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Olejnik P, Golenia A, Maciejewska O, Wojtaszek E, Żebrowski P, Małyszko J. The Clock Drawing Task reveals executive dysfunction in the dialysis population - an underrecognized and underestimated problem. Ren Fail 2024; 46:2306232. [PMID: 38275184 PMCID: PMC10823881 DOI: 10.1080/0886022x.2024.2306232] [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] [Received: 10/12/2023] [Accepted: 01/11/2024] [Indexed: 01/27/2024] Open
Abstract
AIM OF THE STUDY The study aimed to assess the prevalence of executive function impairment among patients with chronic kidney disease (CKD) undergoing dialysis, with no subjective cognitive problems and with normal global cognition on the Mini-Mental State Examination (MMSE). We also investigated the relationship between cardiovascular risk factors and cognitive test results. RATIONALE FOR THE STUDY Patients with CKD, including those undergoing renal replacement therapy, are at a higher risk of developing cognitive impairment (CI) than the general population. Recent research has shown CI to be a growing problem among CKD patients worldwide. Yet, it remains underdiagnosed, even though it may significantly influence the lives of patients. MATERIALS AND METHODS In this cross-sectional, prospective study, 58 dialysis patients with no cognitive decline on the MMSE screening were assessed for executive function impairment using the Executive Clock-Drawing Task (CLOX). Moreover, past medical history, demographic data, and laboratory test results were collected. RESULTS The mean patient age was 59.47 ± 14.98 years, and the mean duration of dialysis was 45.93 ± 48.49 months. The prevalence of executive function impairment amounted to 8.6%. Moreover, remarkably similar pattern of clock drawing was observed, with numbers written outside the clock face in the CLOX1 test. CONCLUSIONS Executive dysfunctions in dialysis patients may manifest itself before the onset of global cognitive impairment. There appear to be a deficit in the spatial domain as well. Better education may play a protective role.
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Affiliation(s)
- Piotr Olejnik
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland
| | | | - Oliwia Maciejewska
- Department of Neurology, University Clinical Center, Medical University of Warsaw, Warsaw, Poland
| | - Ewa Wojtaszek
- Department of Nephrology, Dialysis and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Paweł Żebrowski
- Department of Nephrology, Dialysis and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Jolanta Małyszko
- Department of Nephrology, Dialysis and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
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Sánchez-Fernández MDM, Reyes Del Paso GA, Quirós-Ganga PL, Moreno-Salazar AS, Fernández-Serrano MJ. [Neuropsychological impairments in patients undergoing peritoneal dialysis treatment]. Med Clin (Barc) 2024; 162:147-156. [PMID: 38007389 DOI: 10.1016/j.medcli.2023.09.012] [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] [Received: 03/23/2023] [Revised: 09/09/2023] [Accepted: 09/14/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND Patients with chronic kidney disease on hemodialysis (HD) often have cognitive deficits. However, there are few studies that have examined the neuropsychological impairments of patients receiving peritoneal dialysis (PD). METHODS Executive functions, processing speed and verbal memory were assessed in 27 PD patients, 42 HD patients, and 42 healthy participants (HP). Systolic blood pressure and total time on renal replacement therapy (RRT) were controlled statistically. Associations between performance and clinical factors were analyzed using correlations and multiple regression. RESULTS The DP group showed better performance compared to the HD group in verbal fluency, working memory, cognitive flexibility, planning and decision making. The DP group showed worse execution than the HP group in verbal inhibition and memory. Executive function scores were positively associated with total months on PD, total months on RRT, total months on HD, albumin, total cholesterol, and phosphorus, and negatively with ferritin. CONCLUSION Global executive functioning was more optimal in PD patients than in HD patients. The results show the positive effect of PD on executive functions, which must be taken into account when choosing the TRS. The associations observed between biochemical factors and performance show the importance of maintaining an adequate nutritional status in these patients.
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Kim H, Yang S, Park J, Kim BC, Yu KH, Kang Y. Effect of Education on Discriminability of Montreal Cognitive Assessment Compared to Mini-Mental State Examination. Dement Neurocogn Disord 2023; 22:69-77. [PMID: 37179689 PMCID: PMC10166679 DOI: 10.12779/dnd.2023.22.2.69] [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] [Received: 04/03/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
Background and Purpose The Montreal Cognitive Assessment (MoCA) has been known as a screening test for detecting mild cognitive impairment (MCI) better than Mini-Mental State Examination (MMSE). However, in previous domestic studies, no significant difference was found in the discriminability between MoCA and MMSE. Researchers have suggested that this might be because older Koreans are less educated than older Westerners. This study was conducted to examine the effect of education on the discriminability of MoCA compared to the MMSE. Methods Participants were 123 cognitively normal elderly, 118 with vascular MCI, 108 with amnestic MCI, 121 with vascular dementia, and 113 with dementia of the Alzheimer's type. The Korean-MoCA (K-MoCA) and Korean-MMSE (K-MMSE) were administered. Multiple regression analyses and receiver operating characteristic (ROC) curve analyses were performed. Results In all participants, education significantly affected both K-MoCA and K-MMSE scores along with age. The effect of education was re-examined by subgroup analysis after dividing subjects according to the level of education. Effect of education on K-MoCA and K-MMSE was only shown in the group with <9 years of education. ROC curve analyses revealed that the discriminability of K-MoCA to differentiate between vascular MCI and normal elderly was significantly higher than that of K-MMSE. When re-examining subgroups divided by education level, however, this higher discriminability of K-MoCA disappeared in the group with <9 years of education. Conclusions These results indicate no difference in discriminating cognitive deficits between K-MoCA and K-MMSE in Korean elderly with <9 years of education.
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Affiliation(s)
- Haeyoon Kim
- Department of Psychology, College of Social Sciences, Hallym University, Chuncheon, Korea
- Department of Neurology, Choennam National University Hospital, Gwangju, Korea
| | - Seonyeong Yang
- Department of Psychology, College of Social Sciences, Hallym University, Chuncheon, Korea
| | - Jaesel Park
- Department of Psychology, College of Social Sciences, Hallym University, Chuncheon, Korea
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Byeong Chae Kim
- Department of Neurology, Choennam National University Hospital, Gwangju, Korea
| | - Kyung-Ho Yu
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Yeonwook Kang
- Department of Psychology, College of Social Sciences, Hallym University, Chuncheon, Korea
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Hadiyoso S, Ong PA, Zakaria H, Rajab TLE. EEG-Based Spectral Dynamic in Characterization of Poststroke Patients with Cognitive Impairment for Early Detection of Vascular Dementia. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:5666229. [PMID: 36444210 PMCID: PMC9701122 DOI: 10.1155/2022/5666229] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 09/08/2022] [Accepted: 11/03/2022] [Indexed: 10/17/2023]
Abstract
One common type of vascular dementia (VaD) is poststroke dementia (PSD). Vascular dementia can occur in one-third of stroke patients. The worsening of cognitive function can occur quickly if not detected and treated early. One of the potential medical modalities for observing this disorder by considering costs and safety factors is electroencephalogram (EEG). It is thought that there are differences in the spectral dynamics of the EEG signal between the normal group and stroke patients with cognitive impairment so that it can be used in detection. Therefore, this study proposes an EEG signal characterization method using EEG spectral power complexity measurements to obtain features of poststroke patients with cognitive impairment and normal subjects. Working memory EEGs were collected and analyzed from forty-two participants, consisting of sixteen normal subjects, fifteen poststroke patients with mild cognitive impairment, and eleven poststroke patients with dementia. From the analysis results, it was found that there were differences in the dynamics of the power spectral in each group, where the spectral power of the cognitively impaired group was more regular than the normal group. Notably, (1) significant differences in spectral entropy (SpecEn) with a p value <0.05 were found for all electrodes, (2) there was a relationship between SpecEn values and the severity of dementia (SpecEnDem < SpecEnMCI < SpecEnNormal), and (3) a post hoc multiple comparison test showed significant differences between groups at the F7 electrode. This study shows that spectral complexity analysis can discriminate between normal and poststroke patients with cognitive impairment. For further studies, it is necessary to simulate performance validation so that the proposed approach can be used in the early detection of poststroke dementia and monitoring the development of dementia.
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Affiliation(s)
- Sugondo Hadiyoso
- School of Electrical Engineering and Informatics, Bandung Institute of Technology, Bandung, Indonesia
- School of Applied Science, Telkom University, Bandung, Indonesia
| | - Paulus Anam Ong
- Departement of Neurology, Faculty of Medicine, Padjadjaran University, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Hasballah Zakaria
- School of Electrical Engineering and Informatics, Bandung Institute of Technology, Bandung, Indonesia
| | - Tati Latifah E. Rajab
- School of Electrical Engineering and Informatics, Bandung Institute of Technology, Bandung, Indonesia
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Barbosa BJAP, Siqueira Neto JI, Alves GS, Sudo FK, Suemoto CK, Tovar-Moll F, Smid J, Schilling LP, Balthazar MLF, Frota NAF, Souza LCD, Vale FAC, Caramelli P, Bertolucci PHF, Brucki SMD, Nitrini R, Engelhardt E, Chaves MLF. Diagnosis of vascular cognitive impairment: recommendations of the scientific department of cognitive neurology and aging of the Brazilian Academy of Neurology. Dement Neuropsychol 2022. [DOI: 10.1590/1980-5764-dn-2022-s104en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
ABSTRACT Since the publication of the latest recommendations for the diagnosis and treatment of Vascular Dementia by the Brazilian Academy of Neurology in 2011, significant advances on the terminology and diagnostic criteria have been made. This manuscript is the result of a consensus among experts appointed by the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology (2020-2022). We aimed to update practical recommendations for the identification, classification, and diagnosis of Vascular Cognitive Impairment (VCI). Searches were performed in the MEDLINE, Scopus, Scielo, and LILACS databases. This guideline provides a comprehensive review and then synthesizes the main practical guidelines for the diagnosis of VCI not only for neurologists but also for other professionals involved in the assessment and care of patients with VCI, considering the different levels of health care (primary, secondary and tertiary) in Brazil.
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Affiliation(s)
- Breno José Alencar Pires Barbosa
- Universidade Federal de Pernambuco, Brasil; Instituto de Medicina Integral Prof. Fernando Figueira, Brasil; Universidade de São Paulo, Brasil
| | | | | | | | | | | | | | - Lucas Porcello Schilling
- Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil
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Barbosa BJAP, Siqueira Neto JI, Alves GS, Sudo FK, Suemoto CK, Tovar-Moll F, Smid J, Schilling LP, Balthazar MLF, Frota NAF, Souza LCD, Vale FAC, Caramelli P, Bertolucci PHF, Brucki SMD, Nitrini R, Engelhardt E, Chaves MLF. Diagnóstico do comprometimento cognitivo vascular: recomendações do Departamento Científico de Neurologia Cognitiva e do Envelhecimento da Academia Brasileira de Neurologia. Dement Neuropsychol 2022; 16:53-72. [DOI: 10.1590/1980-5764-dn-2022-s104pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 12/08/2021] [Accepted: 04/27/2022] [Indexed: 12/14/2022] Open
Abstract
RESUMO Desde a publicação das últimas recomendações para o diagnóstico e tratamento da Demência Vascular pela Academia Brasileira de Neurologia em 2011, avanços significativos ocorreram na terminologia e critérios diagnósticos. O presente manuscrito é resultado do consenso entre especialistas indicados pelo Departamento Científico de Neurologia Cognitiva e do Envelhecimento da Academia Brasileira de Neurologia (2020-2022). O objetivo foi atualizar as recomendações práticas para a identificação, classificação e diagnóstico do Comprometimento Cognitivo Vascular (CCV). As buscas foram realizadas nas plataformas MEDLINE, Scopus, Scielo e LILACS. As recomendações buscam fornecer uma ampla revisão sobre o tema, então sintetizar as evidências para o diagnóstico do CCV não apenas para neurologistas, mas também para outros profissionais de saúde envolvidos na avaliação e nos cuidados ao paciente com CCV, considerando as diferentes realidades dos níveis de atenção à saúde (primário, secundário e terciário) no Brasil.
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Affiliation(s)
- Breno José Alencar Pires Barbosa
- Universidade Federal de Pernambuco, Brasil; Instituto de Medicina Integral Prof. Fernando Figueira, Brasil; Universidade de São Paulo, Brasil
| | | | | | | | | | | | | | - Lucas Porcello Schilling
- Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil
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7
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Guo Y, Zhao S, Hou X, Nie S, Xu S, Hong Y, Chen Y, Guo S, Liu X, Xia Z. Insidious Attentional Deficits in Patients With Cerebral Small Vessel Disease Revealed by Attention Network Test. Front Neurol 2022; 13:865307. [PMID: 35795794 PMCID: PMC9251063 DOI: 10.3389/fneur.2022.865307] [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: 01/29/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background Several reports have indicated potential cognitive decline for cerebral small vessel disease (CSVD), especially in attention domain, whereas the attentional function at network level is still elusive. In this study, we used the attention network test (ANT) paradigm to characterize the efficiency of the alerting, orienting, and executive control networks in patients with CSVD and explore possible correlations between attention network efficiencies and obtained CSVD total score. Methods A total of 31 patients with CSVD and 30 healthy controls matched for age, gender, and education level were recruited. After neuropsychological and anxiety/depression/somatization assessments, an original version of ANT containing different cue conditions and target stimuli was used to investigate independent attentional components, and then, behavioral performance (accuracy and reaction time) and network efficacy were recorded and analyzed. Results Assessed by traditional neuropsychological scale (MoCA), we did not find difference between groups on general cognition. Nevertheless, the overall reaction time to targets of ANT was markedly prolonged in patients with CSVD, and similar phenomenon was observed for overall accuracy on ANT. Moreover, patients showed significantly lower orienting and executive control network efficiencies compared with controls, while not for alerting network. These impairments were correlated with total CSVD burdens, but not with anxiety, depression, or somatization. Conclusions Although general and almost all individual cognitive function evaluated by MoCA seemed to remain intact, the orienting and executive control function was impaired in individuals with CSVD, which was modulated by lesion grades. Our observations implied insidious attentional deficits regarding CSVD. Given this, considering its simplicity and sensitivity, ANT could serve as an attractive tool for early diagnosis of cognitive dysfunction. Further investigations on the availability of ANT detection for CSVD are warranted.
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Affiliation(s)
- Yunliang Guo
- Department of Geriatric Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Department of Neurology, Liaocheng People's Hospital and Liaocheng Clinical School of Shandong First Medical University, Liaocheng, China
- Department of Geriatric Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Geriatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Shuo Zhao
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Xunyao Hou
- Department of Geriatric Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Department of Geriatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Shanjing Nie
- Department of Geriatric Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Department of Geriatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Song Xu
- Department of Geriatric Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Department of Geriatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Yan Hong
- Department of Geriatric Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Department of Geriatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Yali Chen
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Shougang Guo
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xueping Liu
- Department of Geriatric Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Department of Geriatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Xueping Liu
| | - Zhangyong Xia
- Department of Neurology, Liaocheng People's Hospital and Liaocheng Clinical School of Shandong First Medical University, Liaocheng, China
- Department of Neurology, Liaocheng People's Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- *Correspondence: Zhangyong Xia
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Wu CY, Shapiro L, Ouk M, MacIntosh BJ, Black SE, Shah BR, Swardfager W. Glucose-lowering drugs, cognition, and dementia: The clinical evidence. Neurosci Biobehav Rev 2022; 137:104654. [PMID: 35398114 DOI: 10.1016/j.neubiorev.2022.104654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 04/01/2022] [Accepted: 04/03/2022] [Indexed: 11/19/2022]
Abstract
Type 2 diabetes mellitus (T2DM) is an important risk factor for dementia. The possibility to mitigate this risk by controlling T2DM is compelling; however, different glucose-lowering drugs have different effects on the brain by virtue of their different mechanisms of action. The clinical and epidemiological data appear mixed, warranting careful critical evaluation of the human studies. Here we examine the evidence in the context of dementia prevention and treatment, both for people with and without T2DM. We discuss the evidence on this scaffold of research directions, identifying methodological complexities in the extant literature (e.g. comparator discrepancies, changes in the therapeutic landscape), and the implications of different outcome measures (e.g. neuropsychological). We consider possible implications of cerebrovascular protection vs. effects on progression of neurodegenerative proteinopathy, and we present a research roadmap for glucose-lowering drugs in cognitive neurology, including neuroimaging, and fluid biomarkers. We conclude that there is great potential to advance personalized strategies to prevent and treat dementia with glucose-lowering drugs.
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Affiliation(s)
- Che-Yuan Wu
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada; Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Lila Shapiro
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada; Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Michael Ouk
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada; Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Bradley J MacIntosh
- Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada; Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Sandra E Black
- Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada; Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Medicine, Division of Neurology, University of Toronto, Toronto, Ontario, Canada; Toronto Dementia Research Alliance, Toronto, Ontario, Canada
| | - Baiju R Shah
- ICES, Toronto, Ontario, Canada; Divisions of Endocrinology and Obstetric Medicine, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Walter Swardfager
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada; Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada; Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Ontario, Canada; KITE UHN Toronto Rehabilitation Institute, Toronto, Ontario, Canada
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Ayers MR, Bushnell J, Gao S, Unverzagt F, Gaizo JD, Wadley VG, Kennedy R, Clark DG. Verbal fluency response times predict incident cognitive impairment. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12277. [PMID: 35571962 PMCID: PMC9074715 DOI: 10.1002/dad2.12277] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/18/2021] [Accepted: 11/22/2021] [Indexed: 01/09/2023]
Abstract
Introduction In recent decades, researchers have defined novel methods for scoring verbal fluency tasks. In this work, we evaluate novel scores based on speed of word responses. Methods We transcribed verbal fluency recordings from 641 cases of incident cognitive impairment (ICI) and matched controls, all participants in a large national epidemiological study. Timing measurements of utterances were used to calculate a speed score for each recording. Traditional raw and speed scores were entered into Cox proportional hazards (CPH) regression models predicting time to ICI. Results Concordance of the CPH model with speed scores was 0.599, an improvement of 3.4% over a model with only raw scores and demographics. Scores with significant effects included animals raw and speed scores, and letter F speed score. Discussion Novel verbal fluency scores based on response times could enable use of remotely administered fluency tasks for early detection of cognitive decline. Highlights The current work evaluates prognostication with verbal fluency speed scores. These speed scores improve survival models predicting cognitive decline. Cases with progressive decline have some characteristics suggestive of Alzheimer's disease. The subset of acute decliners is probably pathologically heterogeneous.
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Affiliation(s)
- Matthew R. Ayers
- Department of PsychiatryRichard L. Roudebush VA Medical CenterIndianapolisIndianaUSA
| | - Justin Bushnell
- Department of NeurologyIndiana UniversityIndianapolisIndianaUSA
| | - Sujuan Gao
- Department of BiostatisticsIndiana UniversityIndianapolisIndianaUSA
| | | | - John Del Gaizo
- Biomedical Informatics CenterMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Virginia G. Wadley
- Department of MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Richard Kennedy
- Department of MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
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Ng TP, Nyunt MSZ, Gao Q, Gwee X, Chua DQL, Yap KB. Curcumin-Rich Curry Consumption and Neurocognitive Function from 4.5-Year Follow-Up of Community-Dwelling Older Adults (Singapore Longitudinal Ageing Study). Nutrients 2022; 14:nu14061189. [PMID: 35334842 PMCID: PMC8952785 DOI: 10.3390/nu14061189] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/04/2022] [Accepted: 03/04/2022] [Indexed: 02/04/2023] Open
Abstract
The potential neurocognition protective effects of dietary curcumin in curry consumed with food was investigated in this study of 2734 community-dwelling adults (aged ≥ 55, mean ± SD: 65.9 ± 7.4). We analyzed longitudinal data of baseline curry consumption (“never or rarely”, “occasionally”: <once a month, “often”: >once a month and <once a week, “very often”: >once a week or daily) and baseline and 4.5-year follow-up cognitive function in mixed model analyses controlling for confounding risk factors. Significant between-exposure differences were found for Digit Span-Backward (DS-B), Verbal Fluency-Animals (VF-A) and Block Design (BD). Compared to “never or rarely” consumption, “very often” and “often” consumptions were associated with higher DS-B performance; “very often”—with higher VF-A, and “occasional”, “often” and “very often” consumptions—with higher BD: Cohen’s d: from 0.130 to 0.186. Among participants with cardiometabolic and cardiac diseases (CMVD), curry consumption was associated with significantly higher DS-B and VF-A. Among CMVD-free participants, curry consumption was associated with significantly higher DS-B, VF-A and BD: Cohen’s d: from 0.098 to 0.305. The consumption of dietary curcumin was associated with the maintenance over time of higher functioning on attention, short-term working memory, visual spatial constructional ability, language and executive function among community-dwelling older Asian adults.
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Affiliation(s)
- Tze Pin Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; (X.G.); (D.Q.L.C.)
- Geriatric Education and Research Institute, Singapore 768024, Singapore
- Correspondence: ; Tel.: +65-67724518 or +65-67723478
| | - Ma Shwe Zin Nyunt
- Office of the Senior Deputy President and Provost, National University of Singapore, Singapore 119077, Singapore;
| | - Qi Gao
- National Public Health and Epidemiology Unit, National Centre for Infectious Diseases, Singapore 308442, Singapore;
| | - Xinyi Gwee
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; (X.G.); (D.Q.L.C.)
| | - Denise Qian Ling Chua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; (X.G.); (D.Q.L.C.)
| | - Keng Bee Yap
- Department of Medicine, Ng Teng Fong General Hospital, Singapore 609606, Singapore;
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11
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Martynova OO, Zakharov VV. Differential diagnosis of vascular cognitive impairment. CONSILIUM MEDICUM 2022. [DOI: 10.26442/20751753.2022.2.201520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background. Vascular cognitive impairment (VCI), аccording to world statistics, is the second most common cause of cognitive impairment after Alzheimer's disease (AD). Differential diagnosis between the two most common nosological forms of cognitive impairment is not always simple and is based on the clinical characteristic, neuropsychological and neuroradiological features of the disease.
Aim. To present a differential diagnosis between VCI and AD using the example of a clinical case of vascular mild cognitive impairment.
Materials and methods. A 68-year-old female patient with mild cognitive impairment underwent a neuropsychological testing: the Mini-mental state exam, Frontal assessment battery, the MoCA-test, the Clock-Drawing Test, the 12 Words test, Verbal Association Technique (literal and categorical), The Trail making test (A and B), The digit symbol substitution test, The Boston naming test (40 images), EXIT-25, Beck Depression Scale, Hospital anxiety and depression scale; neuroimaging magnetic resonance imaging in T1, T2, FLAIR, DWI, SWI sequence.
Results. On the basis of clinical data, the results of neuropsychological testing and neuroimaging, the differential diagnosis with AD, the patient was diagnosed with vascular mild cognitive impairment. Nootropic therapy (choline alfoscerate) was prescribed and recommendations on risk factors correction were given.
Conclusion. The article describes a patient with mild VCI. This case study discusses the main differences between AD and VCI that can be used as a basis for differential diagnosis. The features of cognitive impairments in VCI and AD are described, including the predominance of attention impairment, an executive function disorder in VCI and an impairment of memory progressing according to the Ribots law in AD. Differences in visuospatial skills and language in VCI and AD are discussed. The most reliable neuroradiological signs of cerebrovascular diseases are described.
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Rabin LA, Guayara-Quinn CG, Nester CO, Ellis L, Paré N. Informant report of practical judgment ability in a clinical sample of older adults with subjective cognitive decline, mild cognitive impairment, and dementia. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2022; 29:139-157. [PMID: 33618617 PMCID: PMC8380745 DOI: 10.1080/13825585.2020.1859081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 11/29/2020] [Indexed: 01/03/2023]
Abstract
Despite the importance of capturing problems with judgment and decision-making during neuropsychological evaluations of older adults, there are a limited number of validated measures and no informant rating scales. We developed an informant measure that captures compromised judgment related to safety, medical, financial, and social-ethical issues After item refinement and piloting in a memory disorders clinic, we utilized the Test of Practical Judgment-Informant (TOP-J-Informant) at two clinics in the Midwestern U.S., including 189 patient/informant dyads (mean age = 79.0, median years of education = 13, % female = 67.7) with various preclinical and clinical dementia conditions. We found psychometric support, including evidence for convergent, divergent, and criterion-related validity, and internal consistency. Importantly, we were able to discriminate between diagnostic groups in the expected direction. The TOP-J-Informant is brief (<5 minutes), easy to administer, and can reveal areas of concern related to poor judgment when administered in the context of a neuropsychological evaluation or clinic visit.
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Affiliation(s)
- Laura A Rabin
- Department of Psychology, Brooklyn College and the Graduate Center of CUNY, Brooklyn, NY, USA
- Department of Psychology, Queens College and the Graduate Center of CUNY, New York, NY, USA
| | | | - Caroline O Nester
- Department of Psychology, Queens College and the Graduate Center of CUNY, New York, NY, USA
| | - Liam Ellis
- Neuropsychology Division, Department of Neurological Sciences, Nebraska Medicine, Omaha, NE, USA
| | - Nadia Paré
- Neuropsychology Division, Department of Neurological Sciences, Nebraska Medicine, Omaha, NE, USA
- Department of Neurology, University of Nebraska Medical Center, Omaha, NE, USA
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13
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Effective cognitive screening tools for Alzheimer's disease in the primary care setting: the role of the visual paired associative learning task. Int Psychogeriatr 2021; 33:1111-1114. [PMID: 34127156 DOI: 10.1017/s1041610221000338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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14
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Månsson T, Elmståhl S. Processing speed is affected by early impairment in kidney function in the general elder population. BMC Nephrol 2021; 22:314. [PMID: 34548062 PMCID: PMC8456650 DOI: 10.1186/s12882-021-02517-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 08/04/2021] [Indexed: 01/04/2023] Open
Abstract
Background Chronic kidney disease, cardiovascular disease, and cognitive dysfunction are common in the elder population. There is evidence of a connection between these conditions, possibly by a shared vascular pathogenesis. Processing speed is commonly impaired in cerebrovascular disease. Methods The data was obtained from the population based study “Good aging in Skåne” (GÅS), and included 905 individuals (mean age = 68 years). We investigated the impact of impaired kidney function at baseline on the development of dementia, MCI, and impairment in specific cognitive domains at follow up 6 years later, using logistic regression models. Impaired kidney function was defined as GFR < 60 ml/min/1,73 m2. GFR was estimated from creatinine and cystatin C, using the CKD-EPI formula. Function in the cognitive domains learning and memory, language, complex attention, executive function, perceptual-motor, as well as meta-memory, and global cognitive function, was assessed using a neuropsychological test battery consisting of 12 tests. We compared the test results from follow up, with the results obtained at baseline, using linear regression models in order to assess changes in performance in cognitive domains. Results At follow up, 14 and 158 participants had developed dementia and MCI, respectively. We did not find evidence that moderately impaired eGFR at baseline increased the odds of dementia or MCI. A decline in processing speed was associated with impaired kidney function. Conclusions The effect on processing speed could represent early vascular implications on cognition. Even at moderately impaired kidney function, overview of cardiovascular risk factors could potentially prevent further cognitive impairment.
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Affiliation(s)
- Tomas Månsson
- Department of Clinical Sciences in Malmö, Lund University, Jan Waldenströms gata 35, 205 02, Malmö, Sweden. .,Division of Geriatric Medicine, Skåne University Hospital, Jan Waldenströms gata 35, 205 02, Malmö, Sweden.
| | - Sölve Elmståhl
- Department of Clinical Sciences in Malmö, Lund University, Jan Waldenströms gata 35, 205 02, Malmö, Sweden. .,Division of Geriatric Medicine, Skåne University Hospital, Jan Waldenströms gata 35, 205 02, Malmö, Sweden.
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15
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Richards E, Thornton IM, Bayer A, Tales A. Inhibitory control deficits in vascular cognitive impairment revealed using the MILO task. Neuropsychologia 2021; 155:107794. [PMID: 33610617 DOI: 10.1016/j.neuropsychologia.2021.107794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/29/2021] [Accepted: 02/15/2021] [Indexed: 02/08/2023]
Abstract
We used the MILO (Multi-Item Localization) task to characterise the performance of a group of older adults diagnosed with mild to moderate vascular cognitive impairment (VCI). The MILO task is designed to explore the temporal context of visual search and in addition to measuring overall completion time, provides a profile of serial reaction time (SRT) patterns across all items in a sequence. Of particular interest here is the Vanish/Remain MILO manipulation that can identify problems with inhibitory control during search. Typically, SRT functions closely overlap, regardless of whether items Vanish or Remain visible when selected, indicating an ability to ignore previously selected targets. Based on the distributed nature of VCI-related pathology and previous visual search studies from our group, we speculated that MILO performance would be compromised in this group of participants when items remained visible after being selected relative to when they vanished. Compared to cognitively healthy, age-matched control participants, the performance of VCI participants was characterised by overall slowing, increased error rates, and crucially, a compromised ability to ignore past locations. As predicted, the Vanish versus Remain SRT functions of VCI participants significantly diverged towards the end of the sequence, which was not the case for control groups. Overall, our findings suggest that the MILO task could be a useful tool for identifying non-age-related changes in behaviour with patient populations, and more generally hints at a possible inhibitory deficit in VCI.
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Affiliation(s)
- Emma Richards
- Centre for Innovative Ageing, Swansea University, Swansea, SA2 8PP, Wales, UK
| | - Ian M Thornton
- Department of Cognitive Science, University of Malta, Msida, MSD 2080, Malta
| | - Antony Bayer
- School of Medicine, Cardiff University, Cardiff, CF64 2XX, Wales, UK
| | - Andrea Tales
- Centre for Innovative Ageing, Swansea University, Swansea, SA2 8PP, Wales, UK.
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Charisis S, Ntanasi E, Yannakoulia M, Anastasiou CA, Kosmidis MH, Dardiotis E, Hadjigeorgiou G, Sakka P, Veskoukis AS, Kouretas D, Scarmeas N. Plasma GSH levels and Alzheimer's disease. A prospective approach.: Results from the HELIAD study. Free Radic Biol Med 2021; 162:274-282. [PMID: 33099001 DOI: 10.1016/j.freeradbiomed.2020.10.027] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 10/08/2020] [Accepted: 10/18/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Potential links between oxidative stress and the pathophysiology of Alzheimer's disease (AD) have been reported in the existing literature. Biological markers of oxidative stress, such as the reduced form of glutathione (GSH), may have a potential role as predictive biomarkers for AD development. The aim of the present study was to explore the longitudinal associations between plasma GSH and the risk of developing AD or cognitive decline, in a sample of community-dwelling, non-demented older adults. METHODS Participants from the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD) were included in the present prospective study. The sample used in the analyses consisted of 391 non-demented individuals over the age of 64 (mean age = 73.85 years; SD = 5.06), with available baseline GSH measurements and longitudinal follow-up. Plasma GSH was treated both as a continuous variable and as tertiles in our analyses. Cox proportional hazards models were used to evaluate the hazard ratio (HR) for AD incidence as a function of baseline plasma GSH. Generalized estimating equations (GEE) models were deployed to explore the associations between baseline plasma GSH and the rate of change of performance scores on individual cognitive domains over time. Models were adjusted for age, years of education and sex. Supplementary exploratory models were also adjusted for mild cognitive impairment (MCI) at baseline, risk for malnutrition, physical activity and adherence to the Mediterranean dietary pattern. RESULTS A total of 24 incident AD cases occurred during a mean (SD) of 2.99 (0.92) years of follow-up. Individuals in the highest GSH tertile group (highest baseline plasma GSH values) had a 70.1% lower risk for development of AD, compared to those in the lowest one [HR = 0.299 (0.093-0.959); p = 0.042], and also demonstrated a slower rate of decline of their executive functioning over time (5.2% of a standard deviation less decline in the executive composite score for each additional year of follow-up; p = 0.028). The test for trend was also significant suggesting a potential dose-response relationship. CONCLUSION In the present study, higher baseline plasma GSH levels were associated with a decreased risk of developing AD and with a better preservation of executive functioning longitudinally.
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Affiliation(s)
- S Charisis
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece
| | - E Ntanasi
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - M Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - C A Anastasiou
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - M H Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Dardiotis
- School of Medicine, University of Thessaly, Larissa, Greece
| | - G Hadjigeorgiou
- Department of Neurology, Medical School, University of Cyprus, Cyprus
| | - P Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Athens, Greece
| | - A S Veskoukis
- Department of Biochemistry and Biotechnology, University of Thessaly, Viopolis, Mezourlo, 41500, Larissa, Greece; Department of Nutrition and Dietetics, University of Thessaly, Argonafton 1, 42132, Trikala, Greece
| | - D Kouretas
- Department of Biochemistry and Biotechnology, University of Thessaly, Viopolis, Mezourlo, 41500, Larissa, Greece
| | - N Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, New York, USA.
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Burke MK, Colin Wilson F, Curran DB, Dempster M. A meta-analysis of executive functions among survivors of subarachnoid haemorrhage. Neuropsychol Rehabil 2020; 31:1607-1628. [PMID: 32698664 DOI: 10.1080/09602011.2020.1788954] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Subarachnoid Haemorrhage (SAH) is a type of stroke which is suggested to result in Executive Functioning (EF) deficits. Within the SAH research, EF is typically assessed as a unitary cognitive construct. Therefore, the nature and extent to which the different components of EF are impacted post SAH remain unclear. In this meta-analysis, 10 studies met selection criteria including 248 SAH participants, treated by endovascular coiling. Participants were assessed by EF measures and compared with 230 controls. Searches were conducted in November 2018 including Medline, PsychINFO, Web of Science, Scopus and CINAHL databases. EF measures were assigned to categories including Cognitive Flexibility, Working Memory, Inhibitory Control and Planning/Problem Solving [Diamond, 2013. Executive functions. Annual Review of Psychology, 64(1), 135-168. https://doi.org/10.1146/annurev-psych-113011-143750]. A statistically significant effect was found for overall EF. Cognitive Flexibility (G = -0.76) and Inhibitory Control (G = -0.51) generated moderate effect sizes, while Working Memory and Planning/Problem Solving found a small effect size (G = -0.45 and G = -0.49, respectively). The I2 statistic suggested small to moderate heterogeneity between studies, hypothesized to relate to different cognitive tools. Underlying components of EF appear to be differentially impacted post SAH, with Cognitive flexibility demonstrating the largest degree of deficit. Recommendations for a standardized and uniform assessment of EF post SAH are outlined.
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Affiliation(s)
- Mary-Kate Burke
- Clinical Psychology Department, Queen's University Belfast, Belfast, Co. Antrim, Northern Ireland
| | - F Colin Wilson
- Clinical Neuropsychologist, Regional Acquired Brain Injury Unit, Musgrave Park Hospital, Belfast, Northern Ireland
| | - David B Curran
- Clinical Psychology Department, Queen's University Belfast, Belfast, Co. Antrim, Northern Ireland
| | - Martin Dempster
- School of Psychology, Queen's University Belfast, Belfast, Northern Ireland
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Kazlauskaite R, Janssen I, Wilson RS, Appelhans BM, Evans DA, Arvanitakis Z, El Khoudary SR, Kravitz HM. Is Midlife Metabolic Syndrome Associated With Cognitive Function Change? The Study of Women's Health Across the Nation. J Clin Endocrinol Metab 2020; 105:5735651. [PMID: 32083676 PMCID: PMC7059989 DOI: 10.1210/clinem/dgaa067] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 02/11/2020] [Indexed: 02/08/2023]
Abstract
CONTEXT Metabolic syndrome (MetS) affects cognitive function in late life, particularly in women. But longitudinal research is scarce on associations of MetS with cognitive function during midlife. OBJECTIVE To determine associations between MetS exposure and cognitive function trajectories in midlife women. DESIGN AND SETTING This is a 17-year prospective, longitudinal study of multiracial/ethnic women in 7 US communities, with annual/biennial assessments. PARTICIPANTS Participants were 2149 US women traversing menopause. EXPOSURE Exposure consisted of MetS assessments (median 4 assessments over 4 years). MAIN OUTCOME MEASURES Main outcome measures were assessments of cognitive function in 3 domains: perceptual speed (symbol digit modalities test, SDMT), episodic memory (East Boston Memory Test, EBMT), and working memory (Digit Span Backward Test, DSB). RESULTS By their first cognitive assessment (age 50.7 ± 2.9 years), 29.5% met the criteria for MetS. Women completed a median (interquartile range [IQR]) of 6 (IQR 4-7) follow-up cognitive assessments over 11.2 (IQR 9.2-11.5) years. Women with MetS, compared with those without, had a larger 10-year decline in SDMT z-score (estimate -0.087, 95% confidence interval, -0.150 to -0.024; P = 0.007), after adjustment for cognitive testing practice effects, sociodemographics, lifestyle, mood, and menopause factors. As such, MetS accelerated the 10-year loss of perceptual speed by 24%. MetS did not differentially affect the rate of decline in either immediate (P = 0.534) or delayed (P = 0.740) episodic memory or in working memory (P = 0.584). CONCLUSIONS In midlife women MetS exposure was associated with accelerated decline in perceptual speed, but not episodic or working memory.
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Affiliation(s)
- Rasa Kazlauskaite
- Department of Medicine, Rush University Medical Center, Chicago, Illinois
- Correspondence and Reprint Requests: Rasa Kazlauskaite, MD, Rush University Medical Center, 1750 W. Harrison St. (Jelke) Ste. 604w | Chicago, IL 60612. E-mail:
| | - Imke Janssen
- Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois
| | - Robert S Wilson
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Bradley M Appelhans
- Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
| | - Denis A Evans
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Zoe Arvanitakis
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Samar R El Khoudary
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Howard M Kravitz
- Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
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Chehrehnegar N, Nejati V, Shati M, Rashedi V, Lotfi M, Adelirad F, Foroughan M. Early detection of cognitive disturbances in mild cognitive impairment: a systematic review of observational studies. Psychogeriatrics 2020; 20:212-228. [PMID: 31808989 DOI: 10.1111/psyg.12484] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 09/11/2019] [Accepted: 09/21/2019] [Indexed: 11/28/2022]
Abstract
Mild cognitive impairment (MCI) is an intermediate state between normal cognition and early dementia and is not considered as a typical outcome of brain aging. It has been estimated that 10% to 20% of individuals above 65 years of age will be diagnosed as having MCI. The increased rate of dementia and the importance of early detection of its forerunners have encouraged researchers to focus on detecting MCI and modifiable risk factors with the hope of developing better ways of managing dementia and its consequences. The main aim of this study was to systematically review the related literature concerning the cognitive changes in the spectrum of cognitive aging to cognitive impairment. Articles included in this review were identified through searching the databases of PubMed, Psych Info, Embase, ProQuest, and Scopus. Many domains like verbal memory, language, executive function, visual memory, attentional skills, and working memory showed acceptable predictive power. Testing subdomains such as executive function, speed of processing, working memory and semantic language are critical and others may indicate some suggestions for further clinical deteriorations in normal individuals. Although various cognitive instruments have been used for evaluation of impaired cognitive domains, it remains challenging to select the most appropriate ones having high-level accuracy and their related cognitive subdomains. It also revealed that none of the identified cognitive domains solely fulfilled the criteria for MCI screening; in clinical settings, multiple neuropsychological batteries may be used for one single cognitive domain, while longitudinal studies prefer the use of at least two cognitive measures for each domain to improve accuracy and research settings might focus on only a single neuropsychological test. However, along with episodic memory, testing for amnestic MCI, executive function could increase the chance of early detection of MCI. Executive control has been found to deteriorate the earliest in MCI patients.
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Affiliation(s)
- Negin Chehrehnegar
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.,Occupational Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Vahid Nejati
- Department of Psychology and Educational Sciences, Shahid Behehsti University Tehran, Tehran, Iran.,Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Mohsen Shati
- Mental Health Research Centre, School of Behavioural Science and Mental health, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
| | - Vahid Rashedi
- School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadsajad Lotfi
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Fatemeh Adelirad
- Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahshid Foroughan
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Tiel C, Sudo FK, Calmon AB. Neuropsychiatric symptoms and executive function impairments in Alzheimer's disease and vascular dementia: The role of subcortical circuits. Dement Neuropsychol 2019; 13:293-298. [PMID: 31555401 PMCID: PMC6753905 DOI: 10.1590/1980-57642018dn13-030005] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 06/24/2019] [Indexed: 11/22/2022] Open
Abstract
Neuropsychiatric symptoms (NPS) in dementia are prevalent, under-recognized and little studied regarding their pathophysiological aspects. The pathophysiological mechanism, as well as the possible role of vascular lesions in the genesis of these symptoms, are still matters of debate. OBJECTIVE to describe and compare the prevalence and severity of NPS in subjects with Alzheimer's disease (AD) and vascular dementia (VaD). METHODS a cross-sectional study involving 82 outpatients, divided into two groups (AD × VaD), was conducted. Patients were submitted to the Cambridge Cognitive Test (CAMCOG), the Clock Drawing Test (CLOX 1 and 2), the Neuropsychiatric Inventory (NPI) and the Clinical Dementia Rating (CDR) scale. Neuroimaging was scored using the de Leon and Fazekas scales. RESULTS 90.8% of the patients had at least one neuropsychiatric symptom. There were statistical differences on the CLOX test and in the apathy symptoms between AD and VaD groups. Apathy and disinhibition proved more prevalent in patients with higher vascular load. CONCLUSION apathy and impaired executive function may reflect vascular damage in subcortical circuits in dementia patients.
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Affiliation(s)
- Chan Tiel
- Universidade de VassourasMedical SchoolVassourasRJBrazilUniversidade de Vassouras (UV), Medical School, Vassouras, Rio de Janeiro, RJ, Brazil.
- Federal University of the State of Rio de JaneiroDepartment of NeurologyRio de JaneiroRJBrazilDepartment of Neurology, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, RJ, Brazil.
| | - Felipe Kenji Sudo
- Instituto D’Or de Ensino e PesquisaMemory ClinicRio de JaneiroRJBrazilMemory Clinic, Instituto D’Or de Ensino e Pesquisa, Rio de Janeiro, RJ, Brazil.
| | - Ana Beatriz Calmon
- Universidade de VassourasMedical SchoolVassourasRJBrazilUniversidade de Vassouras (UV), Medical School, Vassouras, Rio de Janeiro, RJ, Brazil.
- Federal University of the State of Rio de JaneiroDepartment of NeurologyRio de JaneiroRJBrazilDepartment of Neurology, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, RJ, Brazil.
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Attenuation of hyperhomocysteinemia induced vascular dementia by sodium orthovanadate perhaps via PTP1B: Pertinent downstream outcomes. Behav Brain Res 2019; 364:29-40. [DOI: 10.1016/j.bbr.2019.01.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Revised: 01/22/2019] [Accepted: 01/22/2019] [Indexed: 02/07/2023]
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Transcranial Doppler ultrasound in vascular cognitive impairment-no dementia. PLoS One 2019. [PMID: 31017968 DOI: 10.1371/journal.pone.0216162.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Although cerebral white matter lesions (WMLs) are considered as a risk factor for vascular dementia, data on their impact on cerebral hemodynamics are scarce. We test and compare transcranial Doppler (TCD) features in WML patients with or without associated cognitive impairment. METHODS A sample of non-demented elderly patients with WMLs was consecutively recruited. Mean blood flow velocity (MBFV), pulsatility index (PI), peak systolic blood flow velocity (PSV), end-diastolic blood flow velocity (EDV), and resistivity index (RI) were recorded from the middle cerebral artery bilaterally. Global cognitive functioning, frontal lobe abilities, functional status, and WML severity were also assessed. RESULTS 161 patients satisfying the clinical criteria for vascular cognitive impairment-no dementia (VCI-ND) were age-matched with 97 presenting WMLs without any cognitive deficit. VCI-ND patients exhibited a decrease in MBFV and EDV, as well as an increase in PI, RI, and PSV. Moreover, a significant correlation between all TCD parameters and the severity of executive dysfunction was observed, whereas PI, RI, and EDV were significantly correlated with the WML load. CONCLUSIONS VCI-ND showed a hemodynamic pattern indicative of cerebral hypoperfusion and enhanced vascular resistance. These changes may be considered as the TCD correlate of VCI-ND due to microcirculation pathology. TCD provides useful indices of the occurrence and severity of small vessel disease and executive dysfunction in elderly patients at risk of future dementia.
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Glycogen synthase kinase-3 inhibition as a potential pharmacological target for vascular dementia: In silico and in vivo evidence. Comput Biol Med 2019; 108:305-316. [PMID: 31022582 DOI: 10.1016/j.compbiomed.2019.03.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 02/13/2019] [Accepted: 03/02/2019] [Indexed: 12/18/2022]
Abstract
Vascular dementia is a serious problem as it creates significant disability and dependency in the affected person. Lives of these patients can be improved through the advent of novel drug targets which can be targeted by pharmacological therapies. However, finding a precise and druggable target for vascular dementia is experimentally impossible and challenging task owing to a complex and mostly unknown interplay between the cognitive abilities of the brain with a diversity of vascular diseases. To address this issue, we have systematically analyzed the literature reports by using well-known methods and approaches of bioinformatics (viz. network pharmacology, reverse pharmacology, enrichment analysis of KEGG pathways, biological processes of Gene Ontology and DIAMOnD algorithm). Because glycogen synthase kinase-3 (GSK-3) seems to be one of the most promising targets, therefore, we have tested the capacity of lithium carbonate, a classical inhibitor of GSK-3, for treatment of dementia resulting from mild chronic cerebral hypoperfusion in mice. To this end, our study shows in-vivo validation of predicted target, i.e., pharmacological deactivation of GSK-3 enzyme and its impact on cognitive abilities employing a behavioral test battery, i.e., object recognition task, step-through passive avoidance task, elevated plus maze task and water maze task. In this framework, we observed that lithium carbonate attenuates recognition, emotion, spatial and fear-motivated learning and memory impairments along with attenuation of oxidative stress, cholinergic dysfunction and glutamate-induced excitotoxicity in cerebral cortex and hippocampus. In conclusion, we propose GSK-3 as a promising drug target for vascular dementia in light of experimental results and in-silico predictions.
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Vinciguerra L, Lanza G, Puglisi V, Pennisi M, Cantone M, Bramanti A, Pennisi G, Bella R. Transcranial Doppler ultrasound in vascular cognitive impairment-no dementia. PLoS One 2019; 14:e0216162. [PMID: 31017968 PMCID: PMC6481922 DOI: 10.1371/journal.pone.0216162] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 04/15/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Although cerebral white matter lesions (WMLs) are considered as a risk factor for vascular dementia, data on their impact on cerebral hemodynamics are scarce. We test and compare transcranial Doppler (TCD) features in WML patients with or without associated cognitive impairment. METHODS A sample of non-demented elderly patients with WMLs was consecutively recruited. Mean blood flow velocity (MBFV), pulsatility index (PI), peak systolic blood flow velocity (PSV), end-diastolic blood flow velocity (EDV), and resistivity index (RI) were recorded from the middle cerebral artery bilaterally. Global cognitive functioning, frontal lobe abilities, functional status, and WML severity were also assessed. RESULTS 161 patients satisfying the clinical criteria for vascular cognitive impairment-no dementia (VCI-ND) were age-matched with 97 presenting WMLs without any cognitive deficit. VCI-ND patients exhibited a decrease in MBFV and EDV, as well as an increase in PI, RI, and PSV. Moreover, a significant correlation between all TCD parameters and the severity of executive dysfunction was observed, whereas PI, RI, and EDV were significantly correlated with the WML load. CONCLUSIONS VCI-ND showed a hemodynamic pattern indicative of cerebral hypoperfusion and enhanced vascular resistance. These changes may be considered as the TCD correlate of VCI-ND due to microcirculation pathology. TCD provides useful indices of the occurrence and severity of small vessel disease and executive dysfunction in elderly patients at risk of future dementia.
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Affiliation(s)
- Luisa Vinciguerra
- Neurology Department and Stroke Unit, IRCCS Centro Neurolesi “Bonino Pulejo”, Messina, Italy
| | - Giuseppe Lanza
- Department of Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
- Department of Neurology IC, Oasi Research Institute – IRCCS, Troina, Italy
- * E-mail:
| | - Valentina Puglisi
- Neurology Department and Stroke Unit, IRCCS Centro Neurolesi “Bonino Pulejo”, Messina, Italy
| | - Manuela Pennisi
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | | | - Alessia Bramanti
- IRCCS Centro Neurolesi “Bonino Pulejo”, Institute of Applied Sciences and Intelligent Systems (ISASI), Messina, Italy
| | - Giovanni Pennisi
- Department of Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Rita Bella
- Department of Medical and Surgical Sciences and Advanced Technology, Section of Neurosciences, University of Catania, Catania, Italy
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Lehtisalo J, Levälahti E, Lindström J, Hänninen T, Paajanen T, Peltonen M, Antikainen R, Laatikainen T, Strandberg T, Soininen H, Tuomilehto J, Kivipelto M, Ngandu T. Dietary changes and cognition over 2 years within a multidomain intervention trial-The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER). Alzheimers Dement 2018; 15:410-417. [PMID: 30527596 DOI: 10.1016/j.jalz.2018.10.001] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 10/02/2018] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Association between healthy diet and better cognition is well established, but evidence is limited to evaluate the effect of dietary changes adopted in older age. METHODS We investigated the role of dietary changes in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) with 1260 at-risk participants (60-77 years) who were randomized to intensive multidomain intervention (including dietary counseling) or regular health advice for 2 years. Parallel process latent growth curves of adherence to dietary recommendations and cognitive performance were analyzed. RESULTS Adherence to healthy diet at baseline predicted improvement in global cognition, regardless of intervention allocation (P = .003). Dietary improvement was associated with beneficial changes in executive function, especially in the intervention group (P = .008; P = .051 for groups combined). DISCUSSION Dietary changes initiated during the intervention were related to changes in executive function in 2 years. Long-term diet appeared more influential for global cognition.
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Affiliation(s)
- Jenni Lehtisalo
- Department of Public Health Solutions, Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland.
| | - Esko Levälahti
- Department of Public Health Solutions, Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Jaana Lindström
- Department of Public Health Solutions, Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Tuomo Hänninen
- Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Teemu Paajanen
- Research and Service Centre for Occupational Health, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Markku Peltonen
- Department of Public Health Solutions, Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Riitta Antikainen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland; Oulu City Hospital, Oulu, Finland
| | - Tiina Laatikainen
- Department of Public Health Solutions, Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Joint Municipal Authority for North Karelia Social and Health Services, Joensuu, Finland
| | - Timo Strandberg
- Center for Life Course Health Research, University of Oulu, Oulu, Finland; University of Helsinki, Clinicum, and Helsinki University Hospital, Helsinki, Finland
| | - Hilkka Soininen
- Department of Neurology, Kuopio University Hospital, Kuopio, Finland; Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jaakko Tuomilehto
- Department of Public Health Solutions, Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland; South Ostrobothnia Central Hospital, Seinäjoki, Finland; Department of Clinical Neurosciences and Preventive Medicine, Danube-University Krems, Krems, Austria; Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia; Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Miia Kivipelto
- Department of Public Health Solutions, Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland; Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Huddinge, Sweden; Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, United Kingdom
| | - Tiia Ngandu
- Department of Public Health Solutions, Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland; Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Huddinge, Sweden
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26
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Pantsiou K, Sfakianaki O, Papaliagkas V, Savvoulidou D, Costa V, Papantoniou G, Moraitou D. Inhibitory Control, Task/Rule Switching, and Cognitive Planning in Vascular Dementia: Are There Any Differences From Vascular Aging? Front Aging Neurosci 2018; 10:330. [PMID: 30410439 PMCID: PMC6211074 DOI: 10.3389/fnagi.2018.00330] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 09/28/2018] [Indexed: 01/06/2023] Open
Abstract
Recent studies have shown that patients diagnosed with Vascular Dementia (VaD) exhibit deficits in executive functions. According to “vascular hypothesis of cognitive aging,” community-dwelling older adults having risk factors for vascular disease development (RVD) may suffer from cognitive decline of the same type. The aim of the study was to assess the level of specific executive functions (EF) that have been revealed as most affected by vascular abnormalities, in older adults with incipient VaD and RVD. Subsequently specific ways of EF measuring could be suggested for more accurate diagnosis of early stage VaD. The study compared three adult groups (N = 60): (a) patients diagnosed with incipient VaD, according to DSM-5 criteria (n = 20); (b) community-dwelling older adults presenting cardiovascular risk factors (RVD; n = 20); (c) healthy young adult controls (n = 20). Three types of executive functions were examined: inhibitory control, cognitive flexibility as rule/task switching, and planning. The following D-KEFS subtests were administered for their evaluation: The ‘Color-Word Interference Test,’ the ‘Verbal Fluency Test,’ and the ‘Tower Test.’ Mixed-measures ANOVA, MANOVA, and one-way ANOVA as well as Scheffe post hoc test were applied to the data of the scores in each condition of each test. The results showed that VaD patients had significantly lower performance in test conditions requiring switching and planning, compared to RVD group and young controls. The specific deficits of VaD patients, compared to older adults presenting RVD according to multiple-group path analyses were: more uncorrected errors in inhibition, the use of semantic knowledge primarily instead of switching ability to switch between semantic categories, as well as a lower level of movement precision in planning.
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Affiliation(s)
- Krystallia Pantsiou
- Lab of Psychology, Department of Experimental and Cognitive Psychology, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ourania Sfakianaki
- Lab of Psychology, Department of Experimental and Cognitive Psychology, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasileios Papaliagkas
- Laboratory of Clinical Neurophysiology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitra Savvoulidou
- Lab of Psychology, Department of Experimental and Cognitive Psychology, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vassiliki Costa
- 1st Neurology Department, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgia Papantoniou
- Department of Early Childhood Education, School of Education, University of Ioannina, Ioannina, Greece
| | - Despina Moraitou
- Lab of Psychology, Department of Experimental and Cognitive Psychology, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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