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Choi J, Hall CB, Clouston SAP, Cleven KL, Mann FD, Luft BJ, Zammit AR. Cross-sectional association between posttraumatic stress and cognition is moderated by pulmonary functioning in world trade center responders. Am J Ind Med 2024; 67:823-833. [PMID: 38943489 DOI: 10.1002/ajim.23631] [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: 11/07/2023] [Revised: 04/18/2024] [Accepted: 06/11/2024] [Indexed: 07/01/2024]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) symptomatology and poorer pulmonary function are highly prevalent psychiatric and medical conditions. In the present study, we tested for the individual, additive, and modifying associations of PTSD symptomatology and pulmonary function with cognitive performance. METHODS In this cross-sectional study, a total of 1,401 World Trade Center (WTC) responders (mean age = 53, SD = 8 years, 92% males) participated in the study. Cogstate assessment measured cognitive performance. PTSD symptomatology was measured using the trauma-specific version of the posttraumatic stress disorder checklist (PCL-17) adapted for the WTC attacks. The 1-second forced expiratory volume and forced vital capacity (FEV1/FVC) ratio was used to measure pulmonary function. Linear regressions with cognitive performance as the outcome were conducted to assess individual, additive, and moderating associations of PTSD symptomatology and pulmonary function. RESULTS Higher PTSD symptomatology and poorer pulmonary function were negatively associated with cognitive performance. A 10% increase on the FEV1/FVC ratio moderated the association between PTSD symptomatology and cognition, whereby its association with cognition was stronger when PTSD symptomatology was higher (est. = 0.01, 95%CI = 0.004, 0.01, p < 0.001). When stratified by responder type, these associations persisted in trained (est. = 0.01, 95%CI = 0.01, 0.02, p < 0.001), but not in non-trained (est. = 0.004, 95% C.I. = -0.01, 0.02, p = 0.39) responders. CONCLUSIONS In the presence of higher PTSD, better pulmonary functioning is associated with better cognitive performance. Early intervention efforts to mitigate preventable cognitive decline in high-risk populations should be studied, especially since intervention in one modality may have an impact on others.
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Affiliation(s)
- Jaeun Choi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Charles B Hall
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
- The Saul R Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Sean A P Clouston
- Department of Family, Population and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA
| | - Krystal L Cleven
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Frank D Mann
- Department of Family, Population and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA
| | - Benjamin J Luft
- World Trade Center Program Clinical Center of Excellence, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA
- Department of Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA
| | - Andrea R Zammit
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, USA
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Mann FD, Mueller AK, Zeig-Owens R, Choi J, Prezant DJ, Carr MM, Fels AM, Hennington CM, Armstrong MP, Barber A, Fontana AE, Kroll CH, Chow K, Melendez OA, Smith AJ, Luft BJ, Hall CB, Clouston SAP. Prevalence of Mild and Severe Cognitive Impairment in World Trade Center Exposed Fire Department of the City of New York (FDNY) and General Emergency Responders. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.08.04.24311457. [PMID: 39148853 PMCID: PMC11326356 DOI: 10.1101/2024.08.04.24311457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
Background The emergency personnel who responded to the World Trade Center (WTC) attacks endured severe occupational exposures, yet the prevalence of cognitive impairment remains unknown among WTC-exposed-FDNY-responders. The present study screened for mild and severe cognitive impairment in WTC-exposed FDNY responders using objective tests, compared prevalence rates to a cohort of non-FDNY WTC-exposed responders, and descriptively to meta-analytic estimates of MCI from global, community, and clinical populations. Methods A sample of WTC-exposed-FDNY responders (n = 343) was recruited to complete an extensive battery of cognitive, psychological, and physical tests. The prevalences of domain-specific impairments were estimated based on the results of norm-referenced tests, and the Montreal Cognitive Assessment (MoCA), Jak/Bondi criteria, Petersen criteria, and the National Institute on Aging and Alzheimer's Association (NIA-AA) criteria were used to diagnose MCI. NIA-AA criteria were also used to diagnose severe cognitive impairment. Generalized linear models were used to compare prevalence estimates of cognitive impairment to a large sample of WTC-exposed-non-FDNY responders from the General Responder Cohort (GRC; n = 7102) who completed the MoCA during a similar time frame. Result Among FDNY responders under 65 years, the unadjusted prevalence of MCI varied from 52.57% to 71.37% depending on the operational definition of MCI, apart from using a conservative cut-off applied to MoCA total scores (18 < MoCA < 23), which yielded a markedly lower crude prevalence (24.31%) compared to alternative criteria. The prevalence of MCI was higher among WTC-exposed-FDNY-responders, compared to WTC-exposed-non-FDNY-GRC-responders (adjusted RR = 1.53, 95% C.I. = [1.24, 1.88], p < .001) and meta-analytic estimates from different global, community, and clinical populations. Following NIA-AA diagnostic guidelines, 4.96% of WTC-exposed-FDNY-responders met the criteria for severe impairments (95% CI = [2.91% to 7.82%]), a prevalence that remained largely unchanged after excluding responders over the age of 65 years. Discussion There is a high prevalence of mild and severe cognitive impairment among WTC-responders highlighting the putative role of occupational/environmental and disaster-related exposures in the etiology of accelerated cognitive decline.
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Affiliation(s)
- Frank D Mann
- Department of Family, Population, and Preventative Medicine, Program in Public Health, Renaissance School of Medicine at Stony Brook University
- Department of Medicine, Renaissance School of Medicine at Stony Brook University
| | - Alexandra K Mueller
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, NY
- Department of Medicine, Montefiore Medical Center, Bronx, NY
| | - Rachel Zeig-Owens
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, NY
- Department of Medicine, Montefiore Medical Center, Bronx, NY
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Jaeun Choi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - David J Prezant
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, NY
- Department of Medicine, Montefiore Medical Center, Bronx, NY
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Melissa M Carr
- World Trade Center Health Program, Renaissance School of Medicine at Stony Brook University
| | - Alicia M Fels
- World Trade Center Health Program, Renaissance School of Medicine at Stony Brook University
| | - Christina M Hennington
- World Trade Center Health Program, Renaissance School of Medicine at Stony Brook University
| | - Megan P Armstrong
- World Trade Center Health Program, Renaissance School of Medicine at Stony Brook University
| | - Alissa Barber
- World Trade Center Health Program, Renaissance School of Medicine at Stony Brook University
| | - Ashley E Fontana
- World Trade Center Health Program, Renaissance School of Medicine at Stony Brook University
| | - Cassandra H Kroll
- World Trade Center Health Program, Renaissance School of Medicine at Stony Brook University
| | - Kevin Chow
- World Trade Center Health Program, Renaissance School of Medicine at Stony Brook University
| | - Onix A Melendez
- World Trade Center Health Program, Renaissance School of Medicine at Stony Brook University
| | - Abigail J Smith
- World Trade Center Health Program, Renaissance School of Medicine at Stony Brook University
| | - Benjamin J Luft
- World Trade Center Health Program, Renaissance School of Medicine at Stony Brook University
- Department of Medicine, Renaissance School of Medicine at Stony Brook University
| | - Charles B Hall
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY
| | - Sean A P Clouston
- Department of Family, Population, and Preventative Medicine, Program in Public Health, Renaissance School of Medicine at Stony Brook University
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3
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Sarant JZ, Busby PA, Schembri AJ, Fowler C, Harris DC. ENHANCE: a comparative prospective longitudinal study of cognitive outcomes after 3 years of hearing aid use in older adults. Front Aging Neurosci 2024; 15:1302185. [PMID: 38356856 PMCID: PMC10864469 DOI: 10.3389/fnagi.2023.1302185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/12/2023] [Indexed: 02/16/2024] Open
Abstract
Background With an aging population, the prevalence of hearing loss and dementia are increasing rapidly. Hearing loss is currently considered the largest potentially modifiable risk factor for dementia. The effect of hearing interventions on cognitive function should therefore be investigated, as if effective, these may be successfully implemented to modify cognitive outcomes for older adults with hearing loss. Methods This prospective longitudinal observational cohort study compared outcomes of a convenience sample of prospectively recruited first-time hearing aid users without dementia from an audiology center with those of community-living older adults participating in a large prospective longitudinal cohort study with/without hearing loss and/or hearing aids. All participants were assessed at baseline, 18 months, and 36 months using the same measures. Results Participants were 160 audiology clinic patients (48.8% female patient; mean age 73.5 years) with mild-severe hearing loss, fitted with hearing aids at baseline, and 102 participants of the Australian Imaging, Biomarkers and Lifestyle Flagship Study of Aging (AIBL) (55.9% female patient; mean age 74.5 years). 18- and 36-month outcomes of subsets of the first participants to reach these points and complete the cognition assessment to date are compared. Primary comparative analysis showed cognitive stability for the hearing aid group while the AIBL group declined on working memory, visual attention, and psychomotor function. There was a non-significant trend for decline in visual learning for the AIBL group versus no decline for the hearing aid group. The hearing aid group showed significant decline on only 1 subtest and at a significantly slower rate than for the AIBL participants (p < 0.05). When education effects on cognitive trajectory were controlled, the HA group still performed significantly better on visual attention and psychomotor function (lower educated participants only) compared to the AIBL group but not on working memory or visual learning. Physical activity had no effect on cognitive performance trajectory. Conclusion Hearing aid users demonstrated significantly better cognitive performance to 3 years post-fitting, suggesting that hearing intervention may delay cognitive decline/dementia onset in older adults. Further studies using appropriate measures of cognition, hearing, and device use, with longer follow-up, are required.
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Affiliation(s)
- Julia Z. Sarant
- Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, VIC, Australia
| | - Peter A. Busby
- Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Christopher Fowler
- The Florey Institute of Neuroscience and Mental Health, Melbourne, VIC, Australia
| | - David C. Harris
- Department of Economics, The University of Melbourne, Melbourne, VIC, Australia
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Garcia S, Askew RL, Kavcic V, Shair S, Bhaumik AK, Rose E, Campbell S, May N, Hampstead BM, Dodge HH, Heidebrink JL, Paulson HL, Giordani B. Mild Cognitive Impairment Subtype Performance in Comparison to Healthy Older Controls on the NIH Toolbox and Cogstate. Alzheimer Dis Assoc Disord 2023; 37:328-334. [PMID: 37862614 PMCID: PMC10873007 DOI: 10.1097/wad.0000000000000587] [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: 02/20/2023] [Accepted: 09/06/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Early detection is necessary for the treatment of dementia. Computerized testing has become more widely used in clinical trials; however, it is unclear how sensitive these measures are to early signs of neurodegeneration. We investigated the use of the NIH Toolbox-Cognition (NIHTB-CB) and Cogstate-Brief computerized neuropsychological batteries in the identification of mild cognitive impairment (MCI) versus healthy older adults [healthy control (HC)] and amnestic (aMCI) versus nonamnestic MCI (naMCI). Exploratory analyses include investigating potential racial differences. METHODS Two hundred six older adults were diagnosed as aMCI (n = 58), naMCI (n = 15), or cognitively healthy (HC; n = 133). RESULTS The NIH Toolbox-CB subtests of Flanker, Picture Sequence Memory, and Picture Vocabulary significantly differentiated MCI from HC. Further, subtests from both computerized batteries differentiated patients with aMCI from those with naMCI. Although the main effect of race differences was noted on tests and in diagnostic groups was significant, there were no significant race-by-test interactions. CONCLUSIONS Computer-based subtests vary in their ability to help distinguish MCI subtypes, though these tests provide less expensive and easier-to-administer clinical screeners to help identify patients early who may qualify for more comprehensive evaluations. Further work is needed, however, to refine computerized tests to achieve better precision in distinguishing impairment subtypes.
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Affiliation(s)
- Sarah Garcia
- Psychology Department, Stetson University, DeLand, FL, USA
| | | | | | - Sarah Shair
- Departments of Psychiatry, Neurology, Psychology, and School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, USA
| | - Arijit K Bhaumik
- Departments of Psychiatry, Neurology, Psychology, and School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, USA
| | - Edna Rose
- Departments of Psychiatry, Neurology, Psychology, and School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, USA
| | - Stephen Campbell
- Departments of Psychiatry, Neurology, Psychology, and School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, USA
| | - Nicolas May
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, USA
| | - Benjamin M. Hampstead
- Departments of Psychiatry, Neurology, Psychology, and School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, USA
- VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Hiroko H. Dodge
- Layton Aging and Alzheimer’s Disease Center, Department of Neurology, Oregon Health & Science University, Portland, OR
| | - Judith L Heidebrink
- Departments of Psychiatry, Neurology, Psychology, and School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, USA
| | - Henry L Paulson
- Departments of Psychiatry, Neurology, Psychology, and School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, USA
| | - Bruno Giordani
- Departments of Psychiatry, Neurology, Psychology, and School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, USA
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Holm SP, Wolfer AM, Pointeau GH, Lipsmeier F, Lindemann M. Practice effects in performance outcome measures in patients living with neurologic disorders – A systematic review. Heliyon 2022; 8:e10259. [PMID: 36082322 PMCID: PMC9445299 DOI: 10.1016/j.heliyon.2022.e10259] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 03/05/2021] [Accepted: 08/05/2022] [Indexed: 10/26/2022] Open
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Martin T, Giordani B, Kavcic V. EEG asymmetry and cognitive testing in MCI identification. Int J Psychophysiol 2022; 177:213-219. [PMID: 35618112 PMCID: PMC10756646 DOI: 10.1016/j.ijpsycho.2022.05.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 04/05/2022] [Accepted: 05/18/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Finding the baseline resting-state EEG markers for early identification of cognitive decline can contribute to the identification of individuals at risk of further change. Potential applications include identifying participants for clinical trials, early treatment, and evaluation of treatment, accessible even from a community setting. METHODS Analyses were completed on a sample of 99 (ages 60-90) consensus-diagnosed, community-dwelling African Americans (58 cognitively typical/HC, and 41 mildly cognitively impaired/MCI), who were recruited from the Michigan Alzheimer's Disease Research Center (MADRC) and the Wayne State University Institute of Gerontology. In addition to neuropsychological testing with CogState and Toolbox computerized batteries, resting-state EEGs (rsEEG, eyes closed) were acquired before and after participants were engaged in a visual motion direction discrimination task. rsEEG frontal alpha asymmetry (FAA) and frontal beta asymmetry (FBA) were calculated. RESULTS FAA showed no difference across groups for the pre-task resting state. FBA was significantly different between groups, with more asymmetric frontal beta in MCI. Both physiological indices, however, along with computerized neuropsychological tests were significant predictors in logistic regression classification of MCI vs. control participants. CONCLUSION rsEEG asymmetries can contribute significantly to successful discrimination of older persons with MCI from those without, over and above cognitive testing, alone.
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Affiliation(s)
- Tim Martin
- Department of Psychological Sciences, Kennesaw State University, GA, USA
| | - Bruno Giordani
- Departments of Psychiatry, Neurology, and Psychology and School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Voyko Kavcic
- Institute of Gerontology, Wayne State University, USA; International Institute of Applied Gerontology, Ljubljana, Slovenia.
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Aschenbrenner AJ, Hassenstab J, Wang G, Li Y, Xiong C, McDade E, Clifford DB, Salloway S, Farlow M, Yaari R, Cheng EYJ, Holdridge KC, Mummery CJ, Masters CL, Hsiung GY, Surti G, Day GS, Weintraub S, Honig LS, Galvin JE, Ringman JM, Brooks WS, Fox NC, Snyder PJ, Suzuki K, Shimada H, Gräber S, Bateman RJ. Avoid or Embrace? Practice Effects in Alzheimer's Disease Prevention Trials. Front Aging Neurosci 2022; 14:883131. [PMID: 35783127 PMCID: PMC9244171 DOI: 10.3389/fnagi.2022.883131] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/19/2022] [Indexed: 12/02/2022] Open
Abstract
Demonstrating a slowing in the rate of cognitive decline is a common outcome measure in clinical trials in Alzheimer's disease (AD). Selection of cognitive endpoints typically includes modeling candidate outcome measures in the many, richly phenotyped observational cohort studies available. An important part of choosing cognitive endpoints is a consideration of improvements in performance due to repeated cognitive testing (termed "practice effects"). As primary and secondary AD prevention trials are comprised predominantly of cognitively unimpaired participants, practice effects may be substantial and may have considerable impact on detecting cognitive change. The extent to which practice effects in AD prevention trials are similar to those from observational studies and how these potential differences impact trials is unknown. In the current study, we analyzed data from the recently completed DIAN-TU-001 clinical trial (TU) and the associated DIAN-Observational (OBS) study. Results indicated that asymptomatic mutation carriers in the TU exhibited persistent practice effects on several key outcomes spanning the entire trial duration. Critically, these practice related improvements were larger on certain tests in the TU relative to matched participants from the OBS study. Our results suggest that the magnitude of practice effects may not be captured by modeling potential endpoints in observational studies where assessments are typically less frequent and drug expectancy effects are absent. Using alternate instrument forms (represented in our study by computerized tasks) may partly mitigate practice effects in clinical trials but incorporating practice effects as outcomes may also be viable. Thus, investigators must carefully consider practice effects (either by minimizing them or modeling them directly) when designing cognitive endpoint AD prevention trials by utilizing trial data with similar assessment frequencies.
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Affiliation(s)
| | - Jason Hassenstab
- Washington University in St. Louis School of Medicine, St. Louis, MO, United States
| | - Guoqiao Wang
- Washington University in St. Louis School of Medicine, St. Louis, MO, United States
| | - Yan Li
- Washington University in St. Louis School of Medicine, St. Louis, MO, United States
| | - Chengjie Xiong
- Washington University in St. Louis School of Medicine, St. Louis, MO, United States
| | - Eric McDade
- Washington University in St. Louis School of Medicine, St. Louis, MO, United States
| | - David B. Clifford
- Washington University in St. Louis School of Medicine, St. Louis, MO, United States
| | - Stephen Salloway
- Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Martin Farlow
- Indiana University School of Medicine, Indianapolis, IN, United States
| | - Roy Yaari
- Eli Lilly and Company, Indianapolis, IN, United States
| | | | | | | | | | | | - Ghulam Surti
- The University of Rhode Island, Kingston, RI, United States
| | | | - Sandra Weintraub
- Feiniberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Lawrence S. Honig
- Columbia University Irving Medical Center, New York, NY, United States
| | - James E. Galvin
- Miller School of Medicine, University of Miami, Miami, FL, United States
| | - John M. Ringman
- University of Southern California, Los Angeles, CA, United States
| | - William S. Brooks
- Neuroscience Research Australia, University of New South Wales Medicine, Randwick, NSW, Australia
| | - Nick C. Fox
- Dementia Research Center, University College London, London, United Kingdom
| | | | | | | | - Susanne Gräber
- German Center for Neurodegenerative Disease (DZNE), Tübingen, Germany
| | - Randall J. Bateman
- Washington University in St. Louis School of Medicine, St. Louis, MO, United States
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Famula J, Ferrer E, Hagerman RJ, Tassone F, Schneider A, Rivera SM, Hessl D. Neuropsychological changes in FMR1 premutation carriers and onset of fragile X-associated tremor/ataxia syndrome. J Neurodev Disord 2022; 14:23. [PMID: 35321639 PMCID: PMC8942145 DOI: 10.1186/s11689-022-09436-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 03/14/2022] [Indexed: 11/24/2022] Open
Abstract
Background Carriers of the FMR1 premutation are at increased risk of developing a late-onset progressive neurodegenerative disease, fragile X-associated tremor/ataxia syndrome (FXTAS), characterized by intention tremor, gait ataxia, and cognitive decline. Cross-sectional studies to date have provided evidence that neuropsychological changes, such as executive function alterations, or subtle motor changes, may precede the onset of formal FXTAS, perhaps characterizing a prodromal state. However, the lack of longitudinal data has prevented the field from forming a clear picture of progression over time within individuals, and we lack consensus regarding early markers of risk and measures that may be used to track response to intervention. Methods This was a longitudinal study of 64 male FMR1 premutation carriers (Pm) without FXTAS at study entry and 30 normal controls (Nc), aged 40 to 80 years (Pm M = 60.0 years; Nc M = 57.4 years). Fifty of the Pm and 22 of the Nc were re-assessed after an average of 2.33 years, and 37 Pm and 20 Nc were re-assessed a third time after an average of another 2.15 years. Eighteen of 64 carriers (28%) converted to FXTAS during the study to date. Neuropsychological assessments at each time point, including components of the Cambridge Neuropsychological Test Automated Battery (CANTAB), tapped domains of episodic and working memory, inhibitory control, visual attention, planning, executive control of movement, and manual speed and dexterity. Age-based mixed models were used to examine group differences in change over time on the outcomes in the full sample, and differences were further evaluated in 15 trios (n = 45; 15 Pm “converters,” 15 Pm “nonconverters,” 15 Nc) that were one-one matched on age, education, and socioeconomic status. Results Compared to Nc, Pm showed significantly greater rates of change over time in visual working memory, motor dexterity, inhibitory control, and manual movement speed. After multiple comparison correction, significant effects remained for motor dexterity. Worsening inhibitory control and slower manual movements were related to progression in FXTAS stage, but these effects became statistically non-significant after correcting for multiple comparisons. Higher FMR1 mRNA correlated with worsening manual reaction time but did not survive multiple comparisons and no other molecular measures correlated with neuropsychological changes. Finally, trio comparisons revealed greater rate of decline in planning and manual movement speed in Pm converters compared to Pm nonconverters. Conclusions Accelerated decline in executive function and subtle motor changes, likely mediated by frontocerebellar circuits, may precede, and then track with the emergence of formal FXTAS symptoms. Further research to develop and harmonize clinical assessment of FMR1 carriers across centers is needed to prepare for future prophylactic and treatment trials for this disorder.
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Affiliation(s)
- Jessica Famula
- MIND Institute, University of California Davis Health, 2825 50th Street, Sacramento, CA, 95817, USA.,Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Emilio Ferrer
- Department of Psychology, University of California Davis, Davis, CA, USA
| | - Randi J Hagerman
- MIND Institute, University of California Davis Health, 2825 50th Street, Sacramento, CA, 95817, USA.,Department of Pediatrics, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Flora Tassone
- MIND Institute, University of California Davis Health, 2825 50th Street, Sacramento, CA, 95817, USA.,Department of Biochemistry and Molecular Medicine, University of California Davis School of Medicine, Davis, CA, USA
| | - Andrea Schneider
- MIND Institute, University of California Davis Health, 2825 50th Street, Sacramento, CA, 95817, USA.,Department of Pediatrics, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Susan M Rivera
- MIND Institute, University of California Davis Health, 2825 50th Street, Sacramento, CA, 95817, USA.,Department of Psychology, University of California Davis, Davis, CA, USA.,Center for Mind and Brain, University of California Davis, Davis, CA, USA
| | - David Hessl
- MIND Institute, University of California Davis Health, 2825 50th Street, Sacramento, CA, 95817, USA. .,Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, CA, USA.
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9
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Clouston SAP, Kritikos M, Huang C, Kuan PF, Vaska P, Pellecchia AC, Santiago-Michels S, Carr MA, Gandy S, Sano M, Bromet EJ, Lucchini RG, Luft BJ. Reduced cerebellar cortical thickness in World Trade Center responders with cognitive impairment. Transl Psychiatry 2022; 12:107. [PMID: 35296637 PMCID: PMC8927406 DOI: 10.1038/s41398-022-01873-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 02/21/2022] [Accepted: 02/24/2022] [Indexed: 01/22/2023] Open
Abstract
Prior research has demonstrated high levels of cognitive and physical functional impairments in World Trade Center (WTC) responders. A follow-up neuroimaging study identified changes to white matter connectivity within the cerebellum in responders with cognitive impairment (CI). In the first study to examine cerebellar cortical thickness in WTC responders with CI, we fielded a structural magnetic resonance imaging protocol. WTC responders (N = 99) participated in a structural magnetic resonance imaging (MRI) study, of whom 48 had CI. Participants with CI did not differ demographically or by intracranial volume when compared to cognitively unimpaired participants. MRIs were processed using the CERES imaging pipeline; bilateral cortical thickness in 12 cerebellar lobules was reported. Analyses were completed comparing mean cerebellar cortical thickness across groups. Lobules were examined to determine the location and functional correlates of reduced cerebellar cortical thickness. Multivariable-adjusted analyses accounted for the false discovery rate. Mean cerebellar cortical thickness was reduced by 0.17 mm in responders with CI. Decrements in cerebellar cortical thickness were symmetric and located in the Cerebellar Crus (I and II), and in Lobules IV, VI, VIIb, VIIIa, VIIIb, and IX. Cerebellar cortical thickness was associated with episodic memory, response speed, and tandem balance. WTC responders with CI had evidence of reduced cerebellar cortical thickness that was present across lobules in a pattern unique to this cohort.
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Affiliation(s)
- Sean A P Clouston
- Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook, Stony Brook, NY, USA.
- Program in Public Health, Renaissance School of Medicine at Stony Brook, Stony Brook, NY, USA.
| | - Minos Kritikos
- Program in Public Health, Renaissance School of Medicine at Stony Brook, Stony Brook, NY, USA
| | - Chuan Huang
- Department of Radiology, Renaissance School of Medicine at Stony Brook, Stony Brook, NY, USA
| | - Pei-Fen Kuan
- Department of Applied Mathematics, Stony Brook University, Stony Brook, NY, USA
| | - Paul Vaska
- Department of Radiology, Renaissance School of Medicine at Stony Brook, Stony Brook, NY, USA
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA
| | - Alison C Pellecchia
- Department of Medicine, Renaissance School of Medicine at Stony Brook, Stony Brook, NY, USA
| | | | - Melissa A Carr
- Department of Medicine, Renaissance School of Medicine at Stony Brook, Stony Brook, NY, USA
| | - Sam Gandy
- Center for Cognitive Health and NFL Neurological Care, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mount Sinai Alzheimer's Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mary Sano
- Mount Sinai Alzheimer's Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Evelyn J Bromet
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook, Stony Brook, NY, USA
| | - Roberto G Lucchini
- Department of Environmental Health Sciences, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Benjamin J Luft
- Director of the World Trade Center Health and Wellness Program, Department of Medicine, Renaissance School of Medicine at Stony Brook, Stony Brook, NY, USA
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10
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Laptop-Administered NIH Toolbox and Cogstate Brief Battery in Community-Dwelling Black Adults: Unexpected Pattern of Cognitive Performance between MCI and Healthy Controls. J Int Neuropsychol Soc 2022; 28:239-248. [PMID: 33752763 PMCID: PMC10112283 DOI: 10.1017/s135561772100028x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Black adults are approximately twice as likely to develop Alzheimer's disease (AD) than non-Hispanic Whites and access diagnostic services later in their illness. This dictates the need to develop assessments that are cost-effective, easily administered, and sensitive to preclinical stages of AD, such as mild cognitive impairment (MCI). Two computerized cognitive batteries, NIH Toolbox-Cognition and Cogstate Brief Battery, have been developed. However, utility of these measures for clinical characterization remains only partially determined. We sought to determine the convergent validity of these computerized measures in relation to consensus diagnosis in a sample of MCI and healthy controls (HC). METHOD Participants were community-dwelling Black adults who completed the neuropsychological battery and other Uniform Data Set (UDS) forms from the AD centers program for consensus diagnosis (HC = 61; MCI = 43) and the NIH Toolbox-Cognition and Cogstate batteries. Discriminant function analysis was used to determine which cognitive tests best differentiated the groups. RESULTS NIH Toolbox crystallized measures, Oral Reading and Picture Vocabulary, were the most sensitive in identifying MCI apart from HC. Secondarily, deficits in memory and executive subtests were also predictive. UDS neuropsychological test analyses showed the expected pattern of memory and executive functioning tests differentiating MCI from HC. CONCLUSIONS Contrary to expectation, NIH Toolbox crystallized abilities appeared preferentially sensitive to diagnostic group differences. This study highlights the importance of further research into the validity and clinical utility of computerized neuropsychological tests within ethnic minority populations.
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11
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Wang CSM, Wu JY, Hsu WT, Chien PF, Chen PL, Huang YC, Cheng KS. Using Self-Administered Game-Based Cognitive Assessment to Screen for Degenerative Dementia: A Pilot Study. J Alzheimers Dis 2022; 86:877-890. [PMID: 35147533 DOI: 10.3233/jad-215142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The earlier detection of dementia is needed as cases increase yearly in the aging populations of Taiwan and the world. In recent years, the global internet usage rate has gradually increased among older people. To expand dementia screening and provide timely medical intervention, a simple self-administrated assessment tool to assist in easily screening for dementia is needed. OBJECTIVE The two-part goal of this pilot study was, first, to develop a Game-Based Cognitive Assessment (GBCA) tool, and then, to evaluate its validity at early screening for patients with cognitive impairment. METHOD The researchers recruited 67 patients with neurocognitive disorders (NCDs) and 57 healthy controls (HCs). Each participant underwent the GBCA and other clinical cognitive assessments (CDR, CASI, and MMSE), and filled out a questionnaire evaluating their experience of using the GBCA. Statistical analyses were used to measure the validity of the GBCA at screening for degenerative dementia. RESULTS The average GBCA scores of the HC and NCD groups were 87 (SD = 7.9) and 52 (SD = 21.7), respectively. The GBCA correlated well with the CASI (r2 = 0.90, p < 0.001) and with the MMSE (r2 = 0.92, p < 0.001), indicating concurrent validity. The GBCA cut-off of 75/76 corresponded to measurements of sensitivity, specificity, and area under curve of 85.1%, 91.5%, and 0.978, respectively. The positive predictive value was 91.9%, and the negative predictive value was 84.4%. The results of the user-experience questionnaire for the HC and NCD groups were good and acceptable, respectively. CONCLUSION The GBCA is an effective and acceptable tool for screening for degenerative dementia.
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Affiliation(s)
- Carol Sheei-Meei Wang
- Department of BioMedical Engineering, National Cheng Kung University, Tainan City, Taiwan.,Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan City, Taiwan.,Department of Psychiatry, National Cheng Kung University Hospital, Tainan City, Taiwan
| | - Jia-Yun Wu
- Department of BioMedical Engineering, National Cheng Kung University, Tainan City, Taiwan
| | - Wen-Tzu Hsu
- Department of BioMedical Engineering, National Cheng Kung University, Tainan City, Taiwan
| | - Pei-Fang Chien
- Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan City, Taiwan
| | | | - Ying-Che Huang
- Department of Neurology, Tainan Hospital, Ministry of Health and Welfare, Tainan City, Taiwan
| | - Kuo-Sheng Cheng
- Department of BioMedical Engineering, National Cheng Kung University, Tainan City, Taiwan
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12
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Yaneva A, Massaldjieva R, Mateva N. Initial Adaptation of the General Cognitive Assessment Battery by Cognifit™ for Bulgarian Older Adults. Exp Aging Res 2021; 48:336-350. [PMID: 34605370 DOI: 10.1080/0361073x.2021.1981096] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Online neuropsychological assessment batteries may facilitate the screening of cognitive functions in older adults and could be useful for early diagnosis and detection of cognitive impairments. OBJECTIVE The primary aim of this study was to assess the psychometric qualities of an online multi-domain cognitive assessment battery (General Cognitive Assessment Battery (GCAB) by Cognifit™) applied for the first time in Bulgaria. METHODS A total of 20 healthy older adults (6 male and 14 female, aged 60-82) completed the GCAB as well as the Mini-Mental State Examination (MMSE) and the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropsychological battery. Descriptive statistics were used to describe the demographic characteristics of the sample and the scores on the GCAB and the CERAD battery. The internal consistency of the GCAB was evaluated using item analysis and measured with Cronbach's alpha. The concurrent validity of the GCAB was assessed with respect to the CERAD using Spearman's r after verifying the linear relationship between the GCAB and CERAD scores. RESULTS The GCAB showed good concurrent validity when compared with the corresponding CERAD tests. The correlation coefficients ranged from 0.67 for working memory to 0.47 for short-term auditory memory. We found very good reliability of the GCAB, with the inter-class correlation coefficient higher than 0.8 for all cognitive domains. There were no significant correlations between MMSE and GCAB scores. CONCLUSION The GCAB was found to be valid for the cognitive screening of Bulgarian healthy older adults and may provide an adequate assessment of their cognitive status. The GCAB showed good concurrent validity when compared with the CERAD battery, measuring similar cognitive constructs. Further work is necessary to explore its validity and reliability.
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Affiliation(s)
- Antonia Yaneva
- Department of Medical Informatics, Biostatistics and eLearning, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Radka Massaldjieva
- Department of Healthcare Management, Medical University of Plovdiv, Bulgaria University, Plovdiv, Bulgaria
| | - Nonka Mateva
- Department of Medical Informatics, Biostatistics and eLearning, Medical University of Plovdiv, Plovdiv, Bulgaria
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13
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Deri Y, Clouston SAP, DeLorenzo C, Gardus JD, Bartlett EA, Santiago-Michels S, Bangiyev L, Kreisl WC, Kotov R, Huang C, Slifstein M, Parsey RV, Luft BJ. Neuroinflammation in World Trade Center responders at midlife: A pilot study using [ 18F]-FEPPA PET imaging. Brain Behav Immun Health 2021; 16:100287. [PMID: 34589784 PMCID: PMC8474562 DOI: 10.1016/j.bbih.2021.100287] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 06/20/2021] [Indexed: 02/08/2023] Open
Abstract
Background Neuroinflammation has long been theorized to arise from exposures to fine particulate matter and to be modulated when individuals experience chronic stress, both of which are also though to cause cognitive decline in part as a result of neuroinflammation. Objectives Hypothesizing that neuroinflammation might be linked to experiences at the World Trade Center (WTC) events, this study explored associations between glial activation and neuropsychological measures including post-traumatic stress disorder (PTSD) symptom severity and WTC exposure duration. Methods Translocator protein 18-kDa (TSPO) is overexpressed by activated glial cells, predominantly microglia and astrocytes, making TSPO distribution a putative biomarker for neuroinflammation. Twenty WTC responders completed neuropsychological assessments and in vivo PET brain scan with [18F]-FEPPA. Generalized linear modeling was used to test associations between PTSD, and WTC exposure duratiioni as the predictor and both global and regional [18F]-FEPPA total distribution volumes as the outcomes. Result Responders were 56.0 ± 4.7 years-old, and 75% were police officers on 9/11/2001, and all had at least a high school education. Higher PTSD symptom severity was associated with global and regional elevations in [18F]-FEPPA binding predominantly in the hippocampus (d = 0.72, P = 0.001) and frontal cortex (d = 0.64, P = 0.004). Longer exposure duration to WTC sites was associated with higher [18F]-FEPPA binding in the parietal cortex. Conclusion Findings from this study of WTC responders at midlife suggest that glial activation is associated with PTSD symptoms, and WTC exposure duration. Future investigation is needed to understand the important role of neuroinflammation in highly exposed WTC responders. We examined the theory that glial activation is associated with 9/11 exposures. TSPO-Vt was examined using PET in 20 responders adjusting for TSPO genotype. Responders with PTSD had increased TSPO distribution volume in the hippocampus. Heavily exposed responders had increased TSPO distribution in the parietal cortex.
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Affiliation(s)
- Yael Deri
- Department of Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Sean A P Clouston
- Program in Public Health and Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Christine DeLorenzo
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.,Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA
| | - John D Gardus
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Elizabeth A Bartlett
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA.,Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
| | - Stephanie Santiago-Michels
- Stony Brook World Trade Center Wellness Program, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Lev Bangiyev
- Department of Radiology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - William C Kreisl
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA
| | - Roman Kotov
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Chuan Huang
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.,Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA.,Department of Radiology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Mark Slifstein
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Ramin V Parsey
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.,Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA
| | - Benjamin J Luft
- Department of Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.,Stony Brook World Trade Center Wellness Program, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
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14
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Niemczak CE, Lichtenstein JD, Magohe A, Amato JT, Fellows AM, Gui J, Huang M, Rieke CC, Massawe ER, Boivin MJ, Moshi N, Buckey JC. The Relationship Between Central Auditory Tests and Neurocognitive Domains in Adults Living With HIV. Front Neurosci 2021; 15:696513. [PMID: 34658754 PMCID: PMC8517794 DOI: 10.3389/fnins.2021.696513] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 09/07/2021] [Indexed: 12/21/2022] Open
Abstract
Objective: Tests requiring central auditory processing, such as speech perception-in-noise, are simple, time efficient, and correlate with cognitive processing. These tests may be useful for tracking brain function. Doing this effectively requires information on which tests correlate with overall cognitive function and specific cognitive domains. This study evaluated the relationship between selected central auditory focused tests and cognitive domains in a cohort of normal hearing adults living with HIV and HIV- controls. The long-term aim is determining the relationships between auditory processing and neurocognitive domains and applying this to analyzing cognitive function in HIV and other neurocognitive disorders longitudinally. Method: Subjects were recruited from an ongoing study in Dar es Salaam, Tanzania. Central auditory measures included the Gap Detection Test (Gap), Hearing in Noise Test (HINT), and Triple Digit Test (TDT). Cognitive measures included variables from the Test of Variables of Attention (TOVA), Cogstate neurocognitive battery, and Kiswahili Montreal Cognitive Assessment (MoCA). The measures represented three cognitive domains: processing speed, learning, and working memory. Bootstrap resampling was used to calculate the mean and standard deviation of the proportion of variance explained by the individual central auditory tests for each cognitive measure. The association of cognitive measures with central auditory variables taking HIV status and age into account was determined using regression models. Results: Hearing in Noise Tests and TDT were significantly associated with Cogstate learning and working memory tests. Gap was not significantly associated with any cognitive measure with age in the model. TDT explained the largest mean proportion of variance and had the strongest relationship to the MoCA and Cogstate tasks. With age in the model, HIV status did not affect the relationship between central auditory tests and cognitive measures. Age was strongly associated with multiple cognitive tests. Conclusion: Central auditory tests were associated with measures of learning and working memory. Compared to the other central auditory tests, TDT was most strongly related to cognitive function. These findings expand on the association between auditory processing and cognitive domains seen in other studies and support evaluating these tests for tracking brain health in HIV and other neurocognitive disorders.
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Affiliation(s)
- Christopher E. Niemczak
- Space Medicine Innovations Laboratory, Geisel School of Medicine, Dartmouth College, Hanover, NH, United States
| | - Jonathan D. Lichtenstein
- Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
- Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, NH, United States
| | - Albert Magohe
- Department of Otorhinolaryngology, Muhimibili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Jennifer T. Amato
- Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
- Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, NH, United States
| | - Abigail M. Fellows
- Space Medicine Innovations Laboratory, Geisel School of Medicine, Dartmouth College, Hanover, NH, United States
| | - Jiang Gui
- Department of Data Science, Geisel School of Medicine, Dartmouth College, Hanover, NH, United States
| | - Michael Huang
- Space Medicine Innovations Laboratory, Geisel School of Medicine, Dartmouth College, Hanover, NH, United States
| | - Catherine C. Rieke
- Space Medicine Innovations Laboratory, Geisel School of Medicine, Dartmouth College, Hanover, NH, United States
- Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Enica R. Massawe
- Department of Otorhinolaryngology, Muhimibili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Michael J. Boivin
- Department of Psychiatry, Michigan State University, East Lansing, MI, United States
| | - Ndeserua Moshi
- Department of Otorhinolaryngology, Muhimibili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Jay C. Buckey
- Space Medicine Innovations Laboratory, Geisel School of Medicine, Dartmouth College, Hanover, NH, United States
- Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
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15
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Bell SA, Cohen HR, Lee S, Kim H, Ciarleglio A, Andrews H, Rivera AM, Igwe K, Brickman AM, Devanand DP, Harvey PD, Schneider LS, Goldberg TE. Development of novel measures for Alzheimer's disease prevention trials (NoMAD). Contemp Clin Trials 2021; 106:106425. [PMID: 33933666 PMCID: PMC10001317 DOI: 10.1016/j.cct.2021.106425] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Assessment of cognition and everyday function is essential in clinical trials for Alzheimer's disease (AD). Two novel measures of cognition (No Practice Effects (NPE) cognitive battery and Miami Computerized Functional Assessment Scale (CFAS)) were designed to have robust psychometric properties and reduced practice and ceiling effects. This study aims to evaluate if the NPE and CFAS demonstrate stronger psychometric properties and reduced practice effects compared with established measures, including the Preclinical Alzheimer Cognitive Composite (PACC), Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog), and Functional Activities Questionnaire (FAQ). METHODS This parallel group, four-site study will randomize 320 cognitively intact adults aged 60 to 85 years to novel or well-established measures of cognition and function. All participants will receive assessments at baseline (week 0), 3-months, and 12-months, as well as a brain MRI scan and Apolipoprotein E genetic test at study entry. Analyses will determine psychometric properties of the NPE and CFAS, compare the sensitivity of measures to AD risk markers, and identify cognitive domains within the NPE. DISCUSSION Practice effects have been a major limitation of Alzheimer's disease clinical trials that typically assess cognitive changes over serial assessments. Detection of functional impairment in cognitively normal individuals with biomarkers for Alzheimer's disease requires instruments sensitive to very subtle functional changes. This study is intended to support the validation of two new composite measures, the NPE battery and the CFAS, which may advance clinical testing of interventions for individuals across the spectrum of early stage Alzheimer's disease. TRIAL REGISTRATION NCT03900273.
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Affiliation(s)
- Sophie A Bell
- Division of Geriatric Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Hannah R Cohen
- Division of Geriatric Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Seonjoo Lee
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA; Division of Mental Health Data Science, New York State Psychiatric Institute, New York, NY, USA
| | - Hyun Kim
- Division of Geriatric Psychiatry, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
| | - Adam Ciarleglio
- Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Howard Andrews
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Andres M Rivera
- Department of Neurology, Taub Institute for Research in Alzheimer's Disease and the Aging Brain, and Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Kay Igwe
- Department of Neurology, Taub Institute for Research in Alzheimer's Disease and the Aging Brain, and Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Adam M Brickman
- Department of Neurology, Taub Institute for Research in Alzheimer's Disease and the Aging Brain, and Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - D P Devanand
- Division of Geriatric Psychiatry, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
| | - Philip D Harvey
- University of Miami Miller School of Medicine, Miami VA Medical Center, Miami, FL, USA
| | - Lon S Schneider
- University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Terry E Goldberg
- Division of Geriatric Psychiatry, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Columbia University Medical Center, New York, NY, USA.
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16
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Udeh-Momoh CT, Watermeyer T, Price G, de Jager Loots CA, Reglinska-Matveyev N, Ropacki M, Ketter N, Fogle M, Raghavan N, Arrighi M, Brashear R, Di J, Baker S, Giannakopoulou P, Robb C, Bassil D, Cohn M, McLellan-Young H, Crispin J, Lakey K, Lisa C, Chowdary Seemulamoodi Y, Kafetsouli D, Perera D, Car J, Majeed A, Ward H, Ritchie K, Perneczky R, Kivipelto M, Scott D, Bracoud L, Saad Z, Novak G, Ritchie CW, Middleton L. Protocol of the Cognitive Health in Ageing Register: Investigational, Observational and Trial Studies in Dementia Research (CHARIOT): Prospective Readiness cOhort (PRO) SubStudy. BMJ Open 2021; 11:e043114. [PMID: 34168021 PMCID: PMC8230926 DOI: 10.1136/bmjopen-2020-043114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The Cognitive Health in Ageing Register: Investigational, Observational and Trial Studies in Dementia Research (CHARIOT): Prospective Readiness cOhort (PRO) SubStudy (CPSS), sponsored by Janssen Pharmaceutical Research & Development LLC, is an Alzheimer's disease (AD) biomarker enriched observational study that began 3 July 2015 CPSS aims to identify and validate determinants of AD, alongside cognitive, functional and biological changes in older adults with or without detectable evidence of AD pathology at baseline. METHODS AND ANALYSIS CPSS is a dual-site longitudinal cohort (3.5 years) assessed quarterly. Cognitively normal participants (60-85 years) were recruited across Greater London and Edinburgh. Participants are classified as high, medium (amnestic or non-amnestic) or low risk for developing mild cognitive impairment-Alzheimer's disease based on their Repeatable Battery for the Assessment of Neuropsychological Status performance at screening. Additional AD-related assessments include: a novel cognitive composite, the Global Preclinical Alzheimer's Cognitive Composite, brain MRI and positron emission tomography and cerebrospinal fluid analysis. Lifestyle, other cognitive and functional data, as well as biosamples (blood, urine, and saliva) are collected. Primarily, study analyses will evaluate longitudinal change in cognitive and functional outcomes. Annual interim analyses for descriptive data occur throughout the course of the study, although inferential statistics are conducted as required. ETHICS AND DISSEMINATION CPSS received ethical approvals from the London-Central Research Ethics Committee (15/LO/0711) and the Administration of Radioactive Substances Advisory Committee (RPC 630/3764/33110) The study is at the forefront of global AD prevention efforts, with frequent and robust sampling of the well-characterised cohort, allowing for detection of incipient pathophysiological, cognitive and functional changes that could inform therapeutic strategies to prevent and/or delay cognitive impairment and dementia. Dissemination of results will target the scientific community, research participants, volunteer community, public, industry, regulatory authorities and policymakers. On study completion, and following a predetermined embargo period, CPSS data are planned to be made accessible for analysis to facilitate further research into the determinants of AD pathology, onset of symptomatology and progression. TRIAL REGISTRATION NUMBER The CHARIOT:PRO SubStudy is registered with clinicaltrials.gov (NCT02114372). Notices of protocol modifications will be made available through this trial registry.
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Affiliation(s)
- Chinedu T Udeh-Momoh
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Tamlyn Watermeyer
- Department of Psychology, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | - Geraint Price
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
| | | | - Natalia Reglinska-Matveyev
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | | | - Nzeera Ketter
- Janssen Alzheimer Immunotherapy Research and Development LLC, South San Francisco, California, USA
| | - Michael Fogle
- Janssen Research and Development LLC, Titusville, New Jersey, USA
| | - Nandini Raghavan
- Janssen Research and Development LLC, Titusville, New Jersey, USA
| | | | - Robert Brashear
- Janssen Alzheimer Immunotherapy Research and Development LLC, South San Francisco, California, USA
| | - Jianing Di
- Department of Biostatistics, Janssen Research and Development Shanghai, Shanghai, China
| | - Susan Baker
- Janssen Research and Development LLC, Titusville, New Jersey, USA
| | | | - Catherine Robb
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
| | - Darina Bassil
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
| | - Martin Cohn
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
| | - Heather McLellan-Young
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
| | - Jennifier Crispin
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
| | - Kristina Lakey
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
| | - Curry Lisa
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
| | | | - Dimitra Kafetsouli
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
| | - Dinithi Perera
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
| | - Josip Car
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
- Centre for Population Health Sciences (CePHaS), Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Azeem Majeed
- Department of Primary Care and Public Health, School of Public, Imperial College London, London, UK
| | - Heather Ward
- Department of Epidemiology and Biostatistics, School of Public, Imperial College London, London, UK
| | - Karen Ritchie
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
- Neuropsychiatry: Epidemiological and Clinical Research, INSERM, University of Montpellier, Montpellier, France
| | - Robert Perneczky
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilians University Munich, Munchen, Germany
| | - Miia Kivipelto
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - David Scott
- BioClinica Inc Newark California Office, Newark, California, USA
| | | | - Ziad Saad
- Janssen Research and Development, Fremont, California, USA
| | - Gerald Novak
- Janssen Research and Development LLC, Titusville, New Jersey, USA
| | - Craig W Ritchie
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | - Lefkos Middleton
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
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17
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Deri Y, Clouston SAP, DeLorenzo C, Gardus JD, Horton M, Tang C, Pellecchia AC, Santiago‐Michels S, Carr MA, Gandy S, Sano M, Bromet EJ, Lucchini RG, Luft BJ. Selective hippocampal subfield volume reductions in World Trade Center responders with cognitive impairment. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2021; 13:e12165. [PMID: 33816755 PMCID: PMC8011041 DOI: 10.1002/dad2.12165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 01/20/2023]
Abstract
INTRODUCTION The objective of this study was to investigate associations between dementia in World Trade Center (WTC) responders and in vivo volumetric measures of hippocampal subfield volumes in WTC responders at midlife. METHODS A sample of 99 WTC responders was divided into dementia and unimpaired groups. Participants underwent structural T1-weighted magnetic resonance imaging. Volumetric measures included the overall hippocampus and eight subfields. Regression models examined volumetric measure of interest adjusting for confounders including intracranial volume. RESULTS Dementia was associated with smaller hippocampal volume and with reductions across hippocampal subfields. Smaller hippocampal subfield volumes were associated with longer cumulative time worked at the WTC. Domain-specific cognitive performance was associated with lower volumetric measures across hippocampal subregions. CONCLUSIONS This is the first study to investigate hippocampal subfield volumes in a sample of WTC responders at midlife. Selective hippocampal subfield volume reductions suggested abnormal cognition that were associated with WTC exposure duration.
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Affiliation(s)
- Yael Deri
- Department of MedicineRenaissance School of Medicine at Stony Brook UniversityStony BrookNew YorkUSA
| | - Sean A. P. Clouston
- Program in Public Health and Department of Family, Population, and Preventive MedicineRenaissance School of Medicine at Stony Brook UniversityStony BrookNew YorkUSA
| | - Christine DeLorenzo
- Department of PsychiatryRenaissance School of Medicine at Stony Brook UniversityStony BrookNew YorkUSA
- Department of Biomedical EngineeringStony Brook UniversityStony BrookNew YorkUSA
| | - John D. Gardus
- Department of PsychiatryRenaissance School of Medicine at Stony Brook UniversityStony BrookNew YorkUSA
| | - Megan Horton
- Department of Environmental Medicine and Public HealthIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Cheuk Tang
- Biomedical Engineering and Imaging InstituteIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Alison C. Pellecchia
- Stony Brook World Trade Center Wellness ProgramRenaissance School of Medicine at Stony Brook UniversityStony BrookNew YorkUSA
| | - Stephanie Santiago‐Michels
- Stony Brook World Trade Center Wellness ProgramRenaissance School of Medicine at Stony Brook UniversityStony BrookNew YorkUSA
| | - Melissa A. Carr
- Stony Brook World Trade Center Wellness ProgramRenaissance School of Medicine at Stony Brook UniversityStony BrookNew YorkUSA
| | - Sam Gandy
- Barbara and Maurice Deane Center for Wellness and Cognitive Health and the Mount Sinai Center for NFL Neurological Care, Department of NeurologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Mount Sinai Alzheimer's Disease Research CenterIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Mary Sano
- Mount Sinai Alzheimer's Disease Research CenterIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Evelyn J. Bromet
- Department of PsychiatryRenaissance School of Medicine at Stony Brook UniversityStony BrookNew YorkUSA
| | - Roberto G. Lucchini
- Department of Environmental Medicine and Public HealthIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Benjamin J. Luft
- Department of MedicineRenaissance School of Medicine at Stony Brook UniversityStony BrookNew YorkUSA
- Stony Brook World Trade Center Wellness ProgramRenaissance School of Medicine at Stony Brook UniversityStony BrookNew YorkUSA
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18
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Aung HL, Bloch M, Vincent T, Quan D, Jayewardene A, Liu Z, Gates TM, Brew B, Mao L, Cysique LA. Cognitive ageing is premature among a community sample of optimally treated people living with HIV. HIV Med 2021; 22:151-164. [PMID: 33085207 PMCID: PMC7984032 DOI: 10.1111/hiv.12980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/24/2020] [Accepted: 09/17/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Evidence of premature cognitive ageing amongst people living with HIV (PLHIV) remains controversial due to previous research limitations including underpowered studies, samples with suboptimal antiretroviral access, varying rate of virological control, high rate of AIDS, over-representation of non-community samples, and inclusion of inappropriate controls. The current study addresses these limitations, while also considering mental health and non-HIV comorbidity burden to determine whether PLHIV showed premature cognitive ageing compared with closely comparable HIV-negative controls. METHODS This study enrolled 254 PLHIV [92% on antiretroviral therapy; 84% with HIV RNA < 50 copies/mL; 15% with AIDS) and 72 HIV-negative gay and bisexual men [mean (SD) age = 49 (10.2) years] from a single primary care clinic in Sydney, Australia. Neurocognitive function was evaluated with the Cogstate Computerized Battery (CCB) at baseline and 6 months after. Linear mixed-effects (LME) models examined main and interaction effects of HIV status and chronological age on the CCB demographically uncorrected global neurocognitive z-score (GZS), adjusting for repeated testing, and then adjusting sequentially for HIV disease markers, mental health and comorbidities. RESULTS HIV status and age interacted with a lower GZS (β = -0.43, P < 0.05). Higher level of anxiety symptoms (β = -0.11, P < 0.01), historical AIDS (β = -0.12, P < 0.05) and historical HIV brain involvement (β = -0.12, P < 0.05) were associated with lower GZS. CONCLUSIONS We found a robust medium-sized premature ageing effect on cognition in a community sample with optimal HIV care. Our study supports routine screening of cognitive and mental health among PLHIV aged ≥ 50 years.
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Affiliation(s)
- HL Aung
- Department of Neurology and HIV Medicine, St Vincent’s Hospital and Peter Duncan Neurosciences UnitSt Vincent’s Centre for Applied Medical ResearchSydneyNSWAustralia
- Neuroscience Research AustraliaSydneyNSWAustralia
- Faculty of MedicineUNSWSydneyNSWAustralia
| | - M Bloch
- Faculty of MedicineUNSWSydneyNSWAustralia
- Holdsworth House Medical PracticeSydneyNSWAustralia
| | - T Vincent
- Holdsworth House Medical PracticeSydneyNSWAustralia
| | - D Quan
- Holdsworth House Medical PracticeSydneyNSWAustralia
| | - A Jayewardene
- Holdsworth House Medical PracticeSydneyNSWAustralia
- Charles Perkins CentreUniversity of SydneySydneyNSWAustralia
| | - Z Liu
- Stats CentralUNSWSydneyNSWAustralia
| | - TM Gates
- Department of Neurology and HIV Medicine, St Vincent’s Hospital and Peter Duncan Neurosciences UnitSt Vincent’s Centre for Applied Medical ResearchSydneyNSWAustralia
| | - B Brew
- Department of Neurology and HIV Medicine, St Vincent’s Hospital and Peter Duncan Neurosciences UnitSt Vincent’s Centre for Applied Medical ResearchSydneyNSWAustralia
- Faculty of MedicineUNSWSydneyNSWAustralia
- Faculty of MedicineUniversity of Notre DameSydneyNSWAustralia
| | - L Mao
- Centre for Social Research in HealthUNSWSydneyNSWAustralia
| | - LA Cysique
- Department of Neurology and HIV Medicine, St Vincent’s Hospital and Peter Duncan Neurosciences UnitSt Vincent’s Centre for Applied Medical ResearchSydneyNSWAustralia
- Neuroscience Research AustraliaSydneyNSWAustralia
- Faculty of MedicineUNSWSydneyNSWAustralia
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19
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Daniels RD, Clouston SAP, Hall CB, Anderson KR, Bennett DA, Bromet EJ, Calvert GM, Carreón T, DeKosky ST, Diminich ED, Finch CE, Gandy S, Kreisl WC, Kritikos M, Kubale TL, Mielke MM, Peskind ER, Raskind MA, Richards M, Sano M, Santiago-Colón A, Sloan RP, Spiro A, Vasdev N, Luft BJ, Reissman DB. A Workshop on Cognitive Aging and Impairment in the 9/11-Exposed Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E681. [PMID: 33466931 PMCID: PMC7830144 DOI: 10.3390/ijerph18020681] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/09/2021] [Accepted: 01/12/2021] [Indexed: 12/11/2022]
Abstract
The terrorist attacks on 11 September 2001 potentially exposed more than 400,000 responders, workers, and residents to psychological and physical stressors, and numerous hazardous pollutants. In 2011, the World Trade Center Health Program (WTCHP) was mandated to monitor and treat persons with 9/11-related adverse health conditions and conduct research on physical and mental health conditions related to the attacks. Emerging evidence suggests that persons exposed to 9/11 may be at increased risk of developing mild cognitive impairment. To investigate further, the WTCHP convened a scientific workshop that examined the natural history of cognitive aging and impairment, biomarkers in the pathway of neurodegenerative diseases, the neuropathological changes associated with hazardous exposures, and the evidence of cognitive decline and impairment in the 9/11-exposed population. Invited participants included scientists actively involved in health-effects research of 9/11-exposed persons and other at-risk populations. Attendees shared relevant research results from their respective programs and discussed several options for enhancements to research and surveillance activities, including the development of a multi-institutional collaborative research network. The goal of this report is to outline the meeting's agenda and provide an overview of the presentation materials and group discussion.
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Affiliation(s)
- Robert D. Daniels
- World Trade Center Health Program, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Washington, DC 20201, USA; (K.R.A.); (G.M.C.); (T.C.); (T.L.K.); (A.S.-C.); (D.B.R.)
| | - Sean A. P. Clouston
- Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA; (S.A.P.C.); (E.J.B.); (E.D.D.); (M.K.); (B.J.L.)
| | - Charles B. Hall
- Department of Epidemiology & Population Health (Biostatistics), Albert Einstein College of Medicine, Bronx, NY 10461, USA;
| | - Kristi R. Anderson
- World Trade Center Health Program, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Washington, DC 20201, USA; (K.R.A.); (G.M.C.); (T.C.); (T.L.K.); (A.S.-C.); (D.B.R.)
| | - David A. Bennett
- Department of Neurological Sciences, Rush Medical College, Rush University, Chicago, IL 60612, USA;
| | - Evelyn J. Bromet
- Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA; (S.A.P.C.); (E.J.B.); (E.D.D.); (M.K.); (B.J.L.)
| | - Geoffrey M. Calvert
- World Trade Center Health Program, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Washington, DC 20201, USA; (K.R.A.); (G.M.C.); (T.C.); (T.L.K.); (A.S.-C.); (D.B.R.)
| | - Tania Carreón
- World Trade Center Health Program, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Washington, DC 20201, USA; (K.R.A.); (G.M.C.); (T.C.); (T.L.K.); (A.S.-C.); (D.B.R.)
| | - Steven T. DeKosky
- McKnight Brain Institute, University of Florida, Gainesville, FL 32611, USA;
| | - Erica D. Diminich
- Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA; (S.A.P.C.); (E.J.B.); (E.D.D.); (M.K.); (B.J.L.)
| | - Caleb E. Finch
- USC Leonard Davis School of Gerontology, Los Angeles, CA 90089, USA;
| | - Sam Gandy
- Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (S.G.); (M.S.)
| | - William C. Kreisl
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, New York, NY 10032, USA;
| | - Minos Kritikos
- Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA; (S.A.P.C.); (E.J.B.); (E.D.D.); (M.K.); (B.J.L.)
| | - Travis L. Kubale
- World Trade Center Health Program, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Washington, DC 20201, USA; (K.R.A.); (G.M.C.); (T.C.); (T.L.K.); (A.S.-C.); (D.B.R.)
| | - Michelle M. Mielke
- Division of Epidemiology and Department of Neurology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA;
| | - Elaine R. Peskind
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98195, USA;
| | - Murray A. Raskind
- Northwest Mental Illness Research, Education and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, WA 98108, USA;
| | - Marcus Richards
- Faculty of Population Health Sciences, University College London, London WC1E 6BT, UK;
| | - Mary Sano
- Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (S.G.); (M.S.)
| | - Albeliz Santiago-Colón
- World Trade Center Health Program, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Washington, DC 20201, USA; (K.R.A.); (G.M.C.); (T.C.); (T.L.K.); (A.S.-C.); (D.B.R.)
| | - Richard P. Sloan
- Division of Behavioral Medicine, Columbia University, New York, NY 10027, USA;
| | - Avron Spiro
- Boston University Schools of Public Health and Medicine and Veterans Affairs Boston Healthcare System, Boston, MA 02130, USA;
| | - Neil Vasdev
- Azrieli Centre for Neuro-Radiochemistry, Brain Health Imaging Centre, Centre for Addiction and Mental Health (CAMH) & Department of Psychiatry, University of Toronto, Toronto, ON M5S, Canada;
| | - Benjamin J. Luft
- Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA; (S.A.P.C.); (E.J.B.); (E.D.D.); (M.K.); (B.J.L.)
| | - Dori B. Reissman
- World Trade Center Health Program, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Washington, DC 20201, USA; (K.R.A.); (G.M.C.); (T.C.); (T.L.K.); (A.S.-C.); (D.B.R.)
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20
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Tsoy E, Zygouris S, Possin KL. Current State of Self-Administered Brief Computerized Cognitive Assessments for Detection of Cognitive Disorders in Older Adults: A Systematic Review. JPAD-JOURNAL OF PREVENTION OF ALZHEIMERS DISEASE 2021; 8:267-276. [PMID: 34101783 PMCID: PMC7987552 DOI: 10.14283/jpad.2021.11] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Early diagnosis of cognitive disorders in older adults is a major healthcare priority with benefits to patients, families, and health systems. Rapid advances in digital technology offer potential for developing innovative diagnostic pathways to support early diagnosis. Brief self-administered computerized cognitive tools in particular hold promise for clinical implementation by minimizing demands on staff time. In this study, we conducted a systematic review of self-administered computerized cognitive assessment measures designed for the detection of cognitive impairment in older adults. Studies were identified via a systematic search of published peer-reviewed literature across major scientific databases. All studies reporting on psychometric validation of brief (≤30 minutes) self-administered computerized measures for detection of MCI and all-cause dementia in older adults were included. Seventeen studies reporting on 10 cognitive tools met inclusion criteria and were subjected to systematic review. There was substantial variability in characteristics of validation samples and reliability and validity estimates. Only 2 measures evaluated feasibility and usability in the intended clinical settings. Similar to past reviews, we found variability across measures with regard to psychometric rigor and potential for widescale applicability in clinical settings. Despite the promise that self-administered cognitive tests hold for clinical implementation, important gaps in scientific rigor in development, validation, and feasibility studies of these measures remain. Developments in technology and biomarker studies provide potential avenues for future directions on the use of digital technology in clinical care.
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Affiliation(s)
- E Tsoy
- Katherine L. Possin, PhD, Associate Professor in Residence, Department of Neurology, University of California San Francisco, Memory and Aging Center, Box 1207, 675 Nelson Rising Lane, Suite 190, San Francisco, CA 94158, Tel: 415-476-1889, E-mail:
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21
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Erhardt R, Cardoso BR, Meyer BJ, Brownell S, O'Connell S, Mirzaee S, Duckham RL, Macpherson H. Omega-3 Long-Chain Polyunsaturated Fatty Acids: Are They Beneficial for Physical and Cognitive Functioning in Older Adults? J Nutr Health Aging 2021; 25:454-461. [PMID: 33786562 DOI: 10.1007/s12603-020-1553-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND There is equivocal evidence about beneficial properties of omega-3 long-chain polyunsaturated fatty acids (ω-3 LCPUFA) for older adults. OBJECTIVE This study investigated the relationship between circulating ω-3 LCPUFA, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) levels and their corresponding dietary intakes with cognition and physical function in a cohort of community-dwelling older adults at risk of dementia. METHODS A cross-sectional analysis was conducted among 142 community-dwelling older adults (60-85 years) with subjective memory complaints. Erythrocyte fatty acids (ω-3 LCPUFA) and the omega-3 index were measured; dietary DHA and EPA were assessed with a LCPUFA specific questionnaire. Cognition was measured using the Cogstate computerised battery and Trail-making tests. Muscle strength was assessed by grip strength and physical function via the four-square step test, 30-second sit-to-stand, timed up-and-go test, and 4-m walk test. Multiple regression analysis was used to assess the relationship between erythrocyte ω-3 LCPUFA, dietary intake, cognitive and physical function. RESULTS Higher dietary DHA and EPA were associated with better global cognitive function (DHA: β=0.164, p=0.042; EPA: β=0.188, p=0.020). Higher dietary EPA was associated with better attention/psychomotor composite scores (β=0.196, p=0.024), mobility (four-square step test: β=-0.202, p=0.015) and gait speed (4m walk test: β=-0.200, p=0.017). No associations were found between erythrocyte ω-3 LCPUFA and cognitive or functional performance measures. CONCLUSIONS In community-dwelling older adults with subjective memory complaints, higher dietary ω-3 LCPUFA intake was associated with better cognitive and physical function, supporting the evidence that ω-3 fatty acids play a role in optimising physical and cognitive health during ageing.
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Affiliation(s)
- R Erhardt
- Barbara R Cardoso, Department of Nutrition and Dietetics, Monash University, 264 Ferntree Gully Road, Notting Hill, VIC 3168, Australia;
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22
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Puttaert D, Coquelet N, Wens V, Peigneux P, Fery P, Rovai A, Trotta N, Sadeghi N, Coolen T, Bier JC, Goldman S, De Tiège X. Alterations in resting-state network dynamics along the Alzheimer's disease continuum. Sci Rep 2020; 10:21990. [PMID: 33319785 PMCID: PMC7738511 DOI: 10.1038/s41598-020-76201-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 10/26/2020] [Indexed: 12/26/2022] Open
Abstract
Human brain activity is intrinsically organized into resting-state networks (RSNs) that transiently activate or deactivate at the sub-second timescale. Few neuroimaging studies have addressed how Alzheimer's disease (AD) affects these fast temporal brain dynamics, and how they relate to the cognitive, structural and metabolic abnormalities characterizing AD. We aimed at closing this gap by investigating both brain structure and function using magnetoencephalography (MEG) and hybrid positron emission tomography-magnetic resonance (PET/MR) in 10 healthy elders, 10 patients with subjective cognitive decline (SCD), 10 patients with amnestic mild cognitive impairment (aMCI) and 10 patients with typical Alzheimer's disease with dementia (AD). The fast activation/deactivation state dynamics of RSNs were assessed using hidden Markov modeling (HMM) of power envelope fluctuations at rest measured with MEG. Correlations were sought between temporal properties of HMM states and participants' cognitive test scores, whole hippocampal grey matter volume and regional brain glucose metabolism. The posterior default-mode network (DMN) was less often activated and for shorter durations in AD patients than matched healthy elders. No significant difference was found in patients with SCD or aMCI. The time spent by participants in the activated posterior DMN state did not correlate significantly with cognitive scores, nor with the whole hippocampal volume. However, it correlated positively with the regional glucose consumption in the right dorsolateral prefrontal cortex (DLPFC). AD patients present alterations of posterior DMN power activation dynamics at rest that identify an additional electrophysiological correlate of AD-related synaptic and neural dysfunction. The right DLPFC may play a causal role in the activation of the posterior DMN, possibly linked to the occurrence of mind wandering episodes. As such, these data might suggest a neural correlate of the decrease in mind wandering episodes reported in pathological aging.
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Affiliation(s)
- D Puttaert
- Laboratoire de Cartographie fonctionnelle du Cerveau (LCFC), UNI-ULB Neuroscience Institute, Université libre de Bruxelles (ULB), Brussels, Belgium. .,Neuropsychology and Functional Neuroimaging Research Unit (UR2NF), Center for Research in Cognition and Neurosciences (CRCN), UNI-ULB Neuroscience Institute, Université libre de Bruxelles (ULB), Brussels, Belgium.
| | - N Coquelet
- Laboratoire de Cartographie fonctionnelle du Cerveau (LCFC), UNI-ULB Neuroscience Institute, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - V Wens
- Laboratoire de Cartographie fonctionnelle du Cerveau (LCFC), UNI-ULB Neuroscience Institute, Université libre de Bruxelles (ULB), Brussels, Belgium.,Department of Functional Neuroimaging, Service of Nuclear Medicine, CUB Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - P Peigneux
- Neuropsychology and Functional Neuroimaging Research Unit (UR2NF), Center for Research in Cognition and Neurosciences (CRCN), UNI-ULB Neuroscience Institute, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - P Fery
- Neuropsychology and Functional Neuroimaging Research Unit (UR2NF), Center for Research in Cognition and Neurosciences (CRCN), UNI-ULB Neuroscience Institute, Université libre de Bruxelles (ULB), Brussels, Belgium.,Service of Neuropsychology and Speech Therapy, CUB Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - A Rovai
- Laboratoire de Cartographie fonctionnelle du Cerveau (LCFC), UNI-ULB Neuroscience Institute, Université libre de Bruxelles (ULB), Brussels, Belgium.,Department of Functional Neuroimaging, Service of Nuclear Medicine, CUB Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - N Trotta
- Laboratoire de Cartographie fonctionnelle du Cerveau (LCFC), UNI-ULB Neuroscience Institute, Université libre de Bruxelles (ULB), Brussels, Belgium.,Department of Functional Neuroimaging, Service of Nuclear Medicine, CUB Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - N Sadeghi
- Department of Radiology, CUB Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - T Coolen
- Department of Radiology, CUB Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - J-C Bier
- Department of Neurology, CUB Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - S Goldman
- Laboratoire de Cartographie fonctionnelle du Cerveau (LCFC), UNI-ULB Neuroscience Institute, Université libre de Bruxelles (ULB), Brussels, Belgium.,Department of Functional Neuroimaging, Service of Nuclear Medicine, CUB Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - X De Tiège
- Laboratoire de Cartographie fonctionnelle du Cerveau (LCFC), UNI-ULB Neuroscience Institute, Université libre de Bruxelles (ULB), Brussels, Belgium.,Department of Functional Neuroimaging, Service of Nuclear Medicine, CUB Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
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23
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Staffaroni AM, Tsoy E, Taylor J, Boxer AL, Possin KL. Digital Cognitive Assessments for Dementia: Digital assessments may enhance the efficiency of evaluations in neurology and other clinics. PRACTICAL NEUROLOGY (FORT WASHINGTON, PA.) 2020; 2020:24-45. [PMID: 33927583 PMCID: PMC8078574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Adam M Staffaroni
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Elena Tsoy
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Jack Taylor
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Adam L Boxer
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Katherine L Possin
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, Global Brain Health Institute, University of California, San Francisco, San Francisco, CA
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24
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Maternal working memory, emotion regulation, and responsivity to infant distress. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2020. [DOI: 10.1016/j.appdev.2020.101202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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25
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Rhodius‐Meester HF, Paajanen T, Koikkalainen J, Mahdiani S, Bruun M, Baroni M, Lemstra AW, Scheltens P, Herukka S, Pikkarainen M, Hall A, Hänninen T, Ngandu T, Kivipelto M, van Gils M, Hasselbalch SG, Mecocci P, Remes A, Soininen H, van der Flier WM, Lötjönen J. cCOG: A web-based cognitive test tool for detecting neurodegenerative disorders. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2020; 12:e12083. [PMID: 32864411 PMCID: PMC7446945 DOI: 10.1002/dad2.12083] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/13/2020] [Accepted: 07/13/2020] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Web-based cognitive tests have potential for standardized screening in neurodegenerative disorders. We examined accuracy and consistency of cCOG, a computerized cognitive tool, in detecting mild cognitive impairment (MCI) and dementia. METHODS Clinical data of 306 cognitively normal, 120 mild cognitive impairment (MCI), and 69 dementia subjects from three European cohorts were analyzed. Global cognitive score was defined from standard neuropsychological tests and compared to the corresponding estimated score from the cCOG tool containing seven subtasks. The consistency of cCOG was assessed comparing measurements administered in clinical settings and in the home environment. RESULTS cCOG produced accuracies (receiver operating characteristic-area under the curve [ROC-AUC]) between 0.71 and 0.84 in detecting MCI and 0.86 and 0.94 in detecting dementia when administered at the clinic and at home. The accuracy was comparable to the results of standard neuropsychological tests (AUC 0.69-0.77 MCI/0.91-0.92 dementia). DISCUSSION cCOG provides a promising tool for detecting MCI and dementia with potential for a cost-effective approach including home-based cognitive assessments.
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Affiliation(s)
- Hanneke F.M. Rhodius‐Meester
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam NeuroscienceVrije Universiteit AmsterdamAmsterdam UMCAmsterdamthe Netherlands
- Department of Internal MedicineGeriatric Medicine SectionVrije Universiteit AmsterdamAmsterdam UMCAmsterdamthe Netherlands
| | - Teemu Paajanen
- Research and Service CentreFinnish Institute of Occupational HealthHelsinkiFinland
| | | | - Shadi Mahdiani
- VTT Technical Research Centre of Finland LtdTampereFinland
| | - Marie Bruun
- Department of NeurologyDanish Dementia Research CentreRigshospitaletCopenhagen University HospitalCopenhagenDenmark
| | - Marta Baroni
- Section of Gerontology and GeriatricsUniversity of PerugiaPerugiaItaly
| | - Afina W. Lemstra
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam NeuroscienceVrije Universiteit AmsterdamAmsterdam UMCAmsterdamthe Netherlands
| | - Philip Scheltens
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam NeuroscienceVrije Universiteit AmsterdamAmsterdam UMCAmsterdamthe Netherlands
| | - Sanna‐Kaisa Herukka
- Department of NeurologyUniversity of Eastern FinlandKuopioFinland
- Department of NeurologyNeurocenterKuopio University HospitalKuopioFinland
| | | | - Anette Hall
- Department of NeurologyUniversity of Eastern FinlandKuopioFinland
| | - Tuomo Hänninen
- Department of NeurologyNeurocenterKuopio University HospitalKuopioFinland
| | - Tiia Ngandu
- Finnish Institute for Health and WelfareHelsinkiFinland
- Department of Clinical GeriatricsKarolinska InstitutetNVSCenter for Alzheimer ResearchStockholmSweden
| | - Miia Kivipelto
- Department of NeurologyUniversity of Eastern FinlandKuopioFinland
- Finnish Institute for Health and WelfareHelsinkiFinland
- Department of Clinical GeriatricsKarolinska InstitutetNVSCenter for Alzheimer ResearchStockholmSweden
| | - Mark van Gils
- VTT Technical Research Centre of Finland LtdTampereFinland
| | - Steen Gregers Hasselbalch
- Department of NeurologyDanish Dementia Research CentreRigshospitaletCopenhagen University HospitalCopenhagenDenmark
| | - Patrizia Mecocci
- Section of Gerontology and GeriatricsUniversity of PerugiaPerugiaItaly
| | - Anne Remes
- Unit of Clinical NeuroscienceNeurology and Medical Research CenterUniversity of OuluOuluFinland
| | - Hilkka Soininen
- Department of NeurologyUniversity of Eastern FinlandKuopioFinland
- Department of NeurologyNeurocenterKuopio University HospitalKuopioFinland
| | - Wiesje M. van der Flier
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam NeuroscienceVrije Universiteit AmsterdamAmsterdam UMCAmsterdamthe Netherlands
- Department of Epidemiology and BiostatisticsVU University Medical CentreAmsterdamthe Netherlands
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26
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Clouston SAP, Deri Y, Horton M, Tang C, Diminich E, DeLorenzo C, Kritikos M, Pellecchia AC, Santiago‐Michels S, Carr MA, Gandy S, Sano M, Bromet EJ, Lucchini RG, Luft BJ. Reduced cortical thickness in World Trade Center responders with cognitive impairment. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2020; 12:e12059. [PMID: 32695871 PMCID: PMC7364857 DOI: 10.1002/dad2.12059] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 06/02/2020] [Accepted: 06/04/2020] [Indexed: 12/31/2022]
Abstract
INTRODUCTION This study examined cortical thickness (CTX) in World Trade Center (WTC) responders with cognitive impairment (CI). METHODS WTC responders (N = 99) with/without CI, recruited from an epidemiologic study, completed a T1-MPRAGE protocol. CTX was automatically computed in 34 regions of interest. Region-based and surface-based morphometry examined CTX in CI versus unimpaired responders. CTX was automatically computed in 34 regions of interest. Region-based measures were also compared to published norms. RESULTS Participants were 55.8 (SD = 0.52) years old; 48 had CI. Compared to unimpaired responders, global mean CTX was reduced in CI and across 21/34 cortical subregions. Surface-based analyses revealed reduced CTX across frontal, temporal, and parietal lobes when adjusting for multiple comparisons. Both CI and unimpaired WTC groups had reduced CTX in the entorhinal and temporal cortices compared to published normative data. DISCUSSION Results from the first structural magnetic resonance imaging study in WTC responders identified reduced CTX consistent with a neurodegenerative disease of unknown etiology.
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Affiliation(s)
- Sean A. P. Clouston
- Program in Public Health Department of Family, Population, and Preventive MedicineRenaissance School of Medicine at Stony Brook UniversityStony BrookNew YorkUSA
| | - Yael Deri
- Department of MedicineRenaissance School of Medicine at Stony Brook UniversityStony BrookNew YorkUSA
| | - Megan Horton
- Department of Environmental Medicine and Public HealthIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Cheuk Tang
- Department of RadiologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Department of NeurologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Erica Diminich
- Program in Public Health Department of Family, Population, and Preventive MedicineRenaissance School of Medicine at Stony Brook UniversityStony BrookNew YorkUSA
| | - Christine DeLorenzo
- Department of PsychiatryRenaissance School of Medicine at Stony Brook UniversityStony BrookNew YorkUSA
| | - Minos Kritikos
- Program in Public Health Department of Family, Population, and Preventive MedicineRenaissance School of Medicine at Stony Brook UniversityStony BrookNew YorkUSA
| | - Alison C. Pellecchia
- Stony Brook World Trade Center Wellness ProgramRenaissance School of Medicine at Stony Brook UniversityStony BrookNew YorkUSA
| | - Stephanie Santiago‐Michels
- Stony Brook World Trade Center Wellness ProgramRenaissance School of Medicine at Stony Brook UniversityStony BrookNew YorkUSA
| | - Melissa A. Carr
- Stony Brook World Trade Center Wellness ProgramRenaissance School of Medicine at Stony Brook UniversityStony BrookNew YorkUSA
| | - Samuel Gandy
- Department of NeurologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Department of Psychiatry and Mount Sinai Alzheimer's Disease Research CenterIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Mary Sano
- Department of Psychiatry and Mount Sinai Alzheimer's Disease Research CenterIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Evelyn J. Bromet
- Department of PsychiatryRenaissance School of Medicine at Stony Brook UniversityStony BrookNew YorkUSA
| | - Roberto G. Lucchini
- Department of Environmental Medicine and Public HealthIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Benjamin J. Luft
- Department of MedicineRenaissance School of Medicine at Stony Brook UniversityStony BrookNew YorkUSA
- Stony Brook World Trade Center Wellness ProgramRenaissance School of Medicine at Stony Brook UniversityStony BrookNew YorkUSA
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27
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Effective differentiation of mild cognitive impairment by functional brain graph analysis and computerized testing. PLoS One 2020; 15:e0230099. [PMID: 32176709 PMCID: PMC7075594 DOI: 10.1371/journal.pone.0230099] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 02/21/2020] [Indexed: 11/25/2022] Open
Abstract
Community-dwelling African American elders are twice as likely to develop mild cognitive impairment (MCI) or Alzheimer’s disease and related dementias than older white Americans and therefore represent a significant at-risk group in need of early monitoring. More extensive imaging or cerebrospinal fluid studies represent significant barriers due to cost and burden. We combined functional connectivity and graph theoretical measures, derived from resting-state electroencephalography (EEG) recordings, with computerized cognitive testing to identify differences between persons with MCI and healthy controls based on a sample of community-dwelling African American elders. We found a significant decrease in functional connectivity and a less integrated graph topology in persons with MCI. A combination of functional connectivity, topological and cognition measurements is powerful for prediction of MCI and combined measures are clearly more effective for prediction than using a single approach. Specifically, by combining cognition features with functional connectivity and topological features the prediction improved compared with the classification using features from single cognitive or EEG domains, with an accuracy of 86.5%, compared with the accuracy of 77.5% of the best single approach. Community-dwelling African American elders find EEG and computerized testing acceptable and results are promising in terms of differentiating between healthy controls and persons with MCI living in the community.
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28
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McMahon WR, Ftouni S, Drummond SPA, Maruff P, Lockley SW, Rajaratnam SMW, Anderson C. The wake maintenance zone shows task dependent changes in cognitive function following one night without sleep. Sleep 2019; 41:5086290. [PMID: 30169703 DOI: 10.1093/sleep/zsy148] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Indexed: 11/12/2022] Open
Abstract
Study Objectives The interaction between homeostatic sleep pressure and circadian timing modulates the impact of sleep deprivation on cognition. We aimed to investigate how this interaction affects different cognitive functions. Methods Twenty-three healthy volunteers (18 males; mean age = 25.4 ± 5.7 years) underwent 40 hours of sleep deprivation under constant routine conditions. Performance on the Psychomotor Vigilance Test and a cognitive battery assessing vigilant attention, complex attention, recognition memory, and working memory was assessed in the morning (27 hours awake) and evening (37 hours awake) during sleep deprivation and compared to well-rested performance 24 hours earlier. Circadian phase assessments confirmed evening tests occurred in the wake maintenance zone (WMZ). Results Increased time awake significantly impacted performance on all measures except recognition memory. Post hoc analyses found performance on all measures was significantly impaired in the morning following 27 hours of sleep deprivation compared to well-rested performance 24 hours earlier. In contrast, complex attention and working memory were preserved in the WMZ after 37 hours awake compared to 24 hours earlier, while vigilant attention and PVT performance were significantly impaired. During sleep deprivation, composite scores of speed and accuracy were both impaired in the morning, while only speed was impaired during the WMZ. Conclusions We observed task- and time-dependent effects of sleep deprivation, such that vigilant attention was significantly impaired after both 27 hours and 37 hours awake (compared to when well-rested at the same circadian clock time). In contrast, complex attention and working memory were impaired at 27 hours awake, but preserved in the WMZ despite increased homeostatic sleep pressure (37 hours awake).
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Affiliation(s)
- William R McMahon
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia.,Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia
| | - Suzanne Ftouni
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia.,Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia
| | - Sean P A Drummond
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia
| | - Paul Maruff
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia.,Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia.,Cogstate Ltd., Melbourne, Victoria, Australia.,The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Steven W Lockley
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia.,Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia.,Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Shantha M W Rajaratnam
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia.,Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia
| | - Clare Anderson
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia.,Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia
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29
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Macpherson H, Brownell S, Duckham RL, Meyer B, Mirzaee S, Daly RM. Multifaceted intervention to enhance cognition in older people at risk of cognitive decline: study protocol for the Protein Omega-3 and Vitamin D Exercise Research (PONDER) study. BMJ Open 2019; 9:e024145. [PMID: 31072850 PMCID: PMC6527972 DOI: 10.1136/bmjopen-2018-024145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 12/19/2018] [Accepted: 03/12/2019] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION An increasing number of people are living with cognitive impairment and dementia. Current pharmacological therapies at best reduce Alzheimer's disease symptomatology but do not delay dementia onset in those at high risk. Structured exercise interventions can enhance cognition in older people; however, to produce long lasting, clinically relevant cognitive benefits, it is proposed that a multifaceted approach incorporating exercise with dietary supplements will address a wider range of mechanisms involved in cognitive decline. The Protein Omega-3 aNd vitamin D Exercise Research (PONDER) study aims to investigate the cognitive effects of a multimodal exercise programme combined with nutritional supplementation in older adults with subjective memory impairment (SMI). METHODS AND ANALYSIS The PONDER study is a single-centre, 12-month, community-based, parallel group, randomised, double-blind, placebo controlled trial involving a 6-month multifaceted intervention with a further 6-month follow-up. Participants will be 148 people from Melbourne, Australia, aged 60-85 years with SMI who will be randomised (1:1 ratio) to either a 6-month supervised multimodal exercise programme combined with omega-3 fatty acid, vitamin D and protein supplementation or a stretching/flexibility exercise programme combined with placebo supplements. The primary outcome is the change in cognition after 6 months as assessed by the Trail Making Test and global cognitive function assessed from the Cogstate Computerised battery. Secondary outcomes will include memory, working memory/learning and attention/psychomotor function, the Montreal Cognitive Assessment, mood, quality of life, muscle strength, physical function, body composition, cardiovascular health and sleep quality. Cognition at 12 months will represent a secondary outcome. ETHICS AND DISSEMINATION This study has been approved by the Deakin University Human Research Ethics Committee (project 2016-260). Informed consent will be obtained from all participants. The authors intend to submit the findings of the study to peer-reviewed journals or academic conferences to be published. TRIAL REGISTRATION NUMBER ACTRN12616001549415; Pre-results.
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Affiliation(s)
- Helen Macpherson
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Sarah Brownell
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Rachel L Duckham
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Victoria, UK
| | - Barbara Meyer
- Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Sam Mirzaee
- Monash Cardiovascular Research Centre, Monash HEART, Monash University, Melbourne, Australia
| | - Robin M Daly
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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30
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Paek EJ, Murray LL, Newman SD, Kim DJ. Test-retest reliability in an fMRI study of naming in dementia. BRAIN AND LANGUAGE 2019; 191:31-45. [PMID: 30807893 DOI: 10.1016/j.bandl.2019.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 12/18/2018] [Accepted: 02/12/2019] [Indexed: 06/09/2023]
Abstract
fMRI has been used as an outcome measure in dementia treatment studies, with many previous studies comparing only single pre- and post-treatment fMRI scans to determine treatment-induced neural changes, while utilizing single subject experimental designs. The purpose of the current study was to evaluate fMRI test-retest reliability in dementia patients and typical older adults using noun and verb confrontation naming to evaluate the validity of using a single pre/post-treatment scan comparison. Seven individuals with dementia and 9 control participants were tested three times over two months using the same fMRI procedures. Differences in individual and group level activation patterns were observed that varied across time. Additionally, the extent of variability fluctuated across individuals, groups, and the grammatical category of target words. Our findings suggested that one time fMRI scanning may inadequately represent an individual's typical brain activation pattern, particularly an individual with dementia. Thus, multiple imaging baselines are recommended.
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Affiliation(s)
- Eun Jin Paek
- Department of Audiology and Speech Pathology, University of Tennessee Health Science Center, Knoxville, TN 37996, United States.
| | - Laura L Murray
- School of Communication Sciences and Disorders, Western University, London, Ontario N6G 1H1, Canada.
| | - Sharlene D Newman
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN 47401, United States.
| | - Dae-Jin Kim
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN 47401, United States.
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31
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Bartlett E, Shaw M, Schwarz C, Feinberg C, DeLorenzo C, Krupp LB, Charvet LE. Brief Computer-Based Information Processing Measures are Linked to White Matter Integrity in Pediatric-Onset Multiple Sclerosis. J Neuroimaging 2018; 29:140-150. [DOI: 10.1111/jon.12566] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 09/18/2018] [Accepted: 09/19/2018] [Indexed: 12/13/2022] Open
Affiliation(s)
- Elizabeth Bartlett
- Department of Biomedical Engineering; Stony Brook University; Stony Brook NY
| | - Michael Shaw
- Department of Neurology, New York University Langone Medical Center; NYU Langone Health; New York NY
| | - Colleen Schwarz
- Department of Nursing; Stony Brook University; Stony Brook NY
| | - Charles Feinberg
- Department of Neurology, New York University Langone Medical Center; NYU Langone Health; New York NY
| | - Christine DeLorenzo
- Department of Biomedical Engineering; Stony Brook University; Stony Brook NY
- Department of Psychiatry; Stony Brook University; Stony Brook NY
| | - Lauren B. Krupp
- Department of Neurology, New York University Langone Medical Center; NYU Langone Health; New York NY
| | - Leigh E. Charvet
- Department of Neurology, New York University Langone Medical Center; NYU Langone Health; New York NY
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32
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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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33
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Daglas R, Allott K, Yücel M, Henry LP, Macneil CA, Hasty MK, Berk M, Cotton SM. Cognitive functioning following stabilisation from first episode mania. Int J Bipolar Disord 2017; 5:39. [PMID: 29250705 PMCID: PMC6155457 DOI: 10.1186/s40345-017-0108-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 10/03/2017] [Indexed: 11/22/2022] Open
Abstract
Background The purpose of this study was to examine cognitive functioning in people following first-episode mania relative to a demographically similar healthy control group. Methods Forty-one patients, who had recently stabilised from a first manic episode, and twenty-one healthy controls, were compared in an extensive cognitive assessment. Results First-episode mania participants had significantly lower Full-Scale IQ (FSIQ) relative to healthy controls; however, this finding could be driven by premorbid differences in intellectual functioning. There were no significant differences between groups in Verbal IQ (VIQ) and Performance IQ (PIQ). First-episode mania participants performed significantly poorer than healthy controls in processing speed, verbal learning and memory, working memory, and cognitive flexibility with medium-to-large effects. There were no group differences in other measures of cognition. Conclusions Participants following first-episode mania have poorer global intelligence than healthy controls, and have cognitive difficulties in some, but not all areas of cognitive functioning. This highlights the importance of early intervention and cognitive assessment in the early course of the disorder.
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Affiliation(s)
- Rothanthi Daglas
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC, 3052, Australia.,Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia
| | - Kelly Allott
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC, 3052, Australia.,Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia
| | - Murat Yücel
- Brain and Mental Health Laboratory, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| | - Lisa P Henry
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC, 3052, Australia
| | - Craig A Macneil
- Orygen Youth Health-Clinical Program, 35 Poplar Road, Parkville, 3052, Australia
| | - Melissa K Hasty
- Orygen Youth Health-Clinical Program, 35 Poplar Road, Parkville, 3052, Australia
| | - Michael Berk
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC, 3052, Australia.,Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia.,IMPACT Strategic Research Centre, School of Medicine, Deakin University, PO Box 281, Geelong, 3220, Australia.,Barwon Health and the Geelong Clinic, Swanston Centre, PO Box 281, Geelong, VIC, 3220, Australia.,Florey Institute for Neuroscience and Mental Health, Kenneth Myer Building, Royal Parade, Parkville, Australia
| | - Sue M Cotton
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC, 3052, Australia. .,Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia.
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34
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Kulason K, Nouchi R, Hoshikawa Y, Noda M, Okada Y, Kawashima R. Indication of Cognitive Change and Associated Risk Factor after Thoracic Surgery in the Elderly: A Pilot Study. Front Aging Neurosci 2017; 9:396. [PMID: 29259553 PMCID: PMC5723308 DOI: 10.3389/fnagi.2017.00396] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 11/16/2017] [Indexed: 12/02/2022] Open
Abstract
Background: This pilot study investigated the effects of partial pulmonary lobectomy lung surgery on cognitive functions of elderly Japanese patients. It is recognized that elderly patients undergoing surgery have increased risk of Postoperative Cognitive Decline (POCD), a condition in which learning, memory, and processing speed is greatly reduced after surgery. Since elderly patients are more likely to exhibit symptoms of POCD, the incidence is increasing as the population receiving surgery is aging. Methods: Cognitive function was measured for all subjects (n = 12) before and after surgery using three different cognitive tests: Mini-Mental Status Exam-Japanese (MMSE-J), Frontal Assessment Battery (FAB), and a computerized Cogstate Brief Battery (CBB). Changes in these measures indicate changes in cognitive function. In addition, the 12-item General Health Questionnaire (GHQ-12), the Geriatric Depression Scale (GDS), and the 5-item Quality of Life questionnaire (QOL-5) were administered at each time point to measure mental and emotional state. Changes in outcome measures were analyzed via Wilcoxon signed-rank test. Exploratory correlation analysis was conducted using Spearman’s rho. Results: Data show a decline in detection (DET; p = 0.045) and identification (IDN; p = 0.038). Spearman’s correlation coefficient show a significant correlation between postoperative DET scores and postoperative IDN scores (ρ = 0.78, p = 0.005), a significant correlation between change in IDN and baseline GHQ-12 scores (ρ = -0.595, p = 0.027), and a significant correlation between change in one-back (OBK) scores and duration of anesthesia (ρ = -0.72, p = 0.012). Discussion: This was the first report to examine cognitive decline after major thoracic surgery in Japanese patients. Previous studies have evidenced that POCD is a common phenomenon after surgery, and that age is a major risk factor. The CCB measured significant change in two cognitive domains: attention and psycomotor function. This study clarified that decline in cognition is detectable in certain measures after thoracic surgery in the elderly Japanese patient population. Additionally, longer anesthetic exposure may negatively impact attention and working memory, and preoperative mental wellbeing is a possible predictor of POCD. These preliminary results have important implications and support the need for future studies.
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Affiliation(s)
- Kay Kulason
- Department of Advanced Brain Science, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Rui Nouchi
- Department of Advanced Brain Science, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.,Creative Interdisciplinary Research Division, Frontier Research Institute for Interdisciplinary Science, Tohoku University, Sendai, Japan.,Human and Social Response Research Division, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Yasushi Hoshikawa
- Department of Thoracic Surgery, School of Medicine, Fujita Health University, Toyoake, Japan.,Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Masafumi Noda
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Yoshinori Okada
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Ryuta Kawashima
- Department of Advanced Brain Science, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.,Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
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Salimi S, Irish M, Foxe D, Hodges JR, Piguet O, Burrell JR. Can visuospatial measures improve the diagnosis of Alzheimer's disease? ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2017; 10:66-74. [PMID: 29780858 PMCID: PMC5956809 DOI: 10.1016/j.dadm.2017.10.004] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Introduction Overlapping and evolving symptoms lead to ambiguity in the diagnosis of dementia. Visuospatial function relies on parietal lobe function, which may be affected in the early stages of Alzheimer's disease (AD). This review evaluates visuospatial dysfunction in patients with AD, frontotemporal dementia, dementia with Lewy bodies, and vascular dementia to determine the diagnostic and prognostic potential of visuospatial tasks in AD. Methods A systematic search of studies (1960–2016) investigating visuospatial dysfunction in dementia was conducted. Results Tests measuring construction, specifically Block Design and Clock Drawing Test, and visual memory, specifically Rey-Osterrieth Complex Figure recall and topographical tasks, show the greatest diagnostic potential in dementia. The Benton visual retention, Doors and People, and topographical memory tests show potential as prognostic markers. Discussion Tests of visuospatial function demonstrate significant diagnostic and prognostic potential in dementia. Further studies with larger samples of pathologically confirmed cases are required to verify clinical utility. Memory deficits have been demonstrated in Alzheimer's and non-Alzheimer's dementias. Parietal lobes are uniquely affected in the early stages of Alzheimer's disease. Visuospatial tasks demonstrate significant diagnostic and prognostic potential. Computerized test protocols have been developed to test aspects of visuospatial function and memory. Novel topographical memory tasks demonstrated the greatest prognostic potential.
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Affiliation(s)
- Shirin Salimi
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Muireann Irish
- School of Psychology and Brain & Mind Centre, The University of Sydney, Sydney, New South Wales, Australia.,Australian Research Council Centre of Excellence in Cognition and its Disorders, Sydney, New South Wales, Australia
| | - David Foxe
- School of Psychology and Brain & Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - John R Hodges
- Central Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Australian Research Council Centre of Excellence in Cognition and its Disorders, Sydney, New South Wales, Australia
| | - Olivier Piguet
- School of Psychology and Brain & Mind Centre, The University of Sydney, Sydney, New South Wales, Australia.,Australian Research Council Centre of Excellence in Cognition and its Disorders, Sydney, New South Wales, Australia
| | - James R Burrell
- Central Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Australian Research Council Centre of Excellence in Cognition and its Disorders, Sydney, New South Wales, Australia.,Neurosciences, Concord Hospital, Sydney, New South Wales, Australia
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Clouston S, Pietrzak RH, Kotov R, Richards M, Spiro A, Scott S, Deri Y, Mukherjee S, Stewart C, Bromet E, Luft BJ. Traumatic exposures, posttraumatic stress disorder, and cognitive functioning in World Trade Center responders. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2017; 3:593-602. [PMID: 29201993 PMCID: PMC5700827 DOI: 10.1016/j.trci.2017.09.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION This study examined whether World Trade Center (WTC)-related exposures and posttraumatic stress disorder (PTSD) were associated with cognitive function and whether WTC responders' cognition differed from normative data. METHODS A computer-assisted neuropsychological battery was administered to a prospective cohort study of 1193 WTC responders with no history of stroke or WTC-related head injuries. Data were linked to information collected prospectively since 2002. Sample averages were compared to published norms. RESULTS Approximately 14.8% of sampled responders had cognitive dysfunction. WTC responders had worse cognitive function compared to normative data. PTSD symptom severity and working >5 weeks on-site was associated with lower cognition. DISCUSSION Results from this sample highlight the potential for WTC responders to be experiencing an increased burden of cognitive dysfunction and linked lowered cognitive functioning to physical exposures and to PTSD. Future research is warranted to understand the extent to which cognitive dysfunction is evident in neural dysfunction.
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Affiliation(s)
| | | | - Roman Kotov
- Stony Brook University, Stony Brook, NY, USA
| | | | | | | | - Yael Deri
- Stony Brook University, Stony Brook, NY, USA
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Song W, Woon FL, Doong A, Persad C, Tijerina L, Pandit P, Cline C, Giordani B. Fatigue in Younger and Older Drivers: Effectiveness of an Alertness-Maintaining Task. HUMAN FACTORS 2017; 59:995-1008. [PMID: 28510495 DOI: 10.1177/0018720817706811] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The aim of this study was to examine the effects of an alertness-maintaining task (AMT) in older, fatigued drivers. BACKGROUND Fatigue during driving increases crash risk, and previous research suggests that alertness and driving in younger adults may be improved using a secondary AMT during boring, fatigue-eliciting drives. However, the potential impact of an AMT on driving has not been investigated in older drivers whose ability to complete dual tasks has been shown to decline and therefore may be negatively affected with an AMT in driving. METHOD Younger ( n = 29) and older drivers ( n = 39) participated in a 50-minute simulated drive designed to induce fatigue, followed by four 10-minute sessions alternating between driving with and without an AMT. RESULTS Younger drivers were significantly more affected by fatigue on driving performance than were older drivers but benefitted significantly from the AMT. Older drivers did not demonstrate increased driver errors with fatigue, and driving did not deteriorate significantly during participation in the AMT condition, although their speed was significantly more variable with the AMT. CONCLUSION Consistent with earlier research, an AMT applied during fatiguing driving is effective in improving alertness and reducing driving errors in younger drivers. Importantly, older drivers were relatively unaffected by fatigue, and use of an AMT did not detrimentally affect their driving performance. APPLICATION These results support the potential use of an AMT as a new automotive technology to improve fatigue and promote driver safety, though the benefits of such technology may differ between different age groups.
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38
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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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Agreement among neuropsychological and behavioral data and PiB findings in diagnosing Frontotemporal Dementia. J Clin Neurosci 2017; 44:128-132. [PMID: 28601570 DOI: 10.1016/j.jocn.2017.05.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 05/22/2017] [Indexed: 11/23/2022]
Abstract
Diagnostic inaccuracies have been reported in Alzheimer's disease (AD) and Frontotemporal Dementia (FTD) using clinical data alone. The [11C]-PiB PET scan offers a new method of identifying AD based on the detection of amyloid deposits. Our study investigated whether there was an agreement between neuropsychological and behavioral data and PiB findings in the diagnosis of FTD. Participants were 32 patients diagnosed with suspected FTD by clinical consensus. All participants underwent neuropsychological testing and PiB imaging. In addition, caregivers completed behavioral ratings of participants' memory, frontal behaviors, and mood. Seventeen participants were classified as PiB positive (+). Results of MANOVA and subsequent ANOVA analyses showed a significant difference on memory performance between the PiB- and PiB+groups, with the PiB- group performing better than the PiB+group. There were no significant differences between the groups on cognitive or behavioral measures of executive/frontal impairment, mood. Both groups showed similar severity of dementia. These findings provide evidence for the utility of the [11C]-PiB PET scan in distinguishing between AD and FTD, with evaluation of memory at clinical diagnosis serving as a valuable indicator of the absence of FTD and consideration for an AD diagnosis. Our results would support the concern that patients who may present with primary behavioral or executive dysfunction may not necessarily have FTD, particularly if memory deficits are evident.
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Webster L, Groskreutz D, Grinbergs-Saull A, Howard R, O'Brien JT, Mountain G, Banerjee S, Woods B, Perneczky R, Lafortune L, Roberts C, McCleery J, Pickett J, Bunn F, Challis D, Charlesworth G, Featherstone K, Fox C, Goodman C, Jones R, Lamb S, Moniz-Cook E, Schneider J, Shepperd S, Surr C, Thompson-Coon J, Ballard C, Brayne C, Burke O, Burns A, Clare L, Garrard P, Kehoe P, Passmore P, Holmes C, Maidment I, Murtagh F, Robinson L, Livingston G. Development of a core outcome set for disease modification trials in mild to moderate dementia: a systematic review, patient and public consultation and consensus recommendations. Health Technol Assess 2017; 21:1-192. [PMID: 28625273 PMCID: PMC5494514 DOI: 10.3310/hta21260] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND There is currently no disease-modifying treatment available to halt or delay the progression of the disease pathology in dementia. An agreed core set of the best-available and most appropriate outcomes for disease modification would facilitate the design of trials and ensure consistency across disease modification trials, as well as making results comparable and meta-analysable in future trials. OBJECTIVES To agree a set of core outcomes for disease modification trials for mild to moderate dementia with the UK dementia research community and patient and public involvement (PPI). DATA SOURCES We included disease modification trials with quantitative outcomes of efficacy from (1) references from related systematic reviews in workstream 1; (2) searches of the Cochrane Dementia and Cognitive Improvement Group study register, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Latin American and Caribbean Health Sciences Literature and PsycINFO on 11 December 2015, and clinical trial registries [International Standard Randomised Controlled Trial Number (ISRCTN) and clinicaltrials.gov] on 22 and 29 January 2016; and (3) hand-searches of reference lists of relevant systematic reviews from database searches. REVIEW METHODS The project consisted of four workstreams. (1) We obtained related core outcome sets and work from co-applicants. (2) We systematically reviewed published and ongoing disease modification trials to identify the outcomes used in different domains. We extracted outcomes used in each trial, recording how many used each outcome and with how many participants. We divided outcomes into the domains measured and searched for validation data. (3) We consulted with PPI participants about recommended outcomes. (4) We presented all the synthesised information at a conference attended by the wider body of National Institute for Health Research (NIHR) dementia researchers to reach consensus on a core set of outcomes. RESULTS We included 149 papers from the 22,918 papers screened, referring to 125 individual trials. Eighty-one outcomes were used across trials, including 72 scales [31 cognitive, 12 activities of daily living (ADLs), 10 global, 16 neuropsychiatric and three quality of life] and nine biological techniques. We consulted with 18 people for PPI. The conference decided that only cognition and biological markers are core measures of disease modification. Cognition should be measured by the Mini Mental State Examination (MMSE) or the Alzheimer's Disease Assessment Scale - Cognitive subscale (ADAS-Cog), and brain changes through structural magnetic resonance imaging (MRI) in a subset of participants. All other domains are important but not core. We recommend using the Neuropsychiatric Inventory for neuropsychiatric symptoms: the Disability Assessment for Dementia for ADLs, the Dementia Quality of Life Measure for quality of life and the Clinical Dementia Rating scale to measure dementia globally. LIMITATIONS Most of the trials included participants with Alzheimer's disease, so recommendations may not apply to other types of dementia. We did not conduct economic analyses. The PPI consultation was limited to members of the Alzheimer's Society Research Network. CONCLUSIONS Cognitive outcomes and biological markers form the core outcome set for future disease modification trials, measured by the MMSE or ADAS-Cog, and structural MRI in a subset of participants. FUTURE WORK We envisage that the core set may be superseded in the future, particularly for other types of dementia. There is a need to develop an algorithm to compare scores on the MMSE and ADAS-Cog. STUDY REGISTRATION The project was registered with Core Outcome Measures in Effectiveness Trials [ www.comet-initiative.org/studies/details/819?result=true (accessed 7 April 2016)]. The systematic review protocol is registered as PROSPERO CRD42015027346. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Lucy Webster
- Division of Psychiatry, University College London, London, UK
| | - Derek Groskreutz
- Division of Psychology and Language Sciences, University College London, London, UK
| | | | - Rob Howard
- Division of Psychiatry, University College London, London, UK
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Gail Mountain
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Sube Banerjee
- Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Bob Woods
- Dementia Services Development Centre Wales, Bangor University, Bangor, UK
| | - Robert Perneczky
- Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - Louise Lafortune
- Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Charlotte Roberts
- International Consortium for Health Outcomes Measurement, London, UK
| | | | | | - Frances Bunn
- Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK
| | - David Challis
- Personal Social Services Research Unit, University of Manchester, Manchester, UK
| | - Georgina Charlesworth
- Research Department of Clinical, Educational, and Health Psychology, University College London, London, UK
| | | | - Chris Fox
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Claire Goodman
- Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK
| | - Roy Jones
- Research Institute for the Care of Older People, University of Bath, Bath, UK
| | - Sallie Lamb
- Oxford Clinical Trials Research Unit, University of Oxford, Oxford, UK
| | - Esme Moniz-Cook
- Faculty of Health and Social Care, University of Hull, Hull, UK
| | - Justine Schneider
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Sasha Shepperd
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Claire Surr
- School of Health & Community Studies, Leeds Beckett University, Leeds, UK
| | - Jo Thompson-Coon
- Collaboration for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter, Exeter, UK
| | - Clive Ballard
- Wolfson Centre for Age-Related Diseases, King's College London, London, UK
| | - Carol Brayne
- Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Orlaith Burke
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Alistair Burns
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - Linda Clare
- Collaboration for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter, Exeter, UK
- School of Psychology, University of Exeter, Exeter, UK
- Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
| | - Peter Garrard
- Neuroscience Research Centre, St George's, University of London, UK
| | - Patrick Kehoe
- School of Clinical Sciences, University of Bristol, Bristol, UK
| | - Peter Passmore
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Clive Holmes
- School of Medicine, University of Southampton, Southampton, UK
| | - Ian Maidment
- Aston Research Centre for Healthy Ageing, Aston University, Birmingham, UK
| | - Fliss Murtagh
- Cicely Saunders Institute, King's College London, London, UK
| | - Louise Robinson
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Gill Livingston
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
- North Thames Collaboration for Leadership in Applied Health Research and Care, London, UK
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Marusic U, Giordani B, Moffat SD, Petrič M, Dolenc P, Pišot R, Kavcic V. Computerized cognitive training during physical inactivity improves executive functioning in older adults. AGING NEUROPSYCHOLOGY AND COGNITION 2016; 25:49-69. [PMID: 27937138 DOI: 10.1080/13825585.2016.1263724] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The hippocampus is closely tied to spatial navigation, a central component in cognitive functioning, and critically involved in age-associated cognitive decline and dementia. This study evaluated a novel, cognitive computerized spatial navigation training (CSNT) program targeting the hippocampus, with expectation of mitigating possible cognitive decline with bed rest (BR). During a 14-day BR study with 16 healthy, older men (mean age = 60 ± 3, range = 55-65 years), half received CSNT for 12 days in 50-min sessions and half were controls (watching documentaries). This design uniquely controlled diet, sleep, and other personal and environmental activities. Although there were no cognitive declines in controls post-BR, CSNT participants demonstrated significant increases in executive/attention ability and processing speed, and continued spatial navigation testing showed improvement to 400 days post-BR. This intervention may prove useful to mitigate cognitive declines known to occur in long periods of immobilization and could have broader implications in protecting against age-related cognitive decline.
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Affiliation(s)
- Uros Marusic
- a Institute for Kinesiology Research, Science and Research Centre , University of Primorska , Koper , Slovenia
| | - Bruno Giordani
- b Departments of Psychiatry, Neurology, and Psychology and School of Nursing , University of Michigan , Ann Arbor , MI , USA
| | - Scott D Moffat
- c School of Psychology , Georgia Institute of Technology , Atlanta , GA , USA
| | - Mojca Petrič
- d Faculty of Education , University of Primorska , Koper , Slovenia
| | - Petra Dolenc
- d Faculty of Education , University of Primorska , Koper , Slovenia
| | - Rado Pišot
- a Institute for Kinesiology Research, Science and Research Centre , University of Primorska , Koper , Slovenia
| | - Voyko Kavcic
- e Institute of Gerontology , Wayne State University , Detroit , MI , USA
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Kavcic V, Zalar B, Giordani B. The relationship between baseline EEG spectra power and memory performance in older African Americans endorsing cognitive concerns in a community setting. Int J Psychophysiol 2016; 109:116-123. [PMID: 27613569 DOI: 10.1016/j.ijpsycho.2016.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 09/01/2016] [Accepted: 09/03/2016] [Indexed: 01/22/2023]
Abstract
The finding that some older individuals report declines in aspects of cognitive functioning is becoming a frequently used criteria to identify elderly at risk for mild cognitive impairment (MCI) and dementia. Once concerns are identified in a community setting, however, effective means are necessary to pinpoint those individuals who should go on to more complex and costly diagnostic evaluations (e.g., functional imaging). We tested 44 African American volunteers endorsing cognitive concerns (37 females, 7 males) age≥65years with CogState battery subtests and recorded resting-state EEG, with eyes closed. After current source density (CSD) transformations of EEG recordings we obtained spectral power for delta, theta, alpha, and beta frequency bands. We characterized CogState One Card Back Learning (OCL, memory) with diffusion model parameters drift rate, boundary and non-decision time (NDT). Forward regression models showed that lower OCL drift rate, slower accumulation of information needed for decision making was linked to increased absolute and relative delta at occipital region. Lower drift rate was also linked to decrease in OCL theta power at parietal region, with no findings for ONB. Results show that cortical resting, eyes closed EEG rhythms are related to memory in African American seniors endorsing cognitive concerns. This study further supports the use of EEG as an easily accessible, cost-effective, culture-fair, and noninvasive clinical measurement that could provide potentially reliable diagnostic (and perhaps prognostic) information to differentiate at-risk from stable African American seniors.
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Affiliation(s)
- Voyko Kavcic
- Institute of Gerontology, Wayne State University, Detroit, MI, USA; Biomedical Research Institute, Ljubljana, Slovenia.
| | - Bojan Zalar
- Biomedical Research Institute, Ljubljana, Slovenia; University Psychiatric Clinic, Ljubljana, Slovenia
| | - Bruno Giordani
- Departments of Psychiatry, Neurology, and Psychology and School of Nursing, University of Michigan, Ann Arbor, MI, USA
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Kulason K, Nouchi R, Hoshikawa Y, Noda M, Okada Y, Kawashima R. The beneficial effects of cognitive training with simple calculation and reading aloud in an elderly postsurgical population: study protocol for a randomized controlled trial. Trials 2016; 17:334. [PMID: 27484173 PMCID: PMC4971755 DOI: 10.1186/s13063-016-1476-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 07/05/2016] [Indexed: 11/18/2022] Open
Abstract
Background This project proposes a pilot study to investigate the positive healing effects of cognitive training with simple arithmetic and reading aloud on elderly postsurgical patients. Elderly patients undergoing surgery have an increased risk of Postoperative Cognitive Decline (POCD), a condition in which learning, memory, and processing speed is greatly reduced after surgery. Since elderly patients are more likely to exhibit symptoms of POCD, the incidence is increasing as the population receiving surgery has aged. Little effort has been expended, however, to find treatments for POCD. Learning therapy, which consists of a combination of reading aloud and solving simple arithmetic problems, was developed in Japan as a treatment for Alzheimer’s Disease to improve cognitive functions. Because patients with Alzheimer’s Disease experience similar issues as those with POCD in learning, memory, and processing speed, a cognitive intervention based on the learning-therapy treatments used for Alzheimer’s Disease could show advantageous outcomes for those at risk of POCD. Methods/design Cognitive function will be measured before and after surgery using three different tests (Mini-Mental Status Exam, Frontal Assessment Battery, and Cogstate computerized tests). Subjects will be randomly divided into two groups—one that receives a Simple Calculation and Reading Aloud intervention (SCRA) and a waitlisted control group that does not receive SCRA. To measure cognition before and after the intervention, the previously mentioned three tests will be used. The obtained data will be analyzed using statistical tests such as ANCOVA to indicate whether the cognitive intervention group has made improvements in their cognitive functions. In addition, questionnaires will also be administered to collect data on mental and emotional statuses. Discussion This report will be the first pilot study to investigate the beneficial effects of SCRA on elderly surgical patients. Previous studies have shown sufficient evidence on the effectiveness of learning therapy in healthy elderly people and in those with Dementia. Therefore, this study will clarify whether SCRA can improve cognitive function in the more specialized group of elderly surgical patients. Trial registration University Hospital Medical Information Network Clinical Trial Registry, UMIN000019832. Registered on 18 November 2015. Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1476-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kay Kulason
- Department of Functional Brain Imaging, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, 980-8575, Japan
| | - Rui Nouchi
- Creative Interdisciplinary Research Division, Frontier Research Institute for Interdisciplinary Science (FRIS), Tohoku University, 4-1 Seiryocho, Aobaku, Sendai, 980-8578, Japan. .,Smart Aging International Research Center, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, 980-8575, Japan. .,Human and Social Response Research Division, International Research Institute of Disaster Science (IRIDeS), Tohoku University, Sendai, 980-0845, Japan.
| | - Yasushi Hoshikawa
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, 980-8575, Japan
| | - Masafumi Noda
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, 980-8575, Japan
| | - Yoshinori Okada
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, 980-8575, Japan
| | - Ryuta Kawashima
- Department of Functional Brain Imaging, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, 980-8575, Japan.,Smart Aging International Research Center, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, 980-8575, Japan.,Division of Developmental Cognitive Neuroscience, Institute of Development, Ageing and Cancer, Tohoku University, Sendai, 980-8575, Japan
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Yechoor N, Towe SL, Robertson KR, Westreich D, Nakasujja N, Meade CS. Utility of a brief computerized battery to assess HIV-associated neurocognitive impairment in a resource-limited setting. J Neurovirol 2016; 22:808-815. [PMID: 27245592 DOI: 10.1007/s13365-016-0456-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 05/03/2016] [Accepted: 05/09/2016] [Indexed: 11/30/2022]
Abstract
Despite the persistently high prevalence of neurocognitive impairment in HIV-positive patients, routine HIV care in many resource-limited settings does not include neuropsychological assessment. The objective of this study was to examine the utility of a brief computerized battery for identifying neurocognitive impairment in a busy HIV clinic in Uganda. Specifically, we compared performance on a gold standard neuropsychological exam to that on the CogState Brief Battery. In this cross-sectional study, 181 HIV-positive patients completed both assessment batteries in a randomized order. The primary outcome measures were neurocognitive impairment on the standard exam defined by the global deficit score and cumulative performance on the CogState Brief Battery. Sixty-nine participants (38 %) were classified as impaired on the standard neuropsychological exam, and participants who were classified as impaired performed significantly worse on CogState compared to those who were unimpaired (p < 0.001). CogState had adequate specificity but low sensitivity, suggesting that it may not be a clinically useful screening tool to identify patients who likely have neurocognitive impairment in Uganda. This study supports the feasibility of using a computerized battery for assessing neurocognitive impairment in HIV-positive patients in resource-limited settings, but additional research is needed to identify screening tools with higher sensitivity for use in HIV clinics.
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Affiliation(s)
- Nirupama Yechoor
- Duke Global Health Institute, Duke University, Box 90519, Durham, NC, 27708, USA.,The Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH, 43210, USA
| | - Sheri L Towe
- Duke Global Health Institute, Duke University, Box 90519, Durham, NC, 27708, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, 27708, USA
| | - Kevin R Robertson
- Department of Neurology, Physicians Office Building, 170 Manning Drive, UNC-Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Daniel Westreich
- Duke Global Health Institute, Duke University, Box 90519, Durham, NC, 27708, USA.,Department of Epidemiology, CB 7435 McGavran-Greenberg Hall, UNC-Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Noeline Nakasujja
- Department of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Christina S Meade
- Duke Global Health Institute, Duke University, Box 90519, Durham, NC, 27708, USA. .,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, 27708, USA.
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Gagnon MM, Laforce R. Computerized vs. Paper-Pencil Assessment of Cognitive Change following Acute Ischemic Stroke. ACTA ACUST UNITED AC 2016. [PMID: 28649579 PMCID: PMC5482710 DOI: 10.4172/2329-6895.1000317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Importance Cognitive impairment is common among patients with stroke and early recognition can optimize patient care. Objective To determine the validity of computerized cognitive testing in an adult population with acute ischemic stroke. Design Validation study comparing computerized vs paper-pencil assessments at two time points three months apart in a stroke unit. Main outcome Correlation analyses between computerized (using CogState Brief Battery) and paper-pencil testing (using the Montreal Cognitive Assessment) both at study entry and follow-up visits. Results We found moderate to strong significant correlations between the two instruments at study entry and follow-up sessions. Executive dysfunctions were the main cognitive changes. Test-retest correlations were strong. Conclusion and Relevance The CogState Brief Battery is a valid alternative for clinicians who wish to measure cognitive skills following acute ischemic stroke. Limitations of computerized testing are discussed.
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Affiliation(s)
- Maude-Marie Gagnon
- Département des Sciences Neurologiques, CHU de Québec-Université Laval, Québec, Canada.,Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques, CHU de Québec-Université Laval, Québec, Canada.,Faculty of Medicine, Laval University, Québec, Canada
| | - Robert Laforce
- Département des Sciences Neurologiques, CHU de Québec-Université Laval, Québec, Canada.,Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques, CHU de Québec-Université Laval, Québec, Canada.,Faculty of Medicine, Laval University, Québec, Canada
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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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Shiina A, Kanahara N, Sasaki T, Oda Y, Hashimoto T, Hasegawa T, Yoshida T, Iyo M, Hashimoto K. An Open Study of Sulforaphane-rich Broccoli Sprout Extract in Patients with Schizophrenia. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2015; 13:62-7. [PMID: 25912539 PMCID: PMC4423155 DOI: 10.9758/cpn.2015.13.1.62] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 09/30/2014] [Accepted: 10/02/2014] [Indexed: 12/29/2022]
Abstract
Objective Schizophrenia is a mental disorder characterized by severe cognitive impairment. Accumulating evidence suggests a role for oxidative stress in the pathophysiology of schizophrenia. Sulforaphane (SFN) extracted from broccoli sprout is an agent with potent anti-oxidant and anti-inflammatory activity. In this study, we attempted to evaluate the effect of SFN on cognitive impairment in medicated patients with schizophrenia. Methods We recruited a total of 10 outpatients with schizophrenia, all of whom gave informed consent. Participants took 3 tablets of SFN, consisting of 30 mg of SFN-glucosinolate per day, for 8 weeks. Clinical symptoms using the Positive and Negative Syndrome Scale (PANSS) and cognitive function using the Japanese version of CogState battery were evaluated at the beginning of the study and at week 8. Results A total of 7 patients completed the trial. The mean score in the Accuracy component of the One Card Learning Task increased significantly after the trial. However, we detected no other significant changes in participants. Conclusion This result suggests that SFN has the potential to improve cognitive function in patients with schizophrenia.
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Affiliation(s)
- Akihiro Shiina
- Department of Child Psychiatry, Chiba University Hospital, Chiba, Japan.,Division of Law and Psychiatry, Chiba University Center for Forensic Mental Health, Chiba, Japan
| | - Nobuhisa Kanahara
- Division of Medical Treatment and Rehabilitation, Chiba University Center for Forensic Mental Health, Chiba, Japan
| | - Tsuyoshi Sasaki
- Department of Child Psychiatry, Chiba University Hospital, Chiba, Japan
| | - Yasunori Oda
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Tasuku Hashimoto
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Tadashi Hasegawa
- Department of Psychiatry, Chiba University Hospital, Chiba, Japan
| | | | - Masaomi Iyo
- Department of Child Psychiatry, Chiba University Hospital, Chiba, Japan.,Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan.,Department of Psychiatry, Chiba University Hospital, Chiba, Japan.,Chiba University Center for Forensic Mental Health, 8Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan
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Abstract
OBJECTIVE This article is a review of computerized tests and batteries used in the cognitive assessment of older adults. METHOD A literature search on Medline followed by cross-referencing yielded a total of 76 citations. RESULTS Seventeen test batteries were identified and categorized according to their scope. Computerized adaptive testing (CAT) and the Cambridge Cognitive Examination CAT battery as well as 3 experimental batteries and an experimental test are discussed in separate sections. All batteries exhibit strengths associated with computerized testing such as standardization of administration, accurate measurement of many variables, automated record keeping, and savings of time and costs. Discriminant validity and test-retest reliability were well documented for most batteries while documentation of other psychometric properties varied. CONCLUSION The large number of available batteries can be beneficial to the clinician or researcher; however, care should be taken in order to choose the correct battery for each application.
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Affiliation(s)
- Stelios Zygouris
- 3rd Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Magda Tsolaki
- 3rd Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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de Oliveira MO, Brucki SMD. Computerized Neurocognitive Test (CNT) in mild cognitive impairment and Alzheimer's disease. Dement Neuropsychol 2014; 8:112-116. [PMID: 29213891 PMCID: PMC5619117 DOI: 10.1590/s1980-57642014dn82000005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Currently, computerized batteries are of great value in detecting cognitive
impairment. This aim of this review was to compare the computerized
neurocognitive batteries used in most studies with cognitive decline over the
last 10 years. Using the search words computerized cognitive assessment with:
dementia, mild cognitive impairment, and Alzheimer's disease, the CogState, CNS
Vital Sings, COGDRAS and Mindstreams batteries were retrieved.
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Affiliation(s)
- Maira Okada de Oliveira
- Cognitive Neurology and Behavioral Group of the Department of Neurology of the University of São Paulo, SP, Brazil
| | - Sonia Maria Dozzi Brucki
- Cognitive Neurology and Behavioral Group of the Department of Neurology of the University of São Paulo, SP, Brazil
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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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