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Tseng YT, Chang YL, Chiu YS. Assessment of Language Function in Older Mandarin-Speaking Adults with Mild Cognitive Impairment using Multifaceted Language Tests. J Alzheimers Dis 2024; 97:1189-1209. [PMID: 38217600 PMCID: PMC10836557 DOI: 10.3233/jad-230871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND Individuals with amnestic mild cognitive impairment (aMCI), especially for those with multidomain cognitive deficits, should be clinically examined for determining risk of developing Alzheimer's disease. English-speakers with aMCI exhibit language impairments mostly at the lexical-semantic level. Given that the language processing of Mandarin Chinese is different from that of alphabetic languages, whether previous findings for English-speakers with aMCI can be generalized to Mandarin Chinese speakers with aMCI remains unclear. OBJECTIVE This study examined the multifaceted language functions of Mandarin Chinese speakers with aMCI and compared them with those without cognitive impairment by using a newly developed language test battery. METHODS Twenty-three individuals with aMCI and 29 individuals without cognitive impairment were recruited. The new language test battery comprises five language domains (oral production, auditory and reading comprehension, reading aloud, repetition, and writing). RESULTS Compared with the controls, the individuals with aMCI exhibited poorer performance in the oral production and auditory and reading comprehension domains, especially on tests involving effortful lexical and semantic processing. Moreover, the aMCI group made more semantic naming errors compared with their counterparts and tended to experience difficulty in processing items belonging to the categories of living objects. CONCLUSIONS The pattern identified in the present study is similar to that of English-speaking individuals with aMCI across multiple language domains. Incorporating language tests involving lexical and semantic processing into clinical practice is essential and can help identify early language dysfunction in Mandarin Chinese speakers with aMCI.
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Affiliation(s)
- Yun-Ting Tseng
- Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, Chi Mei Medical Center, Tainan, Taiwan
| | - Yu-Ling Chang
- Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan
- Department of Neurology, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
- Center for Artificial Intelligence and Advanced Robotics, National Taiwan University, Taipei, Taiwan
| | - Yen-Shiang Chiu
- Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan
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2
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Wright LM, De Marco M, Venneri A. Current Understanding of Verbal Fluency in Alzheimer's Disease: Evidence to Date. Psychol Res Behav Manag 2023; 16:1691-1705. [PMID: 37179686 PMCID: PMC10167999 DOI: 10.2147/prbm.s284645] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 04/05/2023] [Indexed: 05/15/2023] Open
Abstract
Since their development, verbal fluency tests (VFTs) have been used extensively throughout research and in clinical settings to assess a variety of cognitive functions in diverse populations. In Alzheimer's disease (AD), these tasks have proven particularly valuable in identifying the earliest forms of cognitive decline in semantic processing and have been shown to relate specifically to brain regions associated with the initial stages of pathological change. In recent years, researchers have developed more nuanced techniques to evaluate verbal fluency performance, extracting a wide range of cognitive metrics from these simple neuropsychological tests. Such novel techniques allow for a more detailed exploration of the cognitive processes underlying successful task performance beyond the raw test score. The versatility of VFTs and the richness of data they may provide, in light of their low cost and speed of administration, therefore, highlight their potential value both in future research as outcome measures for clinical trials and in a clinical setting as a screening measure for early detection of neurodegenerative diseases.
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Affiliation(s)
- Laura M Wright
- Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Matteo De Marco
- Department of Life Sciences, Brunel University London, London, UK
| | - Annalena Venneri
- Department of Life Sciences, Brunel University London, London, UK
- Department of Medicine and Surgery, University of Parma, Parma, Italy
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3
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Investigating the network structure of domain-specific knowledge using the semantic fluency task. Mem Cognit 2023; 51:623-646. [PMID: 35608782 PMCID: PMC9128323 DOI: 10.3758/s13421-022-01314-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2022] [Indexed: 11/08/2022]
Abstract
Cognitive scientists have a long-standing interest in quantifying the structure of semantic memory. Here, we investigate whether a commonly used paradigm to study the structure of semantic memory, the semantic fluency task, as well as computational methods from network science could be leveraged to explore the underlying knowledge structures of academic disciplines such as psychology or biology. To compare the knowledge representations of individuals with relatively different levels of expertise in academic subjects, undergraduate students (i.e., experts) and preuniversity high school students (i.e., novices) completed a semantic fluency task with cue words corresponding to general semantic categories (i.e., animals, fruits) and specific academic domains (e.g., psychology, biology). Network analyses of their fluency networks found that both domain-general and domain-specific semantic networks of undergraduates were more efficiently connected and less modular than the semantic networks of high school students. Our results provide an initial proof-of-concept that the semantic fluency task could be used by educators and cognitive scientists to study the representation of more specific domains of knowledge, potentially providing new ways of quantifying the nature of expert cognitive representations.
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Aiello EN, Verde F, Solca F, Milone I, Giacopuzzi Grigoli E, Dubini A, Ratti A, Ferrucci R, Torresani E, Priori A, Ticozzi N, Silani V, Poletti B. Lower semantic fluency scores and a phonemic-over-semantic advantage predict abnormal CSF P-tau 181 levels in Aβ + patients within the Alzheimer's disease clinical spectrum. Neurol Sci 2023; 44:1979-1985. [PMID: 36705785 DOI: 10.1007/s10072-023-06643-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/22/2023] [Indexed: 01/28/2023]
Abstract
BACKGROUND The present study aimed to determine whether patients with mild cognitive impairment (MCI) and dementia due to Alzheimer's disease (AD), semantic verbal fluency (SVF), and the semantic-phonemic discrepancy (SPD) could predict abnormal cerebrospinal fluid (CSF) phosphorylated tau (P-tau181) and total tau (T-tau) levels. METHODS Phonemic verbal fluency (PVF) and SVF scores of N = 116 Aβ-positive patients with either MCI due to AD (N = 39) or probable AD dementia (ADD; N = 77) were retrospectively collected. The SPD was computed by subtracting PVF scores from SVF ones (positive and negative values corresponding to a semantic and phonemic advantage, respectively). Patients were cognitively phenotyped via a thorough test battery and profiled according to the amyloidosis/tauopathy/neurodegeneration (ATN) framework via CSF analyses. Two separate sets of logistic regressions were run to predict normal vs. abnormal P-tau181 and T-tau levels by encompassing as predictors SVF + PVF and SPD and covarying for demographic, disease-related features, and cognitive profile. RESULTS Lower SVF, but not PVF, scores, as well as a greater phonemic advantage (i.e., negative SPD values), predicted abnormal CSF P-tau181 levels (p ≤ .01). Moreover, lower SVF scores were selectively predictive of abnormal CSF T-tau levels too (p = .016), while the SPD was not. DISCUSSION SVF and the SPD are able to predict tauopathy across the AD spectrum, thus supporting their status of valid, and sufficiently specific, cognitive markers of AD.
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Affiliation(s)
- Edoardo Nicolò Aiello
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Piazzale Brescia 20, 20149, Milan, Italy.,PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Federico Verde
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Piazzale Brescia 20, 20149, Milan, Italy.,Department of Pathophysiology and Transplantation, "Dino Ferrari" Center, Università degli Studi di Milano, Milan, Italy
| | - Federica Solca
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Piazzale Brescia 20, 20149, Milan, Italy
| | - Ilaria Milone
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Piazzale Brescia 20, 20149, Milan, Italy
| | | | - Antonella Dubini
- Department of Laboratory Medicine, Laboratory of Clinical Chemistry, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Antonia Ratti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Piazzale Brescia 20, 20149, Milan, Italy.,Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milan, Italy
| | - Roberta Ferrucci
- Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, International Medical School, University of Milan, Milan, Italy.,ASST Santi Paolo E Carlo, San Paolo University Hospital, Milan, Italy.,IRCCS Ca' Granda Foundation Maggiore Policlinico Hospital, Milan, Italy
| | - Erminio Torresani
- Department of Laboratory Medicine, Laboratory of Clinical Chemistry, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Alberto Priori
- Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, International Medical School, University of Milan, Milan, Italy.,ASST Santi Paolo E Carlo, San Paolo University Hospital, Milan, Italy
| | - Nicola Ticozzi
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Piazzale Brescia 20, 20149, Milan, Italy.,Department of Pathophysiology and Transplantation, "Dino Ferrari" Center, Università degli Studi di Milano, Milan, Italy
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Piazzale Brescia 20, 20149, Milan, Italy.,Department of Pathophysiology and Transplantation, "Dino Ferrari" Center, Università degli Studi di Milano, Milan, Italy
| | - Barbara Poletti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Piazzale Brescia 20, 20149, Milan, Italy.
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5
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Guevara JE, Kurniadi NE, Duff K. Assessing Longitudinal Cognitive Change in Mild Cognitive Impairment Using Estimated Standardized Regression-Based Formulas. J Alzheimers Dis 2023; 95:509-521. [PMID: 37545235 DOI: 10.3233/jad-230160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
BACKGROUND Cognitive change in mild cognitive impairment (MCI), a likely prodrome to Alzheimer's disease, can be tracked with repeated neuropsychological assessments, but there has been little work quantifying these changes over time. Cognitive change can be statistically examined using standardized regression-based (SRB) formulas, which yield a z-score indicating amount of change compared to a normative group. OBJECTIVE To use SRB z-scores to quantify cognitive change in a sample of patients classified as MCI at baseline, and to compare cognitive change in those who remained MCI on follow-up (MCI-Stable) and those who progressed to dementia (MCI-Decline). METHODS Using 283 MCI patients from a cognitive disorders clinic who were re-assessed after approximately one- and one-half years, SRB z-scores were calculated for each test in a comprehensive neuropsychological battery for each participant. RESULTS There was a significant decline between timepoints across all cognitive tests, with the greatest amount of decline on tests of learning and memory. Group differences were seen on nearly all cognitive tests, with the MCI-Decline group showing more decline (i.e., significantly larger and negative z-scores) than the MCI-Stable participants. Notable cognitive decline was also observed in the MCI-Stable group, with z-scores ranging from -0.01 - -2.24 compared to normative data. CONCLUSION This study highlights the amount of cognitive decline that occurs in MCI, including for those who remain "stable" and those who progress to dementia. It also demonstrates the value of the SRB method in more clearly quantifying cognitive decline, which may help identify individuals most vulnerable to MCI progression.
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Affiliation(s)
- Jasmin E Guevara
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Natalie E Kurniadi
- Advanced Neurobehavioral Health of Southern California, San Diego, CA, USA
| | - Kevin Duff
- Department of Neurology, Layton Aging and Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA
- Department of Neurology, Center for Alzheimer's Care, Imaging, and Research, University of Utah, Salt Lake City, UT, USA
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García‐Alberca JM, Gris E, Mendoza S. Combined treatment with Ginkgo biloba extract EGb 761 plus acetylcholinesterase inhibitors improved cognitive function and neuropsychiatric symptoms in patients with mild cognitive impairment. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12338. [PMID: 35929002 PMCID: PMC9345397 DOI: 10.1002/trc2.12338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 03/22/2022] [Accepted: 06/01/2022] [Indexed: 11/11/2022]
Abstract
Introduction Mild cognitive impairment (MCI) is a neurocognitive state between normal aging and dementia. There is currently no approved treatment for MCI, with acetylcholinesterase inhibitors (AChEI) being the commonly prescribed drugs. The Ginkgo biloba extract EGb 761 is an herbal remedy used for cognitive disorders, including dementia. This study aims to explore the potential synergistic effect of combination therapy with EGb 761 plus AChEI in patients with amnestic MCI in a real-life setting. Methods We retrospectively identified 133 patients with amnestic MCI who were attending a memory clinic. Patients had received treatment with any of the following drugs: G. biloba extract EGb 761, donepezil, galantamine, or rivastigmine at their standard doses. Subjects were divided into three treatment groups: EGb 761, AChEI, and EGb 761+AChEI. Patients were assessed by Mini-Mental State Examination (MMSE), Rey Auditory Verbal Learning Test (RAVLT), Symbol Digit Modalities Test, Boston Naming Test, Trail Making Test (TMT Parts A and B), Letter and Category Fluency Test (LFT, CFT), Neuropsychiatric Inventory (NPI), and Interview for Deterioration in Daily Living. Mixed-effects model analysis was carried out to evaluate changes in cognitive, functional, and behavioral outcomes over a 12-month follow-up. Results After 12 months, EGb 761+AChEI showed significant improvement in MMSE, RAVLT, CFT, TMT A-B, and NPI compared to AChEI and in MMSE and RAVLT compared to EGb 761. At 12 months, EGb 761 was superior to AChEI on the CFT, TMT A-B, and NPI. Discussion Our findings suggest that combined therapy with EGb 761 plus AChEI may provide added cognitive and functional benefits in patients with MCI and provides additional real-world evidence for the combined use of EGb 761 and anti-dementia drugs in patients with MCI. This study can serve as a model for the design of clinical trials that help to support the combined use of EGb 761 and anti-dementia drugs in patients with MCI.
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Affiliation(s)
| | - Esther Gris
- Alzheimer Research Center and Memory ClinicInstituto Andaluz de Neurociencia (IANEC)MálagaSpain
| | - Silvia Mendoza
- Alzheimer Research Center and Memory ClinicInstituto Andaluz de Neurociencia (IANEC)MálagaSpain
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7
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A Comparison Between the Performances of Verbal and Nonverbal Fluency Tests in Discriminating Between Mild Cognitive Impairments and Alzheimer’s Disease Patients and Their Brain Morphological Correlates. Dement Neurocogn Disord 2022; 21:17-29. [PMID: 35154337 PMCID: PMC8811206 DOI: 10.12779/dnd.2022.21.1.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 11/28/2021] [Accepted: 12/01/2021] [Indexed: 11/27/2022] Open
Abstract
Background and Purpose Methods Results Conclusions
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8
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Ye M, Wang L, Xiong J, Zheng G. The effect of mind-body exercise on memory in older adults: a systematic review and meta-analysis. Aging Clin Exp Res 2021; 33:1163-1173. [PMID: 32329024 DOI: 10.1007/s40520-020-01557-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 04/06/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The current systematic review aims to examine the effect of mind-body exercise on different memory types in the elderly population. METHODS Four literature databases (Pubmed, Cochrane library, Embase and Sinomed) were searched from inception to March 19, 2019. Randomized controlled trials (RCTs) examining the effect of mind-body exercise on memory in older adults were included. The assessment of risk of bias for the included studies and data synthesis were conducted using the software of review manager 5.3 based on the Cochrane handbook. RESULTS Twelve eligible RCTs with a total 1051 participants were identified that met the inclusion criteria for the systematic review. Meta-analysis in elderly adults without known neurological diseases showed mind-body exercise intervention had a large effect on general memory (SMD = 1.24, p = 0.005), a moderate effect on short-term memory (SMD = 0.51, p = 0.02) and long-term memory (SMD = 0.78, p < 0.001), a small effect on working memory (SMD = 0.28, p = 0.009), and a moderate effect on episodic memory (SMD = 0.74, p < 0.001) and semantic memory (SMD = 0.59, p = 0.003) compared to no specific exercise intervention. Similar results were also found in elderly adults with known neurological diseases, showing a moderate effect on general memory (SMD = 0.56, p < 0.001), short-term memory (SMD = 0.68, p = 0.01), and long-term memory (SMD = 0.80, p = 0.003); a small effect on working memory (SMD = 0.46, p < 0.001); and a large effect on episodic memory (SMD = 0.91, p < 0.001). CONCLUSION Compared with no specific exercise, mind-body exercise enhances memory in older adults. However, larger, more robust trials with longer follow-up periods and standardized neuropsychological outcome measures are needed before more definitive conclusions can be drawn.
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Affiliation(s)
- Mingzhu Ye
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Lecong Wang
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Jian Xiong
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Guohua Zheng
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.
- College of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China.
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9
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Rådestig MA, Skoog J, Zetterberg H, Kern J, Zettergren A, Sacuiu S, Waern M, Wetterberg H, Blennow K, Skoog I, Kern S. Cognitive Performance and Cerebrospinal Fluid Markers in Preclinical Alzheimer's Disease: Results from the Gothenburg H70 Birth Cohort Studies. J Alzheimers Dis 2021; 79:225-235. [PMID: 33216028 DOI: 10.3233/jad-200751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND We have previously shown that older adults with preclinical Alzheimer's disease (AD) pathology in cerebrospinal fluid (CSF) had slightly worse performance in Mini-Mental State Examination (MMSE) than participants without preclinical AD pathology. OBJECTIVE We therefore aimed to compare performance on neurocognitive tests in a population-based sample of 70-year-olds with and without CSF AD pathology. METHODS The sample was derived from the population-based Gothenburg H70 Birth Cohort Studies in Sweden. Participants (n = 316, 70 years old) underwent comprehensive cognitive examinations, and CSF Aβ-42, Aβ-40, T-tau, and P-tau concentrations were measured. Participants were classified according to the ATN system, and according to their Clinical Dementia Rating (CDR) score. Cognitive performance was examined in the CSF amyloid, tau, and neurodegeneration (ATN) categories. RESULTS Among participants with CDR 0 (n = 259), those with amyloid (A+) and/or tau pathology (T+, N+) showed similar performance on most cognitive tests compared to participants with A-T-N-. Participants with A-T-N+ performed worse in memory (Supra span (p = 0.003), object Delayed (p = 0.042) and Immediate recall (p = 0.033)). Among participants with CDR 0.5 (n = 57), those with amyloid pathology (A+) scored worse in category fluency (p = 0.003). CONCLUSION Cognitively normal participants with amyloid and/or tau pathology performed similarly to those without any biomarker evidence of preclinical AD in most cognitive domains, with the exception of slightly poorer memory performance in A-T-N+. Our study suggests that preclinical AD biomarkers are altered before cognitive decline.
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Affiliation(s)
- Maya Arvidsson Rådestig
- Center for Ageing and Health (AgeCap) at the University of Gothenburg, Mölndal, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Johan Skoog
- Center for Ageing and Health (AgeCap) at the University of Gothenburg, Mölndal, Sweden.,Department of Psychology, University of Gothenburg, Gothenburg, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, 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.,UCL Institute of Neurology (H.Z.), Queen Square, London, United Kingdom.,The UK Dementia Research Institute at UCL, London, United Kingdom
| | - Jürgen Kern
- Center for Ageing and Health (AgeCap) at the University of Gothenburg, Mölndal, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Anna Zettergren
- Center for Ageing and Health (AgeCap) at the University of Gothenburg, Mölndal, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Simona Sacuiu
- Center for Ageing and Health (AgeCap) at the University of Gothenburg, Mölndal, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Margda Waern
- Center for Ageing and Health (AgeCap) at the University of Gothenburg, Mölndal, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Hanna Wetterberg
- Center for Ageing and Health (AgeCap) at the University of Gothenburg, Mölndal, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - 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
| | - Ingmar Skoog
- Center for Ageing and Health (AgeCap) at the University of Gothenburg, Mölndal, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Silke Kern
- Center for Ageing and Health (AgeCap) at the University of Gothenburg, Mölndal, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
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10
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White matter pathways underlying Chinese semantic and phonological fluency in mild cognitive impairment. Neuropsychologia 2020; 149:107671. [PMID: 33189733 DOI: 10.1016/j.neuropsychologia.2020.107671] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 11/01/2020] [Accepted: 11/02/2020] [Indexed: 12/21/2022]
Abstract
Neuroimaging evidence has suggested that Chinese-language processing differs from that of its alphabetic-language counterparts. However, the underlying white matter pathway correlations between semantic and phonological fluency in Chinese-language processing remain unknown. Thus, we investigated the differences between two verbal fluency tests on 50 participants with amnestic mild cognitive impairment (aMCI) and 36 healthy controls (HC) with respect to five groups (ventral and dorsal stream fibers, frontal-striatal fibers, hippocampal-related fibers, and the corpus callosum) of white matter microstructural integrity. Diffusion spectrum imaging was used. The results revealed a progressive reduction in advantage in semantic fluency relative to phonological fluency from HC to single-domain aMCI to multidomain aMCI. Common and dissociative white matter correlations between tests of the two types of fluency were identified. Both types of fluency relied on the corpus callosum and ventral stream fibers, semantic fluency relied on the hippocampal-related fibers, and phonological fluency relied on the dorsal stream and frontal-striatal fibers. The involvement of bilateral tracts of interest as well as the association with the corpus callosum indicate the uniqueness of Chinese-language fluency processing. Dynamic associations were noted between white matter tract involvement and performance on the two fluency tests in four time blocks. Overall, our findings suggest the clinical utility of verbal fluency tests in geriatric populations, and they elucidate both task-specific and language-specific brain-behavior associations.
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11
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Jacobs S, Mercuri G, Holtzer R. Assessing within-task verbal fluency performance: the utility of individual time intervals in predicting incident mild cognitive impairment. AGING NEUROPSYCHOLOGY AND COGNITION 2020; 28:733-747. [PMID: 32901518 DOI: 10.1080/13825585.2020.1817306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The current study aimed to determine whether word generation performance on individual within-task 20-second time intervals predicted conversion to Mild Cognitive Impairment (MCI) status. Longitudinal data (Mean follow-up=2.95±1.64 years) was collected from cognitively-healthy community-dwelling older adults (N=344; %female=56.1). Performance on letter and semantic fluency tasks was divided into three consecutive within-task 20-second intervals. Incident MCI status (n=50) was determined via established diagnostic case conference. Fully adjusted Cox proportional-hazards regression models revealed that greater word production on semantic fluency across all time intervals significantly predicted a reduced risk of incident MCI [0-20 seconds (HR=0.906, p=0.002), 21-40 seconds (HR=0.904, p=0.02), and 41-60 seconds (HR=0.892, p=0.017)]. Conversely, on letter fluency, greater word production within the 41-60 second time interval only was significantly associated with reduced risk of incident MCI (HR=0.886, p=0.002). Overall, the clinical use of within-interval performance is supported given evidence of predictive sensitivity and ease of administration.
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Affiliation(s)
- Sydney Jacobs
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Giulia Mercuri
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.,Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
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12
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Abstract
OBJECTIVES A growing body of research suggests that regular participation in long-term exercise is associated with enhanced cognitive function. However, less is known about the beneficial effects of acute exercise on semantic memory. This study investigated brain activation during a semantic memory task after a single session of exercise in healthy older adults using functional magnetic resonance imaging (fMRI). METHODS Using a within-subjects counterbalanced design, 26 participants (ages, 55-85 years) underwent two experimental visits on separate days. During each visit, participants engaged in 30 min of rest or stationary cycling exercise immediately before performing a Famous and Non-Famous name discrimination task during fMRI scanning. RESULTS Acute exercise was associated with significantly greater semantic memory activation (Famous>Non-Famous) in the middle frontal, inferior temporal, middle temporal, and fusiform gyri. A planned comparison additionally showed significantly greater activation in the bilateral hippocampus after exercise compared to rest. These effects were confined to correct trials, and as expected, there were no differences between conditions in response time or accuracy. CONCLUSIONS Greater brain activation following a single session of exercise suggests that exercise may increase neural processes underlying semantic memory activation in healthy older adults. These effects were localized to the known semantic memory network, and thus do not appear to reflect a general or widespread increase in brain blood flow. Coupled with our prior exercise training effects on semantic memory-related activation, these data suggest the acute increase in neural activation after exercise may provide a stimulus for adaptation over repeated exercise sessions. (JINS, 2019, 25, 557-568).
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Chasles MJ, Tremblay A, Escudier F, Lajeunesse A, Benoit S, Langlois R, Joubert S, Rouleau I. An Examination of Semantic Impairment in Amnestic MCI and AD: What Can We Learn From Verbal Fluency? Arch Clin Neuropsychol 2019; 35:22-30. [DOI: 10.1093/arclin/acz018] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 03/01/2019] [Accepted: 03/20/2019] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
The Verbal Fluency Test (VF) is commonly used in neuropsychology. Some studies have demonstrated a marked impairment of semantic VF compared to phonemic VF in Alzheimer’s disease (AD). Since amnestic Mild Cognitive Impairment (aMCI) is associated with increased risk of conversion to incident AD, it is relevant to examine whether a similar impairment is observed in this population. The objective of the present empirical study is to compare VF performance of aMCI patients to those of AD and elderly controls matched one-to-one for age and education.
Method
Ninety-six participants divided into three equal groups (N = 32: AD, aMCI and Controls) were included in this study. Participants in each group were, on average, 76 years of age and had 13 years of education. A repeated measures ANOVA with the Group (AD, aMCI, NC) as between-subject factor and the Fluency condition (“P” and “animals”) as within-subject factor was performed. T-tests and simple ANOVAs were also conducted to examine the interaction.
Results
There was a significant interaction between the groups and the verbal fluency condition. In AD, significantly fewer words were produced in both conditions. In contrast, participants with aMCI demonstrated a pattern similar to controls in the phonemic condition, but generated significantly fewer words in the semantic condition.
Conclusion
These results indicate a semantic memory impairment in aMCI revealed by a simple, commonly-used neuropsychological test. Future studies are needed to investigate if semantic fluency deficits can help predict future conversion to AD.
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Affiliation(s)
- M -J Chasles
- Département de Psychologie, Université du Québec à Montréal, Montréal, Canada
| | - A Tremblay
- Département de Psychologie, Université du Québec à Montréal, Montréal, Canada
| | - F Escudier
- Département de Psychologie, Université de Montréal, Montréal, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, Montréal, Canada
| | - A Lajeunesse
- Département de Psychologie, Université du Québec à Montréal, Montréal, Canada
| | - S Benoit
- Département de Psychologie, Université du Québec à Montréal, Montréal, Canada
| | - R Langlois
- Département de Psychologie, Université du Québec à Montréal, Montréal, Canada
| | - S Joubert
- Département de Psychologie, Université de Montréal, Montréal, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, Montréal, Canada
| | - I Rouleau
- Département de Psychologie, Université du Québec à Montréal, Montréal, Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Canada
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Vaccaro R, Zaccaria D, Colombo M, Abbondanza S, Guaita A. Adverse effect of self-reported hearing disability in elderly Italians: Results from the InveCe.Ab study. Maturitas 2019; 121:35-40. [DOI: 10.1016/j.maturitas.2018.12.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 12/07/2018] [Accepted: 12/10/2018] [Indexed: 12/20/2022]
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Kim JE, Park SH, Hong YJ, Hwang J, Han NE, Lee SM, Roh JH, Kim JS, Lee JH. Qualitative Comparison of Semantic Memory Impairment in Patients with Amnestic Mild Cognitive Impairment Based on β-Amyloid Status. J Clin Neurol 2018; 15:27-37. [PMID: 30375759 PMCID: PMC6325377 DOI: 10.3988/jcn.2019.15.1.27] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 07/17/2018] [Accepted: 07/19/2018] [Indexed: 12/21/2022] Open
Abstract
Background and Purpose Semantic memory remains more stable than episodic memory across the lifespan, which makes it potentially useful as a marker for distinguishing pathological aging from normal senescence. To obtain a better understanding of the transitional stage evolving into Alzheimer's dementia (AD), we focused on the amnestic mild cognitive impairment (aMCI) stage stratified based on β-amyloid (Aβ) pathology. Methods We analyzed the raw data from Korean version of the Boston Naming Test (K-BNT) and the Controlled Oral Word Association Test (COWAT). For K-BNT, the frequencies of six error types and accuracy rates were evaluated. For a qualitative assessment of the COWAT, we computed the number of switching, number of clusters, and mean cluster size. Results The data from 217 participants were analyzed (53 normal controls, 66 with Aβ− aMCI, 56 with Aβ+ aMCI, and 42 disease controls). There were fewer semantically related errors and more semantically unrelated errors on the K-BNT in Aβ+ aMCI than in Aβ− aMCI, without a gross difference in the z score. We also found that Aβ+ aMCI showed a more prominent deficit in the number of clusters in the semantic fluency task [especially for animal names (living items)] than Aβ− aMCI. Conclusions In spite of similar clinical manifestations, Aβ+ aMCI was more similar to AD than Aβ− aMCI in terms of semantic memory disruption. Semantic memory may serve as an early indicator of brain Aβ pathology. Therefore, semantic memory dysfunction deserves more consideration in clinical practice. Longitudinal research with the follow-up data is needed.
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Affiliation(s)
- Ji Eun Kim
- Department of Neurology, University of Ulsan College of Medicine, Gangneung Asan Hospital, Gangneung, Korea
| | - So Hee Park
- Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Yun Jeong Hong
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Jihye Hwang
- Department of Neurology, Keimyung University College of Medicine, Dongsan Medical Center, Daegu, Korea
| | - Noh Eul Han
- Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Sun Mi Lee
- Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jee Hoon Roh
- Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jae Seung Kim
- Department of Nuclear Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jae Hong Lee
- Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
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Eng N, Vonk JMJ, Salzberger M, Yoo N. A cross-linguistic comparison of category and letter fluency: Mandarin and English. Q J Exp Psychol (Hove) 2018; 72:651-660. [PMID: 29512423 DOI: 10.1177/1747021818765997] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Verbal fluency tasks are widely applied in a variety of languages, but whether the quality and quantity of responses are comparable across structurally different writing systems is debatable. For example, since there are no letters in a logographic, non-alphabetic language such as Chinese, the mechanisms speakers use to generate a list of words in a letter fluency task might be structurally different than those used by speakers of alphabetic languages. In this study, we investigated lexical retrieval strategies and approaches in letter and category fluency tasks among monolingual Mandarin speakers compared to monolingual English speakers. We found that the responses of Mandarin speakers are both qualitatively and quantitatively different in letter fluency, and qualitatively different in category fluency. These results suggest that differences in task completion among non-English-speaking populations are important to consider when using this extensively utilised cognitive and linguistic measure in research and clinic.
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Affiliation(s)
- Nancy Eng
- 1 Department of Speech-Language Pathology and Audiology, Hunter College, The City University of New York, New York, NY, USA
| | - Jet M J Vonk
- 2 Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Gertrude H. Sergievsky Center, Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Melissa Salzberger
- 1 Department of Speech-Language Pathology and Audiology, Hunter College, The City University of New York, New York, NY, USA
| | - Nakyung Yoo
- 1 Department of Speech-Language Pathology and Audiology, Hunter College, The City University of New York, New York, NY, USA
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De Marco M, Duzzi D, Meneghello F, Venneri A. Cognitive Efficiency in Alzheimer's Disease is Associated with Increased Occipital Connectivity. J Alzheimers Dis 2018; 57:541-556. [PMID: 28269781 DOI: 10.3233/jad-161164] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
There are cognitive domains which remain fully functional in a proportion of Alzheimer's disease (AD) patients. It is unknown, however, what distinctive mechanisms sustain such efficient processing. The concept of "cognitive efficiency" was investigated in these patients by operationalizing it as a function of the level of performance shown on the Letter Fluency test, on which, very often, patients in the early stages of AD show unimpaired performance. Forty-five individuals at the prodromal/early stage of AD (diagnosis supported by subsequent clinical follow-ups) and 45 healthy controls completed a battery of neuropsychological tests and an MRI protocol which included resting state acquisitions. The Letter Fluency test was the only task on which no between-group difference in performance was found. Participants were divided into "low-performing" and "high-performing" according to the global median. Dual-regression methods were implemented to compute six patterns of network connectivity. The diagnosis-by-level of performance interaction was inferred on each pattern to determine the network distinctiveness of efficient performance in AD. Significant interactions were found in the anterior default mode network, and in both left and right executive control networks. For all three circuits, high-performing patients showed increased connectivity within the ventral and dorsal part of BA19, as confirmed by post hoc t tests. Peristriate remapping is suggested to play a compensatory role. Since the occipital lobe is the neurophysiological source of long-range cortical connectivity, it is speculated that the physiological mechanisms of functional connectivity might sustain occipital functional remapping in early AD, particularly for those functions which are sustained by areas not excessively affected by the prodromal disease.
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Affiliation(s)
- Matteo De Marco
- Department of Neuroscience, University of Sheffield, Royal Hallamshire Hospital, Sheffield, UK.,IRCCS Fondazione Ospedale San Camillo, Venice Lido, Italy
| | - Davide Duzzi
- IRCCS Fondazione Ospedale San Camillo, Venice Lido, Italy
| | | | - Annalena Venneri
- Department of Neuroscience, University of Sheffield, Royal Hallamshire Hospital, Sheffield, UK.,IRCCS Fondazione Ospedale San Camillo, Venice Lido, Italy
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18
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St-Hilaire A, Hudon C, Vallet GT, Bherer L, Lussier M, Gagnon JF, Simard M, Gosselin N, Escudier F, Rouleau I, Macoir J. Normative data for phonemic and semantic verbal fluency test in the adult French-Quebec population and validation study in Alzheimer's disease and depression. Clin Neuropsychol 2016; 30:1126-50. [PMID: 27279436 DOI: 10.1080/13854046.2016.1195014] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Verbal fluency tasks are principally used to assess lexical access and have shown usefulness for differential diagnosis. The purpose of Study 1 was to provide normative data in the adult French-Quebec population (Canada) for semantic verbal fluency (animals), for two sets of phonemic verbal fluency (TNP and PFL), and for letter P alone (60 seconds per category/letter). The objectives of Study 2 were to establish the diagnostic and predictive validity of the present tasks and normative data in Alzheimer's disease (AD) and major depressive episode (MDE). METHOD The normative sample consisted of 932 participants aged 19-91 years. Based on multiple linear regressions, equations to calculate Z-scores were provided. To assess validity, performance of 62 healthy participants was compared to 62 participants with AD and 41 with MDE aged over 50. RESULTS Age and education, but not gender, predicted performance on each verbal fluency task. Healthy adults aged 50 and younger had a better performance on semantic than phonemic verbal fluency. In comparison to MDE, AD participants had lower performance on animals and TNP, but not on letter P. Ninety percent of people with a Z-score ≤ -1.50 on semantic verbal fluency had AD and the global accuracy was 76.6%. Test-retest reliability over one year was high for both animals (r = .711) and TNP (r = .790) in healthy older participants, but dropped for animals in people with AD (r = .493). CONCLUSIONS These data will strengthen accurate detection of verbal fluency deficits in French-Quebec adults.
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Affiliation(s)
| | - Carol Hudon
- a École de psychologie , Université Laval , Québec , Canada
| | - Guillaume T Vallet
- b Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal , Université de Montréal , Montréal , Canada
| | - Louis Bherer
- c Department of Psychology , Concordia University , Montreal , Canada
| | - Maxime Lussier
- d Département de psychologie , Université du Québec à Montréal , Montréal , Canada
| | - Jean-François Gagnon
- d Département de psychologie , Université du Québec à Montréal , Montréal , Canada
| | - Martine Simard
- a École de psychologie , Université Laval , Québec , Canada
| | - Nadia Gosselin
- e Département de psychologie , Université de Montréal , Montréal , Canada
| | - Frédérique Escudier
- d Département de psychologie , Université du Québec à Montréal , Montréal , Canada
| | - Isabelle Rouleau
- d Département de psychologie , Université du Québec à Montréal , Montréal , Canada
| | - Joël Macoir
- f Département de réadaptation , Université Laval , Québec , Canada
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19
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Preservation of the Semantic Verbal Fluency Advantage in a Large Population-Based Sample: Normative Data from the TILDA Study. J Int Neuropsychol Soc 2016; 22:570-6. [PMID: 27055803 DOI: 10.1017/s1355617716000291] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES It is widely believed that phonemic fluency is more difficult than naming exemplars from a semantic category. Normative data in this regard are scarce, and there is considerable disagreement in the literature regarding the pattern in normal ageing and neurodegenerative conditions. Our objective was to provide normative data for semantic phonemic discrepancy scores from a large sample of older adults. METHODS A total of 5780 community-dwelling older adults were included in this prospective, longitudinal study. Discrepancy scores were calculated by subtracting phonemic fluency score from semantic fluency score for each participant. Quantile regression was used to estimate normative values stratified for age. RESULTS Subjects did better on testing of semantic fluency. The average discrepancy score was 9.18±6.89 words, (range, -20 to 37; n=5780). At the fiftieth percentile, those in their fifth decade produced 10 more "animals" than "letter F" words. Subjects scored one word less per decade, with an average of seven more "animal" words produced by those in their eighth decade. CONCLUSIONS Our study is the first to provide normative data and confirms that, for animal versus letter F fluency, the semantic advantage persists into later life in a population-based sample of community-dwelling older adults. Given that a majority of clinical samples have confirmed a reverse of this pattern in Alzheimer's dementia (i.e., loss of semantic advantage in Alzheimer's disease, yielding a phonemic advantage), our findings support the clinical utility of brief fluency tests and encourage further research into their use in diagnosis and prediction of progression to dementia.
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20
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Baerresen KM, Miller KJ, Hanson ER, Miller JS, Dye RV, Hartman RE, Vermeersch D, Small GW. Neuropsychological tests for predicting cognitive decline in older adults. Neurodegener Dis Manag 2016; 5:191-201. [PMID: 26107318 DOI: 10.2217/nmt.15.7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM To determine neuropsychological tests likely to predict cognitive decline. METHODS A sample of nonconverters (n = 106) was compared with those who declined in cognitive status (n = 24). Significant univariate logistic regression prediction models were used to create multivariate logistic regression models to predict decline based on initial neuropsychological testing. RESULTS Rey-Osterrieth Complex Figure Test (RCFT) Retention predicted conversion to mild cognitive impairment (MCI) while baseline Buschke Delay predicted conversion to Alzheimer's disease (AD). Due to group sample size differences, additional analyses were conducted using a subsample of demographically matched nonconverters. Analyses indicated RCFT Retention predicted conversion to MCI and AD, and Buschke Delay predicted conversion to AD. CONCLUSION Results suggest RCFT Retention and Buschke Delay may be useful in predicting cognitive decline.
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Affiliation(s)
- Kimberly M Baerresen
- Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, CA 90095-6980, USA.,Veteran Affairs Long Beach Healthcare System, Long Beach, CA 90822, USA
| | - Karen J Miller
- Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, CA 90095-6980, USA
| | - Eric R Hanson
- Department of Psychology, Loma Linda University, Loma Linda, CA 92350, USA
| | - Justin S Miller
- Fuller Theological Seminary, Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, CA 90095-6980, USA
| | - Richelin V Dye
- Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, CA 90095-6980, USA
| | - Richard E Hartman
- Department of Psychology, Loma Linda University, Loma Linda, CA 92350, USA
| | - David Vermeersch
- Department of Psychology, Loma Linda University, Loma Linda, CA 92350, USA
| | - Gary W Small
- Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, CA 90095-6980, USA
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21
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Skinner JS, Morgan A, Hernandez-Saucedo H, Hansen A, Corbett S, Arbuckle M, Leverenz JB, Wilkins CH, Craft S, Baker LD. Associations between Markers of Glucose and Insulin Function and Cognitive Function in Healthy African American Elders. ACTA ACUST UNITED AC 2015; 4. [PMID: 26798567 DOI: 10.4172/2167-7182.1000232] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Glucose and insulin are important moderators of cognitive function. African Americans have poorer glycemic control across the glycemic spectrum and are at increased risk for type 2 diabetes and poor cognitive health. It is unclear which glucoregulatory markers predict cognitive function in this at-risk population. The purpose of this study was to examine the association between cognitive function and common markers of glucoregulation in non-diabetic African Americans elders. METHODS Thirty-four, community-dwelling African Americans, aged 50-75 years completed cognitive testing and blood collection as part of a health screening assessment. Cognitive outcomes were composite scores derived from neuropsychological tests of executive function and verbal memory. Linear regression was used to examine relationships between cognitive composite scores and fasting blood levels of glucose, insulin, and hemoglobin A1C, with adjustments for age, education, body mass index, and antihypertensive medication use. RESULTS Fasting plasma glucose was negatively associated with executive function (β=-0.41, p=0.03). There was a trend of an association between fasting plasma glucose and verbal memory (β=-0.34, p=0.06). Fasting insulin and hemoglobin A1c were not associated with cognitive function. CONCLUSION High non-diabetic fasting glucose levels were associated with poorer executive function and verbal memory. These results provide preliminary support for proactive glucose control in older African Americans even before glycemic criteria for type 2 diabetes are met. Our findings suggests that high-normal FPG levels may represent an early red-flag to signify increased risk of cognitive impairment or decline.
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Affiliation(s)
- Jeannine S Skinner
- Meharry-Vanderbilt Alliance, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Amy Morgan
- Geriatric Research Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - Hector Hernandez-Saucedo
- Department of Internal Medicine, and Neurology, Wake Forest University Health Sciences, Winston-Salem, NC, USA
| | - Angela Hansen
- Geriatric Research Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA; Division of Gerontology, Geriatric Medicine, University of Washington School of Medicine, USA
| | - Selena Corbett
- Geriatric Research Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - Matthew Arbuckle
- Geriatric Research Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - James Ba Leverenz
- Lou Ruvo Center for Brain Health, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Consuelo H Wilkins
- Meharry-Vanderbilt Alliance, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Suzanne Craft
- Department of Internal Medicine, and Neurology, Wake Forest University Health Sciences, Winston-Salem, NC, USA
| | - Laura D Baker
- Department of Internal Medicine, and Neurology, Wake Forest University Health Sciences, Winston-Salem, NC, USA
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Rinehardt E, Eichstaedt K, Schinka JA, Loewenstein DA, Mattingly M, Fils J, Duara R, Schoenberg MR. Verbal fluency patterns in mild cognitive impairment and Alzheimer's disease. Dement Geriatr Cogn Disord 2015; 38:1-9. [PMID: 24556750 DOI: 10.1159/000355558] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/10/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Verbal fluency patterns can assist in differential diagnosis during neuropsychological assessment and identify individuals at risk for developing Alzheimer's disease (AD). While evidence suggests that subjects with AD perform worse on category fluency than letter fluency tasks, the pattern in mild cognitive impairment (MCI) is less well known. METHODS Performance on the Controlled Oral Word Association Test (COWAT) and Animal fluency was compared in control, amnestic MCI, non-amnestic MCI, and AD groups. The sample included 136 participants matched for age, education, and gender. RESULTS Both MCI groups performed similarly with a category > letter fluency pattern rather than a category < letter fluency pattern typically observed in AD. The pattern in MCI, albeit relatively more impaired than in controls, was more similar to healthy controls who exhibited a category > letter fluency pattern. CONCLUSION MCI using a category < letter fluency pattern may not represent AD; however, future research requires longitudinal studies of pattern analysis.
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Affiliation(s)
- Eric Rinehardt
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, Fla., USA
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Benefits of deep encoding in Alzheimer's disease. Analysis of performance in a memory task using the Item Specific Deficit Approach. NEUROLOGÍA (ENGLISH EDITION) 2014. [DOI: 10.1016/j.nrleng.2013.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Smith JC, Nielson KA, Antuono P, Lyons JA, Hanson RJ, Butts AM, Hantke NC, Verber MD. Semantic memory functional MRI and cognitive function after exercise intervention in mild cognitive impairment. J Alzheimers Dis 2014; 37:197-215. [PMID: 23803298 DOI: 10.3233/jad-130467] [Citation(s) in RCA: 95] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Mild cognitive impairment (MCI) is associated with early memory loss, Alzheimer's disease (AD) neuropathology, inefficient or ineffective neural processing, and increased risk for AD. Unfortunately, treatments aimed at improving clinical symptoms or markers of brain function generally have been of limited value. Physical exercise is often recommended for people diagnosed with MCI, primarily because of its widely reported cognitive benefits in healthy older adults. However, it is unknown if exercise actually benefits brain function during memory retrieval in MCI. Here, we examined the effects of exercise training on semantic memory activation during functional magnetic resonance imaging (fMRI). Seventeen MCI participants and 18 cognitively intact controls, similar in sex, age, education, genetic risk, and medication use, volunteered for a 12-week exercise intervention consisting of supervised treadmill walking at a moderate intensity. Both MCI and control participants significantly increased their cardiorespiratory fitness by approximately 10% on a treadmill exercise test. Before and after the exercise intervention, participants completed an fMRI famous name discrimination task and a neuropsychological battery, Performance on Trial 1 of a list-learning task significantly improved in the MCI participants. Eleven brain regions activated during the semantic memory task showed a significant decrease in activation intensity following the intervention that was similar between groups (p-values ranged 0.048 to 0.0001). These findings suggest exercise may improve neural efficiency during semantic memory retrieval in MCI and cognitively intact older adults, and may lead to improvement in cognitive function. Clinical trials are needed to determine if exercise is effective to delay conversion to AD.
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Affiliation(s)
- J Carson Smith
- Department of Kinesiology, University of Maryland, College Park, MD 20742, USA.
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Johnson M, Lin F. Communication Difficulty and Relevant Interventions in Mild Cognitive Impairment: Implications for Neuroplasticity. TOPICS IN GERIATRIC REHABILITATION 2014; 30:18-34. [PMID: 25356002 PMCID: PMC4209953 DOI: 10.1097/tgr.0000000000000001] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Mild Cognitive Impairment (MCI) represents a critical point for controlling cognitive decline. Patterns of communication difficulty have been observed in patients with MCI and warrant examination and management. The present systematic review examined (1) characteristics of communication difficulty in MCI by focusing on two domains: expressive and receptive communication, and (2) cognitive interventions that addressed communication difficulties in individuals with MCI. Of the 28 observational studies we reviewed, expressive and receptive communications were generally impaired in individuals with MCI, compared to their healthy counterparts. However, only one of seven interventions effectively improved communication related outcomes. We finished the paper with a discussion about how neuroplasticity influences communication abilities in individuals with MCI to inform the future development of interventions for communication difficulty.
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Affiliation(s)
| | - Feng Lin
- School of Nursing, University of Rochester Medical Center
- AD-CARE Program, Department of Psychiatry, School of Medicine and Dentistry, University of Rochester Medical Center
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26
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Kim BJ, Lee CS, Oh BH, Hong CH, Lee KS, Son SJ, Han C, Park MH, Jeong HG, Kim TH, Park JH, Kim KW. A normative study of lexical verbal fluency in an educationally-diverse elderly population. Psychiatry Investig 2013; 10:346-51. [PMID: 24474982 PMCID: PMC3902151 DOI: 10.4306/pi.2013.10.4.346] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Revised: 02/08/2013] [Accepted: 02/15/2013] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE Lexical fluency tests are frequently used to assess language and executive function in clinical practice. We investigated the influences of age, gender, and education on lexical verbal fluency in an educationally-diverse, elderly Korean population and provided its' normative information. METHODS We administered the lexical verbal fluency test (LVFT) to 1676 community-dwelling, cognitively normal subjects aged 60 years or over. RESULTS In a stepwise linear regression analysis, education (B=0.40, SE=0.02, standardized B=0.506) and age (B=-0.10, SE=0.01, standardized B=-0.15) had significant effects on LVFT scores (p<0.001), but gender did not (B=0.40, SE=0.02, standardized B=0.506, p>0.05). Education explained 28.5% of the total variance in LVFT scores, which was much larger than the variance explained by age (5.42%). Accordingly, we presented normative data of the LVFT stratified by age (60-69, 70-74, 75-79, and ≥80 years) and education (0-3, 4-6, 7-9, 10-12, and ≥13 years). CONCLUSION The LVFT norms should provide clinically useful data for evaluating elderly people and help improve the interpretation of verbal fluency tasks and allow for greater diagnostic accuracy.
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Affiliation(s)
- Bong Jo Kim
- Department of Psychiatry, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Cheol Soon Lee
- Department of Psychiatry, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Byoung Hoon Oh
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Chang Hyung Hong
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Kang Soo Lee
- Department of Psychiatry, Kwandong University College of Medicine, Myongji Hospital, Goyang, Republic of Korea
| | - Sang Joon Son
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Changsu Han
- Department of Psychiatry, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Moon Ho Park
- Department of Neurology, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Hyun-Ghang Jeong
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Tae Hui Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Joon Hyuk Park
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Republic of Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
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Executive functions in clinical and preclinical Alzheimer's disease. Rev Neurol (Paris) 2013; 169:695-708. [DOI: 10.1016/j.neurol.2013.07.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 07/23/2013] [Accepted: 07/23/2013] [Indexed: 01/18/2023]
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Oltra-Cucarella J, Pérez-Elvira R, Duque P. Benefits of deep encoding in Alzheimer disease. Analysis of performance on a memory task using the Item Specific Deficit Approach. Neurologia 2013; 29:286-93. [PMID: 24035297 DOI: 10.1016/j.nrl.2013.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 05/08/2013] [Accepted: 06/02/2013] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION the aim of this study is to test the encoding deficit hypothesis in Alzheimer disease (AD) using a recent method for correcting memory tests. To this end, a Spanish-language adaptation of the Free and Cued Selective Reminding Test was interpreted using the Item Specific Deficit Approach (ISDA), which provides three indices: Encoding Deficit Index, Consolidation Deficit Index, and Retrieval Deficit Index. METHODS We compared the performances of 15 patients with AD and 20 healthy control subjects and analysed results using either the task instructions or the ISDA approach. RESULTS patients with AD displayed deficient encoding of more than half the information, but items that were encoded properly could be retrieved later with the help of the same semantic clues provided individually during encoding. Virtually all the information retained over the long-term was retrieved by using semantic clues. Encoding was shown to be the most impaired process, followed by retrieval and consolidation. Discriminant function analyses showed that ISDA indices are more sensitive and specific for detecting memory impairments in AD than are raw scores. CONCLUSIONS These results indicate that patients with AD present impaired information encoding, but they benefit from semantic hints that help them recover previously learned information. This should be taken into account for intervention techniques focusing on memory impairments in AD.
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Affiliation(s)
- J Oltra-Cucarella
- Unidad de Neuropsicología, Servicio de Neurología, Hospital Clínico Universitario, Valencia, España.
| | - R Pérez-Elvira
- NEPSA Rehabilitación Neurológica, Salamanca, España; Hospital Centro de Cuidados Laguna, Madrid, España
| | - P Duque
- Programa de Neuropsicología Clínica, Hospital Virgen Macarena, Sevilla, España; Fundación Instituto Valenciano de Neurorrehabilitación, Valencia, España
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Foster PS, Drago V, Yung RC, Pearson J, Stringer K, Giovannetti T, Libon D, Heilman KM. Differential lexical and semantic spreading activation in Alzheimer's disease. Am J Alzheimers Dis Other Demen 2013; 28:501-7. [PMID: 23800553 PMCID: PMC10852973 DOI: 10.1177/1533317513494445] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
Alzheimer's disease (AD) is known to be associated with disruption in semantic networks. Previous studies examining changes in spreading activation in AD have used a lexical decision task paradigm. We have used a paradigm based on average word frequencies obtained from the words generated on the Controlled Oral Word Association Test (COWAT) and the Animal Naming (AN) test. The COWAT and AN tests were administered to a group of 25 patients with AD and 20 control participants. We predicted that the patients with AD would have higher average word frequencies on the COWAT and AN tests than the control participants. The results indicated that the AD group generated words with a higher average word frequency on the AN test but a lower average word frequency on the COWAT. The reasons for the discrepancy in average word frequencies on the AN test and COWAT are discussed.
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Affiliation(s)
- Paul S Foster
- Department of Psychology, Middle Tennessee State University, Murfreesboro, TN 37132, USA.
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Teng E, Leone-Friedman J, Lee GJ, Woo S, Apostolova LG, Harrell S, Ringman JM, Lu PH. Similar verbal fluency patterns in amnestic mild cognitive impairment and Alzheimer's disease. Arch Clin Neuropsychol 2013; 28:400-10. [PMID: 23752677 DOI: 10.1093/arclin/act039] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Disproportionately greater deficits in semantic relative to phonemic verbal fluency are seen in Alzheimer's disease (AD) and have been attributed to neurodegenerative changes in the temporal lobe. Amnestic (AMN) mild cognitive impairment (MCI), which often represents incipient AD, is also characterized by early temporal lobe neuropathology, but previous comparisons of verbal fluency between AD and AMN MCI have yielded mixed results. We examined semantic and phonemic verbal fluency performance in 399 individuals (78 AD, 138 AMN MCI, 72 non-amnestic MCI, and 111 cognitively normal controls). Similar verbal fluency patterns were seen in AMN MCI and AD; both groups exhibited disproportionately poorer performance on semantic verbal fluency relative to normal controls. However, relative verbal fluency indices performed more poorly than individual semantic or phonemic verbal fluency indices for discriminating AMN MCI or AD participants from normal controls, suggesting that they are unlikely to provide additional utility for predicting progression from MCI to AD.
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Affiliation(s)
- Edmond Teng
- Neurobehavior Unit, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
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Baker LD, Barsness SM, Borson S, Merriam GR, Friedman SD, Craft S, Vitiello MV. Effects of growth hormone–releasing hormone on cognitive function in adults with mild cognitive impairment and healthy older adults: results of a controlled trial. ACTA ACUST UNITED AC 2013; 69:1420-9. [PMID: 22869065 DOI: 10.1001/archneurol.2012.1970] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Growth hormone–releasing hormone(GHRH), growth hormone, and insulin like growth factor 1 have potent effects on brain function, their levels decrease with advancing age, and they likely play a role in the pathogenesis of Alzheimer disease. Previously, we reported favorable cognitive effects of short-term GHRH administration in healthy older adults and provided preliminary evidence to suggest a similar benefit in adults with mild cognitive impairment (MCI). OBJECTIVE To examine the effects of GHRH on cognitive function in healthy older adults and in adults with MCI. DESIGN Randomized,double-blind,placebo-controlled trial. SETTING Clinical Research Center, University of Washington School of Medicine in Seattle. PARTICIPANTS A total of 152 adults (66 with MCI) ranging in age from 55 to 87 years (mean age, 68 years); 137 adults (76 healthy participants and 61 participants with MCI) successfully completed the study. INTERVENTION Participants self-administered daily subcutaneous injections of tesamorelin (Theratechnologies Inc),a stabilized analog of human GHRH (1 mg/d), or placebo 30 minutes before bedtime for 20 weeks. At baseline, at weeks 10 and 20 of treatment, and after a 10-week washout(week 30), blood samples were collected, and parallel versions of a cognitive battery were administered. Before and after the 20-week intervention, participants completed an oral glucose tolerance test and a dual-energy x-ray absorptiometry scan to measure body composition. MAIN OUTCOME MEASURES Primary cognitive outcomes were analyzed using analysis of variance and included 3 composites reflecting executive function, verbal memory, and visual memory. Executive function was assessed with Stroop Color-Word Interference,Task Switching, the Self-Ordered Pointing Test, and Word Fluency, verbal memory was assessed with Story Recall and the Hopkins Verbal Learning Test,and visual memory was assessed with the Visual-Spatial Learning Test and Delayed Match-to-Sample. RESULTS The intent-to-treat analysis indicated a favorable effect of GHRH on cognition (P=.03), which was comparable in adults with MCI and healthy older adults.The completer analysis showed a similar pattern, with a more robust GHRH effect (P=.002). Subsequent analyses indicated a positive GHRH effect on executive function (P=.005) and a trend showing a similar treatment-related benefit in verbal memory(P=.08). Treatment with GHRH increased insulin like growth factor 1 levels by 117 %(P.001), which remained within the physiological range, and reduced percent body fat by 7.4%(P.001). Treatment with GHRH increased fasting insulin levels within the normal range by 35%in adults with MCI (P.001) but not in healthy adults. Adverse events were mild and were reported by 68%of GHRH treated adults and 36% of those who received placebo. CONCLUSIONS Twenty weeks of GHRH administration had favorable effects on cognition in both adults with MCI and healthy older adults. Longer-duration treatment trials are needed to further examine the therapeutic potential of GHRH administration on brain health during normal aging and “pathological aging.” TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00257712
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Affiliation(s)
- Laura D Baker
- Department of Psychiatry and Behavioral Science, University of Washington School of Medicine, USA.
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Vaskinn A, Wilsgård I, Holm A, Wootton R, Elvevåg B. A feasibility study of a telephone-based screening service for mild cognitive impairment and its uptake by elderly people. J Telemed Telecare 2013; 19:5-10. [PMID: 23390214 DOI: 10.1177/1357633x12473904] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The risk of developing mild cognitive impairment (MCI), and subsequently dementia, increases with age. Early detection requires a comprehensive clinical examination, which is time consuming and expensive; a face-to-face examination can also be problematic for people living in rural areas which may result in unequal access to services. Telephone-based screening may provide a feasible method of identifying people who would benefit from a full diagnostic workup. We conducted a pilot study in which we offered telephone screening to all patients aged over 60 years at a health clinic in rural northern Norway (n = 259). Fifteen percent of them volunteered (n = 39). Screening identified a number of suspicious cases and we recommended to their general practitioner that 7 patients (18%) be offered a follow-up appointment. Surveys showed that the volunteers were generally positive towards the service, as was the general practitioner who found it helpful to be provided with such information about the elderly patients in his care. In addition, we surveyed the opinions of all general practitioners (n = 480) in the three northernmost counties of Norway concerning a potential service. There was a response rate of 40% (n = 190). Almost half of respondents (45%) would like to make use of such a service if it existed, and 34% believed that their patients would make use of it if available. The pilot study demonstrates the feasibility of telephone screening for clinically significant memory decline, and that users (general practitioners and the elderly) are positive towards such a service.
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Affiliation(s)
- Anja Vaskinn
- KG Jebsen Centre for Psychosis Research, Oslo University Hospital, Oslo, Norway
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Mårdh S, Nägga K, Samuelsson S. A longitudinal study of semantic memory impairment in patients with Alzheimer’s disease. Cortex 2013; 49:528-33. [DOI: 10.1016/j.cortex.2012.02.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Revised: 10/17/2011] [Accepted: 02/07/2012] [Indexed: 10/28/2022]
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Smith JC, Nielson KA, Woodard JL, Seidenberg M, Rao SM. Physical activity and brain function in older adults at increased risk for Alzheimer's disease. Brain Sci 2013; 3:54-83. [PMID: 24961307 PMCID: PMC4061823 DOI: 10.3390/brainsci3010054] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2012] [Revised: 11/16/2012] [Accepted: 12/20/2012] [Indexed: 11/16/2022] Open
Abstract
Leisure-time physical activity (PA) and exercise training are known to help maintain cognitive function in healthy older adults. However, relatively little is known about the effects of PA on cognitive function or brain function in those at increased risk for Alzheimer's disease through the presence of the apolipoproteinE epsilon4 (APOE-ε4) allele, diagnosis of mild cognitive impairment (MCI), or the presence of metabolic disease. Here, we examine the question of whether PA and exercise interventions may differentially impact cognitive trajectory, clinical outcomes, and brain structure and function among individuals at the greatest risk for AD. The literature suggests that the protective effects of PA on risk for future dementia appear to be larger in those at increased genetic risk for AD. Exercise training is also effective at helping to promote stable cognitive function in MCI patients, and greater cardiorespiratory fitness is associated with greater brain volume in early-stage AD patients. In APOE-ε4 allele carriers compared to non-carriers, greater levels of PA may be more effective in reducing amyloid burden and are associated with greater activation of semantic memory-related neural circuits. A greater research emphasis should be placed on randomized clinical trials for exercise, with clinical, behavioral, and neuroimaging outcomes in people at increased risk for AD.
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Affiliation(s)
- J Carson Smith
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD 20742, USA.
| | - Kristy A Nielson
- Department of Psychology, Marquette University, PO Box 1881, Milwaukee, WI 53201, USA.
| | - John L Woodard
- Department of Psychology, Wayne State University, 5057 Woodward Ave, Detroit, MI 48202, USA.
| | - Michael Seidenberg
- Department of Psychology, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Rd, North Chicago, IL 60064, USA.
| | - Stephen M Rao
- Schey Center for Cognitive Neuroimaging, Neurological Institute, Cleveland Clinic, 9500 Euclid Ave/U10, Cleveland, OH 44195, USA.
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Verma M, Howard RJ. Semantic memory and language dysfunction in early Alzheimer's disease: a review. Int J Geriatr Psychiatry 2012; 27:1209-17. [PMID: 22298328 DOI: 10.1002/gps.3766] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2011] [Accepted: 12/07/2011] [Indexed: 01/18/2023]
Abstract
BACKGROUND Language impairment in Alzheimer's disease occurs early, and language function deteriorates with progression of the illness to cause significant disability. This review focuses on language dysfunction in Alzheimer's disease and the contribution of semantic memory impairment. METHODS Electronic publication databases were searched for literature relevant to the review. Additionally, individual references were examined to elicit further studies not found by online search. RESULTS Language impairment in Alzheimer's disease initially affects verbal fluency and naming before breakdown in other facets. Naming and fluency require integrity of semantic concepts, and dysfunction may be a marker of primary semantic memory impairment rather than overall cognitive decline. Research suggests the presence of semantic loss several years prior to diagnosis. Imaging studies indicate an altered connectivity state with respect to language networks, and this is associated with potential semantic failure. This state may also be present in individuals with established risk factors for Alzheimer's disease. Compensatory recruitment of alternative cortical areas to supplement language function appears to occur and may be a target for future intervention. CONCLUSIONS Identifying and classifying the nature and degree of language impairment more closely could aid in developing targeted therapies. Treatments already established in other aphasic states, such as post-stroke, may be especially relevant. The nature of these and the protective nature of cognitive reserve are potential therapeutic avenues.
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Affiliation(s)
- M Verma
- Dept. of Old Age Psychiatry, Institute of Psychiatry, King's College London, De Crespigny Park, London, SE5 8AF.
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Suzuki T, Shimada H, Makizako H, Doi T, Yoshida D, Tsutsumimoto K, Anan Y, Uemura K, Lee S, Park H. Effects of multicomponent exercise on cognitive function in older adults with amnestic mild cognitive impairment: a randomized controlled trial. BMC Neurol 2012; 12:128. [PMID: 23113898 PMCID: PMC3534485 DOI: 10.1186/1471-2377-12-128] [Citation(s) in RCA: 147] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Accepted: 10/10/2012] [Indexed: 12/02/2022] Open
Abstract
Background To examine the effects of a multicomponent exercise program on the cognitive function of older adults with amnestic mild cognitive impairment (aMCI). Methods Design: Twelve months, randomized controlled trial; Setting: Community center in Japan; Participants: Fifty older adults (27 men) with aMCI ranging in age from 65 to 93 years (mean age, 75 years); Intervention: Subjects were randomized into either a multicomponent exercise (n = 25) or an education control group (n = 25). Subjects in the multicomponent exercise group exercised under the supervision of physiotherapists for 90 min/d, 2 d/wk, for a total of 80 times over 12 months. The exercises included aerobic exercises, muscle strength training, and postural balance retraining, and were conducted using multiple conditions to stimulate cognitive functions. Subjects in the control group attended three education classes regarding health during the 12-month period. Measurements were administered before, after the 6-month, and after the 12-month intervention period; Measurements: The performance measures included the mini-mental state examination, logical memory subtest of the Wechsler memory scale-revised, digit symbol coding test, letter and categorical verbal fluency test, and the Stroop color word test. Results The mean adherence to the exercise program was 79.2%. Improvements of cognitive function following multicomponent exercise were superior at treatment end (group × time interactions for the mini-mental state examination (P = 0.04), logical memory of immediate recall (P = 0.03), and letter verbal fluency test (P = 0.02)). The logical memory of delayed recall, digit symbol coding, and Stroop color word test showed main effects of time, although there were no group × time interactions. Conclusions This study indicates that exercise improves or supports, at least partly, cognitive performance in older adults with aMCI.
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Affiliation(s)
- Takao Suzuki
- Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan.
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Scott Mackin R, Lesselyong JA, Yaffe K. Pattern of cognitive impairment in older veterans with posttraumatic stress disorder evaluated at a memory disorders clinic. Int J Geriatr Psychiatry 2012; 27:637-42. [PMID: 22213461 PMCID: PMC3685474 DOI: 10.1002/gps.2763] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Accepted: 06/20/2011] [Indexed: 11/12/2022]
Abstract
BACKGROUND We determined the pattern of clinically significant cognitive impairment (CI) among older veterans with posttraumatic stress disorder (PTSD) evaluated in a memory disorders clinic. METHODS Data were collected from 19 ethnically diverse veterans. Cognitive functioning in six domains (verbal learning, memory, attention, language, executive functioning, and information processing speed) was assessed. RESULTS The majority of veterans (57%) demonstrated CI on a measure of single trial list learning, 44% exhibited CI on short delay memory for lists, and 31% exhibited CI in long delay memory for lists. CI on measures of memory for stories (14%) and executive functioning (6%) were less common, and none of the participants demonstrated CI on measures of attention, language, or information processing speed. CONCLUSIONS CI on measures of single trial list learning and memory for lists are common in older patients with PTSD evaluated in a memory disorders clinic and are likely to contribute to functional deficits.
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Affiliation(s)
- R. Scott Mackin
- Department of Psychiatry; University of California; San Francisco; CA; USA
| | | | - Kristine Yaffe
- Department of Psychiatry; University of California; San Francisco; CA; USA
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The profile of executive functioning in amnestic mild cognitive impairment: disproportionate deficits in inhibitory control. J Int Neuropsychol Soc 2012; 18:541-55. [PMID: 22370245 DOI: 10.1017/s1355617712000069] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Amnestic mild cognitive impairment (aMCI) represents a group of individuals who are highly likely to develop Alzheimer's disease (AD). Although aMCI is typically conceptualized as involving predominantly deficits in episodic memory, recent studies have demonstrated that deficits in executive functioning may also be present, and thorough categorization of cognitive functioning in MCI may improve early diagnosis and treatment of AD. We first provide an extensive review of neuropsychology studies that examined executive functioning in MCI. We then present data on executive functioning across multiple sub-domains (divided attention, working memory, inhibitory control, verbal fluency, and planning) in 40 aMCI patients (single or multiple domain) and 32 normal elderly controls (NECs). MCI patients performed significantly worse than NECs in all 5 sub-domains, and there was impairment (>1.0 SD below the mean of NECs) in all sub-domains. Impairment on each test was frequent, with 100% of MCI patients exhibiting a deficit in at least one sub-domain of executive functioning. Inhibitory control was the most frequently and severely impaired. These results indicate that executive dysfunction in multiple sub-domains is common in aMCI and highlights the importance of a comprehensive neuropsychological evaluation for fully characterizing the nature and extent of cognitive deficits in MCI.
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Archer T, Kostrzewa RM, Beninger RJ, Palomo T. Staging neurodegenerative disorders: structural, regional, biomarker, and functional progressions. Neurotox Res 2011; 19:211-34. [PMID: 20393891 DOI: 10.1007/s12640-010-9190-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Revised: 03/02/2010] [Accepted: 03/30/2010] [Indexed: 12/11/2022]
Abstract
The notion of staging in the neurodegenerative disorders is modulated by the constant and progressive loss of several aspects of brain structural integrity, circuitry, and neuronal processes. These destructive processes eventually remove individuals' abilities to perform at sufficient and necessary functional capacity at several levels of disease severity. The classification of (a) patients on the basis of diagnosis, risk prognosis, and intervention outcome, forms the basis of clinical staging, and (b) laboratory animals on the basis of animal model of brain disorder, extent of insult, and dysfunctional expression, provides the components for the clinical staging and preclinical staging, respectively, expressing associated epidemiological, biological, and genetic characteristics. The major focus of clinical staging in the present account stems from the fundamental notions of Braak staging as they describe the course and eventual prognosis for Alzheimer's disease, Lewy Body dementia, and Parkinson's disease. Mild cognitive impairment, which expresses the decline in episodic and semantic memory performance below the age-adjusted normal range without marked loss of global cognition or activities of daily living, and the applications of longitudinal magnetic resonance imaging, major instruments for the monitoring of either disease progression in dementia, present important challenges for staging concepts. Although Braak notions present the essential basis for further developments, current staging conceptualizations seem inadequate to comply with the massive influx of information dealing with neurodegenerative processes in brain, advanced both under clinical realities, and discoveries in the laboratory setting. The contributions of various biomarkers of disease progression, e.g., amyloid precursor protein, and neurotransmitter system imbalances, e.g., dopamine receptor supersensitivity and interactive propensities, await their incorporation into the existing staging models thereby underlining the ongoing, dynamic feature of the staging of brain disorders.
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Affiliation(s)
- Trevor Archer
- Department of Psychology, University of Gothenburg, Box 500, SE-405 30 Gothenburg, Sweden.
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Quaderi A. La connotation dans les paroles de patients atteints de la maladie d’Alzheimer : une méthode d’écoute. ANNALES MEDICO-PSYCHOLOGIQUES 2011. [DOI: 10.1016/j.amp.2011.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Baker LD, Frank LL, Foster-Schubert K, Green PS, Wilkinson CW, McTiernan A, Cholerton BA, Plymate SR, Fishel MA, Watson GS, Duncan GE, Mehta PD, Craft S. Aerobic exercise improves cognition for older adults with glucose intolerance, a risk factor for Alzheimer's disease. J Alzheimers Dis 2011; 22:569-79. [PMID: 20847403 DOI: 10.3233/jad-2010-100768] [Citation(s) in RCA: 175] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Impaired glucose regulation is a defining characteristic of type 2 diabetes mellitus (T2DM) pathology and has been linked to increased risk of cognitive impairment and dementia. Although the benefits of aerobic exercise for physical health are well-documented, exercise effects on cognition have not been examined for older adults with poor glucose regulation associated with prediabetes and early T2DM. Using a randomized controlled design, twenty-eight adults (57-83 y old) meeting 2-h tolerance test criteria for glucose intolerance completed 6 months of aerobic exercise or stretching, which served as the control. The primary cognitive outcomes included measures of executive function (Trails B, Task Switching, Stroop, Self-ordered Pointing Test, and Verbal Fluency). Other outcomes included memory performance (Story Recall, List Learning), measures of cardiorespiratory fitness obtained via maximal-graded exercise treadmill test, glucose disposal during hyperinsulinemic-euglycemic clamp, body fat, and fasting plasma levels of insulin, cortisol, brain-derived neurotrophic factor, insulin-like growth factor-1, amyloid-β (Aβ40 and Aβ42). Six months of aerobic exercise improved executive function (MANCOVA, p=0.04), cardiorespiratory fitness (MANOVA, p=0.03), and insulin sensitivity (p=0.05). Across all subjects, 6-month changes in cardiorespiratory fitness and insulin sensitivity were positively correlated (p=0.01). For Aβ42, plasma levels tended to decrease for the aerobic group relative to controls (p=0.07). The results of our study using rigorous controlled methodology suggest a cognition-enhancing effect of aerobic exercise for older glucose intolerant adults. Although replication in a larger sample is needed, our findings potentially have important therapeutic implications for a growing number of adults at increased risk of cognitive decline.
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Affiliation(s)
- Laura D Baker
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA.
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Lonie JA, Parra-Rodriguez MA, Tierney KM, Herrmann LL, Donaghey C, O'Carroll RE, Ebmeier KP. Predicting outcome in mild cognitive impairment: 4-year follow-up study. Br J Psychiatry 2010; 197:135-40. [PMID: 20679266 DOI: 10.1192/bjp.bp.110.077958] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Cognitive impairment precedes the diagnosis of Alzheimer's disease. It is unclear which psychometric measures predict dementia, and what cut-off points should be used. Replicable cognitive measures to provide information about differential diagnosis and prognosis would be clinically useful. AIMS In a prospective cohort study we investigated which measures distinguish between individuals with amnestic mild cognitive impairment (aMCI) that converts to dementia and those whose impairment does not, and which combination of measures best predicts the fate of people with aMCI. METHOD Forty-four participants with aMCI underwent extensive neuropsychological assessment at baseline and annually thereafter for an average of 4 years. Differences in baseline cognitive performance of participants who were converters and non-converters to clinically diagnosed dementia were analysed. Classification accuracy was estimated by sensitivity, specificity, positive and negative predictive values and using logistic regression. RESULTS Forty-one percent of participants had progressed to dementia by the end of study, with a mean annual conversion rate of 11%. Most (63%) showed persisting or progressive cognitive impairment, irrespective of diagnosis. The Addenbrooke's Cognitive Examination together with the discrimination index of the Hopkins Verbal Learning Test - Revised (but none of the demographic indices) differentiated the participants who were converters from the non-converters at baseline with 74% accuracy. CONCLUSIONS Targeted neuropsychological assessment, beyond simple cognitive screening, could be used in clinical practice to provide individuals with aMCI with prognostic information and aid selective early initiation of monitoring and treatment among those who progress towards a clinically diagnosable dementia.
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Affiliation(s)
- Jane A Lonie
- Division of Psychiatry, University of Edinburgh, UK
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Baker LD, Frank LL, Foster-Schubert K, Green PS, Wilkinson CW, McTiernan A, Plymate SR, Fishel MA, Watson GS, Cholerton BA, Duncan GE, Mehta PD, Craft S. Effects of aerobic exercise on mild cognitive impairment: a controlled trial. ACTA ACUST UNITED AC 2010; 67:71-9. [PMID: 20065132 DOI: 10.1001/archneurol.2009.307] [Citation(s) in RCA: 760] [Impact Index Per Article: 54.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To examine the effects of aerobic exercise on cognition and other biomarkers associated with Alzheimer disease pathology for older adults with mild cognitive impairment, and assess the role of sex as a predictor of response. DESIGN Six-month, randomized, controlled, clinical trial. SETTING Veterans Affairs Puget Sound Health Care System clinical research unit. PARTICIPANTS Thirty-three adults (17 women) with amnestic mild cognitive impairment ranging in age from 55 to 85 years (mean age, 70 years). Intervention Participants were randomized either to a high-intensity aerobic exercise or stretching control group. The aerobic group exercised under the supervision of a fitness trainer at 75% to 85% of heart rate reserve for 45 to 60 min/d, 4 d/wk for 6 months. The control group carried out supervised stretching activities according to the same schedule but maintained their heart rate at or below 50% of their heart rate reserve. Before and after the study, glucometabolic and treadmill tests were performed and fat distribution was assessed using dual-energy x-ray absorptiometry. At baseline, month 3, and month 6, blood was collected for assay and cognitive tests were administered. MAIN OUTCOME MEASURES Performance measures on Symbol-Digit Modalities, Verbal Fluency, Stroop, Trails B, Task Switching, Story Recall, and List Learning. Fasting plasma levels of insulin, cortisol, brain-derived neurotrophic factor, insulinlike growth factor-I, and beta-amyloids 40 and 42. RESULTS Six months of high-intensity aerobic exercise had sex-specific effects on cognition, glucose metabolism, and hypothalamic-pituitary-adrenal axis and trophic activity despite comparable gains in cardiorespiratory fitness and body fat reduction. For women, aerobic exercise improved performance on multiple tests of executive function, increased glucose disposal during the metabolic clamp, and reduced fasting plasma levels of insulin, cortisol, and brain-derived neurotrophic factor. For men, aerobic exercise increased plasma levels of insulinlike growth factor I and had a favorable effect only on Trails B performance. CONCLUSIONS This study provides support, using rigorous controlled methodology, for a potent nonpharmacologic intervention that improves executive control processes for older women at high risk of cognitive decline. Moreover, our results suggest that a sex bias in cognitive response may relate to sex-based differences in glucometabolic and hypothalamic-pituitary-adrenal axis responses to aerobic exercise.
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Affiliation(s)
- Laura D Baker
- Departments of Psychiatry and BehavioralScience, University of Washington School of Medicine,Seattle, Washington, USA.
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