
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Jessica Bramham
- School of Psychology, University College Dublin, Dublin, Ireland
| | - David J Libon
- Department of Geriatric and Gerontology, and the Department of Psychology, School of Osteopathic Medicine, Rowan University, Stratford, NJ, USA
| | - Ciara Greene
- School of Psychology, University College Dublin, Dublin, Ireland
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Rezola-Pardo C, Hervás G, Arrieta H, Hernández-de Diego A, Ruiz-Litago F, Gil SM, Rodriguez-Larrad A, Irazusta J. Physical exercise interventions have no effect on serum BDNF concentration in older adults living in long-term nursing homes. Exp Gerontol 2020; 139:111024. [PMID: 32693009 DOI: 10.1016/j.exger.2020.111024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 07/08/2020] [Accepted: 07/12/2020] [Indexed: 02/06/2023]
Abstract
Physical exercise protects against age-related cognitive decline. Brain-derived neurotrophic factor (BDNF) may mediate some of the cognitive benefits of physical exercise, but the effect of physical exercise on serum BDNF is unclear. Indeed, differential findings have been reported depending on the characteristics of the participants and the intensity, duration, and type of exercise. The aim of this study was to determine whether three different physical exercise interventions alter serum BDNF levels in older adults living in long-term nursing homes (LTNHs) and whether changes in physical, cognitive, and dual-task performance are related to changes in serum BDNF. LTNH study participants (n = 126) were randomly assigned to multicomponent or dual-task training or a walking program and serum BDNF levels were analyzed by ELISA. We also assessed physical, cognitive, and dual-task parameters. Neither the multicomponent, dual-task, nor walking exercise programs caused changes in serum BDNF concentration in older adults living in LTNHs. Changes in BDNF during the interventions were not significantly associated with modifications in physical, cognitive or dual-task performance parameters. Our results provide new evidence clarifying the relationship between physical and cognitive exercise and BDNF.
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Affiliation(s)
- Chloe Rezola-Pardo
- Department of Physiology, Faculty of Medicine and Nursery, University of the Basque Country, Bo Sarriena s/n, Leioa 48940, Bizkaia, Spain.
| | - Gotzone Hervás
- Department of Physiology, Faculty of Medicine and Nursery, University of the Basque Country, Bo Sarriena s/n, Leioa 48940, Bizkaia, Spain.
| | - Haritz Arrieta
- Department of Nursing II, Faculty of Medicine and Nursery, University of the Basque Country (UPV/EHU), Paseo Dr. J. Beguiristain, 105, Donostia/San Sebastian 20014, Gipuzkoa, Spain; Onkologikoa Foundation, Paseo Doctor Beguiristain, 121, Donostia/San Sebastián 20014, Gipuzkoa, Spain.
| | | | - Fatima Ruiz-Litago
- Department of Physiology, Faculty of Medicine and Nursery, University of the Basque Country, Bo Sarriena s/n, Leioa 48940, Bizkaia, Spain.
| | - Susana Maria Gil
- Department of Physiology, Faculty of Medicine and Nursery, University of the Basque Country, Bo Sarriena s/n, Leioa 48940, Bizkaia, Spain.
| | - Ana Rodriguez-Larrad
- Department of Physiology, Faculty of Medicine and Nursery, University of the Basque Country, Bo Sarriena s/n, Leioa 48940, Bizkaia, Spain.
| | - Jon Irazusta
- Department of Physiology, Faculty of Medicine and Nursery, University of the Basque Country, Bo Sarriena s/n, Leioa 48940, Bizkaia, Spain.
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Rezola-Pardo C, Rodriguez-Larrad A, Gomez-Diaz J, Lozano-Real G, Mugica-Errazquin I, Patiño MJ, Bidaurrazaga-Letona I, Irazusta J, Gil SM. Comparison Between Multicomponent Exercise and Walking Interventions in Long-Term Nursing Homes: A Randomized Controlled Trial. THE GERONTOLOGIST 2019; 60:1364-1373. [DOI: 10.1093/geront/gnz177] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and Objectives
There is evidence that exercise interventions counteract the functional and cognitive decline experienced by long-term nursing home (LTNH) residents. To determine the most effective exercise intervention, we compared the effects of a multicomponent exercise intervention and a walking intervention on physical and cognitive performance, habitual physical activity, affective function, and quality of life among older adults living in LTNHs.
Research Design and Methods
This 3-month single-blind randomized controlled trial (NCT03996083) involved 81 participants at 9 LTNHs randomly assigned to a multicomponent (MG) or a walking (WG) group. The MG participated in a twice-a-week individualized and progressive program composed of strength and balance exercises for 3 months. The WG was also individualized and participants walked up to 20 min per day. The primary outcome was the score on the short physical performance battery (SPPB). Secondary outcomes included other physical performance tests, habitual physical activity, cognitive performance, affective function, and quality of life.
Results
Compared with the WG, the MG group showed greater improvements in physical performance, including the SPPB (p < .05). No significant differences were observed in cognitive performance or habitual physical activity. Both groups showed improvements in anxiety and quality of life (p < .05).
Discussion and Implications
Although both interventions were effective in maintaining or improving affective function, the MG conferred greater improvements in physical function. Therefore, multicomponent interventions would be preferable over walking-only interventions. Otherwise, individualized and progressive walking interventions should be implemented to face the rapid decline in functionality encountered in LTNHs.
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Affiliation(s)
- Chloe Rezola-Pardo
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa (Bizkaia), Spain
| | - Ana Rodriguez-Larrad
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa (Bizkaia), Spain
| | - Julen Gomez-Diaz
- Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa (Bizkaia), Spain
| | - Garbiñe Lozano-Real
- Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa (Bizkaia), Spain
| | - Itxaso Mugica-Errazquin
- Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa (Bizkaia), Spain
| | - Maria Jesus Patiño
- DomusVi Villa Sacramento, Atarizar Kalea, 18, 20013 Donostia (Gipuzkoa), Spain
| | - Iraia Bidaurrazaga-Letona
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa (Bizkaia), Spain
| | - Jon Irazusta
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa (Bizkaia), Spain
| | - Susana María Gil
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa (Bizkaia), Spain
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Porter KM, Ward M, Hughes CF, O'Kane M, Hoey L, McCann A, Molloy AM, Cunningham C, Casey MC, Tracey F, Strain S, McCarroll K, Laird E, Gallagher AM, McNulty H. Hyperglycemia and Metformin Use Are Associated With B Vitamin Deficiency and Cognitive Dysfunction in Older Adults. J Clin Endocrinol Metab 2019; 104:4837-4847. [PMID: 30920623 DOI: 10.1210/jc.2018-01791] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Accepted: 03/22/2019] [Indexed: 02/02/2023]
Abstract
CONTEXT Emerging evidence suggests that deficiencies of folate-related B vitamins can arise with metformin treatment and are independently linked with cognitive dysfunction, a comorbidity of diabetes. OBJECTIVE To determine the impact of hyperglycemia and metformin use on relevant B vitamin biomarkers and cognitive outcomes in older adults. SETTING AND PARTICIPANTS Community-dwelling older adults (74.1 ± 8.3 years, n = 4160) without dementia, recruited to the Trinity, Ulster and Department of Agriculture cohort study in 2008 to 2012, were classified as normoglycemic (n = 1856) or hyperglycemic, based on HbA1c ≥5.7% (39 mmol/mol), either with (n = 318) or without (n = 1986) metformin treatment. MAIN OUTCOME MEASURES Biomarkers of folate, vitamin B12, vitamin B6, and riboflavin were measured. Cognitive assessments included the Repeatable Battery for Assessment of Neuropsychological Status (RBANS) and the Frontal Assessment Battery (FAB). RESULTS Metformin use was associated with higher risk of deficiency of vitamin B12 (combined B12 index ≤-1; OR 1.45; 95% CI, 1.03 to 2.02) and vitamin B6 (plasma pyridoxal 5-phosphate <30.0 nmol/L; OR 1.48; 95% CI, 1.02 to 2.15). Fortified foods when eaten regularly had a positive impact on all relevant B vitamin biomarkers, even with hyperglycemia. After adjustment for relevant covariates, metformin use was associated with an increased risk of cognitive dysfunction as assessed with the RBANS (OR 1.36; 95% CI, 1.03 to 1.80) and FAB (OR 1.34; 95% CI, 1.03 to 1.74). CONCLUSIONS Use of metformin by older adults is associated with poorer cognitive performance; B vitamin deficiency may be implicated. Fortified foods can optimize B vitamin status and may be beneficial for maintaining better cognitive health in older people with or at risk for diabetes.
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Affiliation(s)
- Kirsty M Porter
- Nutrition Innovation Centre for Food and Health, Biomedical Sciences Research Institute, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Mary Ward
- Nutrition Innovation Centre for Food and Health, Biomedical Sciences Research Institute, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Catherine F Hughes
- Nutrition Innovation Centre for Food and Health, Biomedical Sciences Research Institute, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Maurice O'Kane
- Clinical Chemistry Laboratory, Western Health and Social Care Trust, Altnagelvin Hospital, Londonderry, Northern Ireland, United Kingdom
| | - Leane Hoey
- Nutrition Innovation Centre for Food and Health, Biomedical Sciences Research Institute, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | | | - Anne M Molloy
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Conal Cunningham
- Mercers Institute for Research on Aging, St James's Hospital, Dublin, Ireland
| | - Miriam C Casey
- Mercers Institute for Research on Aging, St James's Hospital, Dublin, Ireland
| | - Fergal Tracey
- Causeway Hospital, Northern Health and Social Care Trust, Coleraine, Northern Ireland, United Kingdom
| | - Sean Strain
- Nutrition Innovation Centre for Food and Health, Biomedical Sciences Research Institute, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Kevin McCarroll
- Mercers Institute for Research on Aging, St James's Hospital, Dublin, Ireland
| | - Eamon Laird
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Alison M Gallagher
- Nutrition Innovation Centre for Food and Health, Biomedical Sciences Research Institute, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Helene McNulty
- Nutrition Innovation Centre for Food and Health, Biomedical Sciences Research Institute, Ulster University, Coleraine, Northern Ireland, United Kingdom
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